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19 Cards in this Set

  • Front
  • Back
What compensatory mechanisms arise in the face of anemia
Shift curve to right, HGB release oxygen more readily in tissue
Increase cardiac output
Shunt blood to vital organs
Increase breathing rate
Stimulate increased EPO within peritubular cells in kidney which are stimulated in case of hypoxia
Compensated increased plasma so that blood volume is normal.
What are the clinical manifestations of anemia?
Inability to concentrate
Decreased exercise tolerance
Hypovolemia if acute
Chronic anemia is better tolerated than acute anemia
May have some neurologic symptoms: dizziness, fainting, weakness
Skin and mucous membrane pallor
At what degree of HGB do we begin to see symptoms of anemia?
"Not how low you go but how fast you go down"
HGB > 10 g/dl - MILD ANEMIA
HGB BTW 7 & 10 - MODERATE (Tachycardia, short of breath)
HGB < 7 g/gl - SEVERE ANEMIA- angina, dizzy, fainting, weakness
Classification of anemia is done in two basic ways:
Pathophysiologic mechanism
Morphology on blood smear. CBC
4 main pathophysiologic reasons that one may have anemia
Decreased RBC production
Ineffective production - don't get released to circulation
Increased destruction of RBC in periphery
Increased blood loss
When classifying anemia, when would you see increase reticulocytosis and when would you see a decrease?
If have anemia due to decreased production of RBC's --> have inappropriately low reticul count
If have hemolysis -> body responds with increased percentage of reticulocytes, polychromasia
Name some of the causes of decreased RBC production in bone marrow that could lead to anemia
Aplastic anemia - failure of multipotent stem cells
Iron deficiency
Chronic inflammatory and infectious disorders
Bone marrow infiltration by a neoplastic or infectious process
underlying malignancies
List some causes of anemia due to increased or premature destruction of RBC's
Hemolytic anemia - intravascular or extravascular
Red cell membrane or cytoskeleton - hereditary spherocytosis, hereditary elliptocytosis
Mechanical destruction
Hypersplenism - sequester RBC's
list three situations where one may have anemia due to the ineffective production of RBC's:
Vitamin B12 or folic acid deficiency
Impaired DNA synthesis
Myelodysplastic stem cells
Anemia of chronic disease
Acute blood loss
Renal disease
List conditions associated with normocytic red blood cells:
Iron deficiency
Anemia of chronic disease
Hemoglobinopathies - HGBpathy E
Lead poisoning
Sideroblastic anemias - due to stem cell defects
What anemic conditions are associated with microcytic anemia?
What conditions are associated with macrocytic anemia?
Megaloblastic anemia
Hemolytic anemias - have increased size of reticulocytes
Liver disease
Alchohol disease
Stem cell disorders - aplastic anemia, myelodysplasia
What anemic conditions are associated with hyperchromatic RBC's?
Sickle cells
Acanthocytes - membrane defect
Abnormal RBC's are known as:
What conditions are the following cells associated with?
Hereditary Spherocytosis
Immune hemolytic anemia
What conditions are the following cells associated with?
Elliptocytes or ovalocytes
Hereditary elliptocytosis
What conditions are the following cells associated with?
Target cells
Thalassemias, hemoglobinopathies,
liver disease
What conditions are the following cells associated with?
Liver disease
Two of the most common red cell inclusions are
Howell-Jolly bodies: nuclear remnants seen with hyposplenims - seen in sicklecell patients
Basophilic stippling (thalassemia, lead poisoning)