anemia

Question 1

define erythropoiesis & important %

Answer 1

produxn of RBC in bone marrow , 1% of RBC replaced daily

Question 2

stages of erythropoiesis

Answer 2

1 stem cell (bone marrow)
2 erythroblast (loses nucleus)
3. reticulocyte
4. erythrocyte

Question 3

describe Fe pathway and what happens to iron during anemia, % in the body

Answer 3

1 dietary iron absorbed in intestines

2. circulates as transferrin (hi in anemia)
3. stored as ferritin in liver and spleen (lo in anemia)
4. 80% in hgb, myoglobin, cytochrome, 20% in liver spleen bone marrow

Question 4

bilirubin pathway (6)

Answer 4

1. old RBC sent to spleen
2. macrophage breaks RBC into heme and globin, globin is reused and then Heme is broken down into iron and bilirubin,
3. unconjugated bilirubin is sent to liver & is conjugated by glucuronyl transferase & is bound to glucuronic acid
   4 bilirubin is now conjugated and water soluble and is secreted into bile and then into intestine
   5 binds with bacteria to become urobilinogen
   6 some excreted in stool, rest is reabsorbed and excreted in urine

Question 5

define haptoglobin & what happens to haptoglobin level in hemolytic dz

Answer 5

globulin in the plasma that carries free hgb when RBC breakdown in circulation (decrease in hemolytic dz)

Question 6

MCV

Answer 6

mean corpuscular volume: size of RBC helpful in ID of anemia

Question 7

MCHC

Answer 7

mean corpuscular hemoglobin concentration ,dependent on hgb content

Question 8

RDW

Answer 8

RBC distribution width; measurement of cell size distribution

Question 9

RBC count
HGB
hematocrit
retic count

Answer 9

3.5-6
11.7-17.3
38-49
1-1.5

Question 10

s/s of anemia lab value

MF paid

Answer 10

1. h&h >12 & >37
2. murmur
3. fatigue
4. pallor
5. angina
6. increased HR
7. dyspnea

Question 11

2 types of macrocytic normochromic anemias

Answer 11

1. b12-

2. folic acid

Question 12

3 causes of b12 anemia

Answer 12

1. vegans, because they do not eat meat which contains b12
2. pernicious b12 anemia: missing Intrinsic factor
3. gastrectomy- no intrinsic factor

Question 13

s/s of b12 anemia, and diagnostic test

Answer 13

sore beefy tongue
paresthesia, trouble walking, mood swings
-schilling test (radioactive cobalamin)

Question 14

causes of folic acid deficiency

Answer 14

1. malnutrition (fruits veggies, grains)
2. etoh abuse
3. pregnancy

Question 15

s/s folic acid deficiency

Answer 15

1. sore tongue
2. cheilosis
3. stomatitis and ulcerations