Screening 3

Question 1

What types of anemia did we discuss?

Answer 1

• blood loss anemia
• aplastic anemia
• megaloblastic anemia
• pernicious anemia
• anemia of inflammation
• sickle cell anemia

Question 2

Blood loss anemia due to

Answer 2

Hemorrhage

Question 3

How long does it take the body to replace the fluid portion of plasma?

Answer 3

1-3 days

Question 4

What problem arises when the body replaces the fluid portion of plasma early on?

Answer 4

Leaves low concentration of RBCs

Question 5

How long does it normally take for RBC concentration to return to normal?

Answer 5

3-6 weeks (if no additional bleeding)

Question 6

Aplastic anemia occurs due to:

Answer 6

Bone marrow aplasia

Question 7

What is bone marrow aplasia?

Answer 7

Lack of functioning bone marrow

Question 8

What are the causes of aplastic anemia?

Answer 8

• gamma ray radiation
• chemotherapy
• excessive x-ray tx
• certain industrial chemicals
• drug sensitivities

Question 9

What does the bone marrow produce with megaloblastic anemia?

Answer 9

Megaloblasts

Question 10

What are megaloblasts?

Answer 10

RBCs that are:

• unusually large
• structurally abnormal
• immature (fragile membranes)

Question 11

Megaloblastic anemia is related to these deficiencies

Answer 11

• B12
• folate
• nutritional deficiencies

Question 12

B12, folate, and proper nutrition are important in the production of:

Answer 12

• hemoglobin

- erythrocytes

Question 13

What is the problem with misshapen cells from megaloblastic anemia?

Answer 13

Rupture easily

Question 14

Pernicious anemia is caused by a loss of

Answer 14

Intrinsic factor (IF)

Question 15

Intrinsic factor (IF) if produced by these cells

Answer 15

Gastric cells

Question 16

What is IF required for?

Answer 16

B12 absorption in small intestine

Question 17

With pernicious anemia, lack of IF production is caused by:

Answer 17

antibody formation against gastric cells

Question 18

Pernicious anemia: What does antibody formation against gastric cells result in?

Answer 18

• atrophy

- loss of IF production

Question 19

With pernicious anemia, when does a decrease in RBCs occur?

Answer 19

When the intestines can’t properly absorb B12

Question 20

Pernicious anemia results in these types of sx

Answer 20

CNS

Question 21

CNS sx seen in pernicious anemia

Answer 21

• HA
• drowsiness
• dizziness
• slow mental processes
• polyneuropathies

Question 22

Anemia of inflammation aka

Answer 22

Anemia of chronic disease

Question 23

Anemia of inflammation (chronic disease) is characterized by these 3 things

Answer 23

• modest reduction in hemoglobin (7-12 g/dL)
• presence of inflammation
• decreased responsiveness to bone marrow to erythropoietin

Question 24

How does chronic illness cause anemia?

Answer 24

• chronic illness signals the immune system to release a steady supply of inflammatory proteins
• interferes with production of RBCs

Question 25

Anemia of inflammation (chronic disease) is common in this setting

Answer 25

Therapy

Question 26

Remember these for prescribing exercise programs for anemia pts

Answer 26

• review with attending physician
• think about pacing and training that evenly distributes workload over time
• progress slowly and monitor vitals
• know underlying cause

Question 27

For a sedentary person, decreased activity can mask _______. Be sure to observe carefully and note mental status changes.

Answer 27

Exercise intolerance

Question 28

It is important for the PT to know the underlying cause of anemia. It would be helpful to do these

Answer 28

• ID red flag sx

- ID direct course of action

Question 29

Which two types of anemia are bone marrow related?

Answer 29

• aplastic

- megaloblastic

Question 30

Why does pernicious anemia cause CNS sx?

Answer 30

Because B12 directly related to myelination!