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Diagnostic medicine > Red Blood Cells > Flashcards

Red Blood Cells Flashcards

1
Q

how long do RBC live

A

120 days

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2
Q

why is the function of the shape of RBC

A

increases their surface area

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3
Q

do RBC have a nucleus? mitochondria?

A

no, no

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4
Q

how do red blood cells produce energy

A

glycolysis

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5
Q

why hormone do kidneys produce that is related to RBC

A

erythropoietin, travels to the bone marrow and stimulates the production of RBC

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6
Q

how many hemoglobin molecule are in a single red blood cell

A

250 million

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7
Q

RBC production should equal

A

the amount of RBC lost

as RBC’s loose ability to bend through capillaries w/ age and are lysed or they are removed by macrophages located in the spleen, liver, and other lymphatic tissues.

parts of the RBC (like amino acids) are reused

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8
Q

a reticulocyte becomes

A

a RBC after the first 4 days

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9
Q

what is the key function of RBCs

A

to transport O2 within the body

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10
Q

what is done with the bilirubin from RBC after they are killed

A

it is sent back to the kidney

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11
Q

what is done with the Fe from RBC after they are killed

A

reabsorbed to various tissues

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12
Q

when oxygen is decreased the kidneys

A

kidney releases erythropoietin which triggers stem cell hematopoiesis which leads to an increased erythrocyte production which will ideally leading to increased blood O2

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13
Q

male RR RBC

A

4.7-6.1 x 106

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14
Q

Female RR RBC

A

4.2-5.4 x 106

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15
Q

what is a RBC

A

A count of the number of circulating RBCs in peripheral venous blood, important because RBCs contain hemoglobin

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16
Q

Hemoglobin RBC male

A

14-18 g/dl

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17
Q

Hemoglobin RBC female

A

12-16 g/dl

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18
Q

what is a hemoglobin count

A

a measure of the total amount of hemoglobin in the blood

important because Hgb binds & transports oxygen

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19
Q

Hematocrit male range

A

42-52%

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20
Q

Hematocrit female range

A

37% to 47%

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21
Q

Hematocrit RBC measures

A

Measure of the percentage of the total blood volume that is made up by RBC’s

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22
Q

The Hct (%) is approximately __ times that of the Hgb (g/dl) concentration

A

3

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23
Q

Peripheral Smear

A

look at RBC for shape and size variation
The degree of anisocytosis correlates with the RDW
Poiliocytosis suggests a defect in the maturation of RBC precursors
We can look for specific abnormalities

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24
Q

anisocytosis

A

size variation

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25
Q

poliocytosis

A

shape variation

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26
Q

specific abnormalities we look for in peripheral smear

A

Target cells, Fragmented cells, Sickle cells

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27
Q

what do target cells look like on a peripheral smear

A

bull’s eye appearance suggesting thalasemia or liver disease

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28
Q

Fragmented cells

A

foreign bodies in blood like from hrt valve and thermal injury

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29
Q

RBC Count – Abnormalities

increased RBC count

A

Dehydration
COPD
Polycythemia vera

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30
Q

RBC Count – Abnormalities

decreased RBC count

A

Anemia

Bleeding / Fe deficiency
B12, Folate deficiency
Hemolytic anemia
Cirrhosis
Bone marrow failure
Pregnancy
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31
Q

When there abnormalities in RBC count we can assume there will be

A

abnormalities in Hgb & Hct

32
Q

Polycythemia / Erythrocytosis

A

Increased RBCs & Hgb/Hct levels

33
Q

if a patient present with complains of Dehydration
presents with Polycythemia vera
and has a history or Smoking & COPD or High altitude, what diagnosis would you consider

A

Polycythemia / Erythrocytosis

34
Q

Polycythemia relative

A

causes artifact of concentration

Due to decreased plasma volume (dehydration)

35
Q

Polycythemia relative labs

A

Elevated Hct with normal RBC mass

36
Q

Polycythemia absolute

A

causes a true increase in RBC mass

37
Q

Polycythemia vera

A

bone marrow disorder characterized by overproduction of erythroid cells
Results in absolute polycythemia

38
Q

secondly polycythemia

A

due to increased erythropoietin production

Tissue hypoxia is major cause (COPD & living at high altitude)

39
Q

Polycythemia vera labs

A 
Elevated Hct with increased RBC mass 
Elevated Hgb/Hct = characteristic initial finding
Also present:
Leukocytosis
Thrombocytosis
40
Q

how do you differentiates between relative or absolute polycythemia

A

by red blood cell mass changes

41
Q

if a patient presents with history of HA, dizziness, tinnitus, blurred vision
Fatigue
Pruritus following warm shower or bath
which diagnosis do you consider?

A

Polycythemia vera

42
Q

Polycythemia vera physical findings

A

Engorged retinal veins
Thrombosis
Splenomegaly

43
Q

treatment for Polycythemia vera

A

phlebotomy

44
Q

Most common hematologic disorder in the U.S. affecting ~3 million

A

anemia

45
Q

anemia is not a ______ it is a ______

A

diagnosis, it is a condition

46
Q

anemia RBC deficiency and dysfunction

A

Abnormal RBC size / shape
reduced RBC number
reduced Hemoglobin (Hb) (important)

47
Q

common manifestations of anemia one in red

A 
yellowing or red eyes 
fainting 
chest pain 
angina 
heart attack
48
Q

Koilonychia

A

hallowing of the nails, common with anemia

49
Q

Pica

A

craving on non food items common with anemia

50
Q

anemia can result from reduced production of RBCs causing

A 
B12, Folate, Iron deficiencies; bone marrow failure
Renal failure (↓erythropoietin)
51
Q

anemia can result from increased destruction of RBCs causing

A

Hemolysis

may result from Hemoglobinopathies and drugs

52
Q

anemia can result from loss of RBCs causing

A

Bleeding (chronic blood loss causes iron deficiency anemia)

53
Q

Anemia – RBC Indices

A

Aid in determining etiology of anemia

54
Q

MCV

A

measure of ave. RBC size
microcytic (little)
normocytic
macrocytic (big)

55
Q

MCH

A

weight of Hgb in RBC

56
Q

MCHC

A

Hgb concentration

hypochromic, normochromic, hyperchromic

57
Q

RDW

A

Measure of variation in RBC size

Indicates degree of anisocytosis (variation in RBC size)

58
Q

Macrocytic

A

MCV > 100 fl

59
Q

Normocytic (normal)

A

MCV 80-99 fl

60
Q

Microcytic

A

MCV < 80 fl

61
Q

Hyperchromic (bright color)

A

MCH>31

62
Q

Normochromic (normal color)

A

MCH 27-31

63
Q

Hypochromic (pale color)

A

MCH <27

64
Q

Iron deficiency

A

Microcytic hypochromic
decreased MCV & decreased MCHC

Usually due to secondary to chronic blood loss
such as GI bleed and Menstrual blood loss

65
Q

mild microcytic hypochromic anemia with basophilic stippling on peripheral smear may indicate

A

lead poisoning

66
Q

Thalassemia

A

Hereditary disorder characterized by reduced synthesis of globin chains

67
Q

Thalassemia minor

A

RBCs will be small (↓ MCV), but total RBC count may be normal or elevated (microcytosis is out of proportion to degree of anemia)

Peripheral smear may reveal target cells & basophilic stippling

68
Q

Thalassemia diagnosis

A

Hemoglobin electrophoresis
Detects abnormal forms of Hgb (hemoglobinopathies)
Can also be used to diagnose sickle cell anemia

69
Q

Different Hgb variations (eg. A1, A2, F, S)

A

in Thalassemia
Hgb from lysed RBCs placed on electrophoresis paper in an electromagnetic field - Hgb variants migrate at different rates & a pattern of bands is created
causes a particular patterns of bands

70
Q

Normocytic

A 
Normal MCV / normal-sized RBCs
Anemia of chronic disease 
e.g, autoimmune diseases, malignancy
Renal failure
Acute blood loss
71
Q

Macrocytic

A

increased RBC count and increase MCV
causes may be a
Vitamin B12 deficiency
Folate deficiency

72
Q

Regular alcohol consumption can cause a _______ with or without anemia

A

macrocytosis

73
Q

Macrocytic anemia

A

often results from B12 and/or folate deficiency

The deficiency causes inhibition of DNA synthesis during RBC production → leads to cell growth without division (development stops) = big RBCs

Characterized by many large immature dysfunctional RBCs (megaloblasts) in the bone marrow and by hypersegmented neutrophils (≥ 5 lobes/segments)

74
Q

Pernicious anemia

A

Results from autoimmune destruction of gastric parietal cells causes a reduction intrinsic factor (IF) causes a decreased absorption of B12 – leads to decreased B12 which can lead to megaloblastic anemia

75
Q

Risks associated with anemia Cardiac events

A

MI, CHF, CVA (due to increased workload on heart)

76
Q

Hgb <8 g/dl and or Hct <24%

A

Consider transfusion
Depends on clinical picture
Consider transfusion in an elderly person with CAD if Hgb <10 g/dl

77
Q

Critical H/H values <5g/15%

A

this is a really low level

Diagnostic medicine (9 decks)

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