Screening 3 Flashcards
What types of anemia did we discuss?
- blood loss anemia
- aplastic anemia
- megaloblastic anemia
- pernicious anemia
- anemia of inflammation
- sickle cell anemia
Blood loss anemia due to
Hemorrhage
How long does it take the body to replace the fluid portion of plasma?
1-3 days
What problem arises when the body replaces the fluid portion of plasma early on?
Leaves low concentration of RBCs
How long does it normally take for RBC concentration to return to normal?
3-6 weeks (if no additional bleeding)
Aplastic anemia occurs due to:
Bone marrow aplasia
What is bone marrow aplasia?
Lack of functioning bone marrow
What are the causes of aplastic anemia?
- gamma ray radiation
- chemotherapy
- excessive x-ray tx
- certain industrial chemicals
- drug sensitivities
What does the bone marrow produce with megaloblastic anemia?
Megaloblasts
What are megaloblasts?
RBCs that are:
- unusually large
- structurally abnormal
- immature (fragile membranes)
Megaloblastic anemia is related to these deficiencies
- B12
- folate
- nutritional deficiencies
B12, folate, and proper nutrition are important in the production of:
- hemoglobin
- erythrocytes
What is the problem with misshapen cells from megaloblastic anemia?
Rupture easily
Pernicious anemia is caused by a loss of
Intrinsic factor (IF)
Intrinsic factor (IF) if produced by these cells
Gastric cells
What is IF required for?
B12 absorption in small intestine
With pernicious anemia, lack of IF production is caused by:
antibody formation against gastric cells
Pernicious anemia: What does antibody formation against gastric cells result in?
- atrophy
- loss of IF production
With pernicious anemia, when does a decrease in RBCs occur?
When the intestines can’t properly absorb B12
Pernicious anemia results in these types of sx
CNS
CNS sx seen in pernicious anemia
- HA
- drowsiness
- dizziness
- slow mental processes
- polyneuropathies
Anemia of inflammation aka
Anemia of chronic disease
Anemia of inflammation (chronic disease) is characterized by these 3 things
- modest reduction in hemoglobin (7-12 g/dL)
- presence of inflammation
- decreased responsiveness to bone marrow to erythropoietin
How does chronic illness cause anemia?
- chronic illness signals the immune system to release a steady supply of inflammatory proteins
- interferes with production of RBCs
Anemia of inflammation (chronic disease) is common in this setting
Therapy
Remember these for prescribing exercise programs for anemia pts
- review with attending physician
- think about pacing and training that evenly distributes workload over time
- progress slowly and monitor vitals
- know underlying cause
For a sedentary person, decreased activity can mask _______. Be sure to observe carefully and note mental status changes.
Exercise intolerance
It is important for the PT to know the underlying cause of anemia. It would be helpful to do these
- ID red flag sx
- ID direct course of action
Which two types of anemia are bone marrow related?
- aplastic
- megaloblastic
Why does pernicious anemia cause CNS sx?
Because B12 directly related to myelination!
