coagulation and RBC disorders Flashcards
what does anemia do
it is the reduction in oxygen-carrying capacity due to;
- reduced numbers of RBC
- reduced amount of hemoglobin in RBC’s
- defective RBC/ hemoglobin structure or development
what are signs and symptoms of anemia
- fatigue
- cold
- pallour
- dizziness
- shortness of breath
- jaundice (increased bilirubin)
- cardiac function signs (palpitations)
- GI system signs (nausea)
- nervous system signs
- epithelial signs (oral inflammation)
iron deficiency anemia (most common)
- due to lack of iron
- RBCs are microcytic (become small) and hypo chronic (decreased colouration)
- decreased iron means decreased haemoglobin
what causes iron deficiency and what are signs and symptoms
RBCs become smaller and loose colour
due to
- low intake of iron
- decreased absorption of iron (celiacs, decreased HCFL)
- increased demand of iron that isn’t being met (periods of growth and pregnancy)
- increased loss (bleeding)
signs and symptoms
- pallor
- palpitations
- shortness of breath
- hair loss
- pics (eating non food items)
what is macrocytic anemia
a condition in which your body has overly large red blood cells and not enough normal red blood cells
- they are structurally immature so they do not have the same oxygen carrying capacity
this is due to
- decrease in folic acid
- decrease in B12
why might someone have a decrease in folic acid
- low intake of it
- increase in demand (pregnancy)
- increase in loss (dialysis)
- alcoholism
- certain medications
why might someone have a decrease in B12
- low intake (rare)
- low IF (intrinsic factor) necessary for vitamin B12 absorption
- certain medications
what are the 2 types of haemophilia and signs and symptoms
- haemophilia type A- clotting factors 8 (most common)
- haemophilia type B- clotting factor 9
it is decreased clotting factors
signs and symptoms
- prolonged bleeding
- easy bruising
- bleeding into joints
describe thrombocytopenia and the implications of this condition
decreased platelets due to decreased platelet production and increased platelet destruction/ consumption. it results in easy, prolonged or spontaneous bleeding, ranging from minor excess bleeding to severe blood loss
haemophilia is an x linked condition, what does this mean?
females need 2 recessive alleles for it to be present but men only need 1 for it to be present because it is linked with the x chromosome
what is polycythemia
- excessive RBCs
- increases blood viscosity and therefore blood pressure
- relative polycythemia is increased RBCs associated with dehydration and is readily corrected with fluid administration
- absolute polycythemia comes in 2 types
- primary is excessive production of RBCs due to a gene mutation
- secondary occurs due to increased EPO secretion which may be associated with the presence of certain tumours
what is disseminated intravascular coagulation (DIC)
- widespread clotting throughout the vascular
- this occurs due to some kind of severe endothelial damage
pathophysiology
severe endothelial damage results in an excessive coagulation response in which there is an increase in procoagulants. this leads to the formation of many small blood clots throughout the small blood vessels, resulting in tissue ischemia and damage. the damaged tissue enhances the coagulation response and eventually, all coagulation factors are used up. there is also an increase in fibrinolytic activity. this leads to hemorrhage as coagulation can no longer occur and there are multiple sites of tissue damage throughout the body.
what happens when there is severe endothelial damage in DIC
- increase release of tissue factor
- increase in procoagulants with a decrease in anticoagulants
- excessive coagulation: micro thrombi form throughout the vasculature/ circulation
what does excessive coagulation cause in DIC
- tissue ischemia and damage which leads to more release of tissue factor and causes a feedback cycle
- clot breakdown which leads to haemorrhage
- all coagulation factors are used up- leads to haemorrhage and hypovolemic shock and death
this is all happening at many clots spread throughout the vascular system
what are reasons for disseminated intravascular coagulation
- obstetric complications
- trauma
- malignancy
- sepsis
- haemorrhage
