Rbc Disorders Chpt 16 (Final)

Front 1

What are RBCs aka?

Back 1

erythrocytes

Front 2

What do erythrocytes transport?

Back 2

Oxygen

Front 3

Diameter of erythrocytes?

Back 3

about 8 micrometers or microns

Front 4

What do RBCs lack? (3)

Back 4

nucleus, organelles, and ribosomes

Front 5

RBCs are mainly a pkg of what?

Back 5

hemoglobin molecules

Front 6

Structure of RBCs?

Back 6

Flat, biconcave (indent on both sides), disc shape well-suited for it's function
-large surface area and thin
(which are advantageous for diffusion)

-flexible plasma membrane allows it to slide thru capillarys

Front 7

2 general parts of hemoglobin?

Back 7

1. globin

2. heme

Front 8

Describe the globin part of hemoglobin?

Back 8

protein made of four highly folded polypeptide chains

Front 9

Describe the heme part of hemoglobin?

Back 9

4 iron-containing, nonprotein groups

Front 10

Hemoglobin has different proteins that change as we ?.

Back 10

grow

Front 11

Hemoglobin proteins of adult vs. fetus?

Back 11

adult has alpha and beta groups...fetus has gamma and beta groups

Front 12

What are the iron carriers of the heme part of hemoglobin?

Back 12

1. transferrin (transport)

2. ferritin (storage)

Front 13

Where is iron absorbed?

Back 13

small intestine

Front 14

When dying where are RBCs broken down/recycled?

Back 14

in the spleen

Front 15

When RBCs are broken down in the spleen what parts are recycled?

Back 15

iron and globin

Front 16

Since RBCs have no nucleus what can they not do?

Back 16

no cellular division...RBCs in CIRCULATION cannot reproduce

Front 17

What is the avg. lifespan of RBCs?

Back 17

120 days

Front 18

The site of final demise for old erythrocytes?

Back 18

the spleen

Front 19

What is erythropoiesis?

Back 19

the production of new RBCs

Front 20

Where does erythropoisesis take place?

Back 20

in the marrow

Front 21

In erythropoisesis, it takes 1 week for the stem cell in the bone marrow to become what?

Back 21

a reticulocyte (immature RBC)

Front 22

Reticulocyte is aka?

Back 22

immature RBC

Front 23

Reticulocytes mature over 24-48 hours to become what?

Back 23

mature RBC

Front 24

What percentage of the blood is normally reticulocytes?

Back 24

about 1% (but may see increased conc. in disease states)

Front 25

The number of erythrocytes normally remains what?

Back 25

constant : highly regulated

Front 26

What is the normal stimulus for erythropoiesis (RBC production)?

Back 26

hypoxia (decreased oxygen concentration)

Front 27

The process of erythropoiesis is controlled by what?

Back 27

erythropoietin (EPO), a hormone produced by the kidneys

Front 28

4 steps of erythropoiesis?

Back 28

1. reduced oxygen carrying capacity stimulates the kidney

2. the kidney produces erythropoietin that stimulates the bone marrow

3. the developing erythrocytes in the bone marrow develop

4. leads to an increase in the oxygen carrying capacity of the circulating blood

Front 29

4 general lab test to determine RBC disorders?

Back 29

1. hemoglobin (content g/dL in blood)

2. hematocrit (vol. of cells in 100mL in blood, should be 99%RBC)

3. mean corpuscular volume (MCV): size of RBC

4. Reticulocyte count : immature RBC (indicates RBC rate of production)

Front 30

What does normocytic mean?

Back 30

normal size

Front 31

What does microcytic mean?

Back 31

small

Front 32

What does macrocytic mean?

Back 32

large

Front 33

How many reticulocytes should be in the blood?

Back 33

only about 1%

Front 34

What is Anemia?

Back 34

reduction below the normal capacity of blood to carry oxygen

Front 35

Is anemia a disease?

Back 35

No, it is not a disease. However, it is indicative of disease.

Front 36

3 manifestations of anemia?

Back 36

1. impaired oxygen transport, with resultant compensatory mechanisms

2. reducion in RBC indices and hemoglobin levels

3. signs and symptoms of pathology causing anemia

Front 37

Name 4 types of anemias?

Back 37

1. hemorrhagic (blood loss) anemia

2. hemolytic anemia

3. deficient RBC production anemias

4. chronic disease anemias

Front 38

Describe hemorrhagic (blood loss) anemia?

Back 38

1. anemia due to a LOSS of significant amounts of blood
(ex. wounds, mentstration, lowered hematocrit)

2. normochromic, normocytic

3. low hct, high reticulocyte count

Front 39

Describe hemolytic anemia and name two types?

Back 39

-due to DESTRUCTION of RBCs
-normochromic, normocytic, low hct, v. high reticulocyte count

1. sickle cell disease : RBCs fragile, vulnerable to hemolysis

2. Acquired hemolytic anemias: drugs, chemicals, toxins, venoms, infections (malaria)...ex. parasitic infections
-often immune-mediated (Abs to RBCs)

Front 40

Name 4 types of DEFICIENT RBC production anemias?

Back 40

1. iron-deficiency anemia

2. pernicious (B12 deficiency) anemia

3. folic acid anemia

4. aplastic anemia

Front 41

Describe iron deficiency anemia?

Back 41

-dietary deficiency of iron, loss of iron (bleeding), increased demand

-microcytic, hypochromic (smaller, decreased color)

-low ferritin

Front 42

Describe pernicious anemia?

Back 42

-due to inability to absorb adequate amounts of vitamin B12

-low absorption of B12 due to lack of "intrinsic factor"

-macrocytic, normochromic

-vegetarians (deprived of B12 from animal products)

Front 43

Describe folic acid anemia?

Back 43

-reqd for DNA synthesis and RBC maturation

-macrocytic, normochromic

Front 44

Describe aplastic anemia?

Back 44

-due to failure of bone marrow to make adequate numbers of RBCs (all blood cells affected, though)(not specific to RBC, because all blood cells come from bone marrow)

-may be seen in radiation, chemotherapy, cancer, etc.

Front 45

Describe chronic disease anemias?

Back 45

-COMPLICATION of chronic infections, inflammation, cancer

-normocytic, normochromic, decreased reticulocyte numbers

Front 46

Theories of chronic disease anemias?

Back 46

-actions of macrophages, lymphocytes in response to cell injury cause short life span, deficient RBC production in response to EPO, low serum iron

-possibly due to : Chronic renal failure, HIV, CA, rheumatoid arthritis

Front 47

5 options for transfusion therapy?

Back 47

1. whole blood

2. packed RBC

3. leukocyte poor RBC

4. washed RBC

5. frozen RBC

Front 48

What is transfusion therapy used for?

Back 48

if someone has less then 7 g/dL of hemoglobin (less than 1/2 the normal amount of hemoglobin)

Front 49

Describe whole blood transfusion therapy?

Back 49

when you replace the total blood volume

Front 50

Describe packed RBC transfusion therapy?

Back 50

centrifuge blood and remove 2/3rds of plasma

Front 51

Describe leukocyte poor RBC transfusion therapy?

Back 51

remove 99% of leukocytes, platelets, "buffy coat" removed, so increased [RBC]

Front 52

Describe washed RBC transfusion therapy?

Back 52

washed in normal saline, centrifuge and remove "junk" and plasma

Front 53

Describe frozen RBC as it relates to transfusion therapy?

Back 53

-good in massive blood drives for storage, mix RBC with glycerol to prevent from dying (when used, needs to be washed and centrifuged)
-will keep up to 10 years

Front 54

What is autologous blood donation?

Back 54

involves your own blood

Front 55

What is predeposit autologous donation?

Back 55

when you donate your own blood before surgery

Front 56

What is hemodilution as it relates to blood donations?

Back 56

phlebotomy before surgery

Front 57

What is intraoperative salvage (blood donation)?

Back 57

middle of operation (blood is continously circulated from patient thru automated system and back into pt)

Front 58

3 things donor blood is tested for?

Back 58

1. ABO surface antigens (to determine blood type)

2. Rh types (+ or -)

3. infection risks

Front 59

How is blood type compatibility determined?

Back 59

by antigens (A or B proteins, on blood cells)

Front 60

Speed of ABO incompatibility?

Back 60

rapid

Front 61

Describe type A blood?

Back 61

Type A (AA or AO)
-have antibodies for B antigen

Front 62

Describe type B blood?

Back 62

Type B (BB or BO)
-abs for A antigen

Front 63

Describe type AB blood?

Back 63

-no serum antibdies
-A and B both look normal

Front 64

Type AB is the univeral what?

Back 64

recipient

Front 65

Describe Type O blood?

Back 65

OO
-no surface antigens
-produce antibodies to both A and B
-universal donor

Front 66

The speed of Rh incompatibilities?

Back 66

slower to develop then ABO incompatibility

Front 67

Different gene pairs involved in Rh compatibility?

Back 67

C and c
D and d
E and e
...only one that matter is D
...if you have D you are positive, if not then negative

Front 68

10 signs and symptoms of transfusion rxns (ABO or Rh incompatibility)?

Back 68

1. heat along vein being infused

2. flushing of face

3. urticaria (skin eruption, often hives)

4. headache

5. pain in lumbar area

6. chills, fever

7. nausea, vomiting

8. tachycardia

9. hypotension (low bp)

10. Dyspnea (labored breathing)

(tachycardia and hypotension can cause death)

Front 69

What is polycythemia?

Back 69

excess circulating RBCs

Front 70

Polycythemia produces an elevated what?

Back 70

hematocrit (>50%)

Front 71

What is absolute polycythemia?

Back 71

elevated hematocrit due to increased total RBC mass

Front 72

Name the two types of absolute polycythemia?

Back 72

1. primary polycythemia

2. 2ndary polycythemia

Front 73

Primary polycythemia is aka?

Back 73

polycythemia vera

Front 74

Describe primary polycythemia?

Back 74

proliferative disease of pluripotent cells in bone marrow

-a type of absolute polycythemia

Front 75

Describe 2ndary polycythemia?

Back 75

-a type of absolute polycythemia

-EPO induced adaptive (appropriate) mechanism to improve the oxygen carrying capacity of the blood

Front 76

What is relative polycythemia?

Back 76

elevated hematocrit due to loss of plasma volume

(ex. dehydration due to heavy sweating, diarrhea)

Front 77

4 signs and symtpoms of polycythemia?

Back 77

1. increased blood viscosity

2. htn

3. venous stasis

4. thromboembolism

Front 78

What is the increased blood viscosity in polycythemia due to?

Back 78

CO and blood flow reduced

Front 79

Describe HTN as it relates to polycythemia?

Back 79

it is common because the heart tries to overcome the increased viscosity by increasing the blood pressure

Front 80

Describe 4 symptoms that may result from the HTN in polycythemia?

Back 80

1. headache

2. inability to concentrate

3. vision

4. hearing trouble from decreased cerebral blood flow

Front 81

Describe the symptom of venous stasis in polycythemia?

Back 81

dusky redness (even cyanosis (blue appearance)) of lips, fingernails, and mucous membranes

Front 82

Describe the symptom of thromboembolism of polycythemia?

Back 82

blood stasis

Front 83

Tx for polycythemia?

Back 83

for primary you reduce viscosity via

1. phlebotomy to draw out blood and decrease RBC volume

2. suppress bone marrow fcn via chemotherapy reduces wbc and platelet counts