Hematologic Disorders Flashcards
what are the cells in the blood
rbc, wbc, thrombocytes ( platelets)
what is blood made of
cells and plasma
what is plasma
water, proteins, glucose, cholesterol, Ca, hormones, metabolic waste, etc
what is the fluid remaining after blood clots called; contains no fibrinogen and cannot clot again ; used for lab analyses since clotting can affect tests
serum
what are the diff types of hematopoiesis
lymphopoeisis, myelopoeisis, erythropoeisis
what is hematopoiesis affected by
infection, allergy, hemorrhage, exertion, and drugs
where are the stem cells located
bone marrow
these are non dividing cells; they transport oxygen and CO2 ; no nucleus, no mitochondria, and have rapid turnover
rbc
these cells have adult sites of production ( vertebrae, pelvis, sternum, ribs); lifespan of 120 days; removed by mononuclear phagoctyes system ( spleen, liver, and lymph nodes)
rbc
what are the growth requirements for rbc
iron, protein, vitamins ( folate and B12)
iron is important for _____
heme pt of hemoglobin molecule
protein is important for ____
globin part of hemoglobin
folate is good for _____
dna synthesis
what are some stimulating factors of rbc
hemorrhage, damage to bone marrow, high altitude, exercise, hemolytic disease, and low hemoglobin levels
this is regulated by oxygen levels in the blood; stimulated by hypoxia
erythropoeisis
what produces erythropoeitin
peritubular cells of the kidney
what induces RBC production in the bone marrow
erythropoietin- takes 4 days
what is the general rbc circulation
rbc produced -> incorporated into hemoglobin-> Hb broken down into heme and globin > heme broken down into iron and bilirubin > bilirubin stored in liver > iron stored in spleen> some iron reused in the synthesis of new Hb
% of blood that is RBCsl convenient way to determine if rbc count is normal ; women have less due to menstrual cycle
hematocrit
what is reduced oxygen carrying capacity
anemia
what is an important cause of anemia
iron deficiency and end stage renal failure
what are some symptoms of anemia
overall weakness, tachycardia, fatigue, dyspnea, pallor
what are 4 diff ways to get anemia
production failure of rbcs, hemorrhage, hemolysis, and hypersplenism ( overly active spleen)
what are the etiologies of anemia
hypoproliferatie and hemolytic
what are the diff size classifications of anemia
macrocytic, microcytic, and normocytic
what is the Hb content of anemia
normochromic and hypochromic
what are large, abnormally shaped rbcs; normal Hb concentration
macrocytic normochromic anemia
which type of anemia is due to lack of vitamin B12; abnormal dna synthesis in the rbc ; premature cell death ; can be congenital or acquired def. of IF or genetic disorder of DNA synthesis; mean pt age 60 YO
pernicious anemia ; more common than folate def )
which type of anemia is due to lack of folate; abnormal dna synthesis and premature cell death ; caused by dietary folate def.
folate def. anemia
causes of this anemia include autoimmune and malabsorption disorder ( Crohns, etc); H pylori infection, ETOH abuse, PPI use, diet ( vegetarians ; treat with B12 injections
pernicious anemia
how do we obtain the B vitamin
through the diet; malabsorption can lead to folate def. ; B vitamin is a coenzyme involved with DNA synthesis in RBCs; this def. associ with neural tube defects in fetuses
what are the causes of folate def.anemia
autoimmune and malabsorption disorders, ETOH abuse, diet ; tx with oral supplements and /or diet changes
which type of anemia has small , abnormally shaped RBCs; reduced Hb concentration
microcytic hypochromic anemia
what are the diff types of macrocytic anemias
pernicious anemia and folate def. anemia
what are the diff types of microcytic anemias
iron def. anemia, and sideroblastic anemia and lead poisoning
which type of micro anemia deals with lack of iron for Hb; insuff Hb ; caused by chronic blood loss, dietary Fe def. and disruption of iron metabolism or iron cycle
iron def. anemia
which type of micro anemia deals with dysfunctional iron uptake by erythroblasts ; defective porphyrin and heme synthesis; caused by congenital dysfunction of iron metabolism in rbc ; acquired dysfunction of iron metabolism as a result of drugs or toxins
sideroblastic anemia
this type of micro anemia deals with the inhibition of heme ad globin ; synthesis of rbc; caused by excessive lead exposure
lead poisoning
this is the most common type of anemia worldwide; risk groups are poor, women, and children
iron def. anemia ( affects 20 %)
what are the main causes of iron def. anemia in the US
pregnancy and heavy menstruation, chronic GI bleeds
how is iron def. anemia dx’d
blood test and hematocrit
how is iron def. anemia tx’d
address bleeding and iron supplementation
this type of anemia cannot incorporate iron into Hb in RBC; ringed nuclei in bone marrow and hemochromatosis ( brown skin)
sideroblastic anemia
what are some causes of sideroblastic anemia
congenital, myelodysplastic syndrome, meds, toxins, and ETOH Abuse
how do we Dx sideroblastic anemia
bone marrow sample containing sideroblasts
how do we tx B6 supplementation and bloodletting
sideroblastic anemia
the MOA of this anemia inhibits heme and globin synthesis of RBCs; children are high risk
lead poisoning
what are some early signs and symptoms of lead poisoning
pallor, ab pains, irritability
what are late signs of lead poisoning
lethargy, anorexia, ataxia, slurred speech, and convulsions
what is tx of lead poisoning
remove lead source and/or chelation
what is anemia that deals with normal size and normal Hb concentration
normocytic/normochromic anemia
what are diff types of normochromic anemia
aplastic anemia, posthemorrhagic anemia, hemolytic anemia, and anemia of chronic inflammation
this type of normo. anemia is when bone marrow is replaced with fibrous, fatty tissue ; abrupt onset of low blood cell counts; increased incidence of infections and hemorrhages; occurs in healthy young adults
aplastic anemia
etiology of this anemia is idiopathic ( 75%); secondary > chloramphenicol ; tx of this anemia includes a bone marrow transplant
aplastic anemia
this type of anemia is due to premature destruction of RBCs; signs include fatigue, jaundice, and red-brown urine
hemolytic anemias
causes of this anemia include inherited def. of RBC membranes, enzyme defects, Hb; toxic or Ab damage to the circulating RBC ( autoimmune/medications)
hemolytic anemias
what is 2nd to IDA in incidence; usually occurs in adults ; causes are AIDS, RA, SLE
Anemia of chronic disease
this type of anemia is assoc with decreased RBC lifespan, suppressed production of EPO; ineffective bone marrow erythroid progenitor response to EPO; altered iron metabolism and iron sequestration in macrophages
anemia of chronic disease
