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WEEK 19:
Red Cell Pathology:
| Question | Answer |
|---|---|
| Hering-Breuer (stretch) respiratory reflexes | prevent overexpansion/ too much deflation during forced breathing |
| types of anaemias (6) | iron deficiency, megaloblastic, haemolytic, aplastic, sickle cell, and thalassaemias, |
| amaemia | common clinical condition with reduced Hb levels |
| typical symptoms of anaemia (depending on severity) (3) | SOB, weakness/ lethargy, and tachycardia |
| unreliable symptoms of anaemia | skin colour (determined by blood flow), nail bed, and conjuctiva |
| severe anaemia in elderly can cause | angina |
| glossitis | painful red tongue |
| angular chelitis | fissues at corner of mouth |
| DPG | may be elevated in RBCs so O2 more readily given to tissues |
| iron deficiency anaemia | |
| microcytic | |
| when would you see iron output increased | |
| when is iron demand increased | pregnancy |
| why does iron deficiency increase during pregnancy** | because there may be an iron deficiency when bone marrow + macrophage Fe stores depleted |
| acute bleed | rapid blood loss eg haemorrhage leading to lower BP and over time haemodilution |
| chronic bleed | long term bleeding eg gastric bleeding/ excessive menstruation |
| immediate response to acute bleeding | normal |
| what decreases after 24 hours of acute bleeding | |
| what decreases in chronic bleeding | |
| what increases after 24 hours of acute bleeding | |
| what increases after 24 hours of chronic bleeding | |
| iron stores in chronic bleeding | 0 |
| treatment | find underlying cause and treat with oral iron (FeSO4 usually) |
| prophylaxis in pregnancy** | |
| transfusion** | |
| renal anaemia | complicates CRF leading to normocytic anaemia |
| renal anaemia treatment | Fe and EPO |
| normocytic meaning | normal shape and size RBC but decreased amount in numbers |
| explain anaemia in pregnancy | dilution and/or iron deficiency which may be normocytic as increases MCV but iron deficiency decreases MCV |
| megaloblastic anaemia^ | abnormal RBC maturation due to defective DNA synthesis |
| macrocyctic | |
| clinical importance in folic acid | |
| mechanism slide 18** | |
| methotrexate | inhibits dihydrofolate reductase so folate regeneration impaired |
| pernicious anaemia | lack intrinsic factor for absorption of B12 due to autoimmune disease |
| Crohn's disease | malabsorption of B12, folate or iron |
| how is pernicious anaemia treated | IM injection of hydroxocobalamin |
| methotrexate treatment | folinic acid |
| haemolytic anaemias | |
| spherocytosis | genetic abnormal reduction in RBC membrane protein (spectrin) |
| symptoms of haemolytic anaemias (3) | jaundice, enlarged spleen, and folate deficiency (due to increased erythropoiesis) |
| malaria slide 21** | |
| sickle cell anaemia | genetic SNP (single nucleotide polymorphism) or aa (valine) substitution for glutamic acid making abnormal Hb that is in the form of insoluble crystals at low O2 |
| risk of sickle cell anaemia | shape may block microcirculation causing haemolytic anaemia |
| thalassaemias | many variations of genetic conditions which reduce the rate of alpha/beta globin units produced |
| in thalassamia, deletion of both alpha genes leads to | death in uterus ab Hb produced in (y4**) |
| in thalassamia, an alpha gene deletion leads to | decrease RBC volume and haematocrit |
| aplastic anaemia | insufficient production of RBCs, WBCs and platelets (pancytopenia) leading to decreased resistance in infections, increased bleeding and increased tiredness |
| aplasia anamiea | |
| pure cell aplasia | |
| apncytopenia | |
| treatment of anaemia | bone marrow trasnplant (tissue match), (prevent immune destruction of stem caells), and colony stimulating factors (increase WBC) |
| slie 26 diagram | |
| polycythaemia^ | increased Hb content and haematocrit (high RBC) leading to increased blood viscosity and poor tissue perfusion |
| spolycythaemia symptoms (5) | ruddy (red) appearance, cyanosis, headaches, blurred vision, and hypertension |
| primary polycythaemia | changes in bone marrow (stem cell defect) |
| secondary polycythaemia | increased erythropoietin |
| causes of secondary polycythaemia | smoking, altitude, or renal carcinoma |
| causes of primary polycythaemia | JAK2mut and CALRmut |
| treatment of primary polycythaemia (2) | venesection (bleeding) and cytotoxic agent (myelosuppression) |
Created by:
kablooey
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