L26 - RBC Disorders Flashcards
True endocrine hormone produced in the kidney
• Enhances the growth and differentiation of the two erythroid progenitors: burst forming units-erythroid (BFUE) and colony forming units-erythroid (CFU-E) into normoblasts of increasing maturity.
Erythropoietin (EPO)
enucleate red blood cell still capable of a limited amount of hemoglobin and protein synthesis
reticulocyte
Helps with hemoglobin production which helps carry out maturation of RBC
Fe
Which is false regarding Hepcidin:
A. Peptide hormone made in the liver, is the principal regulator of systemic iron homeostasis.
B. Controls plasma iron concentration and tissue distribution of iron by inhibiting intestinal iron absorption
C. inc iron recycling by macrophages
D. Dec iron mobilization from hepatic stores.
E. elevated during infections and inflammation
C. dec iron recycling
ultimate cause of most forms of hemochromatosis, either due to mutations in this gene itself or due to mutations in the regulators of this molecule’s synthesis.
Hepcidin deficiency
A. How does chronic inflammation affect EPO and hepcidin?
B.What happens to hepcidin in Fe deficiency?
A. EPO decreases –> no mature RBC –> anemia
Hepcidin inc –> dec Fe absorption –> fe deficient
B. hepcidin dec –> inc Fe absorption
3 parts of the RBC life cycle
- Produce RBC (BM, EPO, Fe, vit b12 and folic acid)
- Eliminated RBC (life span 120 days)
- Steady state (1% RBC eliminated and equal # made each day)
hemoglobin in whole blood, gm/dL
Hemoglobin
% blood vol in RBCs
hematocrit • Hct = Hb x 3
low Hb or Hct
anemia
high Hb or Hct
Erythrocytosis
Why do elderly have lower EPO levels –> dec RBC/Hb
Low androgens
Why do women have lower Hb than men
Low levels of androgens, Fe loss during menses, pregnancy and lactation
T/F Hb varies by race, tobacco smoke exposure and inc altitude
• Black - lower Hb
• Smoker/high altitude - RBC goes up to inc oxygenation
○ Secondary erythrocytosis
○ Baseline higher Hb than normal (Hb 15-16)
- Diagnostic criteria for anemia
- need to use age-adjusted tables
- adult men – Hb ___ g/dL, Hct ___
adult women – Hb ___ g/dL, Hct ____
adult men – Hb 13 g/dL, Hct 40%
adult women – Hb 12 g/dL, Hct 35%
why does alcoholism or being vegan increase your risk of anemia?
- alcohol - folate
- veagn - lack vit B12
Review of systems in anemias
1. T/F : Generally, symptoms are non-specific.
2. T/F: Infants: poor feeding, irritability, tachycardia
3. T/F: Compensation – Cardiovascular & Hematologic
• weakness, dyspnea, palpitations, angina
• heart failure or shock
• SX usually at Hb
- True
- True
- True
- False - Neurologic: drowsiness, syncope, headache, seeing spots, tinnitus, vertigo
- True
T/F a complete physical exam is necessary for anemia
True: vitals, skin, LN, cardiopulm, GI, musc, neuro
Hypoproliferative erythropoiesis indicates what about the BM?
Not working well
Hyperproliferative erythropoiesis indicates what about the BM?
BM is working but there is some peripheral destruction
How do you determine if erythropoiesis is hypo or hyperproliferative?
Reticulocyte index - normally RBC form in marrow and mature for 3 days then spend 1 day in circulation bf maturing to RBC