hematologic sys - different types of anemias Flashcards
what is acute anemia related to? what is the initial reaction?
- blood loss
- vasoconstriction and shunting of blood to vital organs
what does macrocytic mean?
condition where red blood cells are enlarged in size
what does normochromic anemia refer to?
when the red blood cells are normal but there isn’t enough of them to meet the body’s demands
what are macrocytic and normochromic anemias characterized by?
defective DNA synthesis
what are two types of macrocytic-normochromic anemias?
pernicious and folate deficiency
what is pernicious anemia a deficiency of?
vitamin B12
what population does pernicious anemia usually impact?
those over 30 of northern european descent, hispanic, african americans
how long does it take to develop pernicious anemia?
usually progress over 20 to 30 years
what are some significant symptoms of pernicious anemia?
beefy red tongue, splenic or liver enlargement, paresthesia of extremities
what is pernicious anemia caused by? what is this substance required for? what is B12 needed for?
- a lack of intrinsic factor from the gastric parietal cells
- intrinsic factor is required for B12 absorbtion
-nucleus maturation and DNA synthesis in RBCs
what are risk factors for pernicious anemia?
chronic gastritis, alcoholism, liver disease, hypothyroidism, smoking, stomach surgery
what is folate required for?
RNA and DNA synthesis within the RBC
what are clinical manifestations of folate deficiency anemia?
burning mouth syndrome, dysphagia, flatulance, diarrhea
what are microcytic hypochromic anemias characterized by? what are they related to?
-red cells that are abnormally small and contain reduced amounts of hemoglobin
- disorders or iron metabolism
what does the term microcytic mean?
related to red blood cells that are smaller than normal
what does the term hypochromic mean?
refers to blood cells that have less hemegoblin than normal
what are the risk factors for iron deficiency anemia?
females, poverty, lead poisoning, infants, pregnancy
what is iron deficiency anemia?
depleted iron stores and reduced hemoglobin synthesis
what can cause iron deficiency?
inadequate dietary intake or chronic blood loss
what are late manifestations of iron deficiency anemia?
spoon shaped nails, atrophied tongue
what are the early manifestations or iron deficiency anemia?
fatigue, weakness, SOB, pale ear lobes
how many weeks of iron replacement does it take to reverse the symptoms of iron deficiency anemia?
1 - 2 weeks
what are normocytic-normochromic anemias characterized by?
RBCs that are normal in size and hemogoblin content but insufficient in number
what are two examples of normocytic normochromic anemias?
posthemorrhagic anemia and sickle cell disease
what is an example of a microcytic-hypochromic anemia?
iron deficiency anemia
what does hemorrhage mean?
excessive bleeding
what type of disease is sickle cell disease? what mutation causes it?
- autosomal recessive
Point mutation where the DNA triplet coding for glutamic acid (CTC) instead codes for valine (CAC).
what happens to RBCs in sickle cell disease? what does its severity depend on?
- Poor oxygenation and dehydration causes the RBC’s to sickle
- Severity depends on the level of dehydration and oxygenation
what do sickled RBCs lead to?
increased blood viscosity
slower movement of blood through the body
vascular occlusion
what are manifestations of the sickled state?
Pain-generalized and joint pain
Jaundice
Weakness
Fatigue
what does vaso-oclusive mean? what may occur? what decreases?
-Vasospasm from obstruction
-Thrombosis formation and organ damage may occur
-Decreased oxygenation to distal tissues and organs
what are coagulation disorders a result of?
*Result of gene deletions and point mutations
what would a nurse see if clotting does not happen as quickly as it should?
easy bruising, persistent bleeding from minor wounds, swollen joints, blood in urine (hematuria), heavy menses
when clotting happens quicker than it should, what could a nurse see?
a nurse may see a person who develops embolus—which can lead to deep vein thrombosis, pulmonary embolus, stroke (as we’ve discussed in previous lectures)
what are three examples of coagulation disorders?
hemophilia A, Von Willebrand Disease, Factor V Leiden
what is classic hemophilia a deficiency of?
factors VIII
what gene leads to hemophilia A?
X-linked recessive F8 gene
why is a lack of factor VIII problematic?
fibrinogen does not convent to fibrin, scaffolds don’t form, blood does not clot.
what are the manifestations of hemophilia A?
Joint bleeding, bruising, hematuria, oral bleeding can occur. Other bleeds (brain, internal organs, etc.) are more serious and life threatening.
what is von willebrand disease? what is it the most common of?
- Autosomal dominant condition-reduced penetrance
- most common inherited clotting disorder worldwide
what gene causes Von Willebrand Disease ?
Gene is VWF –von Willebrand factor–on chromosome 12
what does the VWF gene do?
VWF works with factor VIII to start the clotting process and activates platelets
what is the treatment for both hemophilia and VWD?
treatment is factor replacement, plasma infusions, mediations to promote factor formation
what is thrombophilia?
When a person has a condition that causes the blood to be hypercoagulable
what is factor V Leiden? who is it common in?
- Most common hereditary thrombophilia
- those of european ancestry
what kind of mutation is factor V leiden? what does it lead to?
Is a single nucleotide mutation that leads to prolonged high levels of factor V and overproduction of thrombin.
what does the F5 gene do?
The F5 gene provides instructions for making a protein called coagulation factor V.
