Alterations Of Hemotologic Function Flashcards by Briana Rodriguez

Anemia

Decrease in RBCs reduces the ability of blood to carry oxygen to tissues

HgB- amount of hemoglobin in blood
Hct- % of blood that has RBCs

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Causes of anemia

Inadequate erythropoiesis (RBCs in bone marrow) due to lack of nutrients
Loss of RBCs (hemorrhage
Shortened RBC lifespan
Dilutional anemia (water only)

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Anemia classification by cell morphology

Macrocytic- big (vit B, folate deficiency)
Normocytic- normal (internal bleeding)
Microcytic- small (low iron and low hemoglobin)

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Anemia hemoglobin content

Normochromic-normal

Hypochromic- pale, lacking hemoglobin

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Anemia clinical manifestations

CNS and musculoskeletal (fatigue, weakness, irritability, confusion, parathesias)

Skin and mucus membranes (pale skin)

Cardiac manifestations (chest pain, heart failure)

Pulmonary (increased rate/depth of respirations, dyspnea)

Gastrointestinal (abdominal pain, nausea, vomiting, deceased bowl activity)

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Iron deficiency anemia

Dietary sources, meat
Absorption, duodenum
Stored as ferritin in liver and bone marrow

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Iron deficiency causes

Chronic bleeding in gastrointestinal tract (bleeding from urinary tract, hematuria, or mensuration in woman)

Inadequate dietary iron

Malabsorption of iron

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People who are at risk for inadequate dietary iron intake in iron deficiency anemia (6)

Vegetarians
Pregnant women 
Infants fed cow milk
Young children 
Adolescents 
Elderly

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Patho of iron deficiency anemia

Depletion of iron stores in liver and bone marrow (ferritin leaks into blood which allows us to check ferritin levels before iron deficiency occurs)

Decrease in MCV, hemoglobin, hematocrit

Development of a microcytic hypochromic anemia

Low plasma iron —> decreased production of RBCs

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Vitamin B12 deficiency is also called?

Pernicious anemia

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Vitamin B12 deficiency dietary sources, absorption, and storage?

Dietary sources: meat, eggs, dairy
Absorption: absorbed in the ileum, requires intrinsic factor
Storage: 3-6 years

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Causes of vitamin B12 deficiency

Inadequate intake of B12
Increased demand (pregnancy)
Malabsorption

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Vitamin B12 patho

B12 and folate are necessary for developing RBC
Decrease in cell division rate
Schilling test

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Vitamin B12 results from?

Decrease in number of RBCs produced by bone marrow
Production of unusually large stem cells that mature into large erythrocytes (MCV increase)
Macrocytes have thin, flimsy plasma membranes that rupture prematurely in spleen and liver
Severe vit B12 results in myelin degeneration, loss of neurons in spinal cord, peripheral nerve damage may be permanent

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Folate deficiency anemia dietary sources and storage

Vegetables, broccoli, lemon

2-4 months in liver

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Folate deficiency anemia causes

Inadequate dietary folate or low body stores of folate (alcoholics, elderly, malnourished)
Increased demand (pregnant women, children, malabsorption)

Folate deficiency patho

Same as B12 except folate doesn’t have brain effects

Hemolytic anemia is?

Premature destruction of normal RBCs

Cause of hemolytic anemia

Genetic effects
Autoimmunity
Infection 
Toxic/chemical injury 
Medications

Hemolytic anemia patho

Antibodies and complement proteins bind to RBC membrane
Opsonized RBCs are phagocytized by macrophages as they migrate through caps in the spleen
After hemolysis, hemoglobin is released from RBCs and broken down by macrophages
Bilirubin is released into bloodstream

Clinical manifestations of hemolytic anemia

Low Hgb and Hct
Elevated bilirubin and jaundice
Elevated lactate dehydrogenase (LDH released by cell lysis)
Elevated reticulocyte count as the bone marrow tries to compensate for loss of RBCs
Reticulocytes: immature RBCs in blood that replace dying cells

Sickle cell anemia is? Found where? Who has it?

Abnormal form of hemoglobin
Equatorial regions
African Americans

Causes of sickle cell anemia

Inherited autosomal recessive disorder (single base pair, aa)

Sickle cell anemia patho

Presence of abnormal Hgb S instead of Hgb A
Reacts to hypothermia, dehydration, low pH, temp changes
Rigid sickle cell shape
Reversible at first then after repeated epidodes, becomes irreversible
Occurs in punctuated “sickle cell crises”

Sickle cell anemia consequences

Sickle cells lyse, leading to hemolytic anemia They aggregate in caps and obstruct blood flow (vasoocclusion crisis) Posing of sickled RBCs in spleen and liver, which holds 20% of the blood (bad)

Aplastic anemia is

Bone marrow failure associated with reduction of WBCs, RBCs, and platelets

Causes of aplastic anemia

Genetic disorder in childhood (20%) Acquired disorders seen in adulthood (80%) Environmental exposure (industrial and ag chemicals, ionizing radiation, infections)

Aplastic anemia patho

Reduction in number or absence of bone marrow stem cells or abnormalities Inadequate production of RBCs, WBC, platelets due to absense of stem cells

Aplastic anemia clinical consequences

Severe panocytopenia Anemia (low Hgb/Hct) Leukopenia (low WBC count) Thrombocytopenia (low platelet count, risk for bleeding)

Hemophilia A is?

Deficiency of clotting factor 8 X-linked recessive disorder Primarily affects males, females are carriers

Hemophilia A patho

Factor 8 deficiency prevents completion of the intrinsic pathway of the clotting cascade Increased risk of bleeding (mild, moderate, severe)

Hemophilia A clinical consequences

Prolonged bleeding times Ecchymoses/hematoma formation Hemarthroses (bleeding in synovial joint) Chronic anemia requiring transfusions

What is immune thrombotic thrombocytopenia?

Immune mediated platelet consumption

Immune thrombotic thrombocytopenia patho

Antibodies produced in response to a virus bind to a platelet instead of the virus Enhanced phagocytosis of platelets by WBC in spleen Results in severe thrombocytopenia (low platelet count cause body is eating them all)

Polycythemia Vera is caused by

The over production of erythrocytes (RBCs) by the bone marrow, usually of unknown cause Too many RBCs makes blood thicker and more likely to clot

What does polycythemia Vera lead to?

Increased blood coaguability, blood clotting events such as deep vein thrombosis, stroke, and MI