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Chapter 13 disorders of red blood cells
Terms in this set (88)
The _____________ in the red blood cells transports oxygen to the tissues.
function as carriers of carbon dioxide and participate in acid-base balance
The red blood cells also ...
_________________ refers to the production of red blood cells.
Red bone marrow
After birth, where are red blood cells produced?
Mainly in the membraneous bones of the vertebrae, sternum, ribs, and pelvis
After 20 years of age where are red blood cells produced?
After 5 years of age bone marrow activity gradually ______________.
Red blood cells are derived from precursor cells called ______________.
Decreased oxygen content is sensed by the kidneys, which then produce a hormone called ___________.
The majority of erythropoietin is is produced by the kidneys with the rest being produced by the ___________.
4 months or 120 days
Mature red blood cells have a life span of:
the total number of red blood cells in a microliter of blood
Red blood cell count measures:
the rate of red blood cell production
The percentage of reticulocytes provides an index of:
Normal hemoglobin in an adult male:
Normal hemoglobin in an adult female:
Normal hematocrit in an adult male:
Normal hematocrit in an adult female:
_________ is defined as an abnormally low number of circulating blood cells or level of hemoglobin, or both, resulting in diminished oxygen-carrying capacity.
from excessive loss (bleeding) or destruction (hemolysis) of red blood cells or deficient red blood cell production because of a lack of nutritional elements or bone marrow failure
Anemia usually results from...
1) manifestations of impaired oxygen transport and the resulting compensatory mechanisms
2)reduction in red cell indices and hemoglobin levels
3) signs and symptoms associated with the pathologic process that is causing the anemia
3 categories of the effects of anemia:
Pallor of the skin, mucous membranes, conjunctiva, and nail beds, tachycardia and heart palpitations
What are the manifestations of anemia:
Hyperbilirubinemia, juandice and pigment gallstones
Anemias caused by the premature destruction of red cells are associated with:
inappropriately high levels of iron absorption from the gut, which can lead to iron overload and eventual damage to endocrine organs and the heart
Anemias that result from ineffective hematopoiesis (premature death of red cells in the bone marrow) are associated with:
Circulatory shock and circulatory collapse
With rapid blood loss anemia, ____________ and ____________ may occur.
iron-deficiency anemia when iron stores are depleted
Chronic blood loss does not affect blood volume but instead leads to...
GI bleeding or menstrual bleeding
Chronic blood loss is commonly caused by ...
Persons with chronic blood loss are commonly asymptomatic until the hemoglobin level is less than _____.
Pallor, tissue hypoxia due to deficient oxygen transport (weakness or fatigue), and recruitment of compensatory mechanisms (tachycardia and palpitations) designed to increase oxygen delivery to the tissues
Manifestations of anemia are caused by the decrease presence of hemoglobin in the blood:
_________ anemia is characterized by the premature destruction of red cells, the retention in the body of iron and other products of hemoglobin destruction, and a compensatory increase in erythropoiesis.
Have been desired for all components of the red cell, including the cell membrane, enzyme systems, and hemoglobin, most of which are hereditary
Intrinsic factors of hemolytic anemia:
Immune mechanisms, mechanical trauma, and infections
Extrinsic factors or acquired factors include..
Caused by abnormalities of the spectrin and ankyrin membrane proteins that lead to a gradual loss of the membrane surface
Hereditary spherocytosis, inherited membrane disorder:
causes the cell to become a tight sphere, retains its ability to transport oxygen but is easily destructed when passing through the venous sinuses of the splenic circulation
How does the loss of cell membrane with Hereditary spherocytosis affect the cell.
include mild hemolytic anemia, jaundice, splenomegaly, and bilirubin gallstones
Manifestations associated with Hereditary spherocytosis..
When a sudden disruption of red cell production (often from viral infection) causes a rapid drop in hematocrit and the hemoblogbin levels.
when would a life threatening aplastic crisis occur with inherited disorders of red blood cells?
With a splenectomy to reduce red cell destruction and blood transfusions may be required in a crisis
How is How is Hereditary pherocytosis treated?
Sickle cell anemia
__________________ is an inherited disorder in which an abnormal hemoglobin leads to chronic hemolytic anemia, pain and organ failure.
What race does sickle cell anemia primarily effect?
Deoxygenation in the lungs, however after repeated episodes of deoxygenation the cell remains permanently sickled
The sickled cell may return to its normal shape after...
Chronic hemolytic anemia and blood vessel occlusion
What are the two major consequences of red blood cell sickling?
The shape of the sickled cells causes premature destruction of the cells in the ______ causing hemolysis and anemia from a decrease in red blood cells.
vaso-occlusive pain crisis and acute chest syndrome
What are the two most common complications associated with sickle cell anemia?
Tissue hypoxia due to vessel occlusion and can occur suddenly in almost any part of the body, commonly the abdomen, chest, bones, and joints
Acute pain episodes of sickle cell anemia are caused by?
Acute chest syndrome
__________________ is a common complication of sickle cell anemia, it is an atypical pneumonia that results from pulmonary infarction.
Acute chest syndrome
What complication os sickle cell anemia can cause chronic respiratory insufficiency and is a leading cause of death in sickle cell disease?
Vacinations are recommended, treatment with penicillin to reduce pneumococcal infections, Hyrdroxyurea, has been shown to reduce pain crises and prevent complications
How is sickle cell anemia treated?
direct membrane destruction or antibody-mediated lysis
Several acquired factors exogenous to the red blood cell produce hemolysis by ...
Various drugs, chemicals, toxins, venom as, and infections such as malaria destroy red cell membranes
What causes acquired hemolytic anemia?
prosthetic heart valves, vasculitis, and severe burns
Hemolysis of acquired hemolytic anemia can also be caused by mechanical factors such as...
Decreased production of erythrocytes by the bone marrow
Anemias of deficient red blood cell production may result from...
This type of anemia results from dietary iron deficiency, loss of iron through bleeding, or increased iron demands.
decreased hemoglobin synthesis and consequent impairment of oxygen delivery
Because iron is a component of hemoglobin, iron deficiency lead to..
the iron is released and reused in the production of new red cells
What happens to the iron of red blood cells when they become senescent and are broken down?
In the feces, which requires that the lost iron be replaced by dietary intake.
How are small amounts of iron lost?
What is the usual reason for iron deficiency in adults in the western world?
Low hemoglobin and hematocrit, decreased iron stored, and low serum iron and ferritin levels.
Iron deficiency anemia is characterized by:
Gi bleeding due to peptic ulcers, intestinal polyps, hemorrhoids, cancer, aspirin intake may cause undetected bleeding in the GI tract, increased iron needs during pregnancy
What are some of the causes of the chronic bleeding that causes iron deficiency?
Pallor, easy fatigue, dyspnea, tachycardia, epithelial atrophy resulting in waxy pallor, brittle hair and nails occasional spoon shaped deformity of finger nails, smooth tongue, cheilosis (cracks in the corners of the mouth), dysphagia, PICA,
What are the manifestations of iron deficient anemia?
The bizarre compulsive eating of ice, dirt or other abnormal substances
What is pica?
0.5-1.5 mg daily
How much iron is required daily to keep balance?
___________ anemias are caused by impaired DNA synthesis that result sin enlarged red blood cells due to impaired maturation and division.
Vitamin B12 and folic acid deficiency
What are the two principle causes of megaloblastic anemia?
the anemia is far advanced
Because megaloblastic anemia develops slowly symptoms may not be apparent until...
It is essential for DNA synthesis and nuclear maturation, which in turn leads to normal red cell maturation and division
Vitamin B12 aka cobalamin, serves as a cofactor for what two important reactions in humans?
an important cause of vitamin B12 deficiency is _______________________ resulting from an atrophic gastritis.
___________ anemia is believed to result from immunologically mediated, possibly autoimmune, destruction of the gastric mucosa.
They are abnormally large due to excess cytoplasmic growth and structural proteins
when vitamin B12 is deficient what is wrong with the red cells that are produced?
The resultant chronic atrophic gastritis is marked by the loss of parietal cells and production of antibodies that interfere with the binding of Vitamin B12 to intrinsic factor
What is lacking with pernicious anemia?
Lifelong treatment consisting of IM injections or high doses of oral vitamin B12 reverses the anemia and prevents the neurologic changes.
What is the treatment for Vitamin B12 deficient/Pernicious anemia?
What is the hallmark of Vitamin B12 deficiency anemia?
deficiency or malnutrition or dietary lack, especially in elderly or in association with alcoholism
What is the most common cause of folic acid anemia?
Celiac disease or other intestinal disorders
Malabsorption of folic acid may be due to syndromes such as...
Medications include oral folic acid supplement indefinitely or foods such as green leafy vegetables, broccoli, organ meats, eggs and milk
What is the treatment of folic acid anemia?
____________ anemia describes a disorder of pluripotential bone marrow stem cells that result in a reduction of all three hematopoietic cell lines--red blood cells, white blood cells, and platelets
replace senescent red cells that are destroyed and leave the circulation, although the cells that remain are of normal size and color
Aplastic anemia results from the failure of the marrow to...
Exposure to high doses of radiation, chemicals, and toxins that suppress hematopoiesis directly or through immune mechanisms
What are the causes of aplastic anemia?
anemia, thrombocytopenia, and neutropenia
Chemotherapy and irradiation commonly result in bone marrow depression, which causes...
Weakness, fatigueability, and pallor; petechiae, ecchymosis, bleeding from the nose, gums, vagina or GI tract may occur because of decreased platelet count
What are the initial presenting symptoms of aplastic anemia?
Stem cell replacement by bone marrow or peripheral blood transplantation, for those not eligible for transplant immunosuppressive therapy with lymphocyte immune globulin prevent the proliferating stem ells, producing remission
How is aplastic anemia treated in the young and severely affected?
Anemia of chronic disease
This type of anemia occurs as a complication of chronic infections, inflammation, and cancer.
Acute or chronic infections, AIDS, osteomyelitis, cancers, autoimmune disorders such as rheumatoid arthritis , systemic lupus, and IBS, and chronic kidney disease.
What are the most common causes of anemia of chronic disease?
chronic renal failure almost always results in anemia, primarily because of a deficiency of erythropoietin
What is the relationship between chronic anemia and renal failure?
You treat the underlying disease, short-term erythropoietin therapy, iron supplementation, and blood transfusions
How do you treat anemia of chronic disease?
____________ represent an abnormally high total red blood cell count with a hematocrit greater than 50%
Primary polycythemia or polycytheia vera
____________ is a neoplastic disease of the pluripotent cells of the bone marrow characterized by an absolute increase in total red blood cell mass accompanied by elevated white cell and platelet counts.
In _________ polycythemia, the hematocrit rises because of a loss of plasma volume without a corresponding decree in red cells.
______________ polycythemia is a rise in hematocrit due to an increase in total red blood cell mass and is classified as primary of secondary.
Thromboembolism and hemorrhage, due to platelet abnormalities
what are common complication associated with Polycythemia vera?
the goal is to reduce blood viscosity, this can be done by withdrawing blood by periodic phlebotomy to reduce red cell volume, low-dose aspirin,suppression of bone marrow function with chemo controls the elevated WBC count
What is the treatment for polycythemia vera?
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