Anemia Symptoms + Etiology

What is the definition of anemia?

Anemia is a decrease in the oxygen carrying capacity of the blood

What two things is oxygen carrying capacity determined by?

1. The number of red blood cells

2. The amount of hemoglobin in the red blood cells

What does anemia cause and what is it?

Anemia causes hypoxemia, which is a reduction in the oxygen content of the blood

What does hypoxemia produce?

Hypoxemia produces hypoxia, which is low oxygen content in the tissue

Why does anemia cause fatigue?

Anemia causes fatigue because less aerobic respiration is happening, leading to a decrease in ATP production

Why does anemia cause dizziness and headaches?

Anemia causes dizziness and headaches because of a decrease in ATP in the CNS (nerve tissue is sensitive)

Why does anemia cause shortness of breath?

Because tissues around the body cannot get enough oxygen that meets their demands

Why does anemia cause increased breathing rate and depth?

The body attempts to correct hypoxemia by increasing the diffusion rate of oxygen in the lungs

Why does anemia cause the heart to beat faster?

Anemia causes the heart to beat faster in an attempt to deliver enough oxygen to the body’s tissues

Why does anemia cause vasodilation?

Hypoxia causes the release of signaling molecules such as nitric oxide which leads to vasodilation

Why does anemia cause a decrease in blood viscosity?

Decrease in blood viscosity happens because of a reduction in the number of blood cells while the body maintains same total volume of blood

Why does anemia cause pale lips, nail beds, and mucous membranes?

Because there is less hemoglobin and oxygen in the blood, leading to a pale appearance

What effect does decreasing oxygen saturation have on blood flow? (increase or decrease due to what?)

Blood flow increases due to vasodilation in the tissues

Common etiologies of anemia

CRIFP

• Chronic blood loss

• Red bone marrow disorders (leukemia)

• Iron deficiency

• Folate anemia: vitamin B9 deficiency

• Pernicious: vitamin B12 deficiency

What is hemoglobin production completely dependent on?

Hemoglobin production is completely dependent on iron availability

Where do we store our iron?

• 80% of our iron is bound to hemoglobin in RBCs

• 20% of our iron is bound to storage protein ferritin in cells or transferrin in plasma

What type of anemia is most common world-wide?

Iron deficiency anemia is most common world-wide

What causes iron deficiency?

Slow or chronic blood loss due to illness or condition, acute bleeding

Describe the Pathogenesis of Iron Deficiency anemia

1. Iron stores deplete

2. Fewer RBCs (low hematocrit) with reduced cell volume (MCV) and low hemoglobin content per cell (MCHC) is produced

3. These anemic blood cells gradually replace older blood cells

What two words are used to describe anemic blood cells in iron deficiency anemia?

Anemic blood cells are described as:

• Microcytic (small)

• Hypochromic (pale)

What is Vitamin B12 essential for?

B12 is essential for: DMM

• DNA synthesis

• Mitosis in RBCs

• Myelination and function of nerves

Where do you get B12 from?

B12 comes from diet including meat fish and dairy

What enables vitamin B12 absorption in the small intestine?

Intrinsic factor from the gastric mucosa enables vitamin B12 absorption in the small intestine

What is the etiology of Vitamin B12 deficiency anemia?

• Autoimmune destruction of gastric mucosa leads to pernicious anemia

• Poor diet

• Smoking

How is Vitamin B12 deficiency anemia diagnosed?

Through the findings of megaloblastic red blood cells that are macrocytic (large) and normochromic (normal color)

How is Vitamin B12 treated?

Vitamin B12 is treated through Vitamin B12 injections

What is folic acid (vitamin B9) essential for?

Folic acid (vitamin B9) is essential for:

• nucleic acid synthesis in RBC

• cell growth and mitosis

Folic acid etiology

Common in malnutrition and diets low in green vegetables and meat

Folic acid symptoms

Symptoms include: mouth ulcers and watery diarrhea