E2: online hematologic Flashcards
anemia definition
reduced circulationg erythrocytes (RBC) and or decreased hemoblibin
normocytic
normal RBC size
microcytic
small RBC
macrocytic
Large RBC
normochromic
normal hemoglobin
hypochromic
low concentration of hemoglobin
hyperchromic
high concentrations of hemoglobin
etiologies of anemia
- altered production
- blood loss
- increased destruction
- combination of the above
clinical mani of anemia
- weakness
- fatigue
- dizziness
- fainting
- lethargy
- increased RR
- decreased hemoglobin
- paleness of ear lobes, conjunctiva and palms
if the clinical mani of anemia are allowed to continue, what happens
may have cardiac, renal and other systemic results
how are the clinical manifestations of anemia classified
according to cause or changes in erythrocytes
what are the 5 types of anemia classified as normocytic-normochromic
- aplastic
- post-hemorrhagic
- hemolytic
- anemia associated with chronic inflammation
- sickle-cell anemia
aplastic anemia
insufficient number of RBCs
aplastic anemia results from
- abnormal stem cell production
- infliltratiove disorders of bone marrow
- altered stem cell environment
etiologies of aplastic anemia
- drug-chloramphenical
- benzene
- toxins
- radiation
- immunologic injury to bone marrow
post hemmorhagic anemia
loss of RBC’s
what causes post hemmorhagic anemia
- shock
- lactic acidosis
- death
- if blood loss of 40-50%
hemolytic anemia
premature descruction of RBC’s
what causes hemolytic anemia
- infectoins
- drugs
- toxins
- systemic diseases
- liver or kidney diseases
- can be hereditary
what are the two hemolytic diseases of newborns
- ABO incompatability
- Rh incompatability
ABO incompatability
- mother is type O
- Baby is either A, B or AB
Rh incompatability
- mother Rh neg
- infant if Rh positive
anemia associated with chronic inflammation increases
demand for erythrocytes
when is anemia associated with chronic inflammation seen
- HIV
- inflammatory diseases like lupus and rheumatic fever
- in chronic renal failure
why is anemia associated with chronic inflammation seen in chronic renal failure
the kidneys do not produce erythropoietin so that can lead to chronic anemia
sickle-cell anemia
abnormal shaped RBC and abnormal hemoglobin synthesis
cause of sickle-cell
autosomal recessive disorder seen in persons from equatorial countries
incidence of sickle-cell
- in the us seen mostly if blacks
- 7-13% chance of having trait
- .7% chance of having disease
etiology of sickle cell disease
-Abnormal S hemoglobin which reacts to decreased O2 and dehydration. under normal conditions, no problems exist
under what conditions does sickle cell cause problems
- hypoxia (infections)
- high altitude
- exercising
- flying in unpresssurized airplanes
how does O2 play a role in sickle cell
when o2 concentration decreases, the RBC become sickled, non-flexible and stiff
when sickle cells become sickled, what happens
- occluded BV
- increased viscosity
- increased deoxygenation and infarction and pain
when do sickle cells go back to normal
regain normal shape when reoxygenated and rehydrated
when do clinical manifestations of sickling happen
until 6 months
clinical mani of sickling
- pallor
- fatigue
- jaundice
- irritability
what is vasoocclusive crisis
may occur if extensive sickling
-begins in micro circulation-log jam occurs causing thrombosis and tissue infarction if not corrected (severe pain)
mani of vvasoocclusive crisis
- painful swelling of jts, hands, feet
- abdominal pain
- enlarged liver and spleen due to RBC breakdown
how long does a crisis last
4-6 days
when does a crisis improve
with rehydration and reoxygenation
anemia classified as macrocytic-normochromic
pernicious anemia
macrocytic- normochromic
- large abnormal RBC
- normal hemoglobin
cause of pernicious anemia
- decreased gastric secretion of intrinsic factor (absent) leads to malabsorption of vitamin b-12
- decreased VB-12 leads to decreased erythrocyte production
- the RBCs are abnormal and large (they die and that causes anemia)
when is pernicious anemia mainly seen
late adult life but also in congenital form (before 2 yoa)
microcytic-hypochromic
iron-deficiency anemia classified as microcytic-hypochromic
iron deficiency anemia
lack of iron for hemoglobin production
-most common type of anemia
cause of iron deficiency enemia
- continual blood loss
- insufficient dietary intake (most common anemia 6mo-2years because of increased iron needed for growth)
stage one of iron def. anemia
body’s store of RBC are depleted
stage 2 of iron def. anemia
insufficient iron, altered RBC’s are produced
stage III iron def. anemia
hypochromic RBC’s put into circulation
when do mani of iron def. anemia occur
develop slowly in stage III
clinical mani of iron d anemia
-Children: pica, decreased growth or developmental delays
hemophilia
genetic disease caused by deficiency of blood clotting factors essential for forming a clot
factor 8 hemophilia A
classic hemophilia and most common type
- X linked, recessive
- occurs in males
- passed on by females
factor 9 hemophilia B
Christmas disease
- x linked, recessive
- less sever than HA
vactor 11 hemophilia C
autosoma recessive, least severe type
clinical mani of hemophilia
- symptoms infrequent in first year of life
- start seeing at age 3-4
- may notice excessive bruising and bleeding when starting to walk or run
- hemoarthrosis
- recurrent bleeding after injury, minor trauma
hemoarthrosis
hallmark of hemophilia
-into elbows, knees, ankles
SE of hemoarthrosis
causes pain, limits movement, predisposes to degeneritive changes in joints
leukemia
malignant disease of blood and blood-forming organs causing an accumulation of dysfunctional cells and loss of cell division regulations
when is leukemia common
- most common childhood cancer (33%)
- adults after 50+ in chronic form
acute leukemia
-cell immiture (blast)
onset of acute leukemia
rapid and abrupt
survival time for acute leukemia
time may be short
acute makes up what % of childrens leukemia
50%
acute myelogenous (aml)
common adult type of acute leukemia
chronic leukemia
cell mature but doesnt function normally
onset of chronic leukemia
gradual, longer survival
chronic lymphocytic
common adult type of chronic leukemia
etiologies of keukemia
- unknown
- recur in families (2-4x if sibling has)
- increased association with other genic abnormalities such as downs, fanconi syndrome
- acquired disorders such as hodgkins, mm
- CLL, CML may cause acute leukemias
- larg edoses of ionizing radiation may cause myelogenous leukemia
- drugs which cause bone marrow depression may predispose person to leukemia
- high doses of chemo for hodgkins, mm and ovarian cancer may cause acute myelogenous leukemia
- viruses cause leukemia in animals but not proven in humans yet