Anemia Flashcards
what makes someone anemic
low iron
low b12
low folate
splenomegaly - hemolytic anemia
cancer
EPO - kidneys
what are the hormonal regulation for erythropoiesis
liver will make building blocks, stimulate
kidney
thyroid
what are the different types of anemias
poor production
blood loss
more EBCs being destroyed
combination
what does -cytic mean
cell size
what does -chromic mean
amount of hemoglobin
what is the presentation of anemia
depend on severity: may be asymptomatic
fatigue, weakness, pallor, palpitations, HA, exertional dyspnea, light headedness
what do the RBC indices help with
give information about size, weight, hemoglobin concerntation of the RBC
assists with classifying anemia
what is the MCV
mean corpuscular volume: average volume/size of one RBC
what is MCH
mean corpuscular hemoglobin: how much hemoglobin is within one RBC
what is MCHC
mean corpuscular hemoglobin concerntation: percentage of hemoglobin in one RBC
what is RDW
RBC distrubution width: indicates the variation in width of the RBCs
what is microcytic anemia
small RBC (defined as decreased MCV, seen on peripheral blood smear compared to other indicators)
what is the cause of microcytic anemia
iron deficinecy anemia
anemia of chronic disease
thalassemia
what is heme
a porphyrin ring that binds iron
what is globin
2 alpha gains and 2 beta chains (normal adult hemoglobins)
what is iron
binds oxygen to heme
what is iron deficiency anemia
iron binds to heme so that it can carry oxygen
low iron will cause small, pale RBCs
serum ferritin measure amount of total body stores of iron (<12mcg)
what is transferrin
a protein that assists with transport of the iron to where it needs to be - the blood, liver, spleen, marrow
what is seen on labs for iron deficiency anemia
low H&H
low MCV
Increased RBC distrubution width
low serum iron
low serum ferritin(most important test)
high total iron binding capacity (TIBC)
low transferrin iron percent saturation
What is thalassemia
hereditary hemolytic anemia
autosomal recessive
mutation that results in problems iwth globin chain synthesis
microcytic anemia
what is macrocytic anemias
big RBC (defined as increased MCV or seen on peripheral blood smear compared to other indicators) - may also see increased RDW
may be associated with increased reticulocytes
what are the causes of macrocytic anemias
ETOH induced anemia
B12 deficiency anemia
Folate deficiency anemia
Hemolytic anemia
what type of anemia may be associated with increased reticulocytes
macrocytic anemias
where is folate absobed
in the duodenum
what is folate needed for
DNA synthesis during erythropoiesis and helps with cellular maturation - if not enough will result in megaloblastic anemia
if there is not enough folate, what type of anemia will result
megaloblastic anemia
what type of anemia is folate anemia
macrocytic anemia
where is folate typically produced
produced by bacteria within the gut flora
what are folate deficiencies associated with
poor dietary intake, increase requirements (pregnancy), malabsorption, ETOH abuse and medications
how are folate anemias diagnosed
elevated MCV
elevated RDW
low serum folate
what is cobalamin
Vitamin B12
what absorbes vitamin b12
through the parietal cells in the stomach
needs intrinsic factor for absorption
absorbed within the terminal ilium
what is the purpose of B12
assists with maturation process, DNA synthesis and helps with folate synthesis
what type of anemia is associated with B12 deficiency anemia
macrocytic anemia
what are hallmark signs of B12 deficiency anemia
will have neurologic findings as well but folate deficiency will not
what are the presentation of B12 deficiency
neuropathy (early)
dementia
Neuropsychiatric
Optic nerve atrophy
what is normocytic anemias
normal RBCs just not enough
what causes normocytic anemia
blood loss (acute)
anemia of chronic disease
hemolytic
aplastic anemia
what is aplastic anemia
bone marrow failure resulting in pancytopenia
loss of hematopoietic stem cells within the marrow
what is aplastic anemia associated with
autoimmune disease
direct injury to the hematopoietic stem cells
viral infections
clonal and genetic disorders
what is sickle cell anemia
autosomal recessive disorder
results in hemoglobin S (s - sickle)
when there is decreased O2, dehydration, the HbS will change shape causing RBCs to “sickle”
what causes sickle cell anemia to result in hemolytic anemia
the removal of the sickled cells
what is sickle cell crisis
if healthy and well oxygenation - likely asymptomatic
if hypoxic, decreased pH, dehydration the abnormal B-globin chill will polymerize
leads to change in shape of RBC
unable to conform well within the vessels and can cause obstruction
what is the duration of sickle cell crisis
typically lasts days to weeks
what is associated with the pain in sickle cell crisis
vasoocculsive crisis (thrombotic crisis)
what is sequestration crisis
especially in children, the sleep and liver can sequester large amounts of sickled cells and cause significant anemia
