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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
Q

what is the treatment for anemia of chronic disease?

A

may not be necessary
transfusion
may receive erythropoietin
(patient could also become iron deficient)

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26
Q

anemias that are microcytic hypochromic

A

iron deficiency
anemia of chronic disease
thalassemia
chronic blood loss anemia

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27
Q

anemias that are normocytic normochromic

A

anemia of chronic disease
acute blood loss anemia
hemolytic anemia
aplastic anemia

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28
Q

anemias that are macrocytic

A

folate deficiency anemia
B12 deficiency anemia
pernicious anemia

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29
Q

what makes someone anemic?

A

they have any of the 3
decreased RBC
decreased Hgb
decreased HCT

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30
Q

what makes someone microcytic/hypochromic anemic?

A

decreased MCV and MCH

31
Q

what makes someone normocytic normochromic anemic?

A

normal MCV and MCH

32
Q

what makes someone macrocytic normochromic anemic?

A

hyperchromic
increased MCH
normal or increased MCH

33
Q

polycyythemia definition

A

increase in erythropoiesis

34
Q

describe lab findings for polycythemia

A

increased RBC
increased Hgb
increased hematocrit
normal or elevated MCV and MCH

35
Q

what are the 3 types of polycythemia?

A

polycythemia very
absolute polycythemia
relative polycythemia

36
Q

signs of polycythemia

A 
red face
high blood pressure
low exercise tolerance
joint pains
splenomegaly
itchiness after warm bath
37
Q

polycythemia vera lab results

A

absolute increase in all cell types

overproduction of erythrocytes (RBCs (chronic myeloproliferative disorders)

38
Q

is erythrocytosis dependant on erythropoietin?

A

no

39
Q

describe bone marrow in polycythemia vera

A

hyperplastic

possibly due to chemical or radiation exposure

40
Q

what might someone die of if they have polycythemia vera?

A

cardiac and thrombotic disease

myelofibrosis and vascular complications

41
Q

what is a possible treatemnt of polycythemia vera?

A

drug therapy

42
Q

describe secondary polycythemia

A

an ethryopoietin mediated increase in RBCs and hemoglobin due to hypoxia

43
Q

what can cause secondary polycythemia?

A 
polycytstic kidney
renal carcinoma
chronic GMN
chronic liver disease
anabolic steroids
44
Q

describe the physiology of secondary polycythemia?

A

physiologic response to the need for omre RBC production due to an increased need for oxygen, pulmonary disorder or increase in erythropoietin

45
Q

lab studies for secondary polycythemia

A 
increase RBC
increase Ngb
increase Hct
normal/elevated MCV
normal/elevated MCH
normal WBC
normal platelet
46
Q

what other disease might someone with secondary polycythemia have?

A 
cyanosis (heart of lung disease)
history of smoking, chronic lung disease (COPD)
high altitudes
renal tumor
heart disease
spleen size normal
47
Q

what is relative polycythemia due to?

A

decrease in plasma volume and the RBC mass remains unchanged

dehydreation

48
Q

lab results for relative polycythemia

A 
increased RBC
increased Hgb
increased Hct
WBC normal
platelets normal
49
Q

symptoms for relative polycythemia

A

decrease in plasma volume and RBC mass remains unchanged

50
Q

ESR

A

measurement of the rate with which the RBCs settle in saline or plasma overa specific time period (one hour)

51
Q

is ESR sensitive?

A

yes, but not specific and is not diagnostic for any particular organ, disease or injury

52
Q

what can ESR detect?

A 
acute and chronic infection
inflammation (collagen vascular disease)
neoplasm
tissue necrosis
infarction
tissue destruction
increase in plasma proteins
53
Q

what might change the ESR?

A

if the RBCs stack together, increasing their weight and descend faster and ESR is increased

54
Q

what can ESR help differentiate between?

A

chest pain + increased ESR= MI
ESR increased in rheumatoid
normal in DDD

55
Q

rouleaux formation

A

stacking of RBCs similar to a stack of coins as they stack they drop more rapidly

56
Q

ESR increases with?

A

age

57
Q

why must ESR formula be corrected in ameia?

A

because there are fewer cells

58
Q

does a CBC include a SED rate?

A

no, they must be ordered separately

59
Q

CRP

A

a non-specific, acute phase reactant used to diagnose bacterial infections, CT disorders, neoplastic disease, inflammatory diseorders

60
Q

CRP indicates

A

acute ifnlammatory reaction, not the cause

61
Q

describe CRP

A

more sensitive and rapidly responding indicator than ESR
CRP disappears sooner than ESR during recovery
increases sonner returnsto normal faster than ESR

62
Q

macrocytes

A

larger than normal size found in accelerated erythropoiesis, chronic liver disease, B12 and folate deficiency (megaloblastic anemia)

63
Q

microcytes

A

smaller than normal size often found in IDA, ACD, thalassemia

64
Q

anisocytes

A

vary in size frequency found in hemolytic anemia

65
Q

hypochromia

A

lower than normal Hgb concentration and indicate decreased Hgb production found in IDA, thalassemia, ACD

66
Q

polychromasia

A

increased numbers of reticulocytes seen on folate and B12 deficiency as well as in polycythemia

67
Q

ovalocytes

A

oval shape, normally only small numbers are present, may be seen in IDA and megaloblastic an

68
Q

teardrop cells

A

teardrop shape and maybe seen in thalassema

69
Q

target cells

A

Hgb found in peripheral rim and central core and are seen with thalassemia, SS of anemia, chronic liver

70
Q

sickle cells

A

crescent shape and are characteristic of SS anemia

71
Q

poikilocytes

A

abnormal variations in the shape seen in the anemias and leukemias

72
Q

basophilic stippling

A

seen in lead poisoning and are remnants of RNA found in the RBC cause stippling appearance, seen in thalassemia and hemolytic anemia

73
Q

reticulocytes

A

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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