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Type of megaloblastic anemia resulting from deficit if B12
Pernicious anemia
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Describe the RBC in pernicios anemia
macrocytic-normochromic
have nuclei
oval rather than bioconcave
shorter life span
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What is the etiology of pernicios anemia
defective gastric secreation of Intrinsic factor which is needed to absorb B12 in the iileum
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Where is intrinsic factor produced
parietal cells of gastric gland
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Why is B12 necessary
DNA synthesis
when lacking, nuclear maturing and mitosis of RBC doesn't occur
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What can cause pernicious anemia
surgical stomach removal
Congenital deficincy of intrinsic factor
atrophy of gastric mucosa(normal with age)
autoimmune
chronic gastritis
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What are the signs of pernicious anemia
paresthesis
weakness in extremities
ataxia
red, sore, large, shiny tounge
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What type of dignostic test are used for pernicious anemia
CBC- Decrease RBC, Hematocrit, Increase Immature RBC
Bone Marrow
Serum B12 low
Schilling Test
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What is the treatment for pernicious anemia
Acute- blood transfusion if hemoglobin below 5g/dl
B12 injection or sublingual
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Why can't patients with pernicious anemia take B12 supplements
no intrinsic factor to absorb them
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What is the prognosis for pernicious anemia
good with continued treatment
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Reduction of RBC due to excessive destruction
hemolytic anemia
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What is the etiology for hemolytic anemias
acquired
inherited
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What causes hemolytic anemia to be acquired by a patient
infection-bacterial toxins
disease-kidney or liver
toxic drugs-penicillin, motrin, sulfonamides
Immune response- incompatible blood transfusion
erthroblastosis fetalis-ABO RH incompatability, mother and fetus blood not compatible
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Name a type of autosomal recessive gene disorder that is a hemolytic anemia
Sickle cell
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What mutation on the Beta globin chain causes sicle cell anemia
amino acid glutamic replaced by amino acid valine
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If you are heterozygus for sickle cell anemia you carry the
sickle cell trait
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Under what conditions would a person with sickle cell trait develop sickle cell anemia?
severe hypoxia
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What is the pathophysiology of sickle cell anemia
- abnormal hemoglobin synthesis
- abnormal RBC shape
- RBC sickle in deoxygenation
- deformed cells block cappillaries
- tissue hypoxia occurs
- shorter life span-20 days(RBC)
- sickled RBC adhesive, attach to tunica intima
- causes obstruction of blood flow in microcirculation
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How long do sickle cell RBC live for?
20 days
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When do RBC sickle
deoxygenation
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Adhesive RBC attach to the tunica intima and cause what
an obstruction of the microcirculation blood flow
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What are the signs of sickle cell anemia
- hyperbiliruinemia
- splenomegaly
- "CRISIS"
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What causes "CRISIS" in patients with sickle cell anemia
vascular occlusions and infarctions
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What tests are used to confirm sickle cell anemia
- Blood smear
- Hemoglobin electrophoresis
- Prenatal diagnosis
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Which diagnostic test for sickle cell anemia can confirm the presence of HbS , thus being able to identify carriers as well
hemoglobin electrophoresis
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What is the treatment for sickle cell anemia
- Daily Drug- Hydroxyurea
- antibiotics
- blood transfusion
- bone marrow transplant
- gene therapy
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Which treatment for sickle cell anemia increases HbF, thus preventing sickling, vascular occlusions, and "CRISIS"
Hydroxyurea
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What are the complications of sickle cell anemia
- Repeated sickleing damages organs
- Retarded and nerurological deficits
- cardiopulmonary insufficiency
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What is the prognosis for sickle cell anemia
high mortality
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What type of gene disorder is classic Hemophilia
sex-linked recessive
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What blood clotting factor is inactive in classic Hemophillia
VIII
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What is lukemia
uncontrolled proliferation of WBC
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What is the etiology of lukemia
- idiopathic
- viruses
- radiation
- chemicals
- heredity
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What is the pathophysiology of lukemia
- WBC transform into malignant cells
- Undifferentiated blasts
- cells proliferate and suppress bone marrow
- End result: thrombocytopenia, anemia, and malignant WBC
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What are the signs of lukemia
- leukocytosis
- Decreased RBC and platelets
- fever
- swollen lymph nodes
- brusing
- opportunistic infections
- splenomegaly
- hepatomegaly
- pallor& fatigue
- weight loss
- bone pain
- hyperuricemia
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What tests are used to confirm lukemia
- CBC-Increased WBC and blast cells
- bone marrow
- philadelphia chromosome
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What translocation on the gene segment is the philadelphia chromosome
9 and 22
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Why does genes 9 and 22 translocate? What happens to cells as a result of this translocation
- mitotic error
- causes cells to grow uncontrollably
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What is the treatment for lukemia
- chemo
- bone marrow transplants
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What are the complications involved with lukemia
- recurring infections
- hemorrage
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What is the prognosis for lukemia
depends on type
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How is lukemia classified
- dominant abnormal cell type
- maturity of cell
- severity of disease
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What abnormal cells are dominant in acute lukemias
immature blast cells in bone marrow and blood smear
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What type of abnormal cells are dominant in chronic lukemias
mature cells
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What are the 4 types of lukemia
- Acute myeloblastic
- Chronic myeloblastic
- acute lymphocytic
- chronic lymphocytic
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Which lukemia has the Philedelphia Chromosome?
CML
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Which lukemia is the 2nd highest cause of cancer after chemotherapy for hodkin's, mutiple myeloma, ovarian and breast cancer?
AML
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What type of lukemia is the most common for children under 5 yrs old?
ALL
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What lukemia is common in people over 50 and decrease humoral immunity?
CLL
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