Blood 3 Flashcards
what are the types of normocytic normochromic anemia?
anemia of chronic disease
acute blood loss
hemolytic anemia
aplastic anemia
aplastic anemia
severe life threatening syndrome
decreased production
hematopoietic stem cell failure leading to hypocellular bone marrow and decreased peripheral blood cell counts
describe the blood with aplastic anemia
decreased RBCs, WBCs, platelets bone marrow is hypocellular low reticulocyte count pancytopenia incraesaed erythropoietin
what can cause aplastic anemia
chemotherapeutic agents, drugs, chemical toxins
hereditary
radiation
infections
what is a good indicator of bone marrow activity?
reticulocyte number
for aplastic anemia, all cell lines are?
decreased (pancytopenia)
prognosis for aplastic anemia?
poor
aplastic anemia is a..
normocytic normochromic anemia
hemolytic anemia
anemia that is due to increased RBC destruction
symtpoms of hemolytic anemia
similar to other forms of anemia
may develop jaundice, splenomegaly and gallstones and isolated reticulocytosis
where does extra-vascular RBC breakdown occur?
reticuloendothelial system
when does intra-vascular RBC breakdown occur?
rarely
transfusions, extensive burns
what kind of anemia is sickle cell anemia?
chronic hemolytic anemia
homozygous hemoglobin SS
what happens in those who have sickle cell/what are the demographics?
their life expectancy is shortened (42male, 48 female)
almost exclusively black population
sickling occurs when?
at times of physiological lowered oxygen tension
signs and symptoms of sickle cell disease?
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
things that cause AVN
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
what kind of anemia is sickle cell anemia?
normocytic normochromic
what specific things may cause sickling of RBCs
hypoxia high altitudes aircraft flight resporatory infections anesthesia CHF diving dehydration
test that confirms sickle cell anemia
sickledex test
hemoglobin electrophoresis
acute bleeding results in?
normocytic normochromic anemia
chronic bleeding results in?
microcytic hypochromic anemia (IDA)
what type of anemia is anemia of chronic disase?
normocytic normochromic
or
microcytic hypochromic
describe anemia of chronic disease?
inhibition of erythropoiesis and altered iron metabolism associated with chronic disease (infections, inflammatory or neoplastic diseases)
what is the treatment for anemia of chronic disease?
may not be necessary
transfusion
may receive erythropoietin
(patient could also become iron deficient)
anemias that are microcytic hypochromic
iron deficiency
anemia of chronic disease
thalassemia
chronic blood loss anemia
anemias that are normocytic normochromic
anemia of chronic disease
acute blood loss anemia
hemolytic anemia
aplastic anemia
anemias that are macrocytic
folate deficiency anemia
B12 deficiency anemia
pernicious anemia
what makes someone anemic?
they have any of the 3
decreased RBC
decreased Hgb
decreased HCT
what makes someone microcytic/hypochromic anemic?
decreased MCV and MCH
what makes someone normocytic normochromic anemic?
normal MCV and MCH
what makes someone macrocytic normochromic anemic?
hyperchromic
increased MCH
normal or increased MCH
polycyythemia definition
increase in erythropoiesis
describe lab findings for polycythemia
increased RBC
increased Hgb
increased hematocrit
normal or elevated MCV and MCH
what are the 3 types of polycythemia?
polycythemia very
absolute polycythemia
relative polycythemia
signs of polycythemia
red face high blood pressure low exercise tolerance joint pains splenomegaly itchiness after warm bath
polycythemia vera lab results
absolute increase in all cell types
overproduction of erythrocytes (RBCs (chronic myeloproliferative disorders)
is erythrocytosis dependant on erythropoietin?
no
describe bone marrow in polycythemia vera
hyperplastic
possibly due to chemical or radiation exposure
what might someone die of if they have polycythemia vera?
cardiac and thrombotic disease
myelofibrosis and vascular complications
what is a possible treatemnt of polycythemia vera?
drug therapy
describe secondary polycythemia
an ethryopoietin mediated increase in RBCs and hemoglobin due to hypoxia
what can cause secondary polycythemia?
polycytstic kidney renal carcinoma chronic GMN chronic liver disease anabolic steroids
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
lab studies for secondary polycythemia
increase RBC increase Ngb increase Hct normal/elevated MCV normal/elevated MCH normal WBC normal platelet
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
what is relative polycythemia due to?
decrease in plasma volume and the RBC mass remains unchanged
dehydreation
lab results for relative polycythemia
increased RBC increased Hgb increased Hct WBC normal platelets normal
symptoms for relative polycythemia
decrease in plasma volume and RBC mass remains unchanged
ESR
measurement of the rate with which the RBCs settle in saline or plasma overa specific time period (one hour)
is ESR sensitive?
yes, but not specific and is not diagnostic for any particular organ, disease or injury
what can ESR detect?
acute and chronic infection inflammation (collagen vascular disease) neoplasm tissue necrosis infarction tissue destruction increase in plasma proteins
what might change the ESR?
if the RBCs stack together, increasing their weight and descend faster and ESR is increased
what can ESR help differentiate between?
chest pain + increased ESR= MI
ESR increased in rheumatoid
normal in DDD
rouleaux formation
stacking of RBCs similar to a stack of coins as they stack they drop more rapidly
ESR increases with?
age
why must ESR formula be corrected in ameia?
because there are fewer cells
does a CBC include a SED rate?
no, they must be ordered separately
CRP
a non-specific, acute phase reactant used to diagnose bacterial infections, CT disorders, neoplastic disease, inflammatory diseorders
CRP indicates
acute ifnlammatory reaction, not the cause
describe CRP
more sensitive and rapidly responding indicator than ESR
CRP disappears sooner than ESR during recovery
increases sonner returnsto normal faster than ESR
macrocytes
larger than normal size found in accelerated erythropoiesis, chronic liver disease, B12 and folate deficiency (megaloblastic anemia)
microcytes
smaller than normal size often found in IDA, ACD, thalassemia
anisocytes
vary in size frequency found in hemolytic anemia
hypochromia
lower than normal Hgb concentration and indicate decreased Hgb production found in IDA, thalassemia, ACD
polychromasia
increased numbers of reticulocytes seen on folate and B12 deficiency as well as in polycythemia
ovalocytes
oval shape, normally only small numbers are present, may be seen in IDA and megaloblastic an
teardrop cells
teardrop shape and maybe seen in thalassema
target cells
Hgb found in peripheral rim and central core and are seen with thalassemia, SS of anemia, chronic liver
sickle cells
crescent shape and are characteristic of SS anemia
poikilocytes
abnormal variations in the shape seen in the anemias and leukemias
basophilic stippling
seen in lead poisoning and are remnants of RNA found in the RBC cause stippling appearance, seen in thalassemia and hemolytic anemia
reticulocytes
young immature non-nuclated RBCs increased levels seen withincreased RBC production, decreased counts seen if bone marrow is not keeping up production
