Chapter 13 Study Guide Flashcards
what is needed for RBC production and where is it produced?
- erythropoietin = EPO = needed for RBC production
- EPO is made by the kidneys
- EPO → stimulates bone marrow to make RBC → RBCs are made
what is hemoglobin?
hemoglobin = iron rich protein that allows RBCs to carry more oxygen → gives blood its red color
hemoglobin structure
- hem = iron
- globin = 2 alpha and 2 beta chains → hemoglobin carries 4 O2 molecules
what are the requirements for erythropoiesis = RBC production?
- erythropoietin = EPO = made by kidneys
- iron
- vitamins = B12 and folate
where is erythropoietin = EPO made in adults vs newborns?
adults = EPO made in kidneys
newborns = EPO made in kidneys and liver
anemia vs polycythemia and their consequences
anemia = low RBC production → anemia leads to…
- tissue hypoxia = less RBC means less O2
- increased HR and CO = to compensate for low O2
- increased BP = increased CO → increases BP
polycythemia = excess RBC production → polycythemia leads to…
- itchiness after warm bath or shower
- increased blood viscosity and blood volume = increase in RBCs
- increased systolic BP
aplastic anemia
stem cell disorder → bone marrow cannot make blood cells because bone marrow/stems cells are damaged → bone marrow is damaged due to radiation/toxins → leads to pancytopenia
- pancytopenia = low RBCs, WBCs, platelets
- RBC size = normal
- treatment =
1. bone marrow transplant
2. stimulate hematopoiesis and bone marrow regeneration
3. immunosuppressive therapy
iron deficiency anemia
- RBC size (MCV)
- MCV and MCHC levels
- S/S
- most common nutritional deficiency in world → most common cause/type of anemia
- iron deficiency → lack of iron → low hemoglobin production → less hemoglobin = smaller RBC → microcytic
- RBC size = microcytic
- MCV and MCHC = both are low → RBC is small and low hemoglobin in RBC
↓ MCV = low mean corpuscular volume = microcytic
↓ MCHC = low mean corpuscular hemoglobin concentration - S/S
1. pica = craving for non food substances → ex. dirt, clay, ice, laundry starch, cardboard, hair
2. koilonychias = spoon shaped nails
3. blue sclerae
what is MCV and MCHC?
MCV = RBC size
(mean corpuscular volume)
MCHC = amount of hemoglobin in RBC
(mean corpuscular hemoglobin concentration)
B12 (cobalamin) or folate deficiency anemia
aka B12 or folic acid anemia
- etiology
- RBC size (MCV)
- MCV and MCHC levels
- S/S
- what associated test?
- lack of intrinsic factor = B12 cannot be absorbed = B12 deficiency
- caused by disruption in DNA synthesis of blast cells in bone marrow → this disruption makes megaloblasts = very large abnormal bone marrow cells
- RBC size = macrocytic → high MCV
- MCV = high → macrocytic
- MCHC = normal amount of hemoglobin
- S/S
1. megaloblastic dysplasia and megaloblastic madness
2. low RBCs, WBCs, and platelets with increased/high MCV - Shilling’s test indicates low B12
what causes pernicious anemia?
- pernicious anemia is caused by a lack of intrinsic factor → related to B12/folic acid anemia
- lack of intrinsic factor = B12 cannot be absorbed → B12 deficiency
sickle cell anemia
- pathogenesis
-S/S
- pathogenesis = hemoglobin defect → leads to hemoglobin instability and insolubility
patients inherit mutated B-globin gene → causes defect in hemoglobin synthesis → producers abnormal hemoglobin known as Hb S = sickle hemoglobin S
- S/S
1. Black race patients are most affected by sickle cell anemia
2. vascular occlusions bc of sickle shaped cells = blood vessel blockage → leads to tissue hypoxia
3. crisis = painful episodes due to sickle RBCs sticking together and cause a blockage
hemolytic disease of the newborn
- hemolytic disease of the newborn = Rh factor
1st pregnancy = Rh- mother has a Rh+ baby
- when the Rh+ baby is delivered, placenta is detached from mom → their blood is mixed → Rh- mom is exposed to baby’s Rh antigens and will develop anti-Rh antibodies as a response
- during mom’s delivery of 1st Rh+ baby, the baby’s Rh antigens will cross placenta causing the mom to produce anti-Rh antibodies
2nd pregnancy = Rh- mother is pregnant with another Rh+ baby
- mom’s anti-Rh antibodies will attack the second Rh+ fetus → mom’s anti-Rh antibodies can cross the placenta and damage/lyse the fetus RBCs = hemolysis of RBCs
- treatment = RhoGAM → given to mom before or after delivery
RhoGAM = anti-Rh immune globulin
in severe cases, utero blood transfusions and early delivery - can lead to hyperbilirubinemia → causes jaundice in the baby
bilirubin = yellow pigment made when RBCs break down
