Anemias

Front 1

General definition of anemia

Back 1

a decrease in the oxygen-carrying capacity of the blood

Front 2

General causes of anemia

Back 2

- Decrease in RBC #
- Decrease in quality/quantity of hemoglobin (Hb)

Front 3

What can anemia lead to?

Back 3

Hypoxia

Front 4

Three specific causes of anemia?

Back 4

1. Decreased production of RBC
2. Increased destruction of RBC
3. Hemorrhage

Front 5

General clinical manifestations

Back 5

1. Increased HR --> Decrease in blood viscosity --> easier to flow --> increased stroke volume (SV)

2. Increased rate and depth of breathing in an attempt to give the body more oxygen since the oxygen-carrying capacity of blood sucks.

Front 6

What is stroke volume (SV)?

Back 6

Amount of blood pumped out with every heart beat

Front 7

What happens with tissue hypoxia?

Back 7

Vasodilation in an attempt to increase oxygen delivery to tissues.

Front 8

What causes tissue hypoxia in this case?

Back 8

Hypoxemia - low oxygen carrying capacity of the blood

Front 9

Specific clinical manifestations

Back 9

1. Dyspnea (shortness of breath) leading to increased HR
2. Rapid, bounding heart beat due to increased SV.
3. Dizziness, fatigue, pallor of the skin

Front 10

What are the four types of anemias, and what is their naming based on?

Back 10

Their naming is based on the size-Hb of the cell.

1. Macrocytic-normochromic anemia
a) Pernicious anemia
b) Folic acid deficiency anemia
2. Microcytic-hypochromic anemia
3. Normocytic-normochromic anemia
4. Polycythemia
a) Relative polycythemia
b) Absolute polycythemia

Front 11

Macrocytic-normochromic anemia

Back 11

- Big cells but normal Hb/colour

Two types:
1. Pernicious anemia
2. Folic acid deficiency anemia

Front 12

Pernicious anemia

Back 12

Due to lack of vitamin B12 (used in DNA synthesis). The lack of vitamin B12 is due to lack of intrinsic factor (made by and secreted into the stomach).

Four causes:
1. Loss of stomach
2. Autoimmune reaction to stomach lining
3. Smoking
4. Heavy alcohol consumption

Symptoms:
- Usual anemia symptoms
- Parasthesias (tingling of fingers/toes)
- Neurological problems (i.e., problems walking)

- Can take 20-30 years to develop
- Treated with vitamin B12 injections

Front 13

Folic acid deficiency

Back 13

Folic acid is also used in DNA synthesis.
- Due to poor diet or alcoholism
- Symptoms resemble pernicious anemia, with no neurological effects

Front 14

Microcytic-hypochromic anemia

Back 14

- Small and pale cells, therefore less iron.
- "Iron deficiency anemia"

Causes:
- Poor diet (underdeveloped countries)
- Slow blood loss due to menstruation or pathological state (developed countries)

Three stages:
1. Iron body stores being depleted. RBC being produced but still normal.
2. RBC is now abnormal, but no symptoms present due to the RBC not being released yet.
3. Abnormal RBC now in system, causing anemic signs and symptoms.

Loss of as little as 2-4 mL of blood per day can eventually lead to iron-deficiency anemia.

Front 15

Normocytic-normochromic anemia

Back 15

Normal size/colour but RBC are few in number due to loss, destruction, or decreased production.

SICKLE-CELL ANEMIA:
- Poor hemoglobin structure leads to abnormal RBC shape. The abnormal RBC get destroyed easily.

Front 16

Polycythemia

Back 16

Too many RBC --> increase blood viscosity --> heart has to work harder to pump.

Two types:
1. Relative polycythemia - normal amount of RBC but plasma decreases. Caused by dehydration.
2. Absolute polycythemia
a. Primary absolute polycythemia - inherited
b. Secondary absolute polycythemia - due to hypoxia
as a result of disease (i.e., COPD) or living at a high
altitude.