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Pharmacology 2 > Anemia > Flashcards

Anemia Flashcards

1
Q

Anemia is a group of diseases characterized by a decrease in what?

A
  • hemoglobin
  • RBCs
  • both
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2
Q

Anemia may occur as what?

A
  • a primary disease
  • secondary to another pathology
  • nutritional deficiency
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3
Q

Describe a RBC and its components

A
  • biconcave discoid shaped cell
  • no nucleus, no mitochondria
  • cell membrane - function
  • hemoglobin - function
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4
Q

RBCs use glucose to produce (…) via glycolysis

A

ATP

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5
Q

A RBC membrane must provide for mechanical strength as well as (…) and (…) and is reversible b/c it needs to squeeze through capillaries that are smaller than diameter of RBC and pass from splenic cords to splenic sinus?

A

deformability and elasticity

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6
Q
  • The RBC membrane is a lipid envelope composed of many (…) and (…)
  • Lipids maintain a (…), meaning certain phospholipids always face (…) or (…)
  • This requires energy (…) to maintain orientation
A
  • phospholipids and cholesterol
  • sidedness; outside or inside
  • glucose
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7
Q

What are long fibrous proteins found on the inner aspect of the RBC membrane, have alpha and beta components, is the most abundant protein of the cytoskeleton, and forms a backbone of the RBC membrane?

A

spectrin

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8
Q

What provides for much of the elasticity and flexibility of the RBC?

A

spectrin

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9
Q

What makes up 5% of the RBC membrane proteins, is a mixture of a few different proteins, and connects spectrins to the transmembrane proteins (band 3)?

A

ankyrin

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10
Q

What RBC protein is a major integral (transmembrane) protein of the RBC membrane and has multiple roles as an anion exchanger (HCO3) and structural support?

A

band 3

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11
Q
  • What is the function of a RBC?
  • What is the key protein that makes up 1/3 of RBC content?
  • Hemoglobin is a tetrameric protein made up of what globin chains?
  • Each globin chain is complexed with 1 (…) with 1 (…)
  • Therefore, each hemoglobin protein carries (…) iron molecules
A
  • oxygen transport through body
  • hemoglobin
  • 2 alpha and 2 beta globin chains
  • heme group; iron molecule
  • 4 iron molecules
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12
Q
  • What is the major form of hemoglobin in adults?
  • What is the major form of hemoglobin in the fetus?
A
  • HbA
  • HbF
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13
Q
  • Where does erythropoiesis occur?
  • What is the primary regulatory hormone of RBC production?
  • What is the physological stimulus for RBC production?
  • What type of cells produce and release EPO when decreased oxygen is sensed?
A
  • red bone marrow
  • erythropoietin (EPO)
  • hypoxia
  • peritubular renal cells (kidney)
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14
Q

Production of mature and function RBCs require what?

A
  • B12
  • folic acid
  • iron
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15
Q
  • What is the normal lifespan of RBCs?
  • What are RBCs typically destroyed by?
  • RBCs lack a (…) and (…) therefore, there is no new protein production and must rely on glycolysis
A
  • 120 days
  • spleen by macrophages
  • nucleus and mitochondria
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16
Q

In the body, as ATP production decreases, changes in membrane integrity of the RBC occurs and it becomes more (…). The membrane proteins cluster/aggregate and (…) recognize senescent RBCs and (…) occurs

A
  • spherical
  • macrophages
  • phagocytosis
17
Q

Pertaining to anemia:
- there is a decrease of (…) below normal values
- results in decreased (…) carrying capacity of the body resulting in (…)

A
  • functional RBCs
  • O2; tissue hypoxia
18
Q
  • What describes variations in RBC size?
  • What describes variations in RBC shape?
A
  • anisocytosis
  • poikilocytosis
19
Q

A patient has low Hb and low MCV, what is the likely diagnosis?

A

microcytic anemia caused by iron deficiency

19
Q

A patient has low Hb and high MCV, what is the likely diagnosis?

A

macrocytic anemia caused by B12 and/or folate deficiency

19
Q

A patient has a low Hb and a normal MCV, what is the likely diagnosis?

A

normocytic anemia that could be many causes such as CKD, malignancy, blood loss, bone marrow failure, hemolysis

20
Q

What are some signs/findings in patients with more advanced anemia?

A
  • splenomegaly
  • koilonychia (concaved, thin nails)
21
Q

What are different mechanisms of anemia?

A
  1. blood loss
  2. increased destruction
  3. decreased production
22
Q
  • Anemia due to blood loss from trauma is due to a rapid shift of fluid from (…) space to (…) resulting in hemodilution and lowering hematocrit
  • There is an increased response of (…), therefore there will be an increased production of (…)
  • Other blood loss mechanisms leading to anemia can be due to what?
A
  • interstitial space to vasculature
  • EPO; reticulocytes
  • heavy menses, blood donations, GI ulcers (may result in iron deficiency anemia)
23
Q

What are the general features of increased destruction of RBCs (hemolytic)?

A
  • premature destruction of RBC
  • increased EPO and increased erythropoiesis
  • accumulation of Hb breakdown products as RBC are destroyed
24
Q
  • Extravascular increased destruction of RBCs predominately occurs by phagocytes in what places?
  • What are some clinical features of this?
A
  • spleen, bone marrow, and liver
  • anemia, splenomegaly, jaundice
25
Q
  • Intravascular increased destruction of RBCs is less common and can be due to (…)
  • What can cause intravascular RBC destruction?
  • What are some of the clinical presentations of this?
A
  • mechanical injury
  • parasites (malaria), complement fixation, exogenous toxins in blood
  • anemia, hemoglobinemia, hemoglobinuria, and jaundice but no splenomegaly
26
Q
  • How is sickle cell disease inherited?
  • This is due to a genetic defect in what hemoglobin chain?
  • Deoxygenation of (…) leads to (…) and forms aggregates, producing a “sickle” shape of the RBC
A
  • autosomal recessive
  • beta chain
  • HbS; polymerization
27
Q
  • Initially the sickling process in sickle cell anemia is (…) so once HbS is (…), it re-obtains normal shape
  • Sickle cell anemia is a (…) problem; once deoxygenated in tissue obtains the sickle shape again, it can cause (…)
A
  • reversible; oxygenated
  • microvascular problem; vaso-occlusion
28
Q

Sickle cell anemia has a single base substitution where (…) replaces (…)

A

valine replaces glucamic acid

29
Q
A

Pharmacology 2 (3 decks)

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