pom-rbc disorders Flashcards
polycythemia-
myeloproliferative disorder leading to overproduction of rbc- polycythemia vera
primary cause of polycethemia
ideopathic- 10M/mm
cyanosis secondary to decreaesed blood flow/stasis
secondary cause
drugs, high altitude, chronic smoker
anemia-
reduction in o2 carrying capcity of blood resulting from a decreased amount of hemoglobin
labs to look at that include rbc
hematocrit, hemoglobin, rbc count
reticulocyte
immature rbc
narrowing down diagnosis of anemia- reduce the diag by these lab result
low eticulocyte count (hypoproliferative anemia), speriopheral blood smear shows sickel cells, spherocytes, schistocytes
elevated reticulocyte count in pt with anemia indicates
acute blood loss, peripheral rbc destruction
types of hypoprolierative anemia
macrocytic, microcytic-hypochromic,normochromic-chormocytic
macrocytic hypoprolierative anemia cuased by
vit b12, folar def
microcytic - hypochromic hypoprolif anemia caused by
iron def, thalassemia
normochromic/normocytic hypoproliferative anemia caused by
secondary anemia, marrow aplasia
hemolytic anemai- 4 types
immune hemolysis, mechanical hemolysis, sickel cell anemia, g6pd deficiency
b12 def- what is b12 for?
dna synth
poikilocytes
seen in b12 def, - large cells with small immature nuclei
cuases of b12 def- 4
pernicious anemia, gi bac overgrowth, loss of ideal fxn, vegetraian diet
what tests to do do diag b12 def
meausre serum b12, peripheral blood film, elevated ldh, plasma bilirubin, iron, schilling test
schilling test-
test dose of b12 is administern, then intestinal absoprtion is measured
b12 deficiency can lead to this nerve problem
demylination of peripheral nerves- leads to megaloblasitic madness, glossodynia
pernicious anemia is assoc with
atrophic gastritis
poor vit b12 in pernicous anemia bc of loss of
intrinsic factor
what do you see in the labs for pernicious anemia
macrocytic or normocytic cells on smear elevated mcv and mch while normal mchc large platelets, hypersegmented pmns serum levels schilling test
folate deficiency
just take supplement, no big deal
iron deficiency is a ? type anemia
micro
clinical features of iron def
parasthesia, glositis, angular chelitis, pallor
iron def diag
microcytiic hypochromic anemia on blood film, rbc incices- mcv, mch, mchc iron and ferrin conc
how to tx iron def
give iron- can give orally but tast e bad but do first
thalessemia
decreased sytn of globin chains
major thalassemia
homozynous
minor thalassemia
heterozygous
rbc count in minor thal
> 5.5 million/ml
are iron stores normal in mild thalassemia
yes
what is normochromic-normocytic anemia usually from?
secondary anemia to chronic inflamm state or uremia- renal failure, or marrow aplasia,
aplastic anemia
bone marrow failure- mno blood cells
fanconi’s anemia
aplastic anemia, childhood, rare auo recessive, can cause oral cancer, risk of infection
in hemolytic anemia you see
decreased hemoglobin- bone marrow can’t keep up with what is being lysed
immune hemolysis
warm igg reacting anti rbc ag- detect with coombs test
mechanical hemolysis
lysis is caused by prosth heart valvue, malignatnt hypertension, disseminated intravstular coag, thrombotic thromccytopenia purpura
blood film in mechanical hemolysis shows:
schistocytes, and other rbc fragments
sickel cell anemia
altered hbg, auto recessive, betwa chain hemoglobin
problems in pt with sickel anemia
consequnces of tissue infaction, recurrent sickel crisis
g6pd deficiency
x-linked, most common metab disorder of rbcs
2 forms of g6pd def
a form, mediterranean type (acute and fatal)
action of g6pd
protect rbc from oxidative damage by main intracellular nadpa
clinical signs of hemolytic anemia
pallor of oral tissue, jaundice, koilonychia, atrophy of tongue, esophageal stricture, dyspaha, increased trabeculation
sickel cell anemia- clinical signs
hair on end lateral ceph, ladder like appears of alveolar bone, increased trabeculation, hypoplasia of dentision, dense lamina dura, area of scleroisis, thickend diploe on skull films shows hari on end
clinical signs of thalessemia
chipmunk face, hair on end, nerve palsies, discoloration of teeth
clinical signs of b12 and pernicious anemia
neuro manif, skin pigmentation, systolic murmur, tonue atrophy and glossodynia, dyspha and taste alteration
folic acid signs
neural tube defect, pharyntis, uclertive stomatistis, angular chelitis
aplastic anemia signs
bornw skin, mental and sexual retard, oral petichia, gingival hypertrophy, spontaneous gingival hemorrhage, increased herpetic leasions
