module 4: Anemia Flashcards
elevated MCV seen in
alcohol abuse, elders
Anemia effect on blood flow/viscocity
=^__/___
=____/____
vRBC=vBV=fluid shifts into vasculature = ^turbulence vViscosity
=^SV/HR
=valve insufficiency/cardiac dilation
vO2 effect on heart
hypoxemia= vasodilation =vResistance, ^bloodflow
=^HR/SV =HF
vO2 effect on RR
^O2 released by hgb, increased RR
Compensatory symptoms of hypoxemia
dyspnea, ^HR, palpitations, fatigue, CP
Severe anemia effect on CAD pt’s
MI
Anemia s/s
jaundice if d/t hemolysis, impaired healing, vTissue elasticity
GI s/s w anemia
abd pain, n/v, anorexia
How does acute anemia= RAAS
vasoconstriction diverts blood to vital organs, kidneys sense that, activate RAAS to ^BV
Pernicious anemia (MacrOcytic) caused by v____ d/t v_____ = _____
vB12 d/t vIntrinsic factor =malabsorption of B12
Internal causes of Pernicious anemia (macrOcytic)
external causes
GI issues, vegan, autoimmune, tapeworms, conditions w ^B12 req (preg, hypthy, infection, CA)
alcohol, hot tea, smoking, PPi (vCobalamine)
Autoimmune cause of Pernicious (macrOcytic) anemia
antibodies on HKATPase on parietal cells
why does pernicious anemia manifest later in life
takes 10yrs to deplete stores, then =s/s
s/s Pernicious anemia (macrOcytic)
beefy red tongue, vWeight/appetite
neuro (demylenation)-parasthesias, lose sense of position/vib
Neurocog decline- encephalopathy, myelopathy, optic neuropathy
Folate deficiency (macrO) common cause seen in
vFolate intake
malnourished alcoholics
Folate deficiency (macro) s/s
stomatitis, flatulence, diarrhea
mouth ulcers, cheilosis, dysphagia
How do folic acid and B12 cause rbc’s to be destroyed
B12/Folic acid needed to mature RBC’s dna/rna
immature rbc’s destroyed in BM
Iron deficiency (mIcro) causes
2-4ml blood loss/day, pregnant
vAbsorption, vStomach acidity (d/t surgery)
cow milk, poor diet
iron deficiency (mIcro) s/s
glossitis, spoon nails, painful mouth
angular stomatitis, hyposalivation
children= irreversible cognitive impairment
Anemia of chronic disease (Normo) d/t
___, ___, ___
characterized by ____, _____
chronic infections, inflammation, CA
characterized by vErythropoiesis and impaired iron use
HF,CKD, lupus, AIDS,
AOCD (normo)
vRBC lifespan vErythropoietin vBM response to erythropoietin altered iron metabolism iron sequestration by macrophages
AOCD (normo)
decreased iron availability d/t
IL6=6Hepcidin=vFerroportin (iron transporter)= no iron released
AOCD (normo) causes increased ferritin how
inflammation =^iron affinity to lactoferrin/apoferritin
turns into ferritin
Sickle cell disease (homozygous recessive) occurs bc of
s/s
genetic mutation causing glutamate amino acid swapped for valine amino acid
jaundice, irritabiility, joint pain
sickle cell
what causes spleen infarction
risk for ____
rbc’s sequestered/hemolysis in spleen
= risk for sreptococcal/pneumococcal , capsulated bacterial infections
what makes sickle cell crisis worse (2)
vasoconstriction d/t hgb released during lysis binding to nitric oxide inhibiting vasodilation
vPH reduces O2 binding to hgb
Acute chest syndrome sickle cell
high risk vaso occlusive crisis
fever, cough, chest pain, hypoxia, lung infiltrates
death
Hemolytic disease in NB/fetus
^erythropoiesis in liver and spleen, immature rbc’s (erythroblastosis fetalis) released
Hemolytic disease NB/fetus
^liver/spleen , jaundice, icterus neonatorum
kernicterus (bili in brain)= cerebral damage/death
Fetal blood differences hgb affinity ^hematopoiesis polycythemia d/t glucose consumption
^hgb affinity w O2 trauma cutting cord/birth hypoxic uterus glucose consumption ^ ^BV
elderly blood differences
decreased ability for everything except clotting
increased plt activation, thrombin generation=thromboembolism risk
