Erythrocytes
- are the most abundant cells of the blood (48% in men; 42% in women)
- are responsible for tissue oxygenation
- contains hemoglobin
- facts about erythrocytes:
- have _____ and _____
- biconcavity: shape provides a surface area and volume ratio that are optimal for _____ and _____
- reversible deformity: enables the _____ to assume a more _____ shape, squeeze through the _____, and return to normal
-have a life span of _____
biconcavity reversible deformity gas diffusion deformity erythrocyte compact torpedo-like microcirculation 100-120 days
anemia terms
classification
-etiologic factor (cause of a disease)
- size:
- -identified by terms that end in _____
- -_____ (large), _____ (small), _____ (normal)
- hemoglobin content:
- -identified by terms that end in _____
- -_____ (normal amount), _____ (decreased amount)
"-cytic" macrocytic microcytic normocytic "-chromic" normochromic hypochromic
_____:
- red blood cells (RBCs) are present in various _____
- _____:
- -RBCs are present in various _____
anisocytosis
sizes
poikilocytosis
shapes
_____ :
clinical manifestations:
-reduced oxygen carrying capacity
-the fundamental physiologic manifestation of anemia is _____
-syncope, angina, compensatory tachycardia, and organ dysfunction
-classic anemia symptoms:
–fatigue, weakness, dyspnea, elevated heart rate, and pallor
- treatment:
- transfusions, dietary correction, and administration of supplemental vitamins or iron
- correction of the underlying conditions
anemia
hypoxia
macrocytic-normochromic anemias
- are also termed _____
- RBCs are usually large
- DNA synthesis is defective
- -due to deficiencies in vitamin B12 or folate.
- -can alter the _____
- RNA processes occur at a normal rate
- -results in unequal growth of the nucleus and cytoplasm
megaloblastic anemias
synthesis of DNA
macrocytic-normochromic anemia-
_____
pernicious anemia
macrocytic-normochromic anemias
pernicious anemia classified as:
- _____:
- -is the most common macrocytic anemia
- -is caused by a vitamin B12 deficiency
- -lacks intrinsic factor from the gastric parietal cells
- –required for vitamin B12 absorption
- -may be a congenital or autoimmune disorder
- –autoantibodies against intrinsic factor
- -conditions that increase the risk include:
- –past infection with helicobacter pylori
- –after a _____ for _____ will have _____
- –proton-pump inhibitors
megaloblastic anemia
subtotal gastrectomy
chronic gastritis
pernicious anemia
pernicious anemia
- _____ causes _____, the most common type of _____
- the physical manifestations of B12 deficiency anemia symptoms are a result of _____
vitamin B12 deficiency
pernicious anemia
megaloblastic anemia
demyelination
macrocytic-normochromic anemias
pernicious anemia
-symptoms generally included in pernicious anemia are:
–_____, _____, _____, _____
–_____ of the _____ and _____, difficulty walking
–loss of appetite, abnormal pains, weight loss
–sore tongue that is smooth and beefy red, secondary to atrophic glossitis
–“lemon yellow” (sallow) skin as a result of a combination of pallor or icterus
–_____ from _____ of the _____
—not reversible, even with treatment
-is often unrecognizable in older adults because of its subtle, slow oneset and presentation
low hemoglobin low hematocrit weakness fatigue paresthesias feet fingers neurologic symptoms nerve demyelination spinal cord
macrocytic-norochromic anemias
pernicious anemia
-evaluation:
–methylmalonic acid and homocysteine levels are elevated early in the disease
–gastric biopsy: is a procedure that removes stomach tissue for diagnostic evaluation
- treatment:
- -_____ by _____
- -if left untreated, the condition that is fatal is _____
- -_____ is required
- -_____ is measured by rising the _____
vitamin B12 injections heart failure life-long treatment vitamin B12 reticulocyte levels
macrocytic
- folate (folic acid) deficiency anemia
- clinical manifestations:
- -_____: scales and fissures of the _____ and corners of the _____
- -_____: mouth inflammation
- –_____ of the _____ and _____: characteristics of _____ syndrome
- -_____ (difficulty swallowing), _____, and _____
- -_____: usually not seen
- treatment:
- oral dose of folate is administered daily until normal blood levels are obtained
- life-long treatment is not necessary
cheilosis lips mouth stomatitis painful ulcerations buccal mucosa tongue burning mouth dysphagia flatulence watery diarrhea neurologic symptoms
_____:
iron-deficiency anemia
microcytic-hypochromic anemia
microcytic-hypochromic anemias iron-deficiency anemia -\_\_\_\_\_ type of anemia world wide -highest risk: older adults, women, infants, and those living in poverty -associated with \_\_\_\_\_ in \_\_\_\_\_
- causes:
- most common cause is _____ and _____
- others:
- -inadequate dietary intake
- -excessive blood loss
- -chronic parasite infections
- -metabolic or functional iron deficiency
- -menorrhagia (excessive bleeding during menstruations)
most common cognitive impairment children pregnancy chronic blood loss
microcytic-hypochromic anemias
iron-deficiency anemia
-clinical manifestations:
–_____, _____, _____
–pale earlobes, palms and conjunctivae
–_____, _____, _____, and _____ (concave or koilonycghia) _____
–red, sore, painful tongue
–angular stomatitis: dryness and soreness in the corners of the mouth
–become symptomatic: when hemoglobin (Hgb) 7 to 8 g/dl
fatigue weakness shortness of breath (dyspnea) brittle, thin, coarsely ridged, and spoon-shaped nails
microcytic-hypochromic anemias sideroblastic anemia -acquired versus hereditary -reversible sideroblastic anemia: associated with alcoholism -myelodysplastic syndrome
- clinical manifestions:
- -_____ (_____)
- mild-moderate symtoms
- -_____ (_____) and _____ (_____)
- -_____ colored skin and _____
- evaluation:
- -bone marrow examination: diagnostic
- –dimorphism: normocytic and normochromic cells concomitantly observed with microcytic-hypochromic cells
iron overload (hemochromatosis) enlarged spleen (splenomegaly) and liver (hepatomegaly) bronze cardiac dysrhythmia
normocytic-normochromic anemias
-_____
aplastic anemia
pathophysiology: of aplastic anemia
- the most common pathophysiologic process that triggers _____ against _____ by _____
aplastic anemia autoimmune disease hematopoiesis cytotoxic T (Tc) cells
normocytic-normochromic anemias aplastic anemia -most aplastic anemias are \_\_\_\_\_; \_\_\_\_\_ are due to \_\_\_\_\_ (benzene, arsenic, \_\_\_\_\_) -those drugs are: --\_\_\_\_\_ --\_\_\_\_\_ --\_\_\_\_\_
autoimmune disorders some chemical exposure drugs chloramphenicol (chloromycetin) phenytoin (dilantin) trimethoprim-sulfamethoxazole (Bactrim)
normocytic-normochromic anemias
aplastic anemia:
-pathophysiology
–hypocellular bone marrow that has been replaced with fat. there is a _____ of _____ to produce adequate amounts of _____, _____ and _____- all three cell lines are down
- clinical manifestations
- -hypoxemia, pallor (occasionally with a brownish pigmentation on the skin)
- -weakness along with fever and dyspnea with rapidly developing signs of hemorrhaging if platelets are affected
- evaluation:
- -bone marrow biopsy
suppression bone marrow erythrocytes leukocytes thrombocytes
the primary symptom of polycythemia vera is _____
increase in blood viscosity
myeloproliferative red blood cells polycythemia vera -treatment --\_\_\_\_\_: withdrawal of \_\_\_\_\_ of blood at a time to reduce \_\_\_\_\_ and \_\_\_\_\_ ---\_\_\_\_\_ ---\_\_\_\_\_ ---\_\_\_\_\_ ---\_\_\_\_\_
therapeutic phlebotomy 300-500 ml erythrocytosis blood volume low-dose aspirin interferon-a hydroxyurea radioactive phosphorus
