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Clin Path 1 - Quiz 2

Reference Range(RR) for Hemoglobin 16 g/dl for males; 14 g/dl for females
RR for RBC 4.3-5.9 for males; 3.5-5.5 for females
RR for Hct 40%-54% for males; 37%-47% for females
RR for MCV 80-100 fl
RR for MCH 27-33 pg
RR for MCHC 32-36 g/dl
RR for RDW 11-15%
RR for platelets 15,000-400,000
RR for WBC 4,500-11,000
RR for reticulocytes 0.5-1.5%
RR for Neutrophils 50-70%
RR for Lymphocytes 20-40%
RR for Eosinophils 1-5%
RR for Monocytes 2-10%
RR for Basophils 0-1%
ESR Rate 3-13 mm/hr children; 1-15 mm/hr Adult Males; 1-2 mm/hr Adult Females
Decrease in the oxygen-carrying capacity of the blood anemia
The clinical expression of anemia results from what? tissue hypoxia
Tissue hypoxia produces increased levels of what? erythropoietin (EPO) in the plasma
EPO does what when it is increased? What is this response called? Stimulates the marrow stem cells to produce more RBC's; normoblastic hyperplasia
General symptoms of anemia weakness, vertigo, headache, tinnitus, spots before the eyes, drowsiness, irritability, amenorrhea, loss of libido, GI complaints, jaundice, pallor and splenomegaly
3 basic mechanisms of anemia blood loss, decreased production of RBC's, increased destruction of RBC's
RBC lives how long 120 days
We make how many RBC's a minutes? 8 million
Clinically anemia is defined as hemoglobin less than what? <11 gm/dl for females and <13 gm/dl for males
What treatment for any type of anemia is not justifiable? treatment with multiple agents also known as shotgun therapy
Lab tests for anemia CBC, PBS, Reticulocyte count, RBC indices, RDW and bond marrow aspiration and biopsy
The most important single test in the diagnosis of anemia? PBS (Blood Smear)
What is a reticulocyte? immature cell which have been released from the bone marrow and appear polychromatophilic
What is the most important RBC index in thet differential diagnosis of anemia? MCV
What is the first test that goes abnormal in anemias? RDW and it only increases
Etiological classifications of anemias Anemia due to blood loss, anemia due to deficient erythropoiesis (dec. production) and anemia due to excessive RBC destruction
2 anemias due to blood loss? acute posthemorrhagic anemia and chronic posthemorrhagic anemia
3 subcategories of anemias due decreased RBC production hypochromic-microcytic anemia, normochromic-normocytic anemia and megaloblastic/macrocytic anemia
Hypochromic-microcytic anemias? Iron-deficiency anemia, sideroblastic anemia, ACD, beta thalassemia
Normochromic-normocytic anemias? anemia of renal disease, anemia of endocrine failure, aplastic anemia, myelophthistic anemia
Megaloblastic/macrocytic anemias? vit B12 anemia and folic acid deficiency anemia
2 subcategories of anemias due to excessive RBC destruction? anemia due to intrinsic red cell defects and anemia due to extrinsic red cell defects
Anemias due to intrinsic red cell defects? hereditary spherocytosis, G6PD deficiency, sickle cell anemia, thalassemia
Anemia due to red cell membrane alterations? hereditary spherocytosis
Anemia due to disorders of red cell metabolism? G6PD deficiency
Anemias due to defective hemoglobin synthesis? sickle cell(structural and thalassemia(rate of synthesis)
Anemia due to extrinsic red cell defects? traumatic hemolytic anemia(microangiopathic HA), hemolysis due to infectious agents, anemia due to immunologic abnormalities
Anemia due to immunologic abnormalities? isoimmune and autoimmune (warm antibody and cold antibody)
Etiology of acute posthemorrhagic anemia due to traumatic or spontaneous rupture of a mojor blood vessel, erosion of an artery by lesions or failure of normal hemostatic processes
Lab findings of acute posthemorrhagic anemia during and immediately after hemorrhage, the RBC counts, Hb and Hct are normal; several days later the blood smears reveals polychromatophilia, slight macrocytosis, occasional normoblasts and immature WBC's
Best lab test to help diagnose hypochromic-microcytic anemias serum ferritin which is an iron storage glycoprotein
Iron deficient anemia does what to serum ferritin levels? decreases it (this is the only anemia that decreases ones serum ferritin)
Most common cause of anemia? iron deficiency
Most common cause of IDA? menorrhagia
Most common age group and sex in IDA? toddlers and menstruating women; females
Etiology of IDA? iron intake not sufficient to replace normal iron losses, iron not available for erythropoiesis despite adequatae body iron, increased loss of body iron not adequately replaced by normal intake
Causes of IDA? inadequate dietary intake, pregnancy, pica, malabsorption diseases, achlorhydria, excessive blood loss, chronic intravascular hemolysis, excessive blood donation
Stage 1 of IDA depleted storage iron, Hb and plasma iron normal; want to diagnose here
Stage 5 of IDA symptoms and signs of iron deficiency
Clinical findings of IDA? pica, pagophagia, koilonychia and cheilosis
What is pica? craving for dirt or clay and its also a symptom and cause of IDA
What is pagophagia? craving ice
What is koilonychia? spoon shaped nails
What is cheilosis? cracked side of lips
Lab findings of IDA? decreased serum ferritin, RBC, Hb, Hct, MCV, MCH, MCHC, hypochromic, microcytic RBC's and elevated RDW
Best noninvasive test for IDA in adults and does it always work to diagnose IDA? low serum ferritin and no because it may miss some deficient patients due to ferritin being an acute phase reactant
What may alter thet lab results of IDA? iron supplements or multivitamin-mineral preparations that contain iron
Iron utilization anemia sideroblastic anemia
Created by: 1277880004
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