Patho lecture 4
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What are the general effects of Anemia??
–Reduction in oxygen-carrying capacity
Compensation: Increased HR, cardiac output, volume, and O2 extraction
What are the Anemias related to dereased RBCs??
- Aplatic Anemia
- Anemia of Chronic Renal Failure
- Anemia related to Vit. B12 or Folate deficiency
- Iron Deficiency Anemia
Reduction of hematopoietic activity in bone marrow
The creation of blood cells
Aplastic Anemia is due to what ???
•Due to toxic, radiation, or immunologic injury to bone marrow
Anemia of Chronic Renal Failure is due to what ??
Due to impaired erythropoietin production by kidneys
if your kidneys are failing then they cant make erythropoetin and then u cant make rbc
Anemia related to Vitamin B12 or Folate deficiency is due to what??
Due to a disruption of DNA synthesis in bone marrow cell
What happens in Anemia related to Vit B12 or Folate deficiency??
Neurologic abnormalities, delusions, and hallucinations
Vit B12 and Folate are involved in what??
Synthesis of DNA
what happens to the cells in Vit B12/ folate anemia??
blast cells will become megablatic which is associated with the neurologic abnormalities
What are Anemias related to inherited RBC disorders??
- Sickle Cell anemia
- Hereditary Spherocytosis
- Glucose-6-Phosphate Dehydrogenase Deficiency
Thalassemia and Sickle Cell anemia are both what??
In Thalassemia there is a defect in what
Defects in α chain or β chain of hemoglobin molecul
Sickle Cell anemia is Most prevalent in who
What happens in Sickle Cell Anemia??
•Point mutation in gene that codes for β chain of hemoglobin
•Defect causes RBCs to sickle in conditions of hypoxia
When does sickling of the cell actually occur??
actually occurs during hypoxic conditions. Rbcs have to go in hypoxic areas to give up there oxygen.
The RBC goes from what to what kind of cell in Sickle cell Anemia??
goes from a biconcave disc to this sickle. It has crinkles
What is hbS
Hereditary Spherocytosis is due to what??
•Due to defective RBC membranes
What does Hereditary Spherocytosis cause??
- •Causes anemia, jaundice, splenomegaly, gall stones and
- leg ulcers
What happens with the spleen in Hereditary Spherocytosis
Spleen is working overtime to knock out the spherical shaped abnormal rbcs. Bc of the excess work of the spleen, we get more gall stones
Glucose-6-Phosphate Dehydrogenase Deficiency is Caused by
a deficiency of the G6PD enzyme
Glucose-6-Phosphate Dehydrogenase Deficiency occurs in who??
Occurs in African American males and in Sephardic Jews
Glucose-6-Phosphate Dehydrogenase Deficiency symptoms are triggered by
are triggered by certain drugs, infection, diabetic acidosis, or the newborn period
What Anemias are related to RBC destruction or loss
- Hemolytic Disease of the Newborn
- Antibody-Mediated Drug Reaction
- Acute Blood Loss Anemia
Hemolytic Disease of the Newborn is Caused by
- Caused by an Rh incompatibility of mother and fetus in
- utero (Rh- mother and Rh+ fetus)
Overproduction of RBCs, WBCs, and platelets
Polycythemia Vera-is typically due to
neoplastic transformation of bone marrow stem cells
Polycythemia Vera is doing what
clogging vasculature with cells, is going to increase the blood viscosity and blood volume
With the increase in blood viscosity and blood volume in Polycythemia Vera it causes
A spike in the blood pressure (hypertension) that causes headaches, fatigue, pruritis, dizzy, sweat, weight loss, dyspnea
Increased RBC production due to tissue hypoxia from high altitude or lung disease
in Secondary Polycythemia what is increased
In Secondary Polycythemia look for a history of what ??
A history of lung disease or living in high altitudes
In Secondary Polycythemia was is evident on a blood gas evaluation??
Relative Polycythemia is due to
A pt which Relative Polycythemia what are you looking for in their history
History of fluid loss or poor intake
What treatments are used for Polycythemia??
Phlebotomy and bone marrow–suppressing agents may be used for polycythemia vera
What are the major complications with Polycythemia??
increased blood viscosity and the risk of thrombi.
What are the vascular disorders??
- Vascular Purpura
- Heritary Hemorrhagic Telangiectasis
Patches of pinpoint hemorrhages (petechiae) on the skin
Tiny ]'[p;little hemorrhages. If they all fuse, it almost looks purple and its caused purpura.
Heritary Hemorrhagic Telangiectasis
Abnormal vascular development leads to bleeding in skin or mucous membranes
has a spinder web like look to it
•Thrombocytopenia (decreased platelets)
•Thrombocytosis (excess platelets)
•Qualitative Platelet Disorders
Qualitative Platelet Disorders
Abnormal platelet functions
Thrombocytosis is typically due to
chronic granulocytic leukemia. Thrombocytes are coming from same site as granulocytes.
An insufficient quantity of platelets are fewer than
Excessive quantity of platelets are more than
more than 400,000/mm3
A normal platelet count does
not ensure adequate platelet function
Coagulation Disorders are
- Von Willebrand Disease
- Vitamin K Deficiency Bleeding in Infancy
- Acquired Vitamin K Deficiency
- Disseminated Intrasvascular Coagulation (DIC)
- Hepatic Disease
Hemophilia A (80%) = deficiency of clotting factor VIII
–X-linked recessive inheritance
deficiency of clotting factor IX
Von Willebrand Disease
inherited bleeding disorde
Deficiency of the clotting factor 8 carrier protein
Von Willebrand Disease is characterized by
Vitamin K Deficiency Bleeding in Infancy is associated with
associated with several coagulation disorders, including hemorrhagic disease of the newborn and bleeding related to malnutrition and liver disease
Vitamin K is a necessary cofactor for
liver production of factors II, VII, IX, and X
Disseminated Intrasvascular Coagulation (DIC)
An acquired hemorrhagic syndrome in which thrombosis and hemorrhage occur simultaneously
clotting and bleeding at same time
DIC is characterized by
widespread clot formation in small vessels
The platelet count and fibrinogen levels are typically what in DIC
PT, aPTT, thrombin time, bleeding time, and fibrin split products are what in DIC
Liver disease alters the synthesis of bile and clotting factors
•Thrombocytopenia is common in liver disease
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