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Macrocytic-Normochromic Anemias (Megaloblastic Anemias)

Terms in this set (21)

Relative Anemia
Normal total red cell numbers (mass) with disturbances in regulation of plasma volume ( i.e. fluid overload), HCT will be low.
Absolute Anemia
anemia—actual decrease in numbers of red cells. RBC low HCT low and HGB low
Decreased production
Increased destruction
Blood loss
Etiology/Cause of Anemia
Blood Loss
By Acute trauma
By Bleeding ulcers
By Colon cancer
Etiology/Cause of Anemia
Increased RBC Destruction
Sickle Cell disease
Some medications (ie. some Antibiotics, Chemo)
Trauma
Hemolytic Disease of the Newborn (HDN)
Etiology/Cause of Anemia
Decreased RBC production
Deficient Nutrients
Deficient Iron
Deficient Vit B12
Deficient Folic acid
Decreased Erythropoietin
Thalassemia (abnormal Hgb production)
Bone Marrow Suppression (Aplastic)
macrocytic anemia
a group of anemias of varying etiologies, marked by larger than normal red cells, absence of the customary central area of pallor, and an increased mean corpuscular volume and mean corpuscular hemoglobin
Morphology/Appearance of Anemia.
Large RBCs
Large RBCs - Macrocytic- Normochromic -normal HGB
(Megaloblastic)
Examples of Megaloblastic Anemia
Pernicious anemia (B12)
Folate deficiency
Morphology/Appearance of Anemia.
Small RBCs
Microcytic - Hypochromic - Less HGB
Example of Small RBCs (Microcytic-Hypochromic-Less HGB)
Iron deficiency anemia
Morphology/Appearance of Anemia
Normal Size RBCs
(Normocytic-normochrois-normal HGB)
Examples of Normal RBCs (Normocytic-normochrois-normal HGB)
Aplastic
Hemorrhagic
Hemolytic
Sickle cell
Chronic illness (example: Chronic Renal Disease)
Acquired e.g., prosthetic cardiac valve
Pernicious Anemia
Macrocytic-Normochromic Anemias (Megaloblastic)- caused due to destruction of gastric mucosa and parietal cells failure to produce the Intrinsic Factor. Strong evidence suggests a genetically determined autoimmune disease.
Folate Deficiency Anemia
Macrocytic-Normochromic Anemias (Megaloblastic)-caused usually by dietary deficiencies as in alcoholism, cirrohosis pregnancy and infancy
Treatment for Pernicious Anemia
B12 injections and if caught early, complete reversal is possible.
Vitamin B12 and Folate
necessary for effective erythrocyte DNA synthesis. Lack of these nutrients can result in Macrocytic-Normochromis Anemias
Some causes of Macrocytic-Normochromic Anemias
Abnormally large RBCs because of excess cytoplasmic growth. RBC's have flimsy membranes and are oval rather than biconcave.
Shorter RBC lifespan of weeks resulting in moderate to severe anemia and mild jaundice.
Decreased numbers of RBC's, WBC's, and Platelets
High MCV and Normal MCHC
Clinical Manifestations of Pernicious Anemia
S&S any anemia
Neurologic lesions, peripheral nerve degeneration, and in posterior columns of spinal cord
Paranoia, dementia, delusions, hallucinations (Megablastic Madness)
Cognitive dysfunction
Spastic Ataxia
Loss of vibratory and position sense
Paresthesia's hands and feet
Irritability, somnolence
Memory Impairment
Perversion of taste and smell, vision
Clinical Manifestations of Folate Deficiency Anemia
Folic acid - needed for DNA synthesis and red cell maturation. Its deficiency leads some of the same megablastic changes as seen in B12 deficiency but no neurological deficits.
S/S
Blunted affect
Depression
Sleep deprivation
Irritability
Memory loss
Personality changes
Folate deficiency in pregnancy
Associated with neural tube defects and abnormalities of heart urinary tract and limbs in neonates. Routine supplementation recommended during pregnancy
Manifestations Common to both Pernicious and Folate Deficiency Anemias are
Tachypnea
Pedal edema
Nocturia
Dyspnea
Tachycardia
Weight loss
Malabsorption
Glossitis
Chronic Diarrhea with Steatorrhea
Arthralgia and Arthritis
Upper and lower extremity cramps
Blotchy brown skin/nail pigmentation
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