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2014-03-18 22:18:36
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  1. What are the classifications of erythrocytosis?
    • Absolute increase in RBC
    • Polycythemia vera
    • Secondary erythrocytosis
    • Relative increase in RBC
    • relative erythrocytosis
  2. Describe the etiology of polycythemia vera
    • Primary disease of the bone marrow
    • Unknown origin (idiopathic)
    • Abnormal proliferation of pluripotential stem cells (the cells that give rise to both lymphoid and myeloid cells)
    • Considered a neoplastic myeloproliferative disease
  3. neoplastic, myeloproliferative disease
    • neoplastic: cancerous
    • myeloproliferative disease: category of disease of bone marrow which causes excessive proliferation of pluripotent stem cell
  4. Describe the clinical features of Polycythemia vera
    • Found in 50-70 year olds (more in males)
    • Splenomegaly
    • Hepatomegaly
    • Headaches, dizziness, breathlessness
    • Night sweats, weight loss, increased BMR
    • clotting and bleeding in nose, gums
    • Flushed, reddened complexion
    • Gout
    • Kidney failt
  5. Describe the laboratory findings of Polycythemia vera
    • Viscous peripheral blood
    • Increased RBC, WBC, and platelets
    • NRBC (nucleatedRBC)
    • poikilocytes, tear drop cells
    • hypercellular bone marrow
    • decrased erythropoietin
    • RBC: 6.9x106/μL
    • Hgb: 18-23g/dL
    • Hct: >52% in women, >58% in men
  6. Describe the treatment and prognosis for polycythemia vera
    • Routine phlebotomy (could result in chronic iron deficiency)
    • myelosuppressive drugs (could cause acute leukemia if incorrectly administered)
    • Mean survival rate is 10-20 years or longer with treatment; 1.5-3 years without
  7. Describe the etiology of secondary erythrocytosis (appropriate vs inappropriate)
    • Increased erythropoietin stimulation of RBC precursors (only)
    • *an appropriate reaction in response to hypoxia (eg lung and heart disease, live in high altitude)
    • *an inappropriate increase (eg kidney tumors, endocrine disorders)
  8. Describe the laboratory findings of secondary erythrocytosis
    • RBC are increased
    • WBC and platelets are normal
  9. What is relative erythrocytosis? Alternate names? Etiology?
    • A relative increase in RBC when compared to other cells (the hematocrit)
    • AKA "Pseudo-polycythemia"
    • Often seen in cases of burns, dehydration, vomiting, diarrhea
  10. What is anemia?
    • Decrease in hgb and/or RBC mass
    • Decrease in hct
    • Inability of blood to provide adequate O2 to tissue
  11. What factors affect the diagnosis of anemia?
    • Gender (female vs male)
    • Age (young vs old)
    • Geography (low vs high altitude)
  12. What are the clinical features of anemia?
    • Fatigue
    • Shortness of breath
    • Headaches
    • Pale lips and nailbeds
    • Increase CO with palpitations
    • Tachycardia
    • Varied pulse rate
    • Congestive heart failure may result
    • Increased 2,3-DPG
    • Increased erythropoeitin
  13. What are the etiological classifications of anemia?
    • Iron deficiency
    • Blood loss (menstruation, nose bleed, etc)
    • Nutritional deficiency
    • Hemolysis
    • Metastatic bone marrow replacement (cancer metastizes for different locations, replaces marrow)
    • Infections (of marrow)
  14. What are the morphological classifications of anemia?
    • Microcytic, hypochromic anemias (RBC too small, lack of color; iron deficiency)
    • Megaloblastic (macrocytic) anemias (RBC too big; B12 and folate deficiency)
    • Normocytic, normochromic anemias (lack of RBC #)
  15. What are the laboratory methods in the diagnosis of anemia
    • RBC count
    • hemoglobin
    • hematocrit
    • RBC indices
    • Peripheral blood smear
    • reticulocyte count
    • bone marrow smear, biopsy, and culture