Anemia FINAL Flashcards
Decreased RBC, HGB, and HCT
Anemia
Inadequate intake of dietary iron or excessive loss of iron
Iron deficiency anemia
Inability to absorb vitamin B12 (cobalamin). Possibly associated with loss of intrinsic factor (e.g., gastrectomy, gastric bypass), or an autoimmune problem.
Pernicious anemia
Pancytopenia— depression of the bone marrow in production
of all blood cell types: RBCs, WBCs, and platelets.
Aplastic anemia
Associated with decreased dietary intake of folic acid.
Folic acid deficiency anemia
Hypochromic
Iron or vitamin deficiency
Malfunctioning bone marrow
aplastic anemia
Decreased B12
Pernicious anemia - lack of intrinsic factor
Destruction by antibodies
Erythroblastosis fetalis
Increased RBC destruction
Sickle cell
Secondary anemia caused by
bleeding, leukemia, cancer, or chronic kidney disease
Causes of anemia
- Defect in bone marrow production of RBCs.
- Loss of RBC’s due to Hemorrhage, Chronic bleeding, Hemolytic processes
- Hereditary disorders of the RBCs.
- Inadequate nutritional intake of iron, folic acid.
General symptoms of anemia
- Pallor of the ears
- Pale mucous membrane
- Spooning of the nails
- SOB
- DOE
- Postural hypotension
- Chronic Fatigue
- Beefy Red Tongue
Iron deficiency anemia sx
- Asymptomatic in early stages
- General sx of anemia
- Pallor, glossitis, cheilitis
Pernicious anemia sx
- General sx of anemia, confusion
- Paresthesia in the extremities, weakness, loss of vibratory sense
- Loss of sense of balance, ataxia
- Smooth beefy red tongue
Aplastic anemia sx
- General sx of anemia
- Fever
- Infections, neutropenia
- Bleeding problems associated with thrombocytopenia
Folic acid deficiency anemia sx
- Slow, insidious onset
- Weight loss, emaciated
- May appear ill with malnourishment
Anemia risk factors
- Acute or chronic blood loss
- Increased hemolysis
- Inadequate dietary intake or malabsorption
- Bone-marrow suppression
- Age
- Common in adolescents.
- Vegetarians and lacto–ovo vegetarians.
- Occurs in infants whose primary diet is milk.
- May occur in pregnancy.
- Heavy menstrual bleeding.
- Other blood loss states (e.g., peptic ulcer disease [PUD]).
- Older adults are more prone to iron deficiency anemia because of poor dietary iron intake and decreased absorption in the small intestine.
Iron deficiency anemia
- Generally, not associated with inadequate dietary intake.
- More common in older adults; most common age at diagnosis is 60 years.
- Familial tendency.
- May be precipitated by gastrectomy, gastritis, Crohn disease, or chronic alcoholism.
- Long-term use of proton pump inhibitors and H2-histamine receptor blockers prevent the release of the intrinsic factor.
- Gastric atrophy, especially in the older adult
Pernicious anemia
- Exposure to certain medications and chemicals can precipitate aplastic anemia.
o Chemotherapeutic agents, radiation.
o Sulfonamides, chloramphenicol, methotrexate.
o Anticonvulsant medications (e.g., phenytoin).
o Benzene, insecticides, arsenic. - Radiation therapy.
- Up to 70% of cases are idiopathic in origin and are thought to have an autoimmune basis.
Aplastic anemia
- Poor nutrition due to decreased folic acid intake, alcoholism, anorexia.
- Malabsorption syndromes.
- Deficiency may occur with increased demands for folic acid: infancy, adolescence, and pregnancy.
- Drugs: anticonvulsants, methotrexate, and oral contraceptives.
- Hemodialysis
Folic acid deficiency anemia
Iron deficiency anemia meds & treatment
Supplemental iron intake is necessary for several months to replenish body storage.
* Supplemental iron.
* Increased dietary iron intake.
* Supplemental folic acid (green leafy vegetables, fortified cereals, enriched rice and bread, liver, Great Northern beans, black-eyed and green peas, avocado, peas, tomatoes, oranges).
Pernicious anemia meds & treatment
- Injections of vitamin B12 or intranasal cyanocobalamin may be required for life.
- Maintain good nutrition with adequate iron, vitamin C, and folic acid intake.
- Monitor for gastric cancer—there is increased potential with pernicious anemia
Aplastic anemia meds & treatment
- Remove causative agent.
- Erythropoietin: epoetin alfa
- Hematopoietic stem cell transplant
Folic acid deficiency anemia meds & treatment
Folic acid oral replacement, 1 mg/day or 5 mg/day for malabsorption syndromes or chronic alcoholism;
encourage increase dietary intake of folic acid (organ meats, green leafy vegetables, citrus fruits, whole grains, and beans)
CBC count includes
RBC, H&H, WBC, platelets, and bands
Mean corpuscular volume (MCV) is
size of red blood cells
Normocytic
normal size
Microcytic
small cells
Macrocytic
large cells
Mean corpuscular Hgb (MCH) determines
the amount of Hgb per RBC
Normochromic
normal amount of Hgb per cell
Hypochromic
decreased Hgb per cell
Mean corpuscular Hgb concentration (MCHC)
Indicates Hgb amount relative to the size of the cell
Reticulocytes
immature RBCs
Major iron storage protein reflects iron storage. Diagnoses iron deficiency anemia.
serum ferritin
-Microcytic, hypochromic anemia
-Decreased MCV, MCH, and MCHC
iron deficiency anemia
-macrocytic anemia
-increased MCV
pernicious anemia
-normocytic, normochromic anemia
-normal MCV, MCH, MCHC
aplastic anemia
-macrocytic anemia
-increased MCV
folic acid deficiency anemia
