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HPP 2 > Anemia > Flashcards

Anemia Flashcards

1
Q

normal total circulating blood volume

A

6-8 liters

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2
Q

flow rate of blood

A

5L/ min

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3
Q

What is in plasma?

A

water
proteins
carbohydrates
electrolytes
enzymes AST and ALT
Bilirubin
BUN, creatine

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4
Q

what do high levels of BUN and creatine indicate?

A

impaired kidney function

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5
Q

which enzymes indicate impaired liver functions?

A

AST and ALT

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6
Q

what are the formed elements in blood?

A

Red blood cells
platelets
white blood cells

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7
Q

What accounts for 45% of packed cell volume in blood?

A

Red Blood Cells

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8
Q

Where are all cells in the blood made?

A

bone marrow
primarily flat bones: skull, sternum, pelvis

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9
Q

hematopoietic stem cells

A

cells that are committed to become blood cells

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10
Q

erythropoiesis

A

process by which red blood cells are produced
takes 5-14 days to complete
3-4 mitotic cell divisions
each stem cell can make 8-16 cells

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11
Q

Reticulocyte

A

precursor to erythrocytes

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12
Q

Red blood cell differentiation

A

degeneration of nucleus and organelles
reduction in size
accumulation of hemoglobin

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13
Q

RBC physical characteristics

A

bionconcave disc to increase surface area
7um in diameter, 2 um thick
one of the smallest cells in the body

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14
Q

Density of erythrocytes in blood

A

4-6 x 10^6 /mm^3

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15
Q

How long does a new RBC stay in circulation?

A

100-120 days

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16
Q

as an RBC ages what does the membrane do?

A

becomes rigid

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17
Q

Functions of erythrocytes

A

pick up oxygen from the lungs and deliver it to tissues elsewhere
oxygen binds to iron atom at the center of heme
each erythrocyte contains 280 million molecules of hemoglobin

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18
Q

Density of hemoglobin

A

12-16g/dL

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19
Q

What determines the rate of RBC production?

A

Tissue oxygenation

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20
Q

Hypoxia

A

lower than normal oxygen levels detected by the cells kidneys
decr blood flow
pulmonary diseases
decr RBC density and or decrease hemoglobin concentration
kidneys release erythropoietin

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21
Q

Erythropoietin

A

a glycoprotein
hematopoietic growth factor
90% in kidneys; 10% in liver
constantly being produced
accelerates erythropoiesis when this is increased

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22
Q

Which organs filter blood?

A

spleen and liver

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23
Q

Monocytic-phagocytic system

A

network of cells residing in tissues that trap and digest aged RBC
recovers iron and amino acids
released from destroyed RBCs

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24
Q

Why must 1% of RBC must be replaced each day?

A

to maintain homeostasis

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25
Q

anemia

A

rate of RBC removed from circulation > rate of their replacement

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26
Q

Examples of anemia that result in decreased production of erythrocytes

A

Iron, B12, Folic Acid, Aplastic Anemia

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27
Q

Examples of anemia that results in increased destruction or loss of erthrocytes

A

acute blood loss
hemolytic anemia

28
Q

Clinical symptoms of anemia

A

pallor
tiredness
dyspnea, shortness of breath
palpitations
intermittent claudication
decreased cognitive function

29
Q

Hematocrit

A

RBC volume expressed as a fraction of total blood volume (37-47%)

30
Q

Hemoglobin Level

A

concentration of oxygen carrying protein
indicative of O2 carrying capacity (12-16 g/dL)

31
Q

Reticulocyte counts

A

immediate precursor of RBC
normal range 0.5-1.5% in blood
reflects bone marrow activity
low-> depressed erythropoiesis
high-> stressed erythropoiesis

32
Q

Polychromasia

A

variation in color (Hb-heme iron content)
normochromic
hyperchromic
hypochromic

33
Q

Mean corpuscular hemoglobin

A

average color of red blood cells

34
Q

Ansiocytosis

A

variation in size
normcytic
microcytic
macrocytic

35
Q

mean corpuscular volume

A

average size of RBC

36
Q

Poikilocytosis

A

variation in shape of RBC

37
Q

Divalent metal transporter

A

absorbs elemental iron in the lumen

38
Q

Transferrin

A

iron transport in blood circulation

39
Q

ferritin

A

iron storage in tissues

40
Q

iron absorption rate from diet

A

5mg/day

41
Q

Iron distribution in body

A

4g total
2-3g hemoglobin
<100mg myoglobin/enzyme/cytochromes

42
Q

Iron demand

A

20-30 mg/day

43
Q

Iron storage

A

ferritin 1 g

44
Q

iron loss and typical intake

A

1-2 mg/day

45
Q

How much iron is stored in the liver?

A

30 times daily needs

46
Q

iron deficiency anemia becomes evident when hemoglobin concentration falls below?

A

10 g/ dL

47
Q

symptoms of iron deficiency anemia

A

tired
pale skin
papillary atrophy and erythema of the tongue
pearly white sclerae in eyes
slight cardiomegaly
tachycardia

48
Q

Diagnosis of Iron deficiency anemia can be made based on

A

decreased Hb and Hct
decreased MCV and MCH
decreased ferritin
increased transferrin

49
Q

What does TIBC stand for?

A

total iron binding capacity

50
Q

How should iron deficiency anemia be treated?

A

cannot be corrected by increasing dietary intake alone
2 months Hb is normal after iron therapy
iron supplements should be used for another 6-12 months

51
Q

Iron content in OTC products

A

ferrous fumarate > ferrous sulfate > ferrous gluconate

52
Q

Folic acid deficiency

A

nutritional and megaloblastic anemia
required for proliferation and differentiation of cells
found in all food especially greens, yeast and liver
treat with continual dietary supplement

53
Q

How much folic acid is stored in the liver?

A

5-10 mg

54
Q

Etiology of folic acid deficiency

A

pregnancy
malabsorption syndromes
inadequate dietary intake
liver diseases
some medications interfere with the absorption of folic acid

55
Q

Vitamin B12 is important for?

A

DNA synthesis

56
Q

Causes of Vitamin B12 deficiency

A

diet
chronic alcoholism
crohn’s disease
abdominal or intestinal surgery that eliminates the site of intrinsic factor production/absorption

57
Q

Pernicious Anemia

A

type of anemia due to inability to absorb B12 in the digestive tract
autoimmune
incr MCV
decr MCH
IF-antibodies

58
Q

What do parietal cells secrete?

A

intrinsic factor

59
Q

Schilling Test

A

used to determine if B12 can be absorbed orally

60
Q

Megaloblasts

A

describe both folic and B12 deficiencies
poorly differentiated, immature red cells

61
Q

What does RDW stand for?

A

red cell distribution width

62
Q

Clinical features common to both B12 and folate

A

megaloblastic anemia
fatigue
weight loss
diarrhea
loss of appetite
fever
sore tongue
jaundice
fundal hemorrhages in severe cases

63
Q

Clinical features of Vitamin B12 deficiency

A

paraesthesiae
dementia
neuropathy
demyelination of spinal cord

64
Q

Clinical features of pernicious anemia

A

family and personal history of vitiligo
autoimmune thyroid disease
itself

65
Q

What can mask the long term effects of B12 deficiency? How does it do it?

A

High dose folate
temporarily reverses anemia without correcting the neurological damage

66
Q

What are the types of increased destruction anemia?

A

Hemolytic Anemia- Glucose-6-Phosphate dehydrogenase deficiency
hereditary cell defects
drug induced

67
Q

Sickle Cell Anemia

A

Hct that are about half the normal value
production of RBCs in the bone marrow increases dramatically, but is unable to keep up with the destruction
RBC production increases 5-10 fold
half life of RBCs can be as low as 4 days
recessive genetic disorder
Point mutation
Hydrophilic Glu -> hydrophobic Val
HbA-> HbS aggregate to bury Val

HPP 2 (11 decks)

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