Anemia Flashcards
Define Anemia
Lower than normal number of RBCs
Define Hematocrit
Measure of the percent of the colume of the whole blood made up by RBCs
Define Hematocrit
The oxygen-carrying pigment and predominant protein in the red blood cells.
Define the 3 types of hemoglobin
Type A, F, A2
What is the role of fetal hemoglobin?
Its primary job is bind tightly to oxygen by facilitating the transfer from mother to fetus across the placenta. After birth, the hgb F transitions to primarily hgb
What is the Retic index formula?
ReticCount X Hematocrit/Normal Hematocrit (45)
What is the cause of microcytic anemias?
"TICS" T- Thalassemia syndromes I- Iron Deficiency C- Chronic Disease S- Sideroblastic Anemia
Define thalassemia
When people do not have enough hemoglobin and is caused by the inheritance of a defective gene.
Discuss Beta thalassemia
Beta chain is absent or diminished (this indicates the severity of the disease); the more beta produced, the less severity of diagnosis
*What do beta thalassemia cells look like?
Target cells present
Hypochromic/microcytis (small and pale)
Discuss Alpha thalassemia
Alpha chain is absent
Discuss hydrops fetalis
No functional/lack of alpha chain
4 gene deletion that results in still borne birth, hepatosplenomegaly, marked anemia, increased MCV, and microcytic/hypochromic
- What are the characteristic lab findings of Iron deficient anemia?
low serum iron, high total iron binding capacity, low serum ferritin
What are the signs of anemia?
Skin Pallor, Pale Mucous Membranes, Mild Tachycardia,
Widened Pulse Pressure,
Systolic Ejection Murmur,
Mild Peripheral Edema
What are the symptoms of anemia?
Dyspnea on Exertion, Palpitations, Fatigue, Syncope
Mood Disturbances, Decreased memory, Abnormal Sleep Patterns, Pica, Brittle spoon nails, Blue Sclera
Glossitis,, Angular stomatitis,
Gastric atrophy, Impaired immunity, Decreased exercise intolerance
What are the causes of macrocytosis vitamin B12 deficiency
Pernicious Anemia Gastrectomy Zollinger-Ellison Syndrome Intestinal Causes Pancreatic Insufficiency Strict vegetarian Diet
What are the causes of macrocytosis folate deficiency
Decreased nutritional intake
Nontropical and tropical sprue
Increased Cell turnover
Drug Induced
Define anisocytosis
red cells are of unequal size.
Define poikilocytosis
which indicates that red cells of abnormal shape are present on the blood film.
Define Hypochromia
An anemic condition in which the percentage of hemoglobin in red blood cells is abnormally low (will present with clearish cells; low color)
Describe the role of erythropoietin.
- Stimulates Proerythroblasts formation
- Causes cells to pass through various stages of Erythropoiesis rapidly
- RBC production
- Anemia due to low erythropoietin will present with which type of cells?
Burr cells (echinocytes)
Definition of bilirubin?
Degradation by-product of heme breakdown within the reticuloendothelial system
What is the location of conjugated bilirubin?
Liver
What medical conditions cause direct (conjugated) bilirubin?
Gallstones Tumor Inflammation Scarring Obstruction of the extrahepatic ducts
What medical conditions cause indirect (unconjugated) bilirubin?
Hemolysis
Hepatitis
Drugs
Define microcytosis
condition in which red blood cells are unusually small as measured by their mean corpuscular volume.
Define macrocytosis
enlargement of red blood cells with near-constant hemoglobin concentration
Define prophyria
group of inherited or acquired disorders of certain enzymes in the heme biosynthetic pathway
What is the cause/pathophysiology of prophyria?
accumulation of porphyrins (heme precursors) which are toxic to tissue in high concentrations.
What are the signs of acute (hepatic)porphyria?
Abdominal pain Vomiting Acute neuropathy Seizures Mental disturbances (ie. hallucinations, depression, anxiety and paranoia) Cardiac arrhythmias and tachycardia
What are the symptoms of cutaneous (erythropoeitic) porphyria?
-Photosensitivity (photodermatitis)
blisters, necrosis of the skin and gums
-itching,swelling, increased hair growth on areas such as the forehead
-purple hue or red urine reddish appearance to the teeth and fingernails
Hypersegmented neutrophils are associated with what?
Macrocytic B12 anemia
What is the treatment for cutaneous porphyrias?
Sunscreen
Pharmaceutical-grade Beta carotene
What is the treatment for acute porphrias?
Diet (90% Carbs)
Early Identification
Symptom control (for seizures, depression, pain, etc.)
Treat underlying liver disease
