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NUR 326-Pathopharm > RBC Disorders > Flashcards

RBC Disorders Flashcards

1
Q

Role of Hemoglobin

A

-reversibly binds oxygen and CO2 for transport
-adequate Hgb necessary for oxygen delivery to the tissues

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2
Q

diseases of red blood cells

A

-relate to either quantity or quality
-all diseases of RBC’s mean less oxygen is able to be transported to the tissues

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3
Q

macrocytic-normochromic

A

-large, abnormally shaped erythrocytes
-hemoglobin concentrations normal
-B12 and folate deficiencies

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4
Q

microcytic-hypochromic

A

-small, abnormally shaped cells
-reduced hemoglobin concentrations
-Iron-deficiency

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5
Q

normocytic-normochromic

A

-normal size
-normal hemoglobin function
-blood loss, sickle cell, aplastic anemia

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6
Q

iron is essential for

A

normal hemoglobin function

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7
Q

folate and vitamin B12 are necessary for

A

normal DNA synthesis of RBC’s

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8
Q

normal Hemoglobin level

A

women: 12-16 g/dL
men: 14-18 g/dL

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9
Q

lab values in anemia: mild

A

hgb women: 10-12 g/dL
hgb men: 10-13.5 g/dL

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10
Q

lab values in anemia: moderate

A

hgb: 8- <10 g/dL

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11
Q

lab values in anemia: severe

A

hgb: <8 g/dL

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12
Q

clinical manifestations of ALL anemias

A

-decreased oxygen carrying capacity
-mild-may have no symptoms
-moderate: fatigue, weakness, tachycardia, dyspnea
-severe: increased HR and RR, hypotension, pallor, faintness, CV symptoms

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13
Q

iron deficiency anemia: etiology

A

-most common anemia
-decreased intake of iron
-impaired absorption of iron
-increased demand for iron
-excessive loss (GI bleed, menstruation, etc.)

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14
Q

iron deficiency clinical manifestations

A

-general s/s of anemia plus:
-smooth tongue/glossitis/mouth ulcers/cheilosis
-koilonychia “spoon nails”
-pica- craving non food items (ice mainly)

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15
Q

anemia from B12 deficiencies

A

also called megaloblastic /macrocytic

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16
Q

megaloblastic anemia

A

-condition in which the bone marrow produces unusually large, structurally abnormal, immature RBC’s
-leading cause is B12 and folic acid deficiency
-most common in the elderly

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17
Q

causes of anemia r/t deficiency of vitamin B12

A

-atrophic gastritis- stomach lining has thinned
-conditions that affect the small intestine, such as Crohn’s, celiac, bacterial growth, or a parasite
-autoimmune disorder-pernicious anemia (most common cause)

18
Q

manifestations specific to B12 deficiency

A

-s/s of anemia plus:
-neuropathy
-ataxia
-glossitis
-dementia/psychosis

19
Q

anemia r/t folate deficiency

A

-folate is a B9 vitamin that is needed for RBC formation
-problem with decreased intake (alcoholism, diet, cirrhosis)
-increased need (pregnancy)

20
Q

anemia of CKD

A

-main etiology: impaired erythropoietin production
-hgb/hct correspond with the degree of kidney insufficiency
-clinical manifestations: general s/s of anemia

21
Q

aplastic anemia

A

-primary condition of bone marrow stem failure
-autoimmune most common cause
-classified as: congenital or acquired
-characterized my PANCYTOPENIA
-treatment: blood transfusions, bone marrow transplant, immunosuppressants, corticosteroids, drugs to stimulate erythropoiesis

22
Q

causes of aplastic anemia

A

-idiopathic
-high dose exposure to toxic agents
-autoimmune mechanisms

23
Q

increased destruction of RBC’s

A

-abnormal hemoglobin: acquired hemolytic anemia; sickle cell anemia; thalassemia

24
Q

acquired hemolytic anemia

A

premature destruction of RBC’s caused by some external agent

25
Q

causes of acquired hemolytic anemia

A

-autoimmune attack
-blood incompatibilities
-drug reactions

26
Q

hemolytic anemia

A

-formation of immune complexes
-lysis
-look for: low hgb, increased reticulocyte count, mild jaundice, hemoglobinuria

27
Q

anemia r/t abnormal hemoglobin

A

-sickle cell diseases
-thalassemia

28
Q

sickle cell anemia

A

-genetic disorder
-inability to bind hemoglobin normally
-hemoglobin S distorts shape, especially when oxygen is low
-easily clog blood vessels and break into pieces that disrupt blood flow leading to ischemia and necrosis

29
Q

clinical manifestations: sickle cell anemia

A

-s/s general anemia
-swelling of hands and feet with a fever
-painful episodes/crisis from ischemia and necrosis from clogged vessels
-crisis triggers: dehydration, stress, high altitude, fever, extreme temps

30
Q

sickle cell anemia treatment

A

-oxygen therapy
-hydration
-pain management
-infection control measures
-antimetabolite drug: hydroxyurea
-blood transfusions
-bone marrow transplants

31
Q

thalassemia

A

-genetic- mostly mediterranean descent
-abnormal hgb makes erythrocytes microcytic, hypochromic, and of carrying size
-lack of one of two proteins that make up hemoglobin- alpha and beta globin

32
Q

thalassemia treatment

A

-blood transfusions
-bone marrow transplants
-splenectomy

33
Q

thalassemia clinical manifestations

A

-delayed growth
-fatigue
-dyspnea
-hepatomegaly (enlarged liver)
-splenomegaly (enlarged spleen)
-bone deformities
-jaundice

34
Q

acute blood loss

A

-500 ml- sx are rare; possibly syncope
-1000 ml- increased HR with exercise
-1500 ml- flat neck veins when supine; increased HR with exercise; decreased bp when sitting up/standing
-2000 ml- increased HR, and decreased BP when supine; air hunger, cool, clammy skin
-2500 ml- shock and death

35
Q

anemia due to blood loss

A

results from: gross or occult
-rate of blood loss is important- acute vs. rapid

36
Q

disorder of too many RBC’s polycythemia risk factors

A

-chronic hypoxia
-living at high altitudes
-long term cigarette smoking
-familial and genetic predisposition
-long term exposure to CO2

37
Q

relative polycythemia

A

-isolated decreased in plasma volume which elevates the Hgb, Hct, and RBC count
-etiology: severe dehydration

38
Q

primary polycythemia

A

-polycythemia vera
-typically >60 years
-most often occurs in men

39
Q

polycythemia vera patho

A

a single stem cell mutates into a cell that overproduces all blood cells except for the lymphocytes

40
Q

polycythemia vera manifestations

A

-many complaints (headache, fatigue, weight loss, dyspnea)
-HTN
-clotting problems
-ruddy color
-intense/painful itching intensified by heat or exposure to water
-biggest concern is CV events- stroke/heart attack from clots

41
Q

secondary polycythemia

A

-etiology: adaptive response to tissue hypoxia
-purpose: provide more oxygen carriers by increasing RBC production

42
Q

secondary polycythemia manifestations

A

-increased blood viscosity and volume cause HTN (headache, inability to concentrate, dusky red coloring, possible cyanosis of lips, nails, mucous membranes
-hyper-metabolism causes: night sweats and weight loss
-increased RBC and h&h causes: itching and pain and fingers in fingers and toes

NUR 326-Pathopharm (24 decks)

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