Anemia physio Flashcards
what is hemoglobin
carrier of oxygen
what else can bind to hemoglobin
carbon monoxide
glucose
what can carbon monoxide binded to hemoglobin cause
asphyxiation
what is the life of a RBC
120 days
What can cause anemia
blood loss
nutritional deficiencies
defective hemoglobin
bone marrow disorders
chronic disases
O2 binds to hemoglobin normally at how many sites
4
what is hematocrit
level of RBCs contained within a sample of blood in percentages
what is anemia
there is not enough RBCs to attach to hemoglobin molecules
what do diseases of red blood cells relate to
quantity or quality
Regardless of the cause all diseases of RBCs mean
Less oxygen is able to be transported to the tissues
Absoulte decrease means
When you do not have enough RBCs
relative decrease
dilution -> increase in plasma but not proportional RBCs.
What are some causes of anemia (8)
iron deficiency
maturation disorders
hemolytic anemias
acute bleeding
marrow damage
inflammation
neoplasia
chronic disease
symptoms of severe anemia
fainting
chest pain
angina
heart attack
worsening CHF
what does patient with anemia look like
pale
fatigued
increase HR
Hypotension
Increase Respiration
Clinical manifestations of MILD anemia
may have no symptoms
clinical manifestations of MILD - MODERATE anemia
fatigue
weakness
tachycardia
dyspnea
clinical manifestations of moderate to SEVERE anemia
Increased HR increased RR hypotension pallor faintness cardio symptoms (especially on exertion)
What is the trend with anemia and oxygen to the muscles
Decreased causing weakness
What is the trend with anemia and energy production
decresed causing fatigue
What is the trend with anemia with peripheral circulation
blood is redistributed causing pallor
What is the trend with anemia with cardiac output
increased causing increase HR and palpations
What is the trend with anemia and secretion of erythropoietin
increeased causing bone pain
What is the trend with anemia with cardiac muscle
hypoxia causing chest pain and heart failure
What is the trend with anemia and overall oxygenation
hypoxia causing dyspnea and increase RR
What disease is caused in Anemia with Abnormal Hgb
Sickle Cell Disease
What is caused by a decreased Hgb content
Loss of iron
Loss of key nutrients
what is caused by a decreased number of circulating erythrocytes
decreased production
increased destruction
loss
hemoglobin usually become distorted under what
Stress on the body
what is Thalassemia
Genetic disorder causing defective hemoglobin, causing cells to be destroyed in liver and spllen causing hemolysis
can sickle cells go back to normal
Yes, but repeated sickling can cause permanent distortion
common blockage areas
liver, heart, spleen, kidneys, and retina
anemia causes the inability to do what
bind to hemoglobin normally
Hemoglobin S distorts what
shape, especially when oxygen is low
What is iron essential for
normal hemoglobin production
what are folate and V-B12 necessary for
normal DNA synthesis
T/F iron is reused when a cell dies
TRUE
anemias are classified by what
the size and shape of RBC
Vitamin B12 or folate deficiency will have a MCV that is larger or smaller?
MCV will be larger
Iron deficiency will have a large or small MCV
Smaller
Etiologies of Iron Deficiency
Decreased intake Decreased absorption Increased demand Excessive loss -GI bleeding (occult) -Menstruation
T/F Iron deficiency is the most common
True
Where is iron stored
in the liver
Iron deficiency manifestations of anemia
Epithelial atrophy
Brittle hair and nails
Koilonychia
GI tract
Smooth tongue
Mouth sores
Dysphagia
PICA
What is PICA
craving non-food substances
what is pagophagia
chewing and craving ice
Folic Acid is activated by what
Vitamin B 12
What can be given to activate Folic Acid instead of Vitamin B 12
Inactive Folic Acid
what is koilonchia
spoon shaped nails
what can B12 deficiency also cause
neuro complications
folate deficiency does not have a problem with what
absorption
decreased intake of folate can be seen in what
alcoholism
diet
cirrhosis
increase need in folate can be seen in what
pregnancy
B12 deficiency is seen in what time of anemia
pernicious anemia
b12 is combined with what
intrinsic factor
intrinsic factor is secreted where
gastric parietal cells
where is vitamin b12 absorbed
terminal ileum
Conditions that reduce Intrinsic factor or inhibit absorption
gastric bypass
gastrectomy
bowel resection
B12 deficiency S/S
Normal signs of anemia
Fatigue Exercise intolerance Weakness Tachycardia Dyspnea Glossitis
B12 deficiency S/S NEURO
Depression Paranoia Confusion Anger/Irritability Anxiety Balance issues Gait issues Memory loss
Chronic kidney disease anemia ETIOLOGY
Impaired erythropoeitin production
Hgb/Hct correspond with the degree of kidney insufficiency
clinical manifestations of chronic kidney disease anemia
General S/S of anemia
What is Aplastic Anemia
Primary condition of bone marrow stem cells.
Decrease in all RBCs in marrow
2 classes of aplastic anemia
Congenital
Acquired
What problems will an aplastic anemia patient have
Reduce RBC, WBC, and platelets
Infection
Bleeding
causes of aplastic anemia
idiopathic
high dose exposure to radiation or chemicals/toxins
autoimmune mechanism with complication of infection
What leads to increased destruction of RBCs
Abnormal hemoglobin
Sickle Cell Anemia
Decreased life span of RBCs
Thalassemia
Absent or decreased production of normal hemoglobin
Alpha or Beta thalassemia
Acquired Hemolytic Anemia
What is Acquired hemolytic anemia
Premature destruction of RBCs caused by some external agent
what are common causes of acquired hemolytic anemia
Autoimmune attack
Blood incompatibilities
Drug reactions
Other
Physical agents (severe burn)
Microangiopathies
What happens in hemolytic anemia
Formation of immune complexes
Lysis = cell death
What to look for in hemolytic anemia
Low hemoglobin increase Reticulocyte count Mild jaundice Hemoglobinuria Decreased haptoglobin
blood loss anemia results from
Gross
Occult
2 Rates of blood loss
Acute/Rapid
slow
