Visceral Disorders- RBC Quiz- CBC Notes- Part 2

Another name for anemia of inflammation

Anemia of chronic disease (ACD)

Subtype of anemia of chronic disease

Chronic renal disease (CRD)

Anemia of chronic disease has _______serum iron, ________ TIBC, ________ferritin

Low serum iron

Low TIBC

Normal or increased ferritin (stores of iron are okay, just can't get to it)

Most of the time anemia of chronic disease is

Normocytic normochromic

What stimulates RBC production

erythropoietin

If anemia of chronic disease is related to kidney disease then it's known as

Anemia of renal disease (ARD)

Hereditary disorder anemia

Thalassemia

What anemia is characterized by reduced synthesis of globulin chains (alpha or beta) of hemoglobin

Thalassemia

Thalassemia is what type of anemia

Microcytic hypochromic anemia

2 types of thalassemia

Alpha and beta

Thalassemia results in

Reduced hemoglobin synthesis

Alpha thalassemia is primarily seen in people from

China and Southeast Asia

Bertha thalassemia is primary in people from

Mediterranean

Thalassemia major is also known as

Cooley`s anemia

Mediterranean anemia

Outcome of having thalassemia major or minor

Minor= clinically normal or require no treatment, symptoms appear under times of stress

Major= require regular transfusions

Thalassemia has iron parameters that are

Normal (normal TIBC, iron and ferritin)

Thalassemia has decreased

Hgb, Hct, MCV, MCH/MCHC

Thalassemia may have normal

RBC count

-body is trying to adapt for need of oxygen by producing more RBC

Oval shaped RBC

Ovalocytes

Thalassemia may show what special thing with RBC? What does this tell you?

May show uncleared red blood cells

-tells you its a very immature RBC therefore not functions

What is needed to differentiate alpha and beta thalassemia

hemoglobin electrophoresis

When you see hair on end skull you should think

Thalassemia

Hair on end from sickle cell disease

How can you tell the difference between a hair on end skull from sickle cell disease and thalassemia

Differentiate by CBC

What happens to bones with thalassemia

Thin cortex with expansion of bone marrow- body is trying to produce more RBC

4 types of Microcytic hypochromic anemia, which is MC

Iron deficiency anemia (IDA)- MOST COMMON

Thalassemia

Anemia of chronic disease (ACD)

Chronic blood loss (CBC)- really an IDA

TIBC with iron deficiency anemia

Increased

TIBC with anemia of chronic disease

Decreased

TIBC with thalassemia

Normal

Microcytic hypochromic anemia with low iron and high TIBC

IDA/CBL

Microcytic hypochromic anemia with normal iron and normal TIBC

Thalassemia

-differentiate between alpha and beta by hemoglobin electrophoresis

Microcytic hypochromic anemia with low iron and low TIBC

ACD or ARD

-normal UA then ACD

-abnormal UA then ARD

Types of Macrocytic normochromic anemia

Vitamin B12 deficiency

Folic acid deficiency (B9)

Alcoholism

Liver disease

Macrocytic normochromic anemia have

Larger than normal RBC, increased MCV

Macrocytic normochromic anemia is most often due to

Vitamin B12 or folic acid (B9) deficiency

Macrocytic normochromic anemia can be_______ or ________

Megaloblastic (more common) or nonmegaloblastic

What does it mean for Macrocytic normochromic anemia to be megaloblastic

Problem in bone marrow (B9 or B12)

What does it mean for Macrocytic normochromic anemia to be nonmegaloblastic

Outside bone marrow

-liver disease alcoholism

Problem that occurs causing megaloblastic Macrocytic normochromic anemia

Inhibition of DNA synthesis in red blood cell produciotn

-folate (B9) or cobalamin (B12) deficiency

What is necessary to convert folic acid to its active form and needed in the formation and function of RBC`s

Vitamin B12

Macrocytic normochromic anemia that have RBC`s that are abnormally large and have shortened life span and decreased oxygen carrying capacity

B12 deficiency

What is the most common cause of B12 deficiency (pernicious Anemia)

Deficiency of intrinsic factor (IF)

Symptoms of B12 deficiency

Lemon yellow skin color, weakness, sore tongue GI symptoms

Parenthesis, loss of vibratory sensation

-raw beef tongue lacking film form papillae

Type of Macrocytic normochromic Vitamin B12 deficiency caused by gastric mucosal failure to severe intrinsic factor

Pernicious anemia

Pernicious anemia is what type of anemia

Macrocytic anemia

Folic acid deficiency does what to the RBCs

Abnormally large (megaloblastic anemia) and have shorten life span and decreased oxygen carrying capacity

Symptoms of megaloblastic anemia from B12 or folic acid

Inflammation of the mouth (stomatitis)

Inflammation of the tongue (glossitis)

Vitamin B12 deficiency may cause what symptoms to develop

Neurological symptoms (numbness and tingling)

Folate deficiency may result in

Depression an dementia

Macrocytic normochromic megaloblastic anemia

Abnormally large RBC

Decreased RBC

Decreased hemoglobin

Increased MCV

Normal/increased MCH/MCHC

Increased iron

Increased ferritin

Decreased B12 or folate

Hypersegmented neutrophils

Macrocytic normochromic nonmegaloblastic anemia

Chronic liver disease

Increased MCV, abnormally large RBC

Increased liver enzymes

Increased bilirubin

S/S of liver disease and or alcoholism

Normocytic normochromic anemia has what type of levels of MCV and MCH/MCHC

Normal

Normocytic normochromic anemia is what types

Anemia of chronic disease

Acute blood loss

Hemolytic anemia

Aplastic anemia

What is a severe life threading syndrome

Aplastic anemia

Aplastic anemia is so bad why?

Decreased RBC, WBC and platelets

Bone marrow is hypocellular

What is the term for all cell types decreased

Pancytopenia

Aplastic anemia has ________ reticulocyte count _______, and __________erythropietin (EPO)

Low reticuloctyte

Pancytopenia

Increased erythropoietin (EPO)

Distinction between blood loss and decreased production is

Reticulocyte count

___________ is not seen with aplastic anemia (low reticulocyte count)

Increase of RBC production

What is a good indicator of bone marrow activity

Number of reticulocyte

In aplastic anemia all cell lines are

Decreased (Pancytopenia)

Aplastic anemia is normally what type of anemia

Normocytic normochromic anemia

Anemia that is due to increased RBC destruction

Hemolytic anemia

Hemolytic anemia may develop which specific symptoms

Jaundice (increased bilirubin from destruction of RBC)

Splenomegaly

Gallstones

Extravascular RBC breakdown occurs within

Reticuloendothelial system (RES)

What is a serous chronic hemolytic anemia

Sickle cell disease

Sickle cell anemia is almost exclusively in what population

Black

Sickling occurs when

Lowered oxygen tension

What occurs with the RBC with sickle cell anemia

They're more fragile (Destruction occurs)

What happens with the hands and feet with sickle cell anemia

Sickle cell dactylitis (hand and foot syndrome)

What happens to bones with sickle cell anemia

Marrow hyperplasia, expansion and thinning cortex

Sickle cell anemia patients are prone to what infection

Staph and salmonella infection

X ray of sickle cell in the hand of a child

Sickle cell dactyitis

When you have a vascular necrosis of femoral heads and h shaped vertebra what does it mean

Most likely sickle cell anemia cause in avascular necrosis

Putti's triad

Increased acetabular angle

Lateral displacement of the femur

Small/absent femoral epiphysis

Sickle cell anemia is what type of anemia

Normocytic normochromic anemia

Most common hemoglobinopathy in the US

Sickle cell trait

When does sickle cell trait show in a patient

Times when oxygen levels decrease in the body

Acute bleeding results in

Normocytic normochromic anemia

Chronic blood loss results in

Microcytic hypochromic anemia (really an IDA)

Anemia of chronic disease is what type of anemia

Normocytic normochromic (MC)

Aka of anemia of chronic disease

Anemia of inflammation

Inhibitor of erythorpoiesis and altered iron metabolism associated with chronic disease

Anemia of chronic disease

Iron deficiency anemia

Microcytic hypochromic

Anemia of chronic disease (ARD)

Microcytic hypochromic

Normocytic normochromic (MOST OFTEN THIS)

Thalassemia

Microcytic hypochromic

Chronic blood loss anemia

Microcytic hypochromic (same as IDA)

Acute blood loss anemia

Normocytic normochromic

Hemolytic anemia

Normocytic normochromic

Folate deficiency anemia

Macrocytic

Pernicious anemia (B12)

Macrocytic

Aplastic anemia

Normocytic normochromic

Microcytic/hypochromic

Decread MCV and MCH

Normocytic normochromic

Normal MCH and MCH

Macrocytic normochromic/hyperchromic

Increased MCV

Normal or increased MCH

TIBC in IDA and CBL

High

TIBC in ACD/ARD

Low

TIBC in thalassemia

Normal