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How is iron lost from the body?
sloughed mucosal cells, desquamation, menstration, other
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Function Erythropoeitin
triggers myeloid stem cells to produce RBCs
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Counts immature RBCs released from bone marrow, gives the measure of bone marrow activity
reticulocyte count
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5 measures from the complete blood count
- Cell Counts (RBC, WBC, PTL)
- Hemoglobin content
- Red blood cell volume (hemocrit)
- MCV- RBC size
- Reticulocyte count
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Male and female Hemoglobin ranges
- male 13-18 g/dl
- female 12-16 g/dl
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Factors that can affect hemoglobin measurements
age, sex, race
- elevation from:
- hemocentration, hyperlipidemia, fat droplets, hypergammaglobinemia, cryoglobinemia, leukocytosis
decrease from: hemodilution
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Volume of red blood cells to volume of whole blood
hemocrit
elevated by: spherocytosis, hypochromic anemia, RBC fragmentation syndromes, improper speciman mixing
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increase in bodys RBC mass
polycythemia- relatively rare, chronic hypoxia, living at high altitude
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decrease in bodies RBC mass
anemia
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Blood loss, impaired RBC production, accelerated RBC destruction
results in anemia
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Feature fatigue, headaches, paleness, menstral irregularity, dyspnea, tachycardia, anorexia, constipation, diarrhea
anemia clinical manifestations
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Blood Loss
Anemia of Chronic Disease
Anemia of Renal Disease
Bone Marrow Disease
Hemolytic anemia
Normocytic anemias
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Anemia of chronic disease
Iron deficiency anemia
Thalassemia syndromes
Hemoglobinopathies
Sideroblastic anemia
lead poisoning
erythropoitic porphyris
Microcytic anemias
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Marked reticulocytosis related to hemolysis or blood loss
Alcohol
Liver disease
Bone Marrow Disease
Folate/Vit B12 deficiency
hypothyroidism
myelodysplasia
hyposplenism
Macrocytic anemia
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Elderly patient presents:
skin changes, mucosal atrophy, splenomegaly, hepatomegaly, decreased renal function, headache, impaired vision, malaise, dyspnea on exertion, angina pectoralis
Chronic blood loss anemia
blood loss is greater than regenerative capacity
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Microcytic, hypochromic anemia
chronic hypoxia, deficient cell growth
chronic blood loss and slow insidious growth
patient presents pale, esp eyes, palms of hands
nails look spoonlike
Iron deficiency anemia
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Pregnant women, fast growing children, malabsorption, chronic blood loss like from menstration
iron deficiency anemia
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Dietary iron sources
red meat = heme
iron fort cereal, beans, potatoes, broccoli = non heme
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normochromic normocytic anemia, increased iron stores, decreased serum iron and transferrin, high serum ferritin, does not respond to iron therapy
anemia of chronic diseases
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Anemia etiology: Chronic infectious disease, chronic inflammatory disease, malignancy
anemia of chronic disease
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Anemia pathogenesis: impairs iron utilization, relative bone marrow failure, shortened RBC life span
anemia of chronic disease
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Anemia etiology: disorders of DNA synthesis, rapid erythrocytosis with marked reticulocytosis, lipid disorders with abnormal RBC membrane
Macrocytic anemia, MCV>100fL
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causes of macrocytic anemia in the US(7)
alcoholism( most common), liver disease, bleeding or hemolysis, hypothyroidism, Vit B12/folate deficiency(Metaloblastic anemia), chemotherapeutic drugs, myelodysplastic syndrome
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This anemia symptoms: psychosis, optic nerve atrophy, weakness, mild jaundice, purpura(bleeding), paresthesia, glossitis, melanin pigmentation, pallor, GI problems , mild malabsorption, weight loss
macrocytic anemia
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