Polycythemia (Exam 3) Flashcards
What is polycythemia?
increased RBC production | above-normal number of RBCs in circulation
What are the 3 main lab findings of polycythemia?
RBC > 6 million/uL | Hb = 18g % | Hct = 54 vol%
What are the 2 types of polycythemia?
relative and absolute
What is relative polycythemia?
loss of blood plasma = hemoconcentration (concentration of RBCs)
What is absolute polycythemia? What is it due to?
actual increase in total RBC mass (absolute) | due to stem cell defect
What are the 2 types of absolute polycythemia? Which one is more common?
primary absolute (polycythemia subra vera) | secondary absolute (more common)
What is Suprious polycythemia?
(stress-induced) stress = increase hormone levels in circulation = diarrhea
What are the 8 probable causes of relative polycythemia?
stress | decreased fluid intake | severe diarrhea | shock | vomit | burn | adrenal insufficiency | dehydration
Which type of polycythemia is more common?
relative polycythemia
What are the lab findings of relative polycythemia?
HIGH = RBC count, Hct, Hb | normal = MCH, MCV, MCHC
In primary absolute polycythemia, what is the main cause of the disease?
stem cell defect
How does primary absolute polycythemia lead to iron deficiency anemia?
increase RBC production = exhaust iron supply = iron deficient
What other diseases can primary absolute polycythemia lead to? (In who?)
leukemia (in older people)
What are the 3 causes of death from primary absolute polycythemia?
thrombosis | hemorrhage | leukemia
What are the 5 characteristics of primary absolute polycythemia?
enlarged veins | increase number of blood cells in circulation | spleenomegaly | gradual onset slow chronic progression | begins late middle life
Who is at high risk of getting primary absolute polycythemia?
males | European Jews
What are the 4 symptoms of primary absolute polycythemia?
headache/dizziness | dysfunctional platelets | increased risk of thrombosis | hyperuricemia
What causes the headache and dizziness in primary absolute polycythemia?
blood viscosity affects cerebral circulation = enlarged vessels in the brain
How can gout result from primary absolute polycythemia?
from thrombosis | related to a high uric acid levels
What is hyperuricemia?
increase uric acid due to increasing nucleic acid synthesis
What is uric acid?
end product of DNA degradation
What food should people with gout not eat?
internal organs since it has DNA
What are the 3 treatment methods of primary absolute polycythemia?
multiple venesections (phlebotomy) | BM transplant | radiation of metabolic cells in BM
What is secondary absolute polycythemia?
increase in RBCs only, not other blood cells
What are the 5 causes of secondary absolute polycythemia?
high altitudes | heavy smoking | pulmonary disorders | renal disease | toxins
What are the 3 pulmonary disorders that can lead to secondary absolute polycythemia?
fibrosis | emphysema | edema
What is the common underlying physiological cause of secondary absolute polycythemia?
low pO2
How can renal disease cause secondary absolute polycythemia?
increase erythropoietin (when not needed)
How can nitrites cause secondary absolute polycythemia?
nitrites = form MetHb = decrease pO2
What is nitrite?
strong oxidizing agent turning ferrous into ferric = low pO2
How can MetHb cause arrhythmia?
increase heart rate
What are the lab findings of secondary absolute polycythemia?
normal MCH/MCV/MCHC | high RBC count, Hct, Hb | BM normal but see mild increase of RBC precursors due to increase erythropoietin
What is the treatment for secondary absolute polycythemia?
supportive (cannot address fundamental cause)
