Test 3: Intro to Anemia Flashcards

1
Q

Reticulocyte count tells how well the _____________ is responding. 

A

 bone marrow 

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2
Q

The lifespan of RBC in circulation is _____ days.
Approximately ____ percent of circulating RBCs are lost daily

A

120

1

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3
Q

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.

A

EPO

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4
Q

What are the effects of erythropoietin? 

A

-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) 

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5
Q

Does EPO expand the lifespan of RBCs?

A

NO!

lifespan is always 120 days

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6
Q

Normal bone marrow response to EPO can increase erythropoiesis ______ fold*, But it takes a full week for complete response to occur! 

A

6-8

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7
Q

Erythropoietin can cause shift Reticulocytes to be seen in peripheral blood in about _____ days. 

A

2

-Increased retic count
-increased RPI (Reticulocyte production index) 

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8
Q

A calculation which indicates whether or not bone marrow is responding adequately to anemia

A

RPI (reticulocyte production index) 

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9
Q

Red cell disorders can be classified as either __________ or _________. 

A

Erythrocytosis, Anemias

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10
Q

What are the two disorders that present with an increase in circulating RBC (Increased Hct.)? 

A

• Erythrocytosis
• Polycythemias 

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11
Q

___________ are disorders that present with a decrease in circulating RBCs (Decreased hematocrit) 

A

Anemias

(Think of rule of 3- Hemoglobin and Hematocrit are directly related) 

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12
Q

Diagnosis of anemia is based on…

A

-history
-Physical examination
-Symptoms
-Lab results

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13
Q

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

A

Anemia

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14
Q

Anemia can be related to what three values?

A

-low RBC count
-decreased Hemoglobin
-Low hematocrit

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15
Q

Anemia that causes a decrease in the oxygen carrying capacity of the blood due to too little hemoglobin or ___________ hemoglobin

A

Dysfunctional

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16
Q

Same symptoms for anemia no matter the type. what are the symptoms?

A

 Pallor, fatigue, and shortness of breath
-skin, eyes, mouth, enlarged lymph nodes and spleen, and heart are all assessed. 

17
Q

What are the first two lab tests that are typically ordered when a physician suspects anemia? 

A

first RBC count and then chem panel 

18
Q

Decreased O2 affinity of hemoglobin shifts the oxygen dissociation curve to the ________. 

A

Right

19
Q

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 ____________. 

A

Tachycardia 

20
Q

___________ anemia- True decrease in red cell mass.

(results from either impaired RBC production, blood loss, or accelerated RBC destruction or Hemolysis) 

A

Absolute 

21
Q

____________ anemia- apparent decrease in red blood cell mass; Not true hematologic disorder.

A

Relative

Ex: Fluid shifts in pregnancy or Diluted blood from IV “Fluid push”

22
Q

What are the laboratory test for anemia?

A

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

23
Q

What is included in an iron panel? 

A

•serum ferritin (Primary form of iron storage)
• serum iron (Amount of ironbound to transferrin)
• Transferrin (transport iron) 

24
Q

What are the three major components associated with anemia?

A

• decreased hematocrit
• degreased hemoglobin
• decreased RBCs 

25
Q

Reticulocyte count divides the anemia into what two groups?

A

• High result means shortened RBC survival
• Low result means there’s decreased production of RBCs

26
Q

After dividing anemia into high result or low result for Reticulocytes, Anemia can then be divided into further sub groups based on….

A

MCV, MCH, and MCHC values

-microcytic, macrocytic, normochromic, normocytic, and hypochromic

27
Q

What is the normal Hemoglobin values for adult male and adult females? 

A

Males: 13.5-18.0 g/dL
Females: 12.0-15.0 g/dL 

28
Q

How are absolute anemias classified?

A

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

29
Q

What are the types of mircocytic anemias?

A

-IDA
-Amemia of chronic inflammation
-Sideroblastic anemia
-Thalassemia

30
Q

What are the types of normocytic anemias?

A

-aplastic anemia
-anemia of renal disease
-infection (parvoviruses 19)
-Myelopthisic anemia
-anemia of chronic inflammation

31
Q

What are the types of macrocytic anemia?

A

-B12 deficiency (pernicious anemia)
-folate deficiency
-aplastic anemia
-myelodysplastic syndromes
-erythroleukemia
-chronic liver disease
-some drugs

32
Q

Normocytic/
Normochromic anemias…

MCV:
MCH:
MCHC:

A

MCV: normal
MCH: normal
MCHC: normal

33
Q

Macrocytic/
Normochromic…

MCV:
MCH:
MCHC:

A

MCV: high
MCH: high
MCHC: normal

34
Q

Microcytic/
Normochromic…

MCV:
MCH:
MCHC:

A

MCV: low
MCH: normal
MCHC: normal

35
Q

Microcytic/
Hypochromic…

MCV:
MCH:
MCHC:

A

MCV: low
MCH: low
MCHC: low