Ch. 29 30 Hematology(Anemias) PDF

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HEMATOLOGY / AnemiasAnemia a deficiency in the number of erythrocytes, quantity of hemoglobin and volume of packed RBC A- absence of Emia- bloodCauses of Anemia - blood loss​ (hemorrhage, surgery, cancer- may be internal bleeding) impaired production of erythrocytes increase destruction of erythrocy...

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HEMATOLOGY / Anemias

Anemia

A- absence of Emia- blood

- a deficiency in the number of erythrocytes, quantity of hemoglobin and volume of packed RBC

Causes of Anemia - blood loss (hemorrhage, surgery, cancer- may be internal bleeding)

● Liver problems o Clotting factors

- impaired production of erythrocytes

● Lack of iron intake ● Impaired production (spleen – young people it creates, older its hemolytic and bone marrow) ● Renal failure (no EPO created results in low RBC production) o When you give iron, you also want to give orange juice so it can be absorbed

- increase destruction of erythrocytes

● Destruction of RBCs o Splenomegaly – responsible for hemolysis after 120 days. Heme is destroyed; Globin is recycled. Chemo can destroy erythrocytes

2 General Types of Anemia 1. Morphologic - microcytic, hypochomic ( low o2) - macrocytic (megaloblastic)

● Morphologic – characteristics o Microcytic (small in size); Hypochromic (pale) ▪ Can’t carry enough O2 o Macrocytic or megaloblastic (big in size) ▪ Big cell = thin membrane. Easily lyses, does not live 120 days.

2. Etiologic

● Etiologic – underlying causes

● Decrease RBC Production - Decrease hemoglobin synthesis Ex. Thalassemia- problem with globin synthesis - Defective DNA Synthesis Ex. Cobalamin (B12) Deficiency

o Decrease in RBC Production ▪ Decrease in hemoglobin synthesis ● In Iron deficiency ● affected by genes ▪ Defective DNA ● vitamin B12 deficiency (Cobalamin) and folic acid deficiency (pregnant women) unable create healthy DNA for RBC

- Decrease Number of RBC Precursors Ex. Aplastic anemia

● Blood loss - Acute - Chronic ● Increased RBC destruction - intrinsic - extrinsic

▪ Decrease # of RBC Precursors ● Chemotherapy ● Vitamin D ● Intrinsic factor (in stomach) released by parietal cell to absorb B12 o Parietal cell could be killed by chronic gastritis, cancer) ● Kidneys secrete Erythropoietin (EPO) (hormone precursor). Triggers bone marrow to increase RBC production o Blood loss ▪ Acute – acute abdominal aneurysms, trauma ▪ Chronic – gastritis, women in menstrual cycle (heavy cycle), ulcers o Hemolytic anemia o Bruising (yellow after 3 days because heme and globin are released. Globin gives yellow color) o Overactive and enlarged spleen (splenomegaly) more surface for RBC to go and be destroyed

Clinical Manifestations of Anemia ( all manifestations are a result of compensating for the lack of O2 being transported) - Decrease hemoglobin level - Palpitations - Dyspnea

- Fatigue - Skin changes

- Cardiopulmonary manifestations

● Clinical manifestations o Decreased HGB level ▪ mild 10-14 g/dL ▪ moderate 6-10 ▪ severe...