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Blood 3 Flashcards

1
Q

what are the types of normocytic normochromic anemia?

A

anemia of chronic disease
acute blood loss
hemolytic anemia
aplastic anemia

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2
Q

aplastic anemia

A

severe life threatening syndrome
decreased production
hematopoietic stem cell failure leading to hypocellular bone marrow and decreased peripheral blood cell counts

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3
Q

describe the blood with aplastic anemia

A 
decreased RBCs, WBCs, platelets
bone marrow is hypocellular
low reticulocyte count
pancytopenia
incraesaed erythropoietin
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4
Q

what can cause aplastic anemia

A

chemotherapeutic agents, drugs, chemical toxins
hereditary
radiation
infections

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5
Q

what is a good indicator of bone marrow activity?

A

reticulocyte number

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6
Q

for aplastic anemia, all cell lines are?

A

decreased (pancytopenia)

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7
Q

prognosis for aplastic anemia?

A

poor

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8
Q

aplastic anemia is a..

A

normocytic normochromic anemia

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9
Q

hemolytic anemia

A

anemia that is due to increased RBC destruction

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10
Q

symtpoms of hemolytic anemia

A

similar to other forms of anemia

may develop jaundice, splenomegaly and gallstones and isolated reticulocytosis

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11
Q

where does extra-vascular RBC breakdown occur?

A

reticuloendothelial system

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12
Q

when does intra-vascular RBC breakdown occur?

A

rarely

transfusions, extensive burns

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13
Q

what kind of anemia is sickle cell anemia?

A

chronic hemolytic anemia

homozygous hemoglobin SS

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14
Q

what happens in those who have sickle cell/what are the demographics?

A

their life expectancy is shortened (42male, 48 female)

almost exclusively black population

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15
Q

sickling occurs when?

A

at times of physiological lowered oxygen tension

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16
Q

signs and symptoms of sickle cell disease?

A

pain is common with sickle cell crisis
may be episodic or unpredictable
chest, abdominal and musculoskeletal pain
s/s of anemia
clinical manifestations vary due to vaso-occlusion, chronic hemolytic anemia, infection

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17
Q

things that cause AVN

A 
PLASTIC RAGS
pancreatits, pregnancy
legg-perthes disease, lupus
alcoholism, atherosclerosis
steroids
trauma
idiopathic, infection
caisson disease, collagen disease
rheumatoid arthritis, radiation treatment
amyloid
gaucher disease
sickle cell disease/spontaneous
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18
Q

what kind of anemia is sickle cell anemia?

A

normocytic normochromic

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19
Q

what specific things may cause sickling of RBCs

A 
hypoxia
high altitudes
aircraft flight
resporatory infections
anesthesia
CHF
diving
dehydration
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20
Q

test that confirms sickle cell anemia

A

sickledex test

hemoglobin electrophoresis

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21
Q

acute bleeding results in?

A

normocytic normochromic anemia

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22
Q

chronic bleeding results in?

A

microcytic hypochromic anemia (IDA)

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23
Q

what type of anemia is anemia of chronic disase?

A

normocytic normochromic
or
microcytic hypochromic

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24
Q

describe anemia of chronic disease?

A

inhibition of erythropoiesis and altered iron metabolism associated with chronic disease (infections, inflammatory or neoplastic diseases)

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25
what is the treatment for anemia of chronic disease?
may not be necessary transfusion may receive erythropoietin (patient could also become iron deficient)
26
anemias that are microcytic hypochromic
iron deficiency anemia of chronic disease thalassemia chronic blood loss anemia
27
anemias that are normocytic normochromic
anemia of chronic disease acute blood loss anemia hemolytic anemia aplastic anemia
28
anemias that are macrocytic
folate deficiency anemia B12 deficiency anemia pernicious anemia
29
what makes someone anemic?
they have any of the 3 decreased RBC decreased Hgb decreased HCT
30
what makes someone microcytic/hypochromic anemic?
decreased MCV and MCH
31
what makes someone normocytic normochromic anemic?
normal MCV and MCH
32
what makes someone macrocytic normochromic anemic?
hyperchromic increased MCH normal or increased MCH
33
polycyythemia definition
increase in erythropoiesis
34
describe lab findings for polycythemia
increased RBC increased Hgb increased hematocrit normal or elevated MCV and MCH
35
what are the 3 types of polycythemia?
polycythemia very absolute polycythemia relative polycythemia
36
signs of polycythemia
``` red face high blood pressure low exercise tolerance joint pains splenomegaly itchiness after warm bath ```
37
polycythemia vera lab results
absolute increase in all cell types | overproduction of erythrocytes (RBCs (chronic myeloproliferative disorders)
38
is erythrocytosis dependant on erythropoietin?
no
39
describe bone marrow in polycythemia vera
hyperplastic | possibly due to chemical or radiation exposure
40
what might someone die of if they have polycythemia vera?
cardiac and thrombotic disease | myelofibrosis and vascular complications
41
what is a possible treatemnt of polycythemia vera?
drug therapy
42
describe secondary polycythemia
an ethryopoietin mediated increase in RBCs and hemoglobin due to hypoxia
43
what can cause secondary polycythemia?
``` polycytstic kidney renal carcinoma chronic GMN chronic liver disease anabolic steroids ```
44
describe the physiology of secondary polycythemia?
physiologic response to the need for omre RBC production due to an increased need for oxygen, pulmonary disorder or increase in erythropoietin
45
lab studies for secondary polycythemia
``` increase RBC increase Ngb increase Hct normal/elevated MCV normal/elevated MCH normal WBC normal platelet ```
46
what other disease might someone with secondary polycythemia have?
``` cyanosis (heart of lung disease) history of smoking, chronic lung disease (COPD) high altitudes renal tumor heart disease spleen size normal ```
47
what is relative polycythemia due to?
decrease in plasma volume and the RBC mass remains unchanged | dehydreation
48
lab results for relative polycythemia
``` increased RBC increased Hgb increased Hct WBC normal platelets normal ```
49
symptoms for relative polycythemia
decrease in plasma volume and RBC mass remains unchanged
50
ESR
measurement of the rate with which the RBCs settle in saline or plasma overa specific time period (one hour)
51
is ESR sensitive?
yes, but not specific and is not diagnostic for any particular organ, disease or injury
52
what can ESR detect?
``` acute and chronic infection inflammation (collagen vascular disease) neoplasm tissue necrosis infarction tissue destruction increase in plasma proteins ```
53
what might change the ESR?
if the RBCs stack together, increasing their weight and descend faster and ESR is increased
54
what can ESR help differentiate between?
chest pain + increased ESR= MI ESR increased in rheumatoid normal in DDD
55
rouleaux formation
stacking of RBCs similar to a stack of coins as they stack they drop more rapidly
56
ESR increases with?
age
57
why must ESR formula be corrected in ameia?
because there are fewer cells
58
does a CBC include a SED rate?
no, they must be ordered separately
59
CRP
a non-specific, acute phase reactant used to diagnose bacterial infections, CT disorders, neoplastic disease, inflammatory diseorders
60
CRP indicates
acute ifnlammatory reaction, not the cause
61
describe CRP
more sensitive and rapidly responding indicator than ESR CRP disappears sooner than ESR during recovery increases sonner returnsto normal faster than ESR
62
macrocytes
larger than normal size found in accelerated erythropoiesis, chronic liver disease, B12 and folate deficiency (megaloblastic anemia)
63
microcytes
smaller than normal size often found in IDA, ACD, thalassemia
64
anisocytes
vary in size frequency found in hemolytic anemia
65
hypochromia
lower than normal Hgb concentration and indicate decreased Hgb production found in IDA, thalassemia, ACD
66
polychromasia
increased numbers of reticulocytes seen on folate and B12 deficiency as well as in polycythemia
67
ovalocytes
oval shape, normally only small numbers are present, may be seen in IDA and megaloblastic an
68
teardrop cells
teardrop shape and maybe seen in thalassema
69
target cells
Hgb found in peripheral rim and central core and are seen with thalassemia, SS of anemia, chronic liver
70
sickle cells
crescent shape and are characteristic of SS anemia
71
poikilocytes
abnormal variations in the shape seen in the anemias and leukemias
72
basophilic stippling
seen in lead poisoning and are remnants of RNA found in the RBC cause stippling appearance, seen in thalassemia and hemolytic anemia
73
reticulocytes
young immature non-nuclated RBCs increased levels seen withincreased RBC production, decreased counts seen if bone marrow is not keeping up production

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