Anemia

Question 1

anemia is _______ blood disorder

Answer 1

most common

Question 2

anemia is the deficiency of

Answer 2

RBCS and hemoglobin

Question 3

deficiency of RBCs and hemoglobin due to

Answer 3

• problems with erythropoiesis
• increased/excessive loss of RBCS (bleeding)
• increased hemolysis: breakdown prior to usual time (aprox 120 days)

Question 4

Patho of anemia

Answer 4

• abnormal number, structure or function of RBC
• decrease in oxygen carrying capacity
• hypoxia

Question 5

what is the primary manifestation that underpins all other complications of anemia

Answer 5

Hypoxia

Question 6

Iron deficiency anemia

Answer 6

• need iron to make hemoglobin
• inadequate intake or increased loss of iron
• iron binds to oxygen molecules for transport
• impaired hemoglobin synthesis

Question 7

what are the manifestations of severe anemia

Answer 7

• chronic exhaustion
• excessive palpitations
• profound weakness & dizziness
• headache (brain will be hypoxic too)
• sensitivity to cold (no 02, not able to carry out anaerobic metabolism, not able to carry heat)

Question 8

you need iron to make

Answer 8

hemoglobin

Question 9

Treatment of iron deficient anemia

Answer 9

• treat underlying cause

- iron supplements, Fe p.o. for 4-6m

Question 10

iron deficiency usually because not taking enough

Answer 10

dietary iron

Question 11

test to find out if iron deficient

Answer 11

measure iron concentration (NOT A CBC)

Question 12

Vitamin b12 & Folic acid deficiency

Answer 12

• responsible for DNA synthesis, invovled in cell division, DNA replication
• abnormal DNA synthesis & cell maturation – imparied RBC, WBC & platelets (cells will not mature)

Question 13

Treatment of Vitamin b12 & folic acid deficiency

Answer 13

• vit B12 & folic acid (supplemental) (dietary deficiency)
• could have a deficiency in one or both

Question 14

Pernicious anemia

Answer 14

• damaged gastric mucosa
• no intrinsic factor (intrinsic factor produced in mucosa of stomach)
• poor B12 absorption (RBC PRODUCTION IS IMPAIRED)

Question 15

pernicious anemia is often in people who have had

Answer 15

gastric surgery

Question 16

Treatment of pernicious anemia

Answer 16

• high dose of vit b12 p.o. (if high dose, some of b12 absorbed without intrinisic factor needed)
• IM b12 injection (only if neuro symptoms present) (IM does through without passing through stomach)

Question 17

Aplastic anemia (no cell anemia)

Answer 17

• marrow (stem cell failure) – defects exists in marrow

- all blood cells affected

Question 18

Aplastic anemia Treatment

Answer 18

• Transfusions
• immune suppression
• marrow transplant (get rid of everything in marrow, donor marrow complex severely compromised when eradicating)

Question 19

Aplastic anemia is from

Answer 19

• 1/3 autoimmune, radiation, toxic chemicals

- 2/3 are idiopathic

Question 20

Hemolytic anemia

Answer 20

• premature or excessive hemolysis (rupture or destruction of RBCS)
• accquired type (eg. autoimmunity, drugs) targeting erythrocytes
• genetic type (eg. in thalassemia)

Question 21

Thanlassemia

Answer 21

genetic type of hemolytic anemia

-defective synthesis of hemoglobin putting together doesn’t happen normally

Question 22

Manifestations of hemolytic anemia

Answer 22

same as general plus:

• Jaundice: excessive bilirubin-bilirubin gets in blood stream, liver can’t keep up to excrete
• Splenomegaly: spleen expands to meed demand of excretion, increase # of cells there also causes it to enlarge
• Hepatomegaly: demand, size and lots of material causes enarlged liver

Question 23

Treatment of hemolytic anemia

Answer 23

• underlying cause
• 02 for nypoxia
• transfusion
• steroids (to halt hemolysis) (cant use long term, can cause damaging side effects)
• Renal function (precipitation in renal tubule d/t hemolysis)
• Spleenectomy (if too many rbcs being removed, some fxs can be taken over by liver -individual can fx without spleen, have to know hemolysis is happening in spleen)

Question 24

Acute Hemorrhagic Anemia

Answer 24

rapid loss of blood (RBCS, hemoglobin, Fe) whole blood

-severity based on site, rate & volume lost

Question 25

Chronic Hemorrhagic Anemia

Answer 25

gradual ongoing blood loss (less easily detected and persists for longer time

Question 26

Major causes of chronic hemorrhagic anemia

Answer 26

- prolonged or heavy menses - Bleeding peptic ulcers: bleeding happening in upper GI tract, occult blood will not know there is blood in stool) - Cancerous lesions of GI tract - hemorrhoids (frank blood)

Question 27

Frank blood is

Answer 27

blood from hemorrhoids can see in the toilet bowl

Question 28

Treatment of Hemorrhagic anemia

Answer 28

-eliminate cause

Question 29

Sickle cell anemia is

Answer 29

genetic, homozygus recessive

Question 30

what is homozygus recessive

Answer 30

two matched defective alleles -matched means they have to be coding for the same thing Both parents have to be carrier

Question 31

If heterozygus (sickle cell)

Answer 31

it is sickle cell trait (no manifestations or mild manifestations not fully fledged)

Question 32

sickle cell anmeia has HBS (hemoglobin sickle cell)instead of

Answer 32

Hba (hemogolbin adult)

Question 33

mnfts of sickle cell anemia:

Answer 33

all in general + - hemolysis - thrombosis & infarction - increase in bilirubin

Question 34

sickle cell anemia has valine instead of

Answer 34

glutamic acid

Question 35

Glutamic acid

Answer 35

acid is normal amino acid needed

Question 36

with sickle cell has valine and this causes a different form of _______

Answer 36

Hemogolobin (sickle cell hemoglobin)

Question 37

Path of sickle cell anemia

Answer 37

- Hbs instead of Hba - Hbs crystallizes on dissociation at low P02 - Rbc deforms & sickles - chronic hemolysis - vessel occlusion - ischemia - infarction - obstructed capillaries - hypoxia - more sickling

Question 38

Treatment of sickle cell anemia

Answer 38

- supportive (02, analgesics, IV fluids & electrolytes) - Hypertransfusion in increased risk (eg. SX, preganacy - Hydroxyurea (used sparingly, only if needed side effects can can cause leukemia) - marrow, stem cell transplant (not easy)

Question 39

Sickle cell breakdown becomes viscous causing

Answer 39

- increase in viscostiy - impairs circulation - occlusion & further hypoxia - more RBC's sickle viscous cycle

Question 40

Hbs is 50X less soluble than

Answer 40

Hba, this is not a problem if stays in erythrocyte but if it comes out into blood it is

Question 41

Sickle cell cannot

Answer 41

move through blood vessel properly

Question 42

what are the two reasons to use hydroxureya

Answer 42

- increases production of fetal hemoglobin | - tends to breakdown erythrocytes before they sickle