Anemia Flashcards
WBC
5,000-10,000
High evident of infection
Hbg
Male 14-18
Female 12-16
Less than 7 transfuse PRBC
HCT
Measures percentage of total RBCs
Male 42-52%
Female 37-47%
Decreased level anemia
MCV mean corpuscular volume
80-100 mm3
Measures the average size of RBC
Classifies types of anemia
RBCs
Males 4.7-6.1
Females 4.2-5.4
Reticulocyte Count
0.5% to 2%
Measures immature RBCs indicator of bone marrow FX or response to anemia
Microcytic (small cell) anemia
MCV count less than 80
Normocytic Anemia
MCV count 80-100
Marcocytic (large cell) anemia
MCV greater than 100
ETOH can cause marcocytic anemia or macrocytosis without anemia
The elderly also can have elevated MCV counts which is normal
Main pathology of anemia
Reduced oxygen carrying capability of the RBC
Low RBC —> low blood volume and consistency —> body compensates by shifting fluid in the intravascular space —> increase BP —> watery blood
More turbulence flow —> increase SV and HR —> cardiac dilation and heart valve insufficiency
Reduced levels of O2 in the blood—> hypoxemia
Causes arterial and venous vasodilation—> decreasing VR and increasing Flow
Increased HR and SV —> HF
Hypoxia —> increased RR to increase O2 to tissues —> more O2 is releases from Hgb
Compensatory mechanisms/SS
Dyspnea, tachycardia, palpitations, dizziness, fatigue, CP
Anemia can cause MI in CADS
Pale skin, mucous membrane, jaundice
hemolysis, impaired healing, loss of tissue elasticity, thinning and graying hair
Decreased O2 to the GI tract —> AB pain, NV and anorexia
Acute anemia —> vasoconstriction —> kidneys activate RAAS
Severe blood loss —> renal injury
Macrocytic Pernicious Anemia
A reduction in the amount of red blood cells caused by vitamin B 12 deficiency the deficiency is caused by lack of intrinsic factor which results in the malabsorption of vitamin B 12 intrinsic factor is secreted by parietal cells which is found in the small intestine specifically in the ileum
Causes include vegan diets gastrectomy atrophy of gastric mucosa due to autoimmune disease resected ileum infestation of tape worms and conditions that require increased levels of vitamin B 12 such as pregnancy hyperthyroidism chronic infection and disseminated cancers
Alcohol abuse hot tea ingestion and smoking can also lead to vitamin B 12 deficiency as well as the use of proton pump inhibitors
Pernicious anemia usually occurs later in life around age 60
clinical manifestations include beefy red tongue weakness fatigue loss of appetite weight loss neurologic symptoms due to nerve demyelination and neuron death. Paresthesia of hands and feet loss of position and vibration
People with gastric atrophy and metaplasia who have this type of anemia also have an increased risk of gastric carcinoma
Macrocytic Folate Deficiency Anemia
Folate deficiency anemia is a rejection of red blood cell production secondary to deficiency in Folic acid most common cause of deficiency is deficient dietary intake
Increase amounts of folic acid are needed during pregnancy and lactating females
Folic acid is absorbed in the small intestine and stored in the liver
Folate acid deficiency is also seen chronically malnourished and alcoholics
Alcohol interferes with bullet metabolism and deliver there for deplete storage
SS:
Cheilosis
Stomatitis
Painful ulcerations of the buccal mucosa and tongue
Dysphasia
Flatulence
Watery diarrhea
Macrocytic Anemia MOA
Both vitamin B 12 in Folic acid are required for red blood cells synthesis
vitamin B12 is needed to metabolize folic acid
folic acid is needed for red blood cell nuclear DNA and RNA maturation without vitamin B12 folic acid is not metabolized in DNA and RNA do not mature
RBC do not mature!!
however the cytoplasm of cells continue to grow and we end up with large cells that do not mature and are hence destroyed by the bone marrow causing anemia
Microcytic iron deficiency anemia
Iron deficiency anemia is a reduction in the production of red blood cells secondary to deficiency of iron
most common anemia worldwide
Most common causes are chronic blood loss pregnancy toddlers adolescent girls women of childbearing age impoverish people infants drinking cows milk and teenagers eating a poor diet
Chronic blood loss may be seen in peptic ulcer disease excessive ministration or G.I. bleeding seen with colon cancer blood loss of 2 to 4 mL of day is enough to cause iron deficiency anemia
Other causes include inadequate dietary intake medication you such as NSAIDs that cause G.I. bleed surgical procedures that decrease stomach acidity, poor absorption and eating disorders
Iron is needed for the production of hemoglobin once iron stores are depleted a smaller amount of hemoglobin is produced resulting in the production of small red blood cells
Clinical manifestations include fatigue hypoxia shortness of breath pale tissues, glossitis and spoon shaped nails as well as painful mouth angular stomatitis dysphasia and hyposalivation
In children iron deficiency may cause cognitive impairment which maybe irreversible

