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Bloc B - Respiration > RBC anemia Oct3 M2 > Flashcards

RBC anemia Oct3 M2 Flashcards

1
Q

normal WBC count

A

4-11x10E9 per L

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2
Q

normal platelet count

A

100-400x10E9 per L L

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3
Q

normal Hb value

A

120-160

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4
Q

Hb value in men and women

A

women menstruating age: 120-135

men: 140-155, 130 in older age bc have less testosterone

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5
Q

normal RBC value

A

3.9-6.5 x 10E12 per L

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6
Q

normal mean cell volume (RBC) (MCV)

A

80-95 fl

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7
Q

normal hematocrit

A

0.35 to 0.53% (45%)

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8
Q

sickle cell anemia cause

A

mutation in beta chain of Hb

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9
Q

thalassemia cause

A

defect in prod of alpha or beta chain

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10
Q

reticulocyte def

A

immature RBC still containing rRNA

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11
Q

name for abnormal MCV values (2)

A

microcytosis or macrocytosis (less than 80 fl or more than 95 fl)

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12
Q

erythropoeisis phases in the blood

A

reticulocyte and RBC phase

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13
Q

reticulocytes in anemia

A

elevated in blood

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14
Q

what controls level of erythropoeisis and how

A

EPO secretion by kidneys, kidneys sense O2 level. EPO acts on erythroid precursors

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15
Q

6 causes of anemia (think about birth to death of RBC)

A
  • deficiency in nutrients
  • abnormal RBC content (Hb)
  • abnormal erythropoesis site
  • chronic illness suppressed erythropoeisis
  • loss of RBC
  • decreased RBC lifespan
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16
Q

how can one be deficient in nutrients of RBCs

A

Iron (heme group) (menstruating women), B12 and folate (vitamins essential to DNA synthesis)

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17
Q

how can one have deficient Hb (2 ex) and why causes anemia

A

thalassemia
sickle cell anemia
increases hemolysis

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18
Q

sickle cell anemia: cause of the shape problems

A

Hb precipitates.
Cell can’t move in capillaries (stroke, pulm hypertension, occlusive pain crises)

fragile RBC, broken down in spleen. 10-20 days survival

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19
Q

how can one have abnormal erythropoeisis site (give 2)

A

1-aplastic anemia (empty bone marrow)

2-bone marrow space filled with something else (leukemia, lymphoma, cancer)

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20
Q

how can one have anemia bc of a chronic illness (or rather why)

A

chronic inflamm state, interleukin prod (cytokines). IL suppresses bone marrow erythropoeisis.

renal disease (EPO prod affected), lupus, heart disease, rhumatoid arthrisis

21
Q

how can one have loss of RBC

A

bleeding (menses, nose bleeds. called epistaxis)

22
Q

how can one have a decreased RBC lifespan

A

increased hemolysis

23
Q

3 steps to anemia investigation

A

history, physical exam, lab investigations

24
Q

5 things to cover in history for anemia

A
  • diet
  • ethnic origin
  • fatigue, weight loss, bruising, feeling unwell (showing bone marrow failure)
  • chronic illness
  • loss of blood
25
Q

5 things to cover in physical exam for anemia

A
  • signs of anemia
  • bone marrow failure
  • chronic disease
  • hemolysis
  • bleeding
26
Q

signs of anemia on physical exam (relating to diet or general) (4)

A
  • pallor (hands’ creases, lower eye lid)
  • koilonichia (nail spooning) shows iron def
  • enlarged smooth tongue shows b12 def
  • tachycardia
27
Q

anemia on physical exam: bone marrow failure signs

A

infection, bruising, petechiae (tiny red dots in legs)

28
Q

anemia on physical exam: chronic illness signs

A

look for evidence of chronic illness (sepsis, lupus, dialysis showing renal failure, rheumatoid arthrisis)

29
Q

anemia on physical exam: signs of hemolysis (2)

A
  • jaundice. heme converted to bilirubin

- splenomegaly

30
Q

anemia: signs of bleeding on physical exam

A
  • nose bleed

- GI bleeding

31
Q

4 things to cover in lab investigations for anemia (includes 3 most important)

A
  • reticulocyte count
  • MCV
  • CBC
  • other lab values
32
Q

reticulocyte count shows what (if increased and if decreased). comes back to 6 causes

A

increased: blood loss, hemolysis, diet deficiency supplemented
decreased: abnormal bone marrow, chronic illness, diet deficiency unsupplemented

33
Q

CBC: what to look for and what it can tell us

A

WBCs
RBCs and Hb
platelets

if 2+ deficient, BM or diet problem

34
Q

MCV: what microcyticanemias show

A

-microcytotic show Hb synthesis deficiency

35
Q

4 causes of microcytic anemia

A

iron deficiency
thalassemia
sideroblastic anemia
chronic illness

36
Q

2 types of macrocytic anemias, what they show, how to distinguish them

A

megaloblastic (more than 108 fl): abnormal DNA synthesis

non-megaloblastic (95-108 fl): RBCs large for other reason

37
Q

MCV: causes of megaloblastic anemia (4)

A
  • B12 deficiency
  • Folate deficiency
  • Drugs (chemo)
  • myelodysplastic syndrome
38
Q

MCV: causes of non-megaloblastic anemia (3)

A
  • reticulocytosis
  • liver disease
  • thyroid disease
39
Q

normocytic anemia: what we usually see and causes

A

low retic count: shows cause is aplastic anemia, leukemia (primary bone failure) or renal failure, chronic illness (BM suppression)

40
Q

other lab investigations: what peripheral blood smear helps see

A

RBC shape (sickle cell, fragments show hemolysis, ancanthocyte shows liver prob, elliptocyte shows membrane prob)

41
Q

other lab tests used in anemia

A

ferritin, serum iron, b12 and folate, liver renal thryoid function, BM aspirate, % sat, Hb electrophoresis for Hb problem

42
Q

main sign of hemolysis

A

elevated reticulocyte count

43
Q

4 causes of hemolysis

A

Hb problem, enzyme problem, membrane problem, external problem

44
Q

ex of extra corpuscular problems giving hemolysis (2)

A
  • autoimmune hemolytic anemia

- heart valves violent flow

45
Q

ex of cell membrane problem giving hemolysis (2)

A
  • elliptocytosis

- spherocytosis

46
Q

ex of Hb problem giving hemolysis (2)

A
  • sickle cell

- thalassemia

47
Q

ex of enzyme problem giving hemolysis (2)

A

G6PD deficiency, pyruvate kinase deficiency

48
Q

what lab investigations can show hemolysis (think of 4 causes of hemolysis + consequence)

A

-retic count (main)

  • anti-globulin (Coomb’s) test
  • blood smear
  • Hb electrophoresis
  • enzyme levels
  • haptoglobin
  • bilirubin
  • LDH (lactate dehydrogenase)
49
Q

haptoglobin job and value in hemolysis

A

free in blood and binds Hb. we measure free haptoglobin so drops in hemolysis

Bloc B - Respiration (36 decks)

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