Anemia due to Decreased Red Cell Production Flashcards
Marrow production can increase _____ fold
6-8
When hgb is outside RBC it dissociates into a _____
dimer
What happens to reticulocytes during stress?
They are released early
Red cells develop in the _____ over ______ days
marrow
10-14
Reticulocyte stays for 3 days in the _____ and then 1 day in the _______
marrow
peripheral blood
Most turnover in the spleen occurs in what way
extravascularly (10% is intravascular)
Know the classification of anemia chart
go memorize this tree/table in the handout
What four things suggest hemolysis if there is a reticulocyte response to anemia?
increased bilirubin
increased lactic dehydrogenase (LDH)
decreased haptoglobin
hemosiderin in urine
BL Up H Down = (BLUHD– you’ve got hemolysis in your bluhd) also should be considerin hemosiderin
What is the hallmark of hereditary spherocytosis?
loss of the plasma membrane and formation of the microspherocyte
What are the three types of Hereditary spherocytosis?
- Spectrin defect
- Ankyrin Defect
- Band 3 defect
What is the problem with having microspherocytes?
They get stuck in the spleen and die much faster than normal.
What are important clinical aspects of HS?
1/3 has hyperbilirubinemia as neonates
25% are autosomal recessive (most are autosomal dominant)
What is treatment for HS?
supportive care and sometimes splenectomy
What is an important lab feature of HS?
unconjugated hyperbilirubinemia
Sometimes when a patient has HS, the patient will also contract a clinical complication called an aplastic crisis. How is this detected?
Reticulocyte count and hematocrit drop like a rock.
G6PD deficiency may be associated with a selective resistance to ______
plasmodium vivax.
Enzyme disorders, such as G6PD are associated with _______
heinz bodies
what is the basic pathway problems in G6PD disease?
inability to replete GSH (glutathione)–> Oxidation of hgb
clincically G6PD presents with episodes of acute hemolytic anemia and _______ associated with_______
hyperbilirubinemia
oxidant stress
RBC makes energy through the _______
glycolytic pathway
in a direct or indirect Coombs test a positive test result is seen as
agglutination
The spleen is critical for clearance of _______
intravascular microbes
The most common problem with a splenectomy is ______. This is often associated with the bacteria ______
sepsis
S. pneumoniae
Is the risk for S. Pneumoniae from splenectomy greatest for children or adults?
children
The Spleen is important for the ____ humoral response and is the origin of the ____ agglutinins, especially for ______ organisms.
adaptive
IgM
encapsulated
