Intro to Anemia - Kroft Flashcards

1
Q

What ultimately causes the pathology in anemia?

A

decreased oxygen delivery to the tissues

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2
Q

What are five adaptations to anemia?

A

1) Increased Red Blood Cell Production
2) Increased 2,3-DPG
3) Shunting Blood from Non-vital Organs
4) Increased Cardiac Output
5) Increased Pulmonary Function

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3
Q

Is anemia a symptom or a disease?

A

A symptom; a cause must be found for anemia

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4
Q

What are the three GENERAL causes of anemia?

A

Blood loss
Decreased Production
Accelerated Destruction

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5
Q

How are anemias classified?

A

Morphlogically, by size and/or color

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6
Q

What are some causes of microcytic anemia?

A

Iron deficiency
Thalassemia traits
Hemoglobinopathy

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7
Q

What are some causes of normocytic anemia?

A
Chronic Disease
Renal Failure
Marrow Infiltration
Aplastic Anemia
Blood Loss
Hemolysis
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8
Q

What are some causes of macrocytic anemia?

A

B12/Folate deficiency
Liver Disease
Myelodysplastic syndrome
Drugs

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9
Q

What are the most useful tests for an anemia?

A

Hemoglobin Concentration- determines ability to carry O2

Mean Corpuscular Volume- determines class of anemia

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10
Q

What is the difference between a megaloblastic and a non-megaloblastic macrocytic anemia?

What are some causes of megaloblastic anemia?

A

Megaloblastics are caused from impaired DNA synthesis

B12/Folate deficiency
some drugs
Myelodysplastic syndromes

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11
Q

What are some common causes of spherocytes?

A

Hereditary spherocytosis

Autoimmune Hemolytic Anemia

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12
Q

What are some causes of target cells?

A

Liver Disease
Splenectomy
Hemoglobinopathies

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13
Q

What are some causes of elliptocytes?

A

Hereditary elliptocytosis
Megaloblastic Anemia
Iron Deficiency

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14
Q

What are some causes of teardrop cells?

A

Megaloblastic Anemia
MYelodysplastic Syndrome
Extramedullary Hematopoiesis

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15
Q

What are some causes of schistocytes?

A

Hemolytic Uremic Syndrome
Disseminated Intravascular Coagulation
Malignant Hypertension

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16
Q

What causes bite cells?

A

G6PD Deficiency

17
Q

What do hypochromic and hyperchromic cells indicate?

A

hypochromia indicates a lack of hemoglobin

hyperchromia indicates very high levels of hemoglobin

18
Q

What are Howell-Jolly Bodies?

In which conditions can you see them?

A

Howell-Jolly bodies are nuclear inclusions

Splenectomy, Megaloblastic anemia

19
Q

What are Pappenheimer bodies?

In which conditions can you see them?

A

Iron granules

Splenectomy, Iron overload

20
Q

What is basophilic stippling?

In which conditions can you see them?

A

Ribosomes with RNA accumulation

Lead poisoning
Thallesemia

21
Q

What is a rouleaux?

What does it indicate?

A

Stacking of red blood cells

increased serum proteins

22
Q

What is agglutination?

What does it indicate?

A

clumping of red blood cells

presence of IgM RBC antibodies

23
Q

What are the stages seen in anemia due to acute blood loss?

A
  • initial lack of anemia
  • fluid movement from intracellular to extracellular compartments causes anemia
  • reticulocyte counts increase 7-10 post hemorrhage
24
Q

What is seen in anemia due to chronic blood loss?

A

Increased reticulocytes and iron deficiency after enough time

25
Where does RBS production take place as an embryo? As a fetus?
Yolk sac | Liver
26
What are normoblasts?
Nucleated RBC precursors (AKA erythroblasts)
27
How do normoblasts acquire iron?
Transferrin from the blood transports iron to normoblasts
28
How many reticulocytes are produced from a normoblast? What is the reticulocytes:normoblasts in the marrow?
16 about 1:1
29
How long do reticulocytes stay in the marrow? How long after being released from the marrow do they mature?
1-2 days about a day
30
What are reticulocyte counts used to measure? How is the reticulocyte count presented?
RBC production Corrected for hemoglobin Reticulocyte % *(Hg/45)
31
What are some general causes of decreased RBC production?
Decreased Erythropoietin Stem cell defect Marrow Replacement Congential Disorders
32
Describe the general structure of an RBC
- Biconcave disc - Extremely flexible - Osmotically flexible - supported by ankyrins, spectrins, and membrane proteins
33
Why doesn't increased destruction of RBCs usually cause problems?
Given enough folate, iron, and otherwise good health, the marrow can produce RBCs at 8 times the rate needed in a typical person
34
What causes extravascular hemolysis?
Decreased RBC deformability
35
What happens to heme when a RBC is lysed?
It is scavenged by a macrophage or picked up by hemopexin/haptoglobin and taken to the liver