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Kirsty 3.1 > CPT2: Anaemia 1 > Flashcards

CPT2: Anaemia 1 Flashcards

1
Q

What is blood made up of?

A
  • 55% - Plasma
  • 45% - RBC, WBC, Platlets

3 principle components are RBC, WBC, Platlets

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2
Q

What are the functions of blood?

A
  • Transportation (O2, CO2, Enzymes, nutrients, hormones)
  • Regulaltion (temperature, homeostasis, pH, water)
  • Protection (WBC, clotting, immune response)
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3
Q

What are examples of blood disorders

A
  • Blood cancers - leukaemia, myeloma, lymphoma
  • Clotting disorders
  • Anaemias of genetic orign - Thalassaemia
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4
Q

What term is used to describe the % of total blood volume occupied by RBCs?

A

Haemotocrit (HCT)

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5
Q

Describe the structure of RBC

A

RBCs are highly specialised to transport O2 from the lungs to the tissues/ cells

They contain NO nucleus and are a disc shape, allowing them to move easily and freely through the blood vessels

RBCs are made up of approx 280 million haemoglobin molecules each with carry 4 O2 molecules each

Hb is made up of 4 chains: 2a and 2B. Each chain contains a haem group in which the O2 binds too.

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6
Q

What do the following terms mean:

  1. Haemoglobin
  2. Myoglobin
  3. Transferrin
  4. Haem
  5. Ferritin
A
  1. Haemoglobin (Hb): Component of red blood cells and transports oxygen around the body.
  2. Myoglobin: The oxygen-transporting protein of muscle (similar to haemoglobin in function).
  3. Transferrin: A protein synthesised in the liver. It transports iron in the blood to erythroblasts to make haem
  4. Haem: A chemical complex with a central iron atom that forms the oxygen binding part of haemoglobin and myoglobin.
  5. Ferritin: The major storage form of iron. It is a complex of iron and apoferitin.
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7
Q

What do the following terms mean?

  1. Ferrous iron
  2. Ferric Iron
  3. Heam iron
  4. Non-haem iron
A
  1. Ferrous Iron (Fe 2+): Reduced form - most commonly found in food.
  2. Ferric Iron (Fe 3+): Oxidised form - to be bound to transferrin for transport.
  3. Haem iron: The iron found in haemoglobin and myoglobin of animal foods.
  4. Non-haem iron: The iron in plants and in animal foods that is not part of haemoglobin or myoglobin.
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8
Q

What is the process of forming RBC called?

Where does this occur?

Describe the process

Which processes required specific nutrients?

A
  1. Erythropoesis
  2. bone marrow

​

8 steps involved, first 7 bone marrow, last step blood.

Formation of RBC begins in the bone marrow (Proerythroblast) and the final maturation of the reticulocyte (no nucleus) into a RBC occurs in the blood. The cell squeezes between the endothelial cells to move from the bone marrow to the blood stream

Matured to RBC within 1 to 2 days

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9
Q

Why are so many RBC needed?

A
  • Are unable to repair themselves or divide so new RBC needed to replace old
  • Live span is approx 120 days
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10
Q

What is iron? and give breif description of use

A
  • What is Iron?
    • Trace metal
    • Plays numerous biochemical roles in the body
      • Oxygen binding in haemoglobin
      • Acting as an important catalytic centre in many enzymes e.g. cytochromes
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11
Q

What are the stats related to iron in the body?

A
  • Total iron ~3800mg in men and ~2300mg in women.
  • 60-70% in haemoglobin in erythrocytes (red blood cells).
  • 10% in muscle myoglobin.
  • §20-30% in storage pools in liver and reticulo-endothial (macrophage) system as ferritin and haemosiderin.
  • 1% in iron-containing enzymes.
  • < 0.2% in plasma transport pool bound to transferrin.
  • Constant recycling between functional and non-functional pools – erythrocytes have life span of about 120 days.
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12
Q

What is anaemia defined as?

A

The reduction of haemoglobin in the blood

(A Hb level below 2 standard deviations of normal for age and gender)

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13
Q

What is the epidemology like?

A

Epidemiology

  • The most common nutritional disorder on the planet
  • Most prevalent in developing countries
  • Worldwide: 50% of pregnant women & 40% of infants
  • UK:14% women (aged 55-64)

3% men (aged 35-64)

•Certain types of anaemia are more common in specific patient groups - (age/gender/ethnicity/genetic)

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14
Q

What are the over all causes of anaemia and ateiology?

A
  1. Destuction of RBC
  2. Loss of RBC
  3. Impaired production of RBC

A lack of iron-carrying haemoglobin caused by:

  1. Reduced haemoglobin synthesis - lack of nutrients or bone marrow failure.
  2. Excessive bleeding – loss of 100ml of blood is equal to the amount of iron absorbed from a western diet over 40days
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15
Q

What are symptoms of anaemia?

A

If left untreated may result in death

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16
Q

After taking a full history and noting symptoms and physical signs it is important ot investigate the cause.

What information should be investigated?

A
  • It is essential to investigate the cause of anaemia
    • No place for “blind” treatment
  • Most important parameters for assessment are the HCT and Hb concentrations.
    • Changes with ethnicity, age, sex, pregnancy
  • Also size, shape and colour of RBC
  • Mean corpuscular volume (MCV) indicates the average size of the RBC
17
Q

What can anaemia be classed based on?

A

Can be classed on basis of Actual cause or on morphology

Microcytic- RBC smaller than normal

Macrocytic - RBC larger than normal

Normocytic - normal size

18
Q

Anaemia classification based on morphology (Causes)

A
19
Q

How can kidney disease or failure cause anaemia?

A

During hypoxia (lack of O2 in circulation) the kidney is activated to produce erythropotein. This is secreted into the blood and travels to the bone marrow. It causes activation and enhancement of the eythropoesis process to produce more RBC.

Kidney failure/ disease would restrict the ability to do this and can lead to anaemia

20
Q

What affect does anaemia have on the heart?

A

Anemia can lead to a rapid or irregular heartbeat (arrhythmia). When you’re anemic your heart must pump more blood to make up for the lack of oxygen in the blood. This can lead to an enlarged heart or heart failure.

21
Q

How does anaemia affect the spleen?

A

Red blood cells develop in the bone marrow, which is the sponge-like tissue inside your bones. Your body normally destroys old or faulty red blood cells in the spleen or other parts of your body through a process called hemolysis. Hemolytic anemia occurs when you have a low number of red blood cells due to too much hemolysis in the body.

spleen (spleen): An organ that filters blood, stores blood cells, removes old blood cells, and makes immune cells known as lymphocytes. It is located in the upper left side of the abdomen.

Kirsty 3.1 (47 decks)

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