Test 3: Intro to Anemia Flashcards
Reticulocyte count tells how well the _____________ is responding. 
 bone marrow 
The lifespan of RBC in circulation is _____ days.
Approximately ____ percent of circulating RBCs are lost daily
120
1
Receptors in kidney are sensitive to changes in oxygen tension/concentration.
When O2 tension drops, more ______ Is made by kidney and released into the blood stream to stimulate bone marrow normoblasts.
EPO
What are the effects of erythropoietin? 
-bone marrow allows for early release of reticulocytes
-Increases the number of mature Erythrocytes
-increases the rate of maturation of erythroid precursors (Accelerated release affect in peripheral blood) 
Does EPO expand the lifespan of RBCs?
NO!
lifespan is always 120 days
Normal bone marrow response to EPO can increase erythropoiesis ______ fold*, But it takes a full week for complete response to occur! 
6-8
Erythropoietin can cause shift Reticulocytes to be seen in peripheral blood in about _____ days. 
2
-Increased retic count
-increased RPI (Reticulocyte production index) 
A calculation which indicates whether or not bone marrow is responding adequately to anemia
RPI (reticulocyte production index) 
Red cell disorders can be classified as either __________ or _________. 
Erythrocytosis, Anemias
What are the two disorders that present with an increase in circulating RBC (Increased Hct.)? 
• Erythrocytosis
• Polycythemias 
___________ are disorders that present with a decrease in circulating RBCs (Decreased hematocrit) 
Anemias
(Think of rule of 3- Hemoglobin and Hematocrit are directly related) 
Diagnosis of anemia is based on…
-history
-Physical examination
-Symptoms
-Lab results
A reduction in the hemoglobin content of blood that can be caused by a decrease in the RBC count, hemoglobin concentration, and hematocrit below reference range for healthy individuals of similar environmental conditions
Anemia
Anemia can be related to what three values?
-low RBC count
-decreased Hemoglobin
-Low hematocrit
Anemia that causes a decrease in the oxygen carrying capacity of the blood due to too little hemoglobin or ___________ hemoglobin
Dysfunctional
Same symptoms for anemia no matter the type. what are the symptoms?
 Pallor, fatigue, and shortness of breath
-skin, eyes, mouth, enlarged lymph nodes and spleen, and heart are all assessed. 
What are the first two lab tests that are typically ordered when a physician suspects anemia? 
first RBC count and then chem panel 
Decreased O2 affinity of hemoglobin shifts the oxygen dissociation curve to the ________. 
Right
Physiological adaptations in anemia:
Selective vasoconstriction, RBCs are rerouted to areas where there is highest oxygen demand, this requires increased cardiac output. In severe anemia this can even cause ____________. 
Tachycardia 
___________ anemia- True decrease in red cell mass.
(results from either impaired RBC production, blood loss, or accelerated RBC destruction or Hemolysis) 
Absolute 
____________ anemia- apparent decrease in red blood cell mass; Not true hematologic disorder.
Relative
Ex: Fluid shifts in pregnancy or Diluted blood from IV “Fluid push”
What are the laboratory test for anemia?
CBC
• Hemoglobin
• Hematocrit - packed red cell
volume
• MCV - mean cell volume
• MCH - mean cell hgb
• MCHC - mean cell hgb
concentration
• RDW - red cell distribution width
Reticulocyte Count
Schilling’s Test - tests for By in urine
TIBC - total iron binding capacity
Serum Ferritin - primary form of iron
storage
Serum Iron - amt of iron bound to
transferrin
Transferrin - transports iron
What is included in an iron panel? 
•serum ferritin (Primary form of iron storage)
• serum iron (Amount of ironbound to transferrin)
• Transferrin (transport iron) 
What are the three major components associated with anemia?
• decreased hematocrit
• degreased hemoglobin
• decreased RBCs 
Reticulocyte count divides the anemia into what two groups?
• High result means shortened RBC survival
• Low result means there’s decreased production of RBCs
After dividing anemia into high result or low result for Reticulocytes, Anemia can then be divided into further sub groups based on….
MCV, MCH, and MCHC values
-microcytic, macrocytic, normochromic, normocytic, and hypochromic
What is the normal Hemoglobin values for adult male and adult females? 
Males: 13.5-18.0 g/dL
Females: 12.0-15.0 g/dL 
How are absolute anemias classified?
On the basis of their physiological cause
-Heme and globin disorder
-DNA disorder
-Bone marrow failure
-RBC survival disorders
Can also be classified by common RBC morphology
-Macrocytic
-Microcytic
-Normocytic
What are the types of mircocytic anemias?
-IDA
-Amemia of chronic inflammation
-Sideroblastic anemia
-Thalassemia
What are the types of normocytic anemias?
-aplastic anemia
-anemia of renal disease
-infection (parvoviruses 19)
-Myelopthisic anemia
-anemia of chronic inflammation
What are the types of macrocytic anemia?
-B12 deficiency (pernicious anemia)
-folate deficiency
-aplastic anemia
-myelodysplastic syndromes
-erythroleukemia
-chronic liver disease
-some drugs
Normocytic/
Normochromic anemias…
MCV:
MCH:
MCHC:
MCV: normal
MCH: normal
MCHC: normal
Macrocytic/
Normochromic…
MCV:
MCH:
MCHC:
MCV: high
MCH: high
MCHC: normal
Microcytic/
Normochromic…
MCV:
MCH:
MCHC:
MCV: low
MCH: normal
MCHC: normal
Microcytic/
Hypochromic…
MCV:
MCH:
MCHC:
MCV: low
MCH: low
MCHC: low
