Week 2 - Anemia and Aplastic Anemia Quiz
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Questions and Answers

Aplastic anemia is characterized by which of the following?

  • Elevated red blood cell count
  • Normal levels of blood cells
  • Fatty marrow replacement (correct)
  • Increased hematopoietic tissue

    • Aplastic anemia typically has a sudden onset of symptoms.

    False (B)

    What is the primary cause of anemia in chronic renal failure?

    impaired erythropoietin production

    Pernicious anemia is caused by a lack of ______, leading to vitamin B12 deficiency.

    <p>intrinsic factor</p> Signup and view all the answers

    Which of the following is a compensatory mechanism the body uses to restore tissue oxygenation in response to anemia?

    <p>Increased circulatory rate (D)</p> Signup and view all the answers

    Which of the following is NOT a typical symptom of late-stage aplastic anemia?

    <p>Bradycardia (A)</p> Signup and view all the answers

    Polycythemia is characterized by a deficit of red blood cells.

    <p>False (B)</p> Signup and view all the answers

    What is the primary consequence of low oxygen-carrying capacity in anemia?

    <p>hypoxia</p> Signup and view all the answers

    Dialysis is a treatment for anemia related to vitamin B12 deficiency

    <p>False (B)</p> Signup and view all the answers

    What is the diagnostic term used for the abnormal, large blood cells that are produced when there is a disruption in DNA synthesis?

    <p>megaloblasts</p> Signup and view all the answers

    In relative anemia, there is a normal total red cell mass accompanied by disturbances in the regulation of ______ volume.

    <p>plasma</p> Signup and view all the answers

    Match the following conditions with their primary treatment strategies:

    <p>Aplastic Anemia = Immunosuppressive therapy, bone marrow transplant Anemia of Chronic Renal Failure = Dialysis, erythropoietin administration Anemia Related to Vitamin B12 Deficiency = Replacing nutritional deficiencies</p> Signup and view all the answers

    A patient with a hemoglobin level below 8g/dl would likely exhibit which of the following symptoms?

    <p>Orthostatic hypotension (D)</p> Signup and view all the answers

    Mild anemia always presents with significant and noticeable symptoms.

    <p>False (B)</p> Signup and view all the answers

    Which of the following is NOT a typical symptom of moderate to severe anemia?

    <p>High blood pressure (B)</p> Signup and view all the answers

    Match the following terms with their definitions:

    <p>Anemia = Deficit of red cells Polycythemia = Excess of red cells Hypoxia = Low oxygen-carrying capacity Absolute Anemia = Actual decrease in the numbers of red cells</p> Signup and view all the answers

    Which of the following best describes the cause of iron deficiency anemia?

    <p>Insufficient iron for hemoglobin synthesis (B)</p> Signup and view all the answers

    Sickle cell anemia is caused by a defective red cell membrane skeleton.

    <p>False (B)</p> Signup and view all the answers

    What is the primary treatment for hereditary spherocytosis?

    <p>splenectomy</p> Signup and view all the answers

    Thalassemia is a group of disorders associated with mutant genes that suppress synthesis of ______.

    <p>globin chains</p> Signup and view all the answers

    Which of the following is a common treatment for beta-thalassemia?

    <p>Blood transfusions (C)</p> Signup and view all the answers

    In iron deficiency anemia, the red blood cells (RBCs) are typically normocytic.

    <p>False (B)</p> Signup and view all the answers

    What is the most common nutritional deficiency worldwide that is related to anemia?

    <p>iron deficiency</p> Signup and view all the answers

    Match the following types of anemia with their characteristic cellular presentation:

    <p>Iron Deficiency Anemia = Hypochromic, microcytic RBCs Sickle Cell Anemia = RBCs of different shapes and sizes Hereditary Spherocytosis = Fragile microspherocytes Thalassemia = Hypochromic, microcytic RBCs</p> Signup and view all the answers

    What is the primary treatment for Glucose-6-Phosphate Dehydrogenase Deficiency?

    <p>Preventive strategy by avoiding trigger drugs and aggressive infection management (B)</p> Signup and view all the answers

    In hemolytic disease of the newborn, maternal antibodies target fetal RBC antigens not inherited by the mother.

    <p>True (A)</p> Signup and view all the answers

    What are two common causes of hemolytic disease of the newborn?

    <p>ABO incompatibility and Rh incompatibility</p> Signup and view all the answers

    A standard dose of anti-Rh immune globulin, also called _____, is given to the mother to prevent hemolytic disease of the newborn.

    <p>RhoGAM</p> Signup and view all the answers

    Which of the following is NOT a mechanism of antibody-mediated drug reactions?

    <p>Increased RBC production (D)</p> Signup and view all the answers

    Symptoms of acute blood loss develop immediately after any loss of blood volume.

    <p>False (B)</p> Signup and view all the answers

    What are some symptoms that may appear after a 20% loss of blood volume?

    <p>tachycardia and postural drop in BP</p> Signup and view all the answers

    Match the following drug reaction mechanisms to their descriptions:

    <p>Hapten mechanisms = A drug molecule binds to a protein, creating an antigen. Neoantigen formation = A drug alters a self-antigen on the RBC surface. Membrane modification = Changes to the integrity of the red cell membrane by a drug. Autoantibody Induction = Drug exposure causes the body to create antibodies against its own RBCs.</p> Signup and view all the answers

    Which of the following can cause hemolytic anemia?

    <p>All of the above (D)</p> Signup and view all the answers

    Transfusions are only indicated for the restoration of blood volume.

    <p>False (B)</p> Signup and view all the answers

    What can excess RBCs cause in the case of polycythemia?

    <p>Increased blood viscosity</p> Signup and view all the answers

    Polycythemia vera involves a neoplastic transformation of bone marrow __________ cells.

    <p>stem</p> Signup and view all the answers

    What is a common treatment for polycythemia vera?

    <p>Phlebotomy (B)</p> Signup and view all the answers

    Secondary polycythemia does not involve an increase in erythropoietin production.

    <p>False (B)</p> Signup and view all the answers

    What causes relative polycythemia?

    <p>Dehydration</p> Signup and view all the answers

    Match the type of polycythemia with its cause:

    <p>Polycythemia Vera = Neoplastic transformation of bone marrow stem cells Secondary Polycythemia = Chronic hypoxemia with increased erythropoietin production Relative Polycythemia = Dehydration</p> Signup and view all the answers

    Study Notes

    Chapter 13: Alterations in Oxygen Transport

    • Learning Objectives:
      • Identify laboratory tests for anemia and polycythemia
      • Describe anemia's general effects on body systems
      • Differentiate various forms of anemia using history, clinical manifestations, and lab studies
      • Differentiate various forms of polycythemia using history, clinical manifestations, and lab studies
      • Describe treatment for common types of anemia and polycythemia

    Anemia

    • Definition: A deficit of red blood cells, leading to reduced oxygen-carrying capacity and hypoxia
    • Types:
      • Relative: Normal red cell mass, but problems with plasma volume regulation
        • Plasma volume decreases, artificially increasing RBC concentration
      • Absolute: Actual decrease in red blood cell numbers

    General Effects of Anemia

    • Reduced oxygen-carrying capacity: Leads to tissue hypoxia
    • Compensatory mechanisms: Increased heart rate, cardiac output, circulatory rate, and flow to vital organs
    • Increased 2,3-DPG: Decreases hemoglobin's affinity for oxygen, promoting oxygen release to tissues

    Manifestations of Anemia

    • Mild anemia (hemoglobin > 8g/dL): Minimal symptoms
    • Moderate/severe anemia (hemoglobin < 8g/dL):
      • Orthostatic hypotension
      • Pallor
      • Tachypnea
      • Headaches/lightheadedness
      • Angina
      • Nighttime leg cramps
      • Tinnitus
      • Fatigue and weakness

    • Aplastic Anemia:

      • Stem cell disorder, reducing hematopoietic tissue in the bone marrow, resulting in fatty marrow replacement (and pancytopenia)
        • Caused by toxic, radiant, or immunologic injury
      • Symptoms: Insidious onset, late symptoms (weakness, fatigue, lethargy, pallor, dyspnea, palpitations, transient murmurs, tachycardia)
      • Pancytopenia and granulocytopenia: Decrease in all blood cells, including neutrophils
      • Treatment: Avoid further toxic exposure, identifying and matching donors for possible bone marrow transplantation, immunosuppressive therapy, or stimulation treatments to promote hematopoiesis and bone marrow regeneration

    • Anemia of Chronic Renal Failure:

      • Impaired renal endocrine function, reduces erythropoietin production
      • Symptoms: Decreased RBC count, low HCT and HGB levels
      • Treatment: Dialysis, administration of erythropoietin

    • Vitamin B12/Folate Deficiency Anemia:

      • Disrupted DNA synthesis in bone marrow, producing megaloblasts
      • Symptoms: Pernicious anemia due to intrinsic factor deficiency, low RBC, WBC and platelet counts (with increased MCV and megalobastic dysplasia)
      • Treatment: Replacing needed nutritional deficiencies

    • Iron Deficiency Anemia:

      • Insufficient iron for hemoglobin synthesis
      • Symptoms: Hypochromic, microcytic RBCs; low MCV, MCH, and MCHC
      • Treatment: Oral ferrous sulfate or intravenous ferric gluconate

    • Thalassemia:

      • Increased red blood cell destruction (hemolysis), reduced RBC survival rates
        • Presence of mutant genes affecting globin chain production
      • Types: Classified according to deficient polypeptide chain(s)
      • Beta-Thalassemia:
        • Alpha globulin excess
        • Precipitation in RBCs and abnormal hemoglobin synthesis
        • Increased erythropoiesis and bone marrow activity
        • Associated with iron overload, liver toxicity, and bone deformation
        • Treatment: Blood transfusions, splenectomy, chelation therapy and bone marrow transplantation

    • Sickle Cell Anemia:

      • Genetically determined defect causing hemoglobin instability, producing sickled red blood cells and causing vascular occlusion
      • Symptoms: Severe anemia, different RBC shapes and sizes.
      • Treatment: Stem cell transplant

    • Hereditary Spherocytosis:

      • Defective red blood cell membrane skeleton, altered properties, and metabolism
      • Symptoms: Fragile microspherocytes, increased destruction of spherocytes
      • Treatment: Splenectomy

    • Glucose-6-Phosphate Dehydrogenase Deficiency:

      • Genetic disorder affecting RBC membrane, leading to premature destruction.
      • Symptoms: Hemolytic anemia triggered by drugs
      • Treatment: Avoiding drugs that trigger hemolytic episodes, and aggressive infection management

    • Hemolytic Disease of the Newborn:

      • Fetal RBCs cross the placenta, creating maternal antibodies that attack the fetus's RBCs (due to incompatibility with maternal blood)
      • Symptoms: Anemia, reticulocytosis, and nucleated RBCs in infant's blood
      • Treatment: Anti-Rh immunoglobulin and possibly in-utero blood transfusions and early delivery

    • Antibody-Mediated Drug Reactions:

      • Exposure to a drug triggers destruction and lysis of sensitized RBCs
      • Mechanisms: Hapten mechanisms, neoantigen formation, membrane modification, autoantibody induction
        • Treatment: Identify and discontinue offending medication

    • Acute Blood Loss:

      • Trauma or disease-related
      • Symptoms start with 20% blood loss, increasing with continued loss (tachycardia, postural BP drop)
      • Treatment: Blood volume replacement (with crystalloids, colloids, and fresh whole blood)

    • Other Extrinsic Abnormalities:

      • Mechanical heart valves (hemolysis)
      • Infections/chemicals
      • Venom from insects/snakes
      • Hypersplenism/splenomegaly (leading to anemia, leukopenia, or thrombocytopenia)

    Polycythemia

    • Definition: Excess RBCs, leading to increased blood viscosity and hypertension
    • Types:

      • Polycythemia Vera: Neoplastic transformation of bone marrow stem cells leading to absolute increase in RBC mass and leukocytosis (along with an increase in WBC and thrombocytopenia/an increase in uric acid due to increased proliferation).

        • Treatment involves reducing blood volume/viscosity(phlebotomy) and possible use of radioactive phosphorus and other chemotherapeutic agents.

      • Secondary Polycythemia: Cause is chronic hypoxemia (leads to increase in erythropoietin production), with an increase in RBC production without an increase in WBCs or platelets.

      • Relative Polycythemia: Spurious increase in RBC production due to dehydration, elevated hematocrit, hemoglobin, and RBC count

    • General Treatment: Identify cause and correct it. Use fluid therapy sometimes and/or phlebotomy to decrease cardiovascular workload.

    Transfusion Therapy

    • Medical indications: Restoration of oxygen-carrying capacity, blood volume, hemostasis and/or leukocyte function
    • Donor testing: Ensuring safety of blood products, specific pre transfusions testing to ensure blood components are safe and compatible for the patient

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    Related Documents

    Chapter 13 Alterations in Oxygen Transport PDF

    Description

    Test your knowledge on anemia, including its various types and causes, such as aplastic anemia and vitamin B12 deficiency. This quiz covers symptoms, compensatory mechanisms, and treatment strategies for these conditions.

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