Heme Part II Flashcards
Anemia
Reduction in number or in quality or quantity of Hgb
Hemoglobin content low
Hypochromic or normal (normochromic)
Anisocytosis
RBCs various sizes
Poikilocytosis
RBCs different shapes
Anemia Clinical manifestations
Hypoxia Syncope ANgina Compensatory tachycardia Organ dysfunction.
Macrocytic-Normochromic
Megaloblastic anemia cells unusually large DNA synthesis is defective Usually due to deficiencies in B12 or folate (B9) • Co-enzymes for nuclear maturation and the DNA synthesis pathway
Pernicious anemia
most common megaloblastic anemia
Lack of intrinsic factor Requires B12 absorption
Congenital or autoimmune
H pylori and PPI increase risk
Pernicious anemia S&S
Weakness, fatigue
paresthesia,
loss of appetite, abdominal pain, weight los
Atrophic glottis
Indicative of Pernicious anemia
B12 deficiency.
B9 cheilitis
Know picture of pernicious anemia
pernicious
Folate B9 deficiency
malnourishment
Neural tube defects
sphenocytes
RBCs shaped like a sphere.
Abnormal small cells with pale color
Microcytic-hypochromic anemia
Causes of microcytic-hypocrhomic anemia
Disorders of iron metabolism
porphyrin
Microcytic hypochromic
Cause Cutaneous porphyria
Caused by defective heme production
most common type of anemia is
Iron-deficiency
Iron deficiency causes by
ASA
NSAIDS
insufficient iron intake
S and symptoms of iron deficiency anemia
Pale conjunctiva
Fatigue,weakness
KOILONYCHIA nails (spoon shaped fingernails)
Sideroblastic anemia
Defect in mitochondrial heme synthesis
iron precipitation
Acquired or hereditary
cline: iron overload
Normocytic normochromic anemia
Normal size and hemoglobin content but low number
Aplastic
Autoimmune
Chemical exposure
Chemotherapy drugs
Good marrow to nonfunctional yellow marrow
Hereditary thalassemia
Acute blood loss
Hemolytic anemia
•
Accelerated destruction of RBCs
Congenital versus acquired
Intravascular versus extravascular hemolysis
Paroxysmal nocturnal hemoglobinuria
Hemolytic anemia
associated with Paroxysmal nocturnal Hemoglobinuria
Deficiency in CD55 and CD59 (MAC inhibitory
protein): Cause complement-mediated intravascular
lysis and release of hemoglobin
• Anemia, hemoglobinuria, severe fatigue, abdominal pain, and thrombosis
G6PD
Protect RBCs from oxidative stress.
Polycythemia vera
Splenomegaly
Treatment: Phlebotom 300-500ml to reduce erythrocytosis and
Acute (children)
High proportion of immature
Chronic
high proportion of mature
Leukemia
PETECHIA
PURPURA
bone pain
Multiple myeloma
Increased production of plasma cells
Pathological fracture
Urine for Multiple myeloma
Bence jones cells
Hodgkins lymphoma
Non-Hodgkins
Single lymph node
Multiple lymph nodes
