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Hematology > Anemic Patient > Flashcards

Anemic Patient Flashcards

1
Q

CBC

A

complete blood count 7 components 1. RBC 2. Hemoglobin 3. Hematocrit 4. RDW 5. MCH 6. MCHC 7. MCV

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2
Q

RBC

A

direct measurement of number of red cells

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3
Q

hemoglobin

A

concentration of hemoglobin, directly measured

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4
Q

hematocrit

A

volume of red cells per total volume of blood, percentage

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5
Q

MCV

A

mean corpuscular volume direct measurement of red cell volume, size

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6
Q

RDW

A

red cell distribution width how much spread there is in the MCVs of all the different red cells in the patients body

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7
Q

anemia

A

decreased hemoglobin/hematocrit below normal range for gender and age

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8
Q

worldwide _____ of the population is anemic

A

1/3

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9
Q

anemia is the _______ of disease and not a final diagnosis

A

manifestation

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10
Q

hypovolemia

A

acute loss of blood which leads to low blood volume or hypovolemia

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11
Q

how does the rate of change of hemoglobin affect symptoms?

A

increased rate leads to increasingly dramatic symptoms

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12
Q

symptoms of acute hemorrhage related to hypovolemia

A
  • hypotension - syncope (blood pressure goes down, heart rate goes up, faint) - shock - orthostatic changes - symptoms of tissue hypoxia
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13
Q

symptoms of tissue hypoxia

A

fatigue shortness of breath cognitive difficulties ischemic pain (angina or claudication)

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14
Q

chronic anemia

A
  • increased fluid retention leading to increased blood volume due to kidneys retaining salt and water - increased erythrocyte 2,3- DPG leading to right shift in O2 dissociation curve leading to increased O2 delivery to tissues - mesangial cells sense decreased oxygen delivery and increase erythropoietin synthesis
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15
Q

body’s response to anemia

A

increased cardiac output mainly from increased heart rate

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16
Q

acute blood loss and hypovolemia trigger a reflex for

A

vasoconstriction

17
Q

mechanisms of anemia

A
  1. hemorrhage 2. increased red cell survival (hemolysis) 3. decreased red cell production
18
Q

classification of anemia

A
  1. erythropoietic response 2. MCV- red cell size
19
Q

erythropoietic response

A
  1. Hyper-proliferative: plenty of reticulocytes 2. Hypo-proliferative: not enough reticulocytes
20
Q

reticulocytes

A

young red blood cells immediately released by the bone marrow as the end result of erythropoiesis

21
Q

wright-giemsa staining

A

stain reticulocytes a blue color, polychromatophilic RNA remnants

22
Q

reticulocyte index

A

(reticulocyte count x hematocrit) / (ideal hematocrit x 0.5)

23
Q

absolute reticulocyte count

A

reticulocyte percentage x RBC

24
Q
A

polychromatophilic cells on wright giemsa staining

25
Q
A

reticulocyte staining using supravital staining

26
Q

reticulocyte index is < 2% or absolute reticulocyte count is < 75,000

A

anemia is likely due to red cell productoin errors

27
Q

reticulocyte index is > 2% or absolute reticulocyte count is > 100,000

A

anemia is likely due to hemorrhage or hemolysis

28
Q

classifications of anemias by RBC size

A
  1. MICROCYTIC ANEMIA
  2. MACROCYTIC ANEMIA
  3. NORMOCYTIC ANEMIA
29
Q

MICROCYTIC ANEMIA

A

low MCV < 80

tends to reflect a problem with hemoglobin synthesis

  1. iron deficency
  2. thalassemia
  3. lead poisoning
  4. anemia of chronic disease
  5. sideroblastic anemia
  6. hemoglobin C
30
Q

macrocytic anemia

A

high MCV > 100

  • impairment of DNA synthesis
    1. aplastic anemia
    2. antiviral therapy
    3. liver disorder
    4. thyroid disorder
    5. MDS- myelodysplastic
    6. b12/folate deficiency
    7. chemotherapy
    8. elevated reticulocyte count
31
Q

treatments of anemia

A
  1. blood transfusions
  2. treat underlying cause
32
Q

indications for blood transfusions

A
  1. cardiovascular compromise
    - congestive heart failure
    - angina
    - shock
  2. hypoproliferative anemia with no or prolonged recovery
  3. anemic patient is gong to surgery and potential for further blood loss

Hematology (23 decks)

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