chapter 20 Flashcards
hemoglobin synthesis requires:
iron
vitamin B12, and B6
folic acid
it is mediated by the kidneys which produce _________
increases RBC production
can be a drug
erythropoeietin
the volume of packed RBC expressed as a percentage of total peripheral blood
hematocrit
reduction of hemoglobin in the blood to below-normal levels
When Hb levels are below ____ g/dL then blood transfusion is needed
anemia
8
chronic inflammation a nd malignant condition
anemia due to chronic disease
due to decreased production of hemoglobin (Fe, Hb, & protoporhyrin ring structure)
examples: iron deficiency anemia, anemia due to chronic disease, sideroblastic anemia, thalassemia
microcytic homochromic anemia
dietary lack or blood loss
infants - human milk is low in _____
children - poor _____
adults - _________ in males and ______ or ________ in females
elderly - ____________ in the western world; ______ infection in the developing world
other causes include malnutrition and gastrectomy surgery ( acid aids iron absorption by maintaining the Fe2+ which is more absorbed than Fe3+) - iron deficiency + vitamin D
iron deficiency anemia iron diet peptic ulcer disease menorrhagia or pregnancy colon polyps/carcinoma hookworm
two forms: ________ and ________
bone marrow depleted of hematopoietic cells and consists only of fibroblasts, fat cells, and scattered lymphocytes
uncontrollanle infections, bleeding tendency, chronic fatigue, sleepiness, and weakness
patient often craves ________
aplastic anemia
idopathic and secondary
ice cubes
caused by a deficiency in B12 or folic acid
folic acid deficiency: dietary folate is obtained from _______ and some _______. it is absorbed in the __________
-inadequate intake in the diet or because of mal absorption caused by intestinal disease like in ______, ______, or increased demand like ______ or _______
Vitamin B12 deficiency
_________: autoimmune disorder due to autoantibodies against parietal cells and intrinsic factor. common cause of deficiency of vitamin b12
- lack of the gastric intrinsic factor: _______ or ______
diagnosis: ________: by oral _____ b12 with or followed by ____ b12
macrocytic (megaloblastic) anemia green veggies fruit jejunum alcoholics, elderly, pregnancy, cancer pernicious anemia stomach cancer, gastric bypass surgery SCHILLING TEST radioactive cold
fatigue, shortness of breath, weakness and neurologic symptoms
with appropriate and prompt therapy neurological may be reversible
megaloblastic anemia
substition of _______ by ______ (point mutation)
synthesis of an abnormal beta chain of ________
_______: 7-10% are heterozygous HbAS, sickle cell trait and 0.4 are homozygous; HbSS sickle cell anemia
pathogenesis: at low oxygen partial pressures on the ______ side of the circulatory system, the abnormal ___ molecules crystallize into long, insoluble polymerized rods, distorting the shape of the RBC which leads to resulting in occlusion of the capillaries, comprimising oxygen delivery to the tissues, which causes headaches, pain, cardiopulmonary insuffeiciency recurrent infections and retarded intellectual development and neurologic deficits in children
-_______ falciparum protection
treatment*** on slide
sickle cell anemia glutamic acid by valine globin american blacks venuous, HbS malaria
genetic defect in the synthesis of _____ that reduces the rate of globin chain cells
no abnormal hemoglobin produced
________ - reduced synthesis of the alpha chain of globin
usually due to _______; normally __ alpha genes are present on chromosome 16
one gene deleted - __________
two genes deleted - _______ mild ______ with _____ blood count
three genes deleted - severe _________
four genes deleted - lethal in utero (________). the r chains form ____ (______) that damage RBCs. Mothers carrying a fetus with Hb bart have a increased risk for obstertric complications
thalassemia HbA a-thalssemia gene deletion asymptomatic anemia, increased severe anemia hydrops fetalis tetramers, Hb Barts
\_\_\_\_\_\_\_ - reduced synthesis of beta chain of globin \_\_\_\_\_\_\_\_\_\_\_\_\_ - heterozygotes - mild non sepcific symptoms \_\_\_\_\_\_\_\_\_\_\_\_\_\_ - homozygotes - severe and serious disease - chronic transfusions are often necessary for survival
B thalassemia
B - thalassemia minor
heterozygotes
B thalassemia major
these patients have distorted long bones, facial bones and cranial bones in a characteristic in crew-cut appearance
B thalassemia
antibody mediated ( IgG or IgM) destruction of RBCs
IgG mediated disease usually involves ______ hemolysis
IgG binds RBCs in the relatively ___ temp of the central body ( ____ agglutinin); membrane of antibody coated RBC is consumed by splenic macrophages, resulting in _________
-associated with ___ and certain drugs ( clasically ______ and _______)
treatment involves stoppage of the drug, steroids and if necessary, splenectomy
IgM mediated disease usually involves ________
IgM binds RBCs and fixes complement in the relatively _____ temp of the extremities (____ agglutinin)
associated with _____ and ____
immune hemolytic anemia extravascular warm spherocytes SLE penicillin, cephalosporins intravascular cold mycoplasma, IM
- clonal proliferation of hematopoietic stem cells
- uncontrolled production of red blood cells due to mutation. erythropoietin level is ______
- clinical symptoms are mostly due to _______ of blood. blurry vision and headache, increased risk of venuous ______,. flushed face due to congestion plethora and itching, especially after ____ (due to histamine release from increased mast cells)
primary polycythemia decreased hyperviscosity thrombosis bathing
