module 4: Anemia

Question 1

elevated MCV seen in

Answer 1

alcohol abuse, elders

Question 2

Anemia effect on blood flow/viscocity
=^__/___
=____/____

Answer 2

vRBC=vBV=fluid shifts into vasculature = ^turbulence vViscosity
=^SV/HR
=valve insufficiency/cardiac dilation

Question 3

vO2 effect on heart

Answer 3

hypoxemia= vasodilation =vResistance, ^bloodflow

=^HR/SV =HF

Question 4

vO2 effect on RR

Answer 4

^O2 released by hgb, increased RR

Question 5

Compensatory symptoms of hypoxemia

Answer 5

dyspnea, ^HR, palpitations, fatigue, CP

Question 6

Severe anemia effect on CAD pt’s

Answer 6

MI

Question 7

Anemia s/s

Answer 7

jaundice if d/t hemolysis, impaired healing, vTissue elasticity

Question 8

GI s/s w anemia

Answer 8

abd pain, n/v, anorexia

Question 9

How does acute anemia= RAAS

Answer 9

vasoconstriction diverts blood to vital organs, kidneys sense that, activate RAAS to ^BV

Question 10

Pernicious anemia (MacrOcytic) caused by v____ d/t v_____ = _____

Answer 10

vB12 d/t vIntrinsic factor =malabsorption of B12

Question 11

Internal causes of Pernicious anemia (macrOcytic)

external causes

Answer 11

GI issues, vegan, autoimmune, tapeworms, conditions w ^B12 req (preg, hypthy, infection, CA)

alcohol, hot tea, smoking, PPi (vCobalamine)

Question 12

Autoimmune cause of Pernicious (macrOcytic) anemia

Answer 12

antibodies on HKATPase on parietal cells

Question 13

why does pernicious anemia manifest later in life

Answer 13

takes 10yrs to deplete stores, then =s/s

Question 14

s/s Pernicious anemia (macrOcytic)

Answer 14

beefy red tongue, vWeight/appetite
neuro (demylenation)-parasthesias, lose sense of position/vib
Neurocog decline- encephalopathy, myelopathy, optic neuropathy

Question 15

Folate deficiency (macrO) common cause
seen in

Answer 15

vFolate intake

malnourished alcoholics

Question 16

Folate deficiency (macro) s/s

Answer 16

stomatitis, flatulence, diarrhea

mouth ulcers, cheilosis, dysphagia

Question 17

How do folic acid and B12 cause rbc’s to be destroyed

Answer 17

B12/Folic acid needed to mature RBC’s dna/rna

immature rbc’s destroyed in BM

Question 18

Iron deficiency (mIcro) causes

Answer 18

2-4ml blood loss/day, pregnant
vAbsorption, vStomach acidity (d/t surgery)
cow milk, poor diet

Question 19

iron deficiency (mIcro) s/s

Answer 19

glossitis, spoon nails, painful mouth
angular stomatitis, hyposalivation
children= irreversible cognitive impairment

Question 20

Anemia of chronic disease (Normo) d/t
___, ___, ___
characterized by ____, _____

Answer 20

chronic infections, inflammation, CA

characterized by vErythropoiesis and impaired iron use
HF,CKD, lupus, AIDS,

Question 21

AOCD (normo)

Answer 21

vRBC lifespan
vErythropoietin
vBM response to erythropoietin
altered iron metabolism
iron sequestration by macrophages

Question 22

AOCD (normo)

decreased iron availability d/t

Answer 22

IL6=6Hepcidin=vFerroportin (iron transporter)= no iron released

Question 23

AOCD (normo) causes increased ferritin how

Answer 23

inflammation =^iron affinity to lactoferrin/apoferritin

turns into ferritin

Question 24

Sickle cell disease (homozygous recessive) occurs bc of

s/s

Answer 24

genetic mutation causing glutamate amino acid swapped for valine amino acid

jaundice, irritabiility, joint pain

Question 25

sickle cell
what causes spleen infarction
risk for ____

Answer 25

rbc’s sequestered/hemolysis in spleen

= risk for sreptococcal/pneumococcal , capsulated bacterial infections

Question 26

what makes sickle cell crisis worse (2)

Answer 26

vasoconstriction d/t hgb released during lysis binding to nitric oxide inhibiting vasodilation
vPH reduces O2 binding to hgb

Question 27

Acute chest syndrome sickle cell

high risk vaso occlusive crisis

Answer 27

fever, cough, chest pain, hypoxia, lung infiltrates

death

Question 28

Hemolytic disease in NB/fetus

Answer 28

^erythropoiesis in liver and spleen, immature rbc’s (erythroblastosis fetalis) released

Question 29

Hemolytic disease NB/fetus

Answer 29

^liver/spleen , jaundice, icterus neonatorum

kernicterus (bili in brain)= cerebral damage/death

Question 30

Fetal blood differences
hgb affinity
^hematopoiesis
polycythemia d/t
glucose consumption

Answer 30

^hgb affinity w O2
 trauma cutting cord/birth
hypoxic uterus
glucose consumption ^
^BV

Question 31

elderly blood differences

Answer 31

decreased ability for everything except clotting

increased plt activation, thrombin generation=thromboembolism risk