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What are the general effects of Anemia??
–Reduction in oxygen-carrying capacity
–Tissue hypoxia
Compensation: Increased HR, cardiac output, volume, and O2 extraction
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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
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Aplastic Anemia
Reduction of hematopoietic activity in bone marrow
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Hematopoietic
The creation of blood cells
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Aplastic Anemia is due to what ???
•Due to toxic, radiation, or immunologic injury to bone marrow
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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
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Anemia related to Vitamin B12 or Folate deficiency is due to what??
Due to a disruption of DNA synthesis in bone marrow cell
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What happens in Anemia related to Vit B12 or Folate deficiency??
Neurologic abnormalities, delusions, and hallucinations
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Vit B12 and Folate are involved in what??
Synthesis of DNA
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what happens to the cells in Vit B12/ folate anemia??
blast cells will become megablatic which is associated with the neurologic abnormalities
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What are Anemias related to inherited RBC disorders??
- Thalassemia
- Sickle Cell anemia
- Hereditary Spherocytosis
- Glucose-6-Phosphate Dehydrogenase Deficiency
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Thalassemia and Sickle Cell anemia are both what??
Heriditary hemoglobinopathy
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In Thalassemia there is a defect in what
Defects in α chain or β chain of hemoglobin molecul
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Sickle Cell anemia is Most prevalent in who
African Americans
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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
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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.
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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
-
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What is hbS
Abnormal sickle
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Hereditary Spherocytosis is due to what??
•Due to defective RBC membranes
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What does Hereditary Spherocytosis cause??
- •Causes anemia, jaundice, splenomegaly, gall stones and
- leg ulcers
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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
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Glucose-6-Phosphate Dehydrogenase Deficiency is Caused by
a deficiency of the G6PD enzyme
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Glucose-6-Phosphate Dehydrogenase Deficiency occurs in who??
Occurs in African American males and in Sephardic Jews
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Glucose-6-Phosphate Dehydrogenase Deficiency symptoms are triggered by
are triggered by certain drugs, infection, diabetic acidosis, or the newborn period
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What Anemias are related to RBC destruction or loss
- Hemolytic Disease of the Newborn
- Antibody-Mediated Drug Reaction
- Acute Blood Loss Anemia
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Hemolytic Disease of the Newborn is Caused by
- Caused by an Rh incompatibility of mother and fetus in
- utero (Rh- mother and Rh+ fetus)
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Polycythemia Vera
Overproduction of RBCs, WBCs, and platelets
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Polycythemia Vera-is typically due to
neoplastic transformation of bone marrow stem cells
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Polycythemia Vera is doing what
clogging vasculature with cells, is going to increase the blood viscosity and blood volume
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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
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Secondary Polycythemia
Increased RBC production due to tissue hypoxia from high altitude or lung disease
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in Secondary Polycythemia what is increased
Erythropoietin level
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In Secondary Polycythemia look for a history of what ??
A history of lung disease or living in high altitudes
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In Secondary Polycythemia was is evident on a blood gas evaluation??
Hypoxemia
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Relative Polycythemia is due to
Dehydration
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A pt which Relative Polycythemia what are you looking for in their history
History of fluid loss or poor intake
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What treatments are used for Polycythemia??
Phlebotomy and bone marrow–suppressing agents may be used for polycythemia vera
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What are the major complications with Polycythemia??
increased blood viscosity and the risk of thrombi.
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What are the vascular disorders??
- Vascular Purpura
- Heritary Hemorrhagic Telangiectasis
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Vascular Purpura
Patches of pinpoint hemorrhages (petechiae) on the skin
Tiny ]'[p;little hemorrhages. If they all fuse, it almost looks purple and its caused purpura.
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Heritary Hemorrhagic Telangiectasis
Abnormal vascular development leads to bleeding in skin or mucous membranes
has a spinder web like look to it
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Platelet Disorders
•Thrombocytopenia (decreased platelets)
•Thrombocytosis (excess platelets)
•Qualitative Platelet Disorders
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Thrombocytopenia
Decreased Platelets
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Thrombocytosis
excess platelets
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Qualitative Platelet Disorders
Abnormal platelet functions
-
Thrombocytosis is typically due to
chronic granulocytic leukemia. Thrombocytes are coming from same site as granulocytes.
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An insufficient quantity of platelets are fewer than
< 50,000/mm3
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Excessive quantity of platelets are more than
more than 400,000/mm3
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A normal platelet count does
not ensure adequate platelet function
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Coagulation Disorders are
- Hemophilia
- Von Willebrand Disease
- Vitamin K Deficiency Bleeding in Infancy
- Acquired Vitamin K Deficiency
- Disseminated Intrasvascular Coagulation (DIC)
- Hepatic Disease
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Hemophilia A
Hemophilia A (80%) = deficiency of clotting factor VIII
–X-linked recessive inheritance
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Hemophilia B
deficiency of clotting factor IX
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Von Willebrand Disease
inherited bleeding disorde
Deficiency of the clotting factor 8 carrier protein
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Von Willebrand Disease is characterized by
platelet dysfunction
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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
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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
decreased
-
PT, aPTT, thrombin time, bleeding time, and fibrin split products are what in DIC
Increased
-
Hepatic Disease
Liver disease alters the synthesis of bile and clotting factors
•Thrombocytopenia is common in liver disease
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