Intro to Anemia - Kroft Flashcards
What ultimately causes the pathology in anemia?
decreased oxygen delivery to the tissues
What are five adaptations to anemia?
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
Is anemia a symptom or a disease?
A symptom; a cause must be found for anemia
What are the three GENERAL causes of anemia?
Blood loss
Decreased Production
Accelerated Destruction
How are anemias classified?
Morphlogically, by size and/or color
What are some causes of microcytic anemia?
Iron deficiency
Thalassemia traits
Hemoglobinopathy
What are some causes of normocytic anemia?
Chronic Disease Renal Failure Marrow Infiltration Aplastic Anemia Blood Loss Hemolysis
What are some causes of macrocytic anemia?
B12/Folate deficiency
Liver Disease
Myelodysplastic syndrome
Drugs
What are the most useful tests for an anemia?
Hemoglobin Concentration- determines ability to carry O2
Mean Corpuscular Volume- determines class of anemia
What is the difference between a megaloblastic and a non-megaloblastic macrocytic anemia?
What are some causes of megaloblastic anemia?
Megaloblastics are caused from impaired DNA synthesis
B12/Folate deficiency
some drugs
Myelodysplastic syndromes
What are some common causes of spherocytes?
Hereditary spherocytosis
Autoimmune Hemolytic Anemia
What are some causes of target cells?
Liver Disease
Splenectomy
Hemoglobinopathies
What are some causes of elliptocytes?
Hereditary elliptocytosis
Megaloblastic Anemia
Iron Deficiency
What are some causes of teardrop cells?
Megaloblastic Anemia
MYelodysplastic Syndrome
Extramedullary Hematopoiesis
What are some causes of schistocytes?
Hemolytic Uremic Syndrome
Disseminated Intravascular Coagulation
Malignant Hypertension
What causes bite cells?
G6PD Deficiency
What do hypochromic and hyperchromic cells indicate?
hypochromia indicates a lack of hemoglobin
hyperchromia indicates very high levels of hemoglobin
What are Howell-Jolly Bodies?
In which conditions can you see them?
Howell-Jolly bodies are nuclear inclusions
Splenectomy, Megaloblastic anemia
What are Pappenheimer bodies?
In which conditions can you see them?
Iron granules
Splenectomy, Iron overload
What is basophilic stippling?
In which conditions can you see them?
Ribosomes with RNA accumulation
Lead poisoning
Thallesemia
What is a rouleaux?
What does it indicate?
Stacking of red blood cells
increased serum proteins
What is agglutination?
What does it indicate?
clumping of red blood cells
presence of IgM RBC antibodies
What are the stages seen in anemia due to acute blood loss?
- initial lack of anemia
- fluid movement from intracellular to extracellular compartments causes anemia
- reticulocyte counts increase 7-10 post hemorrhage
What is seen in anemia due to chronic blood loss?
Increased reticulocytes and iron deficiency after enough time
Where does RBS production take place as an embryo? As a fetus?
Yolk sac
Liver
What are normoblasts?
Nucleated RBC precursors (AKA erythroblasts)
How do normoblasts acquire iron?
Transferrin from the blood transports iron to normoblasts
How many reticulocytes are produced from a normoblast?
What is the reticulocytes:normoblasts in the marrow?
16
about 1:1
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
What are reticulocyte counts used to measure?
How is the reticulocyte count presented?
RBC production
Corrected for hemoglobin
Reticulocyte % *(Hg/45)
What are some general causes of decreased RBC production?
Decreased Erythropoietin
Stem cell defect
Marrow Replacement
Congential Disorders
Describe the general structure of an RBC
- Biconcave disc
- Extremely flexible
- Osmotically flexible
- supported by ankyrins, spectrins, and membrane proteins
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
What causes extravascular hemolysis?
Decreased RBC deformability
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
