RBC Disorders Flashcards
reticulocytes
rate of RBC production
indicator of how active bone marrow is at pumping out RBCs
hemoglobin
Hb content in blood
hematocrit
volume of cells in 100mL of blood (RBC count)
mean corpuscular volume (MCV)
size of the RBC
normocytic
mean corpuscular Hb concentration (MCHC)
concentration of Hb in RBC
normochromic
ferratin
measure of body’s iron stores
iron bound to ferratin protein and stored in liver
hypochromic
MCHC –> pale cell (not enough Hb packed into cell relative to its size)
macrocytic
RBC too big (too much time in maturation –> cannot fit through capillary bed)
microcytic
RBC too small (not very much Hb within; released before they reach full size)
erythrocytes
erythropoeisis –> reticuloctyes are released from red bone marrow (immature, no biconcave shape, not as flexible = cannot function as well) –>
erythroctyes (RBCs) = mature, biconcave disc, flexible; contains Hb
lifespan 120 days
no nuclei or mitochondria
erythropoeitin (EPO)
stimulates RBC production
not enough O2 in blood –> kidney senses drop in partial pressure –> produces EPO (acts on red bone marrow to produce RBCs)
hemoglobin synthesis
rate depends on iron availability
if we do not have Hb –> RBC synthesis is impacted –> smaller cells
transferrin
iron transported (iron transported in blood to red bone marrow –> used in synthesis of RBC)
breakdown of Hb
aged RBCs go to spleen
body reuses components –> Hb broken into heme (iron) and globin (AA chain) –> iron reused to make new RBCs
anemia
deficient RBC production or insufficient Hb
common lab test of all anemias
low Hb
low hematocrit
Hb deficit caused by
reduction in total number of RBCs
decrease in quality/quality of Hb
deficit = reduction in O2 carrying capacity –> impacts how our other tissues are able to operate
typical anemia manifestations
fatigue
tachycardia
pallor
dyspnea
persisting anemia
oxygen deficit prolonged –> decreased regeneration of epithelial cells
- digestive tract becomes inflamed and ulcered (stomatitis)
- inflamed and cracked lips
- hair and skin brittle
- dysphasia (cannot get words out)
severe = angina or CHF
iron deficiency anemia: lab test
low ferratin
low MCHC (hypochromic)
low MCV (microcytic)
IDA: manifestations
typical of anemia
pica
IDA: causes
- increased requirements
- decreased intake
- decreased absorption
- increased loss (acute and chronic)
megaloblastic anemia
large, immature blood cells (macrocytic)
folic acid deficiency or perniculous anemia
folic acid –> improved with diet or supplement
PA –> not improved with diet
low folic acid levels due to
medication (methotrexate)
increased demand (pregnancy, puberty, exercise)
impaired absorption (alcoholism. CD)
perniculous anemia
vitamin B12 deficiency
lack of absorption of b12 (due to lack of intrinsic factor)
large, immature, nucleated RBCs (spend more time in DNA synthesis)
carry less Hb (relative to their size) and have shorter life span
PA: lab test
normal ferratin
low B12
normal MCHC
high MCV
PA: manifestations
typical anemia
tongue enlarged (red, shiny, sore)
digestive discomfort
feelings of pins and needles, tingling in limbs
aplastic anemia
impairment or failure in bone marrow
pancytopenia –> reduction in all 3 stem lines
aplastic lab tests:
normal ferratin
normal MCHC
normal MCV
low RBC
aplastic: signs and symptoms
leukopenia –> increased infection
thrombocytopenia –> bleed and bruise more easily
typical anemia
AA: causes
cancer or cancer treatment
genetic (hereditary)
viruses (Hep C)
AA: treatment
treat underlying cause; transfusion may be necessary or bone marrow transplant
polycythemia
too many RBCs
high RBC count (hematocrit > 50%)
primary polycythemia
polycythemia vera
neoplastic disorder
increased production of RBC and other cells in bone marrow
not EPO issue (Serum levels low)
secondary polycythemia
erythrocytosis
prolonged hypoxia –> increase in RBCs (EPO secretion high)
compensation mechanism
respiratory disease or altitude
poly: manifestations
distended BVs (sluggish blood flow)
increased BP
hypertrophied heart
thromboses and infarctions
hepatomegaly and splenomegaly
dyspnea
headaches
visual disturbances
