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physiology > Polycythemia and Anemia > Flashcards

Polycythemia and Anemia Flashcards

1
Q

Definition of Polycythemia (Erythrocytosis)

A

Polycythemia is the increased number of RBCs in a unit volume of blood
in the presence of increased blood volume.

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2
Q

list Effects of polycythemia

A

Increase in RBCs number leads to increase in blood viscosity and sluggish blood flow.
Subsequently, increased workload on the heart occurs leading to increased peripheral resistance which results in high blood pressure.

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3
Q

list Types of Polycythemia

A

A. Primary polycythemia (Polycythemia rubra vera)
B. Secondary polycythemia

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4
Q

def of Primary polycythemia

A

it is considered as a neoplastic disease involving the normoblastic series of the bone marrow (one of myeloproliferative disorders)

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5
Q

illustrate the Pathological findings of 1ry polycythemia

A

1- Cyanosis due to venous engorgement.
2- Enlargement of liver and spleen with foci of extramedullary hematopoiesis.
3- Increased tendency to thrombosis due to the high platelet count and increased viscosity of blood.
4- Liability to hemorrhages from mucous membranes due to fullness of small vessels with blood.
5- Peptic ulceration due to thrombosis of gastric small arteries.
6- Chronic myeloid leukemia and myelosclerosis may develop.

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6
Q

def of Secondary polycythemia

A

It is an erythropoietin-induced adaptive mechanism to improve the O2 supply to the tissue in conditions of prolonged reduction in O2 delivery to the tissues
- The increase in red blood cells is neither accompanied by leucocytosis nor increased number of platelets.

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7
Q

what’s the Causes of secondary polycythemia?

A

a- Hypoxia: as in
high altitudes, cyanotic congenital heart disease and chronic pulmonary disease.
b- Renal disease: as
renal cell carcinoma, congenital polycystic kidney and hydronephrosis due to secretion of an erythropoietin-like substance.

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8
Q

Definition of anemia

A

It is a decrease or deficiency of RBCs number or decrease in Hb conc. or decrease in both RBCs and Hb. in a unit volume of blood in the presence of a low or normal total blood volume

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9
Q

Classification of anemia can be based on either the ……….. or on………..

A
  • cause of anemia
  • its type
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10
Q

list Classification of anemia based on its CAUSE

A

1- Bone marrow hypofunction anemias.
2- Deficiency anemias.
3- Hemolytic anemia.
4- Hemorrhagic anemia.
5- Renal anemia.

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11
Q

list types of Bone marrow hypofunction anemias

A

A- Aplastic anemia
B- Leuco-erythroblastic anemia (myelophthisic anemia)

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12
Q

illustrate the condition Aplastic anemia

A

Due to bone marrow aplasia with depression in the formation
of RBCs, white blood cells and platelets (pancytopenia) even though all
ingredients necessary for hemopoiesis are available.

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13
Q

what happen in Leuco-erythroblastic anemia (myelophthisic anemia)?

A

The bone marrow is replaced by another tissue as metastatic tumors, myelosclerosis and lipid storage disease.

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14
Q

list causes of aplastic anemia

A

may be :
1) Destruction of the bone marrow due to :
- Excessive X-ray treatment.
- Certain industrial chemicals &drugs to which the person might be sensitive as :
chloramphenicol
Cytotoxic drugs
chloramphenicol
chlorpromazine
thiouracil
- Cancer.
2) Idiopathic (unknown cause that leads the bone marrow to stop functioning)

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15
Q
  • Deficiency anemias: It is caused by ………………..
A

dietary deficiency of a factor needed for erythropoiesis

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16
Q

list types of Deficiency anemias

A

(a) Iron deficiency anemia
(b) Vitamin B12 or Folic acid deficiency

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17
Q

-Iron deficiency anemia occurs when……………..
-because…………

A

-not enough iron is available for the synthesis of hemoglobin.
- because of either:
1- Iron deficient diet.
2- Poor iron absorption from digestive tract.
3- Chronic bleeding

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18
Q

list effect of iron deficiency anemia

A
  1. The number of erythrocytes produced is normal or reduced.
  2. The cells contain less Hb than normal (hypochromic)
  3. They are smaller than usual (microcytic) and are able to transport less O2
19
Q

Iron deficiency anemia causes……….

A

hypochromic microcytic anemia

20
Q

what’s Pathological findings of iron deficiency anemia?

A
  1. Oral manifestations as angular stomatitis.
  2. Plummer-Vinson syndrome: occurs in middle aged women with iron deficiency
    anemia, glossitis, stomatitis and dysphagia. It usually leads to post-cricoid carcinoma.
  3. Finger nails: Spoon shaped, brittle and lusterless.
  4. Bone marrow hyperplasia.
  5. Splenomegaly
21
Q

Deficiency of either vitamin b12 or folic acid or both causes……………

A

megaloblastic anemia
(maturation failure anemia)

22
Q

Because these vitamins are essential for the formation of…………, their deficiency leads to ……………….and thus failure of………..and …………, with slow reproduction of the erythroblasts in the bone marrow

A
  • DNA
    -diminished and abnormal DNA
  • nuclear maturation
    -cell division
23
Q

in vit B12 or folic acid deficiency, the erythroblasts in the bone marrow will fail to proliferate rapidly and will produce ……………called ………………They cannot proliferate enough to form normal number of red blood cells.

A

-RBCs larger than normal
-macrocytes or megalocytes.

24
Q

in vit B12 or folic acid deficiency:
The cells when enter the circulation are capable of ………….. normally,
but they are……… and so have a short life.

A

-carrying oxygen
- fragile

25
Q

illustrate the structure of cells in vit B12 or folic acid deficiency

A
  1. The number of the newly formed cells is markedly reduced.
  2. The cells are mostly oversized of bizarre shapes i.e. macrocytes showing,
    -Anisocytosis (variable size of the RBCs)
    -Poikilocytosis (variable shape )
  3. These cells are fragile and thus they rupture easily
26
Q

Vitamin B12 is also needed for …………, so its deficiency is accompanied
by neurological symptoms. It is also called ………..

A

-myelin formation
-pernicious anemia

27
Q

what’s Pernicious anemia or Addison’s anemia?

A

-It is a type of vitamin B12 deficiency anemia.
-With a familial tendency, common in subjects of blood group A.

28
Q

illustrate the cause of Pernicious anemia or Addison’s anemia.

A

It is due to inability to absorb adequate amounts of vitamin B12 from the digestive tract *(and not due to insufficient dietary supplies of vitamin B12).
This could be due to:
1- Genetic failure of gastric mucosal cells to produce the intrinsic factor.
2- An autoimmune disease where antibodies cause mucosal atrophy

29
Q

what’s the Treatment of Pernicious anemia or Addison’s anemia?

A

Injections of vitamin B12 to bypass the defective absorptive
mechanism.

30
Q

list Pathological findings of pernicious anemia or Addison’s anemia

A
  1. Hemosiderosis in parenchymatous organs due to continued absorption of iron which is not adequately used for erythropoiesis.
  2. Subacute combined degeneration of the spinal cord (B12 deficiency).
  3. Evidence of increased hematopoiesis:
    - Extramedullary foci of hematopoiesis in liver and spleen.
    - Moderate splenomegaly (pernicious anemia).
31
Q

………….do not occur in patients with folic acid deficiency.

A

Neurological changes

32
Q

Hemolytic anemia caused by………………………..

A

rupture of excessive numbers of circulating erythrocytes (excessive
hemolysis)

33
Q

As a result of Hemolytic anemia, there is reduction in ………with rise in……….. leading to ………….

A

-the RBCs count & in the blood Hb level
-serum bilirubin
- jaundice.

34
Q

illustrate the forms of Hemolytic anemia

A

A- Intracapsular defect (Hereditary):
1. Hereditary spherocytosis
2. Haemoglobinopathies (Abnormal Hb)
3. Enzyme-deficient RBCs

B- Extra corpuscular defects (Acquired):
1. Auto Antibodies
2. Iso-antibodies
3. Poisons
4. Incompatible blood transfusion.

35
Q

illustrate Hereditary spherocytosis in Hemolytic anemia

A

-Carried as an autosomal dominant gene.
-There is a defect in RBCs membrane with formation of nondeformable spherocytes highly vulnerable to destruction in the spleen

36
Q

illustrate Haemoglobinopathies (Abnormal Hb) in Hemolytic anemia

A
  • Sickle cell disease:
    Sickling occurs due to the insolubility of Hb-S and occurs when oxygen tension is reduced.
  • Thalassemia This occurs in Mediterranean. The production of α or B-chains of globin is impaired.
37
Q

in Hemolytic anemia , illustrate the role of Enzyme-deficient RBCs

A
  • Due to glucose-6-phosphate dehydrogenase deficiency in RBCs.
  • The RBCs are susceptible to hemolysis after administration of certain drugs as
    primaquine,
    sulphonamides,
    phenacetin
    aspirin
    or ingestion of fava beans (vicia faba) leading to favism.
38
Q

illustrate Extracorpuscular defects (Acquired) in Hemolytic anemia

A
  1. Auto Antibodies:
    As chronic lymphocytic leukemia, SLE
  2. Iso-antibodies:
    Erythroblastosis fetalis.
  3. Poisons:
    as snake venom or certain drugs if given in large amount as phenylhydrazine, arsenic and lead.
  4. Incompatible blood transfusion
39
Q

list Pathological findings of hemolytic anemias

A
  1. Bone marrow hyperplasia.
  2. Extramedullary hematopoiesis.
  3. Splenomegaly.
  4. Hemosiderosis.
  5. Gall bladder stones.
40
Q

Hemorrhagic anemia caused by ………………….

A

excessive blood loss, which can be:
1- Acute : bleeding from a wound.
2- Chronic: excessive menstrual flow or bleeding piles.

41
Q

illustrate Renal anemia

A
  • inadequate secretion of EPO hormone (as a result of kidney disease)
  • causes: insufficient red blood cell production and anemia.
42
Q

list Classification of anemia based on appearance of cells

A
  1. Normocytic normochromic anemia:
    -RBCs normal in size
    Hb content per cell is normal
    - example :
    aplastic anemia & hemorrhagic anemia
  2. Microcytic hypochromic anemia:
    -RBCs are smaller in size
    Hb is decreased in amount in each cell
    - example : iron deficiency anemia.
  3. Macrocytic anemia:
    -RBCs are larger in size
    - example :
    megaloblastic anemia.
43
Q

illustrate the General pathological effects of anemia

A
  1. Those due to hypoxia.
  2. Increased cardiac output to meet the oxygen demands of the tissues, eventually leading to heart failure.
  3. Pallor of skin and mucous membranes.
  4. Fatty change in parenchymatous organs.

physiology (9 decks)

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