Regenerative Flashcards
What is regenerative anaemia
When bone marrow is responding to reduced RBC number
Signs of anaemia
Acute
- pallor
- tachycardia
- muscular weakness
- subnormal temp
- coma
- death
Chronic
- fatigue
- exercise intolerant
- tachycardia
- fainting
- pallor
- cardiac mummer (blood viscosity decreases)
How is anaemia caused
Reduction in bone marrow production
Increases destruction of bone marrow
What hormone regulates RBC production
Erythropoietin (EPO)
How does EPO become stimulates
Decrease oxygen in the kidney
Where is EPO produced
Kidney
What will be seen in blood smear if regenerative
Presence of reticulocyte - bone marrow is replacing lost RBC
Polychromasia
- increased number or RBC
As prematurely released from bone marrow
Stain grey/blue (reticulocyte)
Anisocytosis
- red blood cells are uneven sizes
Macrocytic hyperchromic
- immature RBC are larger than mature
Hypochromic
- have enough haemoglobin but as larger cells they have lower concentration
How long does it take to produce new RBC
3-5 days
What are the 3 types of regenerative anaemia
Haemorrahagic
Haemolytic
Hyproproliferative
What is haemorrhagic anaemia
= loss of blood
Can be acute or chronic
Examples of acute haemorrhagic anaemia
External or internal bleeding - trauma - surgery - parasite (tics or hookworm) Coagulation disorder (warfarin or sweet clover)
Examples of chronic anaemia
GI lesions
Bleeding from ulcers or neoplasms
Parasites
Coagulation disorders - lack of vitamin k or haemophilia
What are howell-jolly bodies
Black dots seen on RBC
= remnants of nucleus on cell surface
What might be seen on blood smear of haemorrhagic anaemia
Polychromasia
H-J bodies
Thrombocytosis - platelet number high to stop
Neutrophilia
Why might haemorrhagic anaemia not be detected in first few days
The blood volume decrease is compensated for by movement of fluid from tissue to plasma
What does degree of regeneration depend on with haemorrhagic anaemia
Volume of blood loss
- greater loss = greater regeneration
Location of bleeding
- internal = iron available for haemoglobin synthesis = greater regeneration
If proteins are being lost
What is haemolytic anaemia
When red blood cells are destroyed before natural life span is over
What are the 2 methods or red blood cell destruction
Extravascular lysis - destroyed out with blood vessel
Intravascular - within blood vessel
How can you detect haemolytic anaemia
Haemoglobinuria
- excrete free haemoglobin
Haematuria
- blood in the urine
Learn Extravascular and intravascular pathways
Do it
Causes of haemolytic anaemia
Inherited
- inherited abnormality in RBC membrane - identified by spleen and destroyed
- inherited abnormality in enzymes in RBC - become fragile
- inherited haemoglobin disorder
Acquired
- infectious agents
- oxidative compounds
- fragmentation
- immune mediated
How do infectious agents cause haemolytic anaemia
Blood borne parasites
Can replicate in RBC and burst them to replicate further
Babesiosis
Mycoplasma
How do oxidative compounds cause anaemia
Oxidative damage to haemoglobin causes formation of Heinz bodies which are then destroyed
Oxidative compounds cause changes to membrane, call structure and/or haemoglobin
Examples of oxidative compounds that cause haemolytic anaemia
Copper poisoning
Onions
Paracetamol
Zinc
