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Kydd - Pathophysiology > Anemia > Flashcards

Anemia Flashcards

1
Q

Here’s a picture. Have a look. Yay, Sickle Cell Anemia.

Things to notice:

HbA and HbS

Cell Shape

Occlusion

A
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2
Q

What is Anemia?

A

A condition marked by a deficiency of red blood cells or of hemoglobin in the blood.

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3
Q

What is erythropoiesis?

A

Erythopoiesis is the production of red blood cells.

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4
Q

How many units of oxygen can each hemaglobin carry?

A

Four.

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5
Q

What does oxygen bind to in a hemaglobin molecule?

A

Iron.

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6
Q

What type of proteins are contained in a hemaglobin molecule?

A

Alpha and Beta Globin

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7
Q

What is the life-span of RBC’s?

A

120 days

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8
Q

What is hemolysis?

A

The rupture or destruction of red blood cells.

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9
Q

What are the three etiologies of anemia?

A
  1. Defective erythropoiesis. 2. Increased Hemolysis. 3. Increased loss of Hemoglobin due to Hemorrage.
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10
Q

What is the Pathophysiology of Anemia?

A

Abnormal RBC number, structure or function which leads to a decreased oxygen carrying capacity by the blood. This results in hypoxia.

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11
Q

What is the underlying manifestation of Anemia?

A

Hypoxia

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12
Q

What are some moderate manifestations of Anemia?

A

Dyspnea (difficult/laboured breathing), Palpitations, Chronic Fatigue.

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13
Q

What are some manifestation of severe Anemia?

A

Chronic exhaustion, Increased palpitations because of systemic hypoxia (it affects the heart muscle), profound weakness, dizziness, headache, sensitivity to cold.

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14
Q

Why does an Anemic individual have sensitivity to cold?

A

Our normal metabolisim produces heat from the releasing energy of ATP. As one becomes incresingly anemic, the body becoms more hypoxic and has less ATP/Energy to use as a heat source.

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15
Q

What is the main complication of Anemia?

A

Acidosis. As the body becomes more hypoxic we use alternative sources of energy, which results in a buildup of acid with-in the body.

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16
Q

How many different types of Anemia are there? What are they called?

A
  1. Iron deficiency 2. Vit. B12 and Folic Acid deficiency 3. Pernicious Anemia 4. Aplastic Anemia 5. Hemolytic Anemia 6. Hemorrhagic Anemia 7. Sickle Cell Anemia
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17
Q

What is Iron deficient anemia?

A

Iron deficient Anemia occurs because there is an inadequate intake or there is too much lost. The loss of iron is typically due to impared Hemaglobin synthesis.

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18
Q

Why does an iron defiency result in Anemia?

A

When there is a lack of iron in the RBCs, they lack the ability to carry and transport oxygen. The decreased ability of the RBCs to carry and deliver oxygen results in hypoxia. So, there may not be a decrease in the number of Hemoglobin in the blood, but there is a reduced ability to deliver oxygen.

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19
Q

Why is a CBC not the test of choice for Anemia?

A

The CBC does not show the amount of iron attached to hemoglobin. The Hb cells are fully intact, except their make-up is different. The CBC will not measure iron content.

20
Q

What is the treatment for Iron deficiency anemia?

A

Treat any underlying cause. Typically, Iron is administered orally for 4 - 6 months which will help restore levels to normal.

21
Q

What is Vitamin B12 and Folic acid deficiency anemia?

A

Vitamin B12 and Folic acid are important in the generation (Erythopoiesis) of blood cells, including RBCs. A deficiency in B12 and folic acid occurs when there is not enough consumption through diet, if the body has an increased need (Pregnancy), if the body does not absorb enough (Alcohol abuse, or kidney problems), or consumption of certain medications used for cancer and arthritis. The shortage of B12 and folic acid results in abnormal DNA synthesis and cell division which results in impaired RBC, WBC, and platelets.

22
Q

What is the treatment for Vitamin B12 and folic acid anemia?

A

Increased intake of Vitamin B12 and folic acid.

23
Q

What is pernicious anemia?

A

Perinicious anemia is a Vitamin B12 issue. Pernicious anemia is caused by damaged gastric mucosa which is responsible for the secreation of intrinsic factor, a protein essential for the absorption of vitamin B12 in the ileum. Due to the decreased absorption of Vit B12 the bodies RBC production is impaired.

24
Q

How do we treat Pernicious Anemia?

A

High does Vitamin B12 PO. 1000 micrograms. IM Vitamin B12 only if neurological symptoms are present

25
Why do we choose PO vitamin B12 over subcutaneous injections when treating pernicious anemia?
We choose an oral route over subcutaneous injections because it ensures adequate presence in the duodenum which leads to passive absorption.
26
What is Aplastic Anemia?
Is a disease in which the bone marrow, and the blood cells that reside there, are damaged. This causes a deficiency of all three blood cell types (Pancytopenia)
27
What is Pancytopenia?
A condition in which all three types of blood cells are reduced in number.
28
What are the causes of Aplastic Anemia?
1/3 of cases are caused by autoimmune, radiation, and toxic chemicals. 2/3 of cases are idiopathic.
29
What is the treatment for Aplastic Anemia?
Treat the underlying cause. Give the patient transfusions if the bone marrow is unable to produce RBCs in sufficient numbers. In severe cases a bone marrow transplant may be required.
30
What is Hemolytic Anemia?
Hemolytic anemia is a form of anemia due to hemolysis. This hemolysis may occur in premature cells or might occur excessively, reducing the number of RBCs.
31
What are the two etiologic ways which one can get Hemolytic Anemia?
Acquired (Ex. Autoimmunity, Drugs). Genetic (Ex. In Thalassemia)
32
What is Thalassemia?
A form of inherited autosomal recessive blood disorder. It is characterized by adnormal formation of hemoglobin. The disorder results in improper oxygen transport and destruction of red blood cells.
33
What are the manifestations of Hemolytic Anemia?
1. Jaundice 2. Splenomegaly 3. Hepatomegaly
34
What is Hepatomegaly
The condition of having an enlarged liver.
35
What is Splenomegaly?
Enlargement of the spleen
36
Why is jaundice a manifestation of Hemolytic Anemia?
RBCs are removed from circulation by the spleen. During the process the liver forms bilirumbin which is processed and excreted with bile. Due to the accumulation of bilirubin, it is distributed throughout the body leaving a yellow tinge in the affected.
37
Why is splenomegaly a manifestation of Hemolytic Anemia?
The spleen destroys and removes the bodies RBCs. When one has Hemolytic Anemia the spleen becomes enlarged because it is overwhelmed with excessive RBCs.
38
What are the treatment methods for Hemolytic Anemia?
1. Treat the underlying cause. 2. Oxygen Therapy (b/c person hypoxic) 3. Transfusion 4. Steroids 5. Renal Function (percipitation in renal tuble d/t hemolysis) 6. Splenectomy (partial or complete removal)
39
What is Hemorrhagic Anemia?
Hemorrhagic Anemia can be either a chronic or acute and arises from the loss of blood. There are many reasons for the blood loss.
40
What are the acute characteristics of Hemorrhagic anemia?
Rapid loss of blood (RBCs and Hb). The severity depends onn the site, rate and volume of blood loss.
41
What are the chronic characteristics of Hemorrhagic Anemia?
Gradual and ongoing blood loss.
42
What are some of the etiological causes of Hemorrhagic Anemia?
Prolonged or heavy menses. Bleeding peptic ulcers. CA lesions in gastrointestinal tract. Hemorrhoids.
43
What is the treatment for Hemorrhagic Anemia?
Eliminate the cause of blood loss
44
What is Sickle Cell Anemia?
Sickle cell anemia is a genetic form of anemia in which a mutated form of Hemoglobin (HbS) crystalizes and distorts into a cresent shape at low oxygen levels. This mutation causes vessel occulsion leading to ischemia and infarction.
45
What is the pathophysiology of sickle cell anemia?
In the Beta-chain of Hemoglobin, our bodies have a genetic mutation which forms Valine (HbS) instead of Glutamic Acid (HbA). HbS crystalizes on dissociation at low O2 levels causing RBCs to deform and take on the sickle shape. Chronic hemolysis and vessel occlusion occurse leading to ischemia and ultimately infarction. Obstructed capillaries lead to hypoxia and more sickling. Increased viscosity impairs circulation which leads to occlusion and further hypoxia as more RBCs sickle. It is a vicious cycle.
46
What are the manifestations of Sickle Cell Anemia? Relate the manifestations to Hemolysis, Thromosis/Infarction, and Increased Bilirubin
47
What are the treatments for Sickle Cell Anemia?
1. Supportive treatment - Rest, oxygen, analgesics, IV fluids, and electrolytes.2. Hypertransfusion in increased irsk (ex. Pregnancy)3. Hydroxyuren - Drug which brings about fetal Hgb, prevents cells from sickling. (Has many side-effects: toxic to the liver, anti-neoplastic, potential to develop leukemia, toxic effect on marrow).4. Marrow or Stem cell transplant

Kydd - Pathophysiology (15 decks)

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