hematologic sys - different types of anemias

Question 1

what is acute anemia related to? what is the initial reaction?

Answer 1

• blood loss
• vasoconstriction and shunting of blood to vital organs

Question 2

what does macrocytic mean?

Answer 2

condition where red blood cells are enlarged in size

Question 3

what does normochromic anemia refer to?

Answer 3

when the red blood cells are normal but there isn’t enough of them to meet the body’s demands

Question 4

what are macrocytic and normochromic anemias characterized by?

Answer 4

defective DNA synthesis

Question 5

what are two types of macrocytic-normochromic anemias?

Answer 5

pernicious and folate deficiency

Question 6

what is pernicious anemia a deficiency of?

Answer 6

vitamin B12

Question 7

what population does pernicious anemia usually impact?

Answer 7

those over 30 of northern european descent, hispanic, african americans

Question 8

how long does it take to develop pernicious anemia?

Answer 8

usually progress over 20 to 30 years

Question 9

what are some significant symptoms of pernicious anemia?

Answer 9

beefy red tongue, splenic or liver enlargement, paresthesia of extremities

Question 10

what is pernicious anemia caused by? what is this substance required for? what is B12 needed for?

Answer 10

• a lack of intrinsic factor from the gastric parietal cells
• intrinsic factor is required for B12 absorbtion
  -nucleus maturation and DNA synthesis in RBCs

Question 11

what are risk factors for pernicious anemia?

Answer 11

chronic gastritis, alcoholism, liver disease, hypothyroidism, smoking, stomach surgery

Question 12

what is folate required for?

Answer 12

RNA and DNA synthesis within the RBC

Question 13

what are clinical manifestations of folate deficiency anemia?

Answer 13

burning mouth syndrome, dysphagia, flatulance, diarrhea

Question 14

what are microcytic hypochromic anemias characterized by? what are they related to?

Answer 14

-red cells that are abnormally small and contain reduced amounts of hemoglobin
- disorders or iron metabolism

Question 15

what does the term microcytic mean?

Answer 15

related to red blood cells that are smaller than normal

Question 16

what does the term hypochromic mean?

Answer 16

refers to blood cells that have less hemegoblin than normal

Question 17

what are the risk factors for iron deficiency anemia?

Answer 17

females, poverty, lead poisoning, infants, pregnancy

Question 18

what is iron deficiency anemia?

Answer 18

depleted iron stores and reduced hemoglobin synthesis

Question 19

what can cause iron deficiency?

Answer 19

inadequate dietary intake or chronic blood loss

Question 20

what are late manifestations of iron deficiency anemia?

Answer 20

spoon shaped nails, atrophied tongue

Question 20

what are the early manifestations or iron deficiency anemia?

Answer 20

fatigue, weakness, SOB, pale ear lobes

Question 21

how many weeks of iron replacement does it take to reverse the symptoms of iron deficiency anemia?

Answer 21

1 - 2 weeks

Question 22

what are normocytic-normochromic anemias characterized by?

Answer 22

RBCs that are normal in size and hemogoblin content but insufficient in number

Question 23

what are two examples of normocytic normochromic anemias?

Answer 23

posthemorrhagic anemia and sickle cell disease

Question 24

what is an example of a microcytic-hypochromic anemia?

Answer 24

iron deficiency anemia

Question 25

what does hemorrhage mean?

Answer 25

excessive bleeding

Question 26

what type of disease is sickle cell disease? what mutation causes it?

Answer 26

- autosomal recessive Point mutation where the DNA triplet coding for glutamic acid (CTC) instead codes for valine (CAC).

Question 27

what happens to RBCs in sickle cell disease? what does its severity depend on?

Answer 27

- Poor oxygenation and dehydration causes the RBC’s to sickle - Severity depends on the level of dehydration and oxygenation

Question 28

what do sickled RBCs lead to?

Answer 28

increased blood viscosity slower movement of blood through the body vascular occlusion

Question 29

what are manifestations of the sickled state?

Answer 29

Pain-generalized and joint pain Jaundice Weakness Fatigue

Question 30

what does vaso-oclusive mean? what may occur? what decreases?

Answer 30

-Vasospasm from obstruction -Thrombosis formation and organ damage may occur -Decreased oxygenation to distal tissues and organs

Question 31

what are coagulation disorders a result of?

Answer 31

*Result of gene deletions and point mutations

Question 32

what would a nurse see if clotting does not happen as quickly as it should?

Answer 32

easy bruising, persistent bleeding from minor wounds, swollen joints, blood in urine (hematuria), heavy menses

Question 33

when clotting happens quicker than it should, what could a nurse see?

Answer 33

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)

Question 34

what are three examples of coagulation disorders?

Answer 34

hemophilia A, Von Willebrand Disease, Factor V Leiden

Question 35

what is classic hemophilia a deficiency of?

Answer 35

factors VIII

Question 36

what gene leads to hemophilia A?

Answer 36

X-linked recessive F8 gene

Question 37

why is a lack of factor VIII problematic?

Answer 37

fibrinogen does not convent to fibrin, scaffolds don’t form, blood does not clot.

Question 38

what are the manifestations of hemophilia A?

Answer 38

Joint bleeding, bruising, hematuria, oral bleeding can occur. Other bleeds (brain, internal organs, etc.) are more serious and life threatening.

Question 39

what is von willebrand disease? what is it the most common of?

Answer 39

- Autosomal dominant condition-reduced penetrance - most common inherited clotting disorder worldwide

Question 40

what gene causes Von Willebrand Disease ?

Answer 40

Gene is VWF --von Willebrand factor--on chromosome 12

Question 41

what does the VWF gene do?

Answer 41

VWF works with factor VIII to start the clotting process and activates platelets

Question 42

what is the treatment for both hemophilia and VWD?

Answer 42

treatment is factor replacement, plasma infusions, mediations to promote factor formation

Question 43

what is thrombophilia?

Answer 43

When a person has a condition that causes the blood to be hypercoagulable

Question 44

what is factor V Leiden? who is it common in?

Answer 44

- Most common hereditary thrombophilia - those of european ancestry

Question 45

what kind of mutation is factor V leiden? what does it lead to?

Answer 45

Is a single nucleotide mutation that leads to prolonged high levels of factor V and overproduction of thrombin.

Question 46

what does the F5 gene do?

Answer 46

The F5 gene provides instructions for making a protein called coagulation factor V.