L8-anemia And Polycythemia

Question 1

Define anemia

Answer 1

State of low hemoglobin in red blood cell count in blood resulting in reduced oxygen binding capacity it might be a result of 1)blood loss 2)insufficient erythropoiesis or 3) hemolysis

Question 2

Describe blood loss anemia

Answer 2

▪️After rapid hemorrhage the body replaces the fluid portion of the plasma in 1 to 3 days but this leaves a low concentration of red blood cells
▪️if a second hemorrhage does not occur red blood cell concentration usually returns to normal within 3 to 6 weeks
▪️in chronic blood loss a person frequently cannot absorb enough iron from the intestines to form hemoglobin as rapidly as it is lost
▪️red cells are then produced that are much smaller than normal and have too little hemoglobin inside them giving rise to iron deficiency anemia

Question 3

What are the types of insufficient erythropoiesis anemias

Answer 3

Aplastic anemia
Iron deficiency anemia
Megaloblastic anemia

Question 4

Describe aplastic anemia

Answer 4

Bone marrow aplasia means lack of functioning bone marrow
▪️Exposure of gamma ray radiation from nuclear bomb blast followed by lethal anemia
▪️excessive x-ray treatment certain industrial chemicals and even drugs which person might be sensitive can cause same affect

Question 5

 describe iron deficiency anemia

Answer 5

▪️Most of iron in the diet is ferric form but is absorbed in the Ferrous form
▪️Gastric secretions dissolve the iron and permitted to form soluble complexes with ascorbic acid that aids introduction to the Ferrous form
▪️ Iron deficiency anemia is a frequent complication of partial gastroectomy also it occurs due to a chronic blood loss

Question 6

Describe megaloblastic anemia

Answer 6

▪️ atrophy of stomach mucosa or loss of entire stomach after surgical total gastrectomy can lead to megaloblastic anemia
▪️also patients who have intestinal sprue
▪️In these states erythroblasts cannot proliferate fast enough to form Normal numbers of red Blood cells
▪️those red blood cells that are formed are mostly oversized have, bizarre shape and have fragile membranes
▪️they can rupture easily leaving the person in dire need of an adequate number of red the blood cells

Question 7

Describe hemolytic anemia

Answer 7

▪️Different abnormalities of red blood cells
▪️the cells are fragile so they can rupture easily as they go through the capillaries especially through the spleen ▪️even though the number of red blood cells formed may be normal or even much greater than normal in some hemolytic diseases
▪️lifespan is so short and the cells are destroyed faster than they can be formed causing serious anemia results

Question 8

Describe hereditary spherocytosis

Answer 8

▪️Red cells are very small and spherical rather than have biconcave disc
▪️cannot withstand compression forces because they do not have the normal losoe bag like cell membrane structure of the biconcave disc
▪️On passing through the splenic pulp and some other tight vascular beds they’re easily ruptured by even slight compression

Question 9

Describe sickle cell anemia

Answer 9

▪️Abnormal type of hemoglobin called hemoglobin S containing faulty beta chains in the hemoglobin molecule
▪️ when this hemoglobin is exposed to low concentrations of oxygen precipitates into long crystals inside the red blood cells
▪️These crystals elongate the cell and give it the appearance of a sickle rather than a biconcave disc
▪️The precipitated hemoglobin also damages the cell membrane so that the cells become highly fragile leading to serious anemia

Question 10

What is sickle cell disease crisis

Answer 10

Low oxygen tension in the tissues causes sicklinv which leads to ruptured red cells which causes a further decrease in oxygen tension and still more sickling and red cell destruction

Question 11

Describe erythroblastosis Fetalis

Answer 11

▪️Rh positive red blood cells in the fetus are Attacked by antibodies from an Rh negative mother
▪️these antibodies make the Rh positive cells fragile leading to rapid hemolysis and causing the child to be born with serious anemia
▪️the extremely rapid formation of new red cells to make up for the destroyed cells causes a large number of early blast forms of red cells to be released from the bone marrow in the blood

could also occur from
Mismatch blood transfusion
reaction to some drugs
infection ex: malaria

Question 12

What is the morphologic classification of anemia

Answer 12

It’s according to red cell volume and mean cell hemoglobin and it’s classified into:
Normocytic normochromic anemia
Microcytic hypochromic anemia
Macrocytic normochromic anemia

Question 13

Describe normocytic normochromic anemia

Answer 13

Occur in acute hemolytic anemia and an acute blood loss

Red cells are of normal size and of normal hemoglobin Content

Question 14

Describe microcytic hypochromic anemia

Answer 14

▪️Most often due to iron deficiency and diet or chronic blood loss with loss of large amounts of iron over a long period ▪️the red blood cells are small in size and the hemoglobin content of each cell is less than normal

Question 15

Describe Macrocytic normochromic anemia

Answer 15

Associated with megaloblastic erythropoiesis due to deficiency of vitamin B12 and folic acid
these red blood cells are larger in size and of normal hemoglobin content

Question 16

what is polycythemia

Answer 16

Increase of red cell count and or an increase of blood hemoglobin level 2 g above the normal value

Question 17

Describe polycythemia(polycythemia vera)

Answer 17

▪️Pathological condition in which the red blood cell count may be 7 to 8 million/mm3
▪️Hematocrit may be 60 to 70% instead of the normal 40 to 45%
▪️Polycythemia vera is caused by genetic abrasion in the hemocytoblastic cells that produce the blood cells
▪️the blast cells no longer stop producing red cells one when too many cells are already present

Question 18

Describe secondary polycythemia

Answer 18

▪️Whenever the tissue becomes hypoxic because of too little oxygen in breathed air such as high altitudes or because of failure of oxygen delivery to tissues such as in cardiac failure the blood forming Organs automatically produce large quantities of extra red blood cells
▪️the red cell count common rises to 6/7 million/mm3

Question 19

What is physiologic polycythemia

Answer 19

Occurs to natives that live at high altitudes where the atmospheric oxygen is very low the blood count is generally 6 to 7 Million/mm3