Chapter 20 Flashcards
-hemoglobin synthesis requires ______, ______, ______, and ______
-the red cell production is regulated by the ______ of the arterial blood. a decrease oxygen supply stimulates ______
It is mediated by the kidneys which produce ______
iron vitamin B12 vitamin B6 folic acid oxygen content erythropoiesis erythropoietin
the volume of packed RBC expressed as a percentage of total peripheral blood
hematocrit
denotes the mean volume of RBC
mean corpuscular volume (MVC)
denotes the content of hemoglobin per RBC
mean corpuscular hemoglobin (MHC)
denotes the concentration of hemoglobin in RBC
mean corpuscular hemoglobin concentration (MCHC)
-______is a reduction of hemoglobin in the blood to below-normal levels. Hb is <13.5 g/dL in males and <12.5 g/dL in females. when Hb levels are below ______ then blood transfusion is needed
anemia
8 g/dL
Chronic
inflammation and malignant condition
Anemia due to chronic disease
Microcytic anemia are due to decreased production of hemoglobin (Fe, Hb & protoporphyrin ring structure). Example: Iron deficiency anemia, anemia due to chronic disease, sideroblastic anemia & thalassemia
-RBC size decreases, and lose their color
Microcytic homochromic Anemia
-iron deficiency in anemia: ______
-infants: ______
-children: ______
adults (20-50 years): ______ in males and ______ in females
-elderly: ______ in the western world; ______ infection in the developing world
-other causes include malnutrition (vegetarians), and gastrectomy surgery (acids aid iron absorption by maintaining the Fe2+ state, which is more absorbed than Fe3+)
-serum iron and ferritin levels decrease but total iron binding capacity increase (Transferrin)-Lab test
-supplement of iron (ferrous state Fe2+ high affinity for oxygen)
dietary lack or blood loss breast-feeding (human milk is low in iron) poor diet peptic ulcers menorrhagia or pregnancy colon polyps/carcinoma hookworm
- two forms: idiopathic(no one knows the reason) and secondary
- bone marrow depleted of ______ and consist only of ______, fat cells, and ______
- uncontrollable infections. bleeding tendency, chronic fatigue, sleepiness, and weakness. Patients often crave for ice cubes
aplastic anemia
hematopoietic cells
fibroblasts
scattered lymphpcytes
- caused by deficiency of vitamin B12 or folic acid
- ______: dietary folate is obtained from geen vegetables and some fruits. it is absorbed in the jejunum. (important for hemoglobin production)
- inadequate intake in the diet or because of malabsorption caused by intestinal disease like in alcoholics, elderly or increased demand like pregnancy or cancer
- vitamin B12 deficiency
- ______: autoimmune disease due to autoantibodies against parietal cells and intrinsic factor. common cause of deficiency of vitamin B12
- lack of the ______: stomach cancer or gastric bypass surgery
- diagnosis: ______: by oral radioactive B12 with or followed by cold B12
macrocytic (megaloblastic) anemia folic acid deficiency pernicious anemia gastric intrinsic factors Schilling test
- fatigue, shortness of breath, weakness and neurologic symptoms
- with appropriate and prompt therapy neurological may be reversible
megaloblastic anemia (B12 deficiency)
- genetic defect in the synthesis of HbA that reduces the rate of globin chain synthesis
- no abnormal ______
- ______: reduced synthesis of the alpha chain of globin
- a-thalassemia is usually due to gene deletion; normally, ______ genes are present on ______
- one gene deleted: ______
- two genes deleted: mild anemia with ______ RBC count
- three genes deleted: ______
- four genes deleted: lethal in utero (______). The gamma chains from tetramers (Hb Barts) that damage RBCs. Mothers carrying a fetus with Hb bart have a increased risk for obstetric complications
Thalassemia hemoglobin produced a-Thalassemia 4 alpha chromosome 16 asymptomatic increased severe anemia hydrops fetalis
- reduced synthesis of the beta chain of globin
- ______ or thalassemia trait
- heterozygotes
- mild, nonspecific symptoms
- ______
- homozygotes
- severe and serious disease
- chronic transfusions are often necessary for survival
B-thalassemia
B-thalassemia minor
B-thalassemia major
B-thalassemia patients have ______, facial bones and cranial bones in a characteristic in ______ appearance
distorted long bones
crew-cut
- antibody-mediated (______ or ______) destruction of RBCs
- IgG mediated disease usually involves ______. IgG binds RBCs in the relatively ______ temperature of the central body (warm agglutinin); membrane of antibody coated RBC is consumed by ______, resulting in spherocytes
- associated with ______ (most common cause), and certain drugs (classically, penicillin and cephalosporins)
- treatment involves stoppages of the drugs, steroids, if necessary, ______
- IgM-mediated disease usually involves ______. IgM binds RBCs and fixes complement in the relatively ______ temperature of the extremities (cold agglutinin)
- associated with ______ and ______
immune hemolytic anemia IgG or IgM extravascular hemolysis warm splenic macrophages SLE splenectomy intravascular hemolysis cold mycoplasma infectious mononucleosis
