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2011-04-10 13:19:37

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  1. Anemia
    a deficiency of red cells or hemoglobin, results from excessive loss (blood loss anemia), increased destruction (hemolytic anemia), or impaired production of RBCs (iron-deficiency, megaloblastic, and aplastic anemias).
  2. Blood loss anemia is characterized by
    loss of iron containing RBCs from the body; hemolytic anemia involves destruction of RBCs in the body with iron being retained in the body.
  3. Manifestations of anemia are caused by
    the decreased presence of hemoglobin in the blood (pallor), tissue hypoxia due to deficient oxygen transport (weakness and fatique), and recruitment of compensatory mechanisms (tachycardia and palpitations) designed to increase oxygen delivery to the tissues
  4. Anemia is not a disease but an...???
    indication of some disease process or alteration in body function
  5. Anemia reduces the ...??
    oxygen-carrying capacity of the blood, leading to tissue hypoxia and fatigue
  6. Blood Loss Anemia
    • Acute blood loss anemia
    • -Carries risk of hypovolemia and shock
    • Chronic blood loss anemia
    • -Leads to iron deficiency, does not affect blood volume
  7. Hemolytic Anemias
    • *Caused by premature destruction of RBCs
    • *Attempted compensation by increased RBC production
  8. Causes of Hemolytic Anemias
    • Inherited Disorders of RBC membrane
    • Hemoglobinopathies
    • Inherited Enzyme Defects
    • Acquired Hemolytic Anemias
  9. Inherited Disorders of Red Cell Membrane (Hemolytic Anemias)
    Hereditary spheroctyosis
  10. Hemoglobinopathies (Hemolytic Anemias)
    • Sickle cell trait and Sickle cell disease
    • Thalassemias (alpha and beta)
  11. Inherited Enzyme Defects (Hemolytic Anemias)
    Glucose-6-phosphate dehydrogenase (G6PD) deficiency
  12. Acquired Hemolytic Anemias (Hemolytic Anemias)
    • Various drugs, chemicals, toxins, venom, and infections (malaria)
    • Autoimmune hemolytic anemia
  13. Iron Deficiency Anemia
    • in adults, usually due to chronic blood loss
    • in children and adolescents, usually due to dietary deficiency, demands of growth spurts, and menstrual losses
  14. Megaloblastic Anemias
    • Mechanism is based on DNA synthesis problems
    • Vit. B12 deficiency Anemia
    • Folic Acie Deficiency Anemia
  15. Aplastic Anemia
    Due to suppression of bone marrow hematopoeisis by radiation, chemicals or toxins
  16. Chronic Disease Anemias
    • Complication of chronic infection, inflammation, and cancer
    • Seen in chronic renal failure, AIDS, RA, Hodgkin Disease
  17. Primary Polycythemia (polycythemia vera)
    *An increase in RBC count, hemoglobin level, and hemacrit, with increased blood volume and viscosity

    *Hypertension and headaches are common

    *thromboembolism and hemorrhage are complications
  18. Secondary Polycythemia
    • *Occurs as a physiologic response to hypoxia
    • *Living at high altitudes, chronic heart and lung disease, smoking
  19. Relative Polycythemia
    Occurs as a result of dehydration

    *decrease in fluid content of the blood
  20. RBC Changes in the Neonate
    • Hyperbilirubinemia in Neonate
    • Hemolytic Disease of the Neonate
  21. Hyperbilirubinemia in the Neonate
    Common cause of jaundice in newborns
  22. Hemolytic Disease of the Neonate
    Occurs in Rh+ infants or Rh- mothers who have been sensitized (in second and subsequent Rh+ children)

    Antibodies from mother's blood destroy fetal RBCs
  23. RBC Changes with Aging
    hemoglobin level decline after middle age
  24. Kinds of Inflammations
    • Acute Inflammation
    • Manifestations of Inflammation
    • Chronic Inflammation
  25. Acute Inflammation
    • Cardinal signs
    • vascular stage
    • Cellular stage
    • inflammatory mediators
  26. Manifestations of inflammation
    • Local manifestations
    • Systemic Manifestations
  27. Chronic Inflammation
    • Nonspecific Chronic inflammation
    • Granulomatous Inflammation
  28. Acute Inflammation Cardinal Signs
    Redness, swelling, heat, pain, and loss of function
  29. Vascular Stage of Acute Inflammation
    Momentary vasoconstriction, followed rapidly by a vasodilatation and increased capillary permeability

    *once injured there is a momentary vasoconstriction and followed by vasodilation (if skin is whipped i goes from white to red)
  30. Cellular Stage of Acute Inflammation (Leukocytosis)
    Granulocytes, Mononuclear phagocytes, Mast cells, Leukocyte response (including phagocytosis)

    • *increase in WBCs in the injured area
    • *mast cells are connective tissue cells
  31. Inflammatory Mediators
    Histamine, Plasma proteases, Arachidonic acid metabolites, Platelet-activating factor, Cytokines
  32. Cells of the Inflammatory Response
    • Basophil
    • Band cell
    • Neutrophil
    • Lymphocyte
    • Eosinophil
    • Monocyte
  33. Inflammation Cellular Stage
    • Margination
    • Emigration
    • Chemotaxis
    • Phaggocytosis
  34. Plasma-Derived Mediators of Inflammation
    • Kinins
    • Coagulation/fibrinolysis components
    • Complement proteins
  35. Cell-Derived Mediators of Inflammation
    • Histamine and serotonin
    • Arachidonic acid metabolites
    • Platelet-activating factor
    • cytokines
    • Nitric oxide
  36. Local Manifestations of Inflammation
    • Swelling
    • Exudate formation
    • Abscess formation
    • Ulceration
  37. Exudate Formation
    • Serous exudate
    • Hemorrhagic exudate: blood
    • Fibrinous exudate fibrous tissue
    • Purulent or supporative exudate puss deas wbcs
  38. Chronic Inflammation is characterized by
    infiltration of macrophages and lymphocytes instead of neutrophils (commonly seen in acute inflammation)
  39. Types of Chronic Inflammation
    • Nonspecific Chronic Inflammation
    • Granulomatous Inflammation
  40. Nonspecific Chronic Inflammation
    Diffuse accumulation of macrophages and lymphocytes at injury site
  41. Granulomatous Inflammation
    A distinctive form of chronic inflammation, involving granuloma formation

    Associated with foreign bodies (such as splinters, sutures, silica, and asbestos) and with microorganisms that cause tuberculosis, syphilis, sarcoidosis, deep fungal infections, and brucellosis
  42. Systemic Manifestations of Inflammation
    • Acute-phase response
    • Leukocytosis and Leukopenia
    • Lymphadenitis
    • Systemic Inflammatory Response
    • Fever
  43. Acute-Phase response
    By release of cytokines, acute-phase response coordinates changes in body activity to enable an optimal host response

    Changes in concentrations of plasma proteins, increased ESR, fever, increased leukocyte count, skeletal muscle catabolism, and negative nitrogen balance
  44. Leukocytosis and Leukopenia
    • Increase in white cell count
    • Leukopenia occurs in infections in persons with debilitating diseases (cancer)
  45. Lymphadenitis
    Painful, palpable lymph nodes are commonly associated with inflammation (nonpainful lymph nodes are more characteristic of neoplasms
  46. shape of Iron-deficiency anemia
    microcytic and hypochromic red cells
  47. characteristics of megaloblastic anemia
    macrocytic and misshaped red blood celss
  48. characteristics of Sickle cell disease
    abnormally shaped red blood cells
  49. characteristics of Normal red cells
    normocytic and normochromic red blood cells