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ECM Extracellukar Matrix > anaemia > Flashcards

anaemia Flashcards

1
Q

anaemia definition

A

condition in which the number of red blood cells or their oxygen carrying capacity is insufficient to meet physiological needs which vary by age, sex, altitude, smoking and pregnancy status

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2
Q

what is the name of the stem cells that make red blood cells

A

haemotopoetic stem cells in the bone marrow in the process of haematopoeisis.

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3
Q

explain the process of haematopoeisis

A

begins with a multipotent haematopoetic stem cell, develops into a common lymphoid progenitor which can differentiate into t cell, b cell or NK cell (natural killer). if the hps cell develops into a common myeloid progenitor then it can diffrentiate into erythrocytes, mast cells or mega karyocytes which can diffrentiate into platelets, or the common myeloid progenitor can differentiate into neutrophil, monocyte or osteoclast.

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4
Q

what is the daily production of red blood cells

A

200 billion

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5
Q

what is the lifespan of a red blood cell

A

120 days +- 20 days

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6
Q

how many red blood cells are destroyed per second

A

2.5 million red blood cells

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7
Q

what are early red blood cells or new red blood cells called

A

reticulocytes
no nucleus but has rna

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8
Q

how does the reticulocyte turn into a mature red blood cell

A

loses rna.
has no rna and no nucleus

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9
Q

what happens in the bone marrow stage of rbc production

A

red blood cell precursors begin to mature

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10
Q

briefly outline how erythropoiesis occurs

A

in the bone marrow, haematopatic stem cells produce RBC. the red blood cell precursors begin to mature causing a reticulocyte to form which is a new red blood cell. although it has no nucleus, it still has rna. as the reticulocyte matures into a red blood cell, it loses its rna.

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11
Q

what is the major function of a red blood cell

A

oxygen carrier, provides oxygen to tissues.

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12
Q

explain how red blood cells act as oxygen carriers

A

red blood cell contains lots of haemoglobin protein which allows oxygen molecules to bind in the lungs, this blood then travels to tissues and releases oxygen into tissue cells , oxyhaemoglobin unloads the oxygen at the tissues.

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13
Q

describe the major protein haemoglobin

A

tetramer of 4 globin folded proteins
2 alpha chains and 2 beta chains
fe2+ haem groups

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14
Q

describe haem group

A

contains fe iron
oxygen binding capacity

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15
Q

what does DO2 represent in the oxygen delivery equation

A

the oxygen delivery

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16
Q

what does Q represent in the oxygen delivery equation

A

cardiac output

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17
Q

what does HB represent in the oxygen delivery equation

A

haemoglobin

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18
Q

what does saO2 represent in the oxygen delivery equation

A

arterial oxygen saturation

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19
Q

what does PaO2 represent in the oxygen delivery equation

A

amount of dissolved oxygen in the blood

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20
Q

what is the oxygen delivery equation

A

DO2= Q x (hbxSaO2) x 1.34 + (pao2 x 0.003)

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21
Q

how is erythropoiesis regulated

A

1) low oxygen blood level is detected
2) stimulus causes kidneys to increase production of EPO (erythropoietin)
3) erythropoietin hormone released by kidneys stimulates RBC production
3) stem cells increase red blood cell production
4) oxygen blood level returns to normal
5) normal oxygen levels in blood
6) stimulus is resolved

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22
Q

explain erythropoiesis regulation including jak 2

A

EPO binds to receptor on bone marrow erythroid progenitor, the binding of the receptor to the epo induces conformational changes in jak 2 that cause stats, mapk, akt/p13k. this occurs on the extracellular membrane cytoplasm

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23
Q

what happens at the end of the life cycle of the red blood cells

A

1) red blood cell death and phagocytosis
2) globin is broken down into amino acids that can be reused for protein synthesis
3) the haem in the red blood cell can be broken down into billiverdin which is eventually broken down into billirubin which is secreted in the gut and some of it is absorbed.

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24
Q

where are red cells produced

A

in the bone marrow

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25
Q

what is the main function of a red blood cell

A

transport oxygen to the tissues

26
Q
A
27
Q

what stimulates erythropoietin by the kidneys to stimulate red cell production

A

hypoxia- low oxygen levels in the blood

28
Q

how many days do red blood cells live

A

120 days and are recycled by the reticulo endothelial system.

29
Q

what procedure can we carry out to diagnose anaemia in the lab

A

venepuncture and then passing the sample through the automated blood count analyser

30
Q

what does a full blood count show us or tell us

A

-haemoglobin
-white cell count
-platelet count

31
Q

what method is used to directly measure haemoglobin

A

photometric method
expressed as a concentration g/L

32
Q

what are red cell indices

A

mean cell volume
red cell distribution width rdw
packed cell volume
red cell count
reticulocyte count

33
Q

what is mean cell volume if measured directly expressed as

A

FL 10^-15

34
Q

what is the reference range for mean cell volume

A

80-99fl

35
Q

what mean cell volume indicates microcytic cells

A

MCV<80fl

36
Q

what is a normal mcv mean cell volume

A

80-100fl

37
Q

what mean cell volume is macrocytic

A

mcv>100fl

38
Q

what pathway follows if the mean cell volume is less than 80fl (microcytic)

A

-next step is to check ferritin levels (ferritin is a protein which carries iron)
if ferritin is too low than this indicates iron deficiency anaemia- mean cell volume low but rdw high.

39
Q

if mean cell volume is lower than 80fl and ferritin levels are high than indicates thalassemia

A

thalassemia, inherited anaemia normal rdw normal distribution width

40
Q

when the mean cell volume is normal 80-100 what is the next steps

A

to check reticulocyte count

41
Q

if cell is normocytic and reticulocyte count is lower than what is the anaemia diagnosis

A

anaemia of chronic disease marrow hypoplasia

42
Q

if reticulocyte count is higher after determining cell is normocytic what is the next test

A

if alot of haemolysis, conduct a DAT test if DAT test positive than autoimmune haemolysis if DAT test negative- hbss g6pd mechanical

43
Q

if cells are macrocytic, the mcv is higher than 100fl than what is the next step

A

test for b12 folate and if b12 low than diagnose as b12 folate deficiency anaemia.
if b12 folate is normal or high than diagnosis is active haemolysis so conduct DAT tests to determine whether anaemia is autoimmune or g6pd anaemia.

44
Q

what is the reference range for red cell distribution width

A

11-15%

45
Q

what is anaemia diagnosed by having

A

hb levels less than lower limit of reference range

46
Q

what can we look at to determine cause of anaemia

A

blood film, fbc parameters

47
Q

what does a normal rdw indicate

A

that cells are more or less uniform size

48
Q

anaemia is a lack of what

A

haemoglobin

49
Q

most common worldwide anaemias

A

iron deficiency thalassemia

50
Q

what are the two main mechanisms of anaemia

A

-insufficient production or excessive loss of red blood cells
-laboratory investigations can help tell them apart

51
Q

what is g6pd deficiency

A

glucose 6 phosphate dehydrogenase deficiency showing irregularly contracted cells. mutation in enzyme pivotal in krebs cycle so when theres oxidative stress triggers such as drugs, cells cannot cope and haemolyse.

52
Q

signs of iron deficiency

A

spooning of nails
pallor
conjunctivitis
angular cholitis

53
Q

what are some signs and symptoms of severe anaemia

A

-angina chest pain
-heart attack
-fainting

54
Q

what are some respiratory symptoms of anaemia

A

shortness of breath

55
Q

what are some blood vessel signs of anaemia

A

low blood pressure

56
Q

what is a sign of anaemia related to spleen

A

enlargement of spleen

57
Q

what is a intestinal sign of anaemia

A

changed stool colour

58
Q

what are some muscular symptoms of anaemia

A

weakness

59
Q

what are some skin symptoms of anaemia

A

pallor
coldness
yellowing
eyes yellow as well

60
Q

what are some heart related symptoms and signs of anaemia

A

palpitations
rapid heart rate
chest pain
angina heart attack

61
Q

what are some central symptoms of anaemia

A

fainting
dizziness
fatigue

62
Q
A

ECM Extracellukar Matrix (16 decks)

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