Pathology Flashcards
what is polycythemia?
Increased number of RBCs /unit blood volume in the presence of increased blood volume.
what is primary polycythemia?
-A neoplastic condition involving normoblastic series of the bone marrow
-myeloproliferative disorder
- Associated with leukocytosis & thrombocytosis
what are the pathological findings of primary polycythemia?
1- Cyanosis or plethora due to venous engorgement
2- Increased blood viscosity with thrombotic tendency due to high platelet count
3- Hemorrhages due to rupture of engorged vessels
4- Hepatosplenomegaly (enlargement of liver and spleen with foci of extramedullary hematopoiesis)
5- Other myeloproliferative disorders such as chronic myeloid leukemia and myelosclerosis
6- Gastric ulcers due to gastric arteriolar thrombi
why is cyanosis seen in polycythemia and not in anemia?
A person with anemia almost never becomes cyanotic because there is not enough hemoglobin for 5 grams to be deoxygenated in 100 ml of arterial blood.
In a person with excess RBCs, as with polycythemia vera, the great excess of hemoglobin that can become deoxygenated leads frequently to cyanosis
what is secondary polycythemia?
It is an erythropoietin-induced adaptive mechanism to improve the O2 supply to the tissues, in conditions of prolonged reduction of O2 delivery to the tissues.
The increase in rbcs is not accompanied by leucocytosis or increased number of platelets.
what are the causes of secondary polycythemia?
increase erythropoeitin or erythrpoietin like substance
secretion due to
1- Hypoxia: high altitudes, lung diseases, cyanotic congenital heart disease
2- Renal diseases; renal cell carcinoma, congenital polycystic kidney and hydronephrosis
define anemia
A decrease or deficiency in RBC number or a decrease in Hb concentration or decrease in both, in a unit volume of blood in the presence of a low or normal total blood volume.
-caused by either too rapid loss or too slow production of rbcs.
what are the general pathological features of anemia?
1- Hypoxia
2- Increased cardiac output that may lead to heart failure
3- Pallor of skin and mucous membranes
4- Fatty change of parenchymatous organs
what is aplastic anemia
Aplasia (Bone marrow failure) with depression in the formation of rbcs, wbcs and platelets (pancytopenia) even though all ingredients necessary for hemopoiesis are available.
what is Myelophthisic anaemia?
Pancytopenia due to extensive bone marrow replacement by metastatic tumours,
lipid storage disease, and myelosclerosis
Causes of Aplastic Anemia
1) Bone marrow destruction due to:
-Excessive X-ray treatments
-Industrial chemicals and drugs (chloramphenicol - cytotoxic drugs - chloropromazine - thiouracil)
what are the causes of iron deficiency anemia?
-Iron deficient diet
-Poor iron absorption from digestive tract
-chronic bleeding
what happens cellularly in iron deficiency anemia?
1- the number of erythrocytes is normal or reduced
2- the cells contain less Hb than normal (hypochromic)
3- rbcs are smaller and transport less oxygen
therefore, iron deficiency anemia causes hypochromic microcytic anemia.
Give some Clinicopathological features of iron deficiency anemia
Pica
Fatigue
Tachycardia
Tachypnea
Pallor
In severe cases:
-angular stomatitis
-smooth tongue
-Koilonychia - spoon nails: thin, flat nails with no convexity
-Cheilosis
-Bone marrow hyperplasia
- Plummer-Vinson syndrome:
In middle-aged women, may lead to post-cricoid carcinoma
What is Plummer-Vinson syndrome?
Plummer-Vinson syndrome is a condition that can occur in people with long-term iron deficiency anemia.
– It is characterized by dysphagia (difficulty swallowing), iron-deficiency anemia, and esophageal webbing.
– The tongue may become swollen and thin webs of tissue may form in the esophagus.
–The condition is more common in middle-aged women.
– Plummer-Vinson syndrome increases the risk of esophageal cancer and may lead to post-cricoid carcinoma
