Red Blood Cells, Anemia and Polycythemia Flashcards

1
Q

What is the volume of blood in the average adult?

A

~5.5 L

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2
Q

RBC do not have what important organelles?

A
  • Nucleus

- Mitochondria

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3
Q

Hematocrit

A

%RBC/Volume

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4
Q

Normal Hematocrit in Males

A

40-50%

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5
Q

Normal Hematocrit in Females

A

36-47%

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6
Q

Organs that produce RBC in adults

A

Bone Marrow

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7
Q

Organs that produce RBC in the fetus

A

Yolk, PAS/AGM, Liver, Blood, Thymus bone marrow

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8
Q

Life span of the RBC

A

120 Days

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9
Q

Life span of the RBC in sickle cell anemia

A

10-15 days

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10
Q

Name of the primary stem cell for blood components

A

Pluripotent Hematopoietic Stem cell (PHSC)

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11
Q

Name the two important progenitor cells PHSC divides into

A
  • Common Myeloid Progenitor

- Common Lymphoid Progenitor

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12
Q

What is the first recognizable cell in the genesis of RBC

A

Proerythrocyte

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13
Q

What is the name of immature RBCs?

A

Reticulocyte

-retain residual RNA/Mitochondria

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14
Q

How long does it take a reticulocyte to mature into a mature RBC?

A

2 days

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15
Q

When are elevated counts of reticulocytes found in the blood?

A

In patients who’s condition requires accelerated RBC production (bleeding)

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16
Q

Erythropoetin

A

Hormonal control of RBC production

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17
Q

What organs release EPO and to what stimuli?

A

Kidneys, and to hypoxia.

-Kidneys sense decreased oxygen levels and release erythropoetin that act on the progenitor cells in bone marrow to increase production of RBC

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18
Q

Steps in Hemoglobin formation (Busy Card)

A
  1. Succinyl Coa + 2 Glycine –> 4 Pyrrole
  2. 4 Pyrrole –> Protoporphyrin IX (Key step)
  3. Protoporphyrin IX + Fe2+ –> Heme
  4. Heme + Polypeptide–> Hemoglobin Chain (alpha, beta)
  5. 2 Alpha + 2 Beta Chains –> Hemoglobin A
19
Q

Fetal Hemoglobin (Hgb F)

A

Alpha2, Gama2

20
Q

Hemoglobin A

A

Alpha2, beta2

21
Q

Why is Iron important in the RBC?

A

It is important for Hgb to carry oxygen

22
Q

Ferritin

A

Where iron is stored in the tissues

-primarily liver and spleen

23
Q

Transferrin

A

Where Fe is bound in the blood

24
Q

Hemosiderin

A

Pathological form of iron storage. The iron is not readily available.

25
Q

What is the most important consequence of Anemia?

A

not transferring enough oxygen

26
Q

Causes of anemia

A

1-blood loss
2-increased RBC destruction (hemolysis)
3-Decreased production (malnutrition)

27
Q

In acute bleeding, H/H stay normal until?

A

Plasma volume is restored

28
Q

Each mL of blood loss is associated with what measurable loss in iron?

A

0.5mg

29
Q

Anemias associated with increased destruction of RBCs

A
  • Membrane defects
  • abnormal hemoglobin (SCD)
  • Immune hemolysis
  • mechanical injury (burns, prosthetic valves)
  • normoblasts being destroyed (thalessemia)
30
Q

Ongoing hemolysis will result in what 3 things?

A
  • Increased total body iron
  • jaundice and bilirubin gallstones
  • expansion of marrow space, increased reticulocyte count
31
Q

What percent of iron is stored in hemoglobin?

A

65%

32
Q

Anemias associated with decreased production of RBCs

A
  1. Lack of Iron, Folate, B12
  2. Low levels of EPO, thyroid hormones, androgens
    - renal disease
  3. Nought enough heme rings on globin chains
  4. Bone marrow dysfunction
  5. Infiltrative disease of bone marrow
33
Q

What nutritional deficiencies can lead to anemia?

A

Iron, B12, Folate

34
Q

What population is Iron deficiency anemia most commonly seen?

A
  • Women of child bearing age as a manifestation of hemorrhage
  • 4-8% of premenopausal women
  • GI neoplasm with GI bleeds- may remain undetected for a while
35
Q

Dietary lifestyles leading to iron deficiency anemia

A

1- vegetarians
2-Old people
3- Picca

36
Q

Pernicious anemia

A

-Vit. B12

37
Q

Sources of dietary Vit. B 12

A

Meat/Dairy

38
Q

Causes of pernicious anemia

A
  • Vegan lifestyle (70% of vegans B12 deficient)

- GI malabsorption (chronic atrophic gastritis)

39
Q

Most common symptom of Vit. B12 deficiency

A

loss of proprioception

  • will also see paresthesia and eventually dementia
  • Due to demylenation of posterior columns of the spinal cord
40
Q

Anemia in the elderly

A
  • While common is still ABNORMAL
  • do not have a lower normal range
  • increased risk for mortality
41
Q

Polycythemia

A

Too many RBCs

  • Factor intrinsic to RBC precursors
  • Functional hypoxia
42
Q

Hematocrit greater than what % can be life threatening and why?

A

60% due to the increased blood viscosity

43
Q

Polycythemic patients should be monitored for what condition?

A

Thrombus formation

-Should be on VTE prophylaxis

44
Q

Increased reticulocytes in the presence of normal CBC is indicative of what RBC disorder?

A

Polycythemia Vera