Normocytic and Hemolytic Anemia Lecture Powerpoint Flashcards
fing curtis
Anemia signs and symptoms
Fatigue, dyspnea/SOB, weakness, palpitations, pallor, tachycardia, low Hct and low Hgb
Icterus or jaundice is often associated with what type of anemia?
Hemolytic
Decreased reticulocytes could indicate a ___ deficiency
Nutritional
Reticulocyte appearance under smear
Slightly larger than mature RBC and contain cytoplasmic remnants of RNA that stains blue
A mean corpuscular volume (MCV) must be taken with consideration of presence of these 2 pathologies
Macro and microcytic anemias (avg out to normal appearing volume)
A RDW will have a large distribution with presence of these 2 pathologies
Macro and microcytic anemias
Normocytic anemia
Normal sized RBC’s with low hematocrit/hemoglobin or hemodilution, a sign of a disease presence
Target, spherocyte, schistocyte, acanthocyte, echinocyte definitions
Target - dark center light colored ring dark periphery
Spherocytes - thickened rounded, microcytic hyperchromatic
Schistocytes - irregular RBC fragments
Acanthocytes - multiple spike like projections
Echinocytes - multiple smaller spiked projections
3 classifications of anemia: cytometric, erythrokinetic, and bicohemical schemes and their definition
Cytometric - cell size and chromaticity
erythrokinetic - Rates of RBC production and destruction
Biochemical - genetic vs acquired
Sickle cell anemia cytometric, erythrokinetic, and biochemical scheme classifications
- normochromic normocytic with production of sickle shaped cells
- Hemolytic
- DNA point mutation producing amino acid substituion on hemoglobin B chain
Iron deficiency anemia cytometric, erythrokinetic, and biochemical scheme classifications
- microcytic, hypochromic
- Impaired production
- Blood loss or insufficient dietary iron
Most frequently encountered class of anemia
Normocytic
Normocytic anemia is a ___ not a ____
sign, disease
Nearly all anemias initially present as ___
normocytic
Normal size pneumonic for normocytic anemia etiology
Normal pregnancy Over hydration Renal disease Marrow problems Acute blood loss Lysis Systemic Inflammation Zero production (aplastic) Endocrine disorderr (thyroid, adrenal)
Anemia of chronic disease (ACD) definition
Most common type of normocytic anemia, derived from autoimmune disorders, cancer, CKD, lliver disease, or other infections
Anemia of renal disease often has ___ cells appear on a smear
Burr
4 sources of pathophysiology of normocytic and hemolytic anemia and some examples
1) decreased RBC production (autoimmune, cancer, renal failure, aplastic bone marrow)
2) destruction or loss of RBC’s (bleeding, hemolysis)
3) uncompensated increase in plasma volume (overhydration, pregnancy)
4) mixed micro/macrocytic anemia (look for elevated RDW because MCV gonna be normal!)
Iron is metabolized to ___
Bilirubin
Unconjugated bilirubin nickname and definition
AKA indirect, goes to liver
Conjugated bilirubin nickname and defintion
AKA direct bilirubin, occurs in the liver
Very high levels of bilirubin can harm the brain, in a disease state called
Kernicterus
Direct coombs test is testing a response that occurs ___ the body
Inside
Indirect coombs test is testing a response that occurs ___ the body
outside (in vitro)
Sickle cell crisis
Acute painful attack of the back abodmen and joints that results in fever, dehydration and pulmonary distress due to sickling cells claudicating
G6PD deficiency definition
An enzyme that protects the RBC from oxidative damage, a deficiency in G6PD can result in hemolysis in sudden episodic periods despite normal health between episodes
3 triggers for G6PD deficiency episode
Sulfonamides
febrile illness
Fava beans
G6PD deficiency appearance on peripheral smear
Heinz bodies (small blue dots) of denatured hemoglobin in the cells and bite cells due to macrophages removing heinz bodies
