Alterations Of Hematologic Function Flashcards
What are the four causes of anemia?
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Differentiate hemoconcentratian from hemodilution
These terms describe the state of the total mass of circulating red blood cells. it can be hemoconcentration with decreased plasma vol or hemodilution with increased plasma vol.
Name the overall symptoms of anemia and why do they vary between people?
Increased respirations, increased fatigue, dizziness, weakness, pallor skin, lethargy, fainting.
Symptoms vary because the clinical manifestations depend on the bodies ability to compensate for the reduced 02 carrying capacity
What is the initial compensation for anemia within the body?
The movement of interstialfluid into the blood to increase plasma vol.
What type of anemia causes the skin to appear yellow and why?
Pernicious anemia because of the combination of pallor and jaundice
What is the difference between anemia and polycythemia Vera?
Anemia is not enough RBC’S and polycythemia is the creation of too many RBC’S (cancer)
What type of anemia affects nerve function and what are the symptoms?
The kind of anemia that occurs because of a lack of vitamin b12,
The symptoms are: numbness, gait disturbances, extreme weakness, spasticity, and reflex abnormalities
What are the compensatory mechanisms that occur with hemorrhage?
Peripheral blood vessel constriction, this is needed so that the blood is diverted to the essential organs.
What are the anemias of diminished erythopoiesis caused by?
The ineffective erythrocyte DNA synthesis caused by a lack of B12 or folate
Explain what is occurring in macrocytic (megaloblastic) anemia
Unusually large stem cells in the marrow mature into red blood cells that are also unusually large in size, thickness, and volume. These defective red blood cells die prematurely causing a decrease in red blood cells circulating in the blood causing anemia. The defective DNA synthesis causes red blood cells and development to occur and unequal rates causing blockage or a delay of the production of red blood cells. This causes an overproduction of hemoglobin during cell division which causes large red blood cells to be produced with disproportionately small nucleus‘.
What occurs with intrinsic factor (IF) in pernicious anemia?
The deficiency of IF is usually associated with end of stage type A chronic atrophic gastritis. The autoimmune gastritis impedes the production of IF, which is needed for the uptake of vitamin B 12 from the gut. B12 and IF is needed for nuclear maturation and DNA synthesis of red blood cells. When this is impeded this leads to anemia.
What other auto immune diseases are associated with pernicious anemia?
Endocrine diseases like type one diabetes, hypo parathyroidism, Addison’s disease, and Graves’ disease.
What are the symptoms of pernicious anemia – both early and when the hemoglobin is extremely low?
The early symptoms include infection, mood swings, G.I., cardiac, and kidney ailments.
When hemoglobin levels are between 7-8G/DL the symptoms include weakness, fatigue, paresthesias of feet and fingers, difficulty walking, loss of appetite, abdominal pain, weight loss, yellow skin, right sided heart failure, and sore tongue.
Who is most likely to suffer from folate deficiency anemia?
People who are alcoholics and people with chronic malnourishment
Who is most at risk for iron deficiency anemia?
Toddlers, adolescents, childbearing women, those living in poverty, infants consuming cows milk, older people with restricted diet, and teenagers eating junk food.
What are the causes of IDA (Iron deficiency anemia)?
dietary deficiency, impaired absorption, increase requirement, chronic blood loss, impaired absorption, and chronic diarrhea.
What are the stages of IDA and what is happening each stage?
In stage one there is decreased bone marrow iron stores but the hemoglobin and serum iron remain normal. And stage to iron transport to the bone marrow diminishes which makes iron deficient erythropoiesis. And stage three the iron deficient red blood cells replace the normal age red blood cells from circulation. The clinical manifestations appear in stage three when there is a depletion of iron stores and diminished hemoglobin production.
What is the symptoms of IDA when the hemoglobin levels are extremely low?
Koilonychia (spoon shaped fingernails), cheilosis, stomatitis, painful ulcerations of bucal Mukosa and tongue, dysphasia, and burning mouth syndrome.
How do we know the treatment for IDA is working?
A measurement of serum ferritin levels is a precise way of measuring improvement. Hematocrit levels should increase 1 to 2 months of therapy. Decrease in fatigue and lethargy should be seen within the first month.
What is anemia of chronic disease (ACD) and what kind of diseases is it see in?
Anemia of chronic disease is a mild to moderate type of anemia that results from the decreased red blood cell production and impaired iron utilization and individuals with chronic conditions of chronic systemic disease or inflammation.
It is often seen in infections, cancers, and auto immune diseases
What is happening in the body that leads to ACD?
The chronic information reduces the body’s ability to absorb and use iron for our red blood cell production. The inflammation increases the production of hepcidin. Hepcidin inhibit iron absorption in the duodenum and the release of iron from macrophages.
When there’s not enough iron to be absorbed, there is not enough iron for the production of red blood cells.
What is the most significant finding of ACD that makes it different from IDA?
There is a high total body iron storage, but in an adequate iron release from bone marrow for erythropoiesis.
What does a return to normal levels in ACD make the patient at risk for?
Hypertension, stroke, and death.
What is aplastic anemia?
It is a hematopoietic failure or bone marrow aplasia with a reduction in the effective production of mature cells by bone marrow causing pancytopenia. Pancytopenia means all blood cell lines are decreased. This means there is a decrease of red blood cells, white blood cells, and platelets.
