Red Blood Cell Disorders Quiz

Anemias: Reduction in Red Blood Cells

• Anemia occurs when the rate of RBC production falls below that of cell destruction or loss of RBCs, causing low hemoglobin levels and reduced RBC count.

Normochromic Normocytic Anemias

• Impaired production of erythrocytes by the bone marrow or abnormal/uncompensated loss of RBCs causes normochromic normocytic anemias.
• RBCs appear normal in color and size, but there are too few for effective oxygen transport.

Acute Blood-Loss Anemia

• Caused by sufficient blood loss to lead to anemia, such as:
• Trauma (internal bleeding)
• Acute nephritis (blood lost in urine)
• Placenta previa, maternal-fetal or twin-to-twin transfusion
• Trauma to cord or placenta (newborn)
• Intestinal parasites (tapeworm, hookworm) in children
• Bedbug bites in small infants
• Signs and symptoms:
• Pale
• Tachycardia
• Increased respiration rate
• Gasping respirations
• Intercostal retractions
• Cyanosis
• Inactive
• Dizziness
• Comatose
• Treatment:
• Control bleeding by addressing its underlying cause
• Transfuse additional RBCs
• Lay the child flat to increase circulation to brain cells
• Keep the child warm with blankets or radiant heat warmer
• Administer blood expanders (plasma or intravenous fluids) until blood is available for transfusion

Anemia of Acute Infection

• Caused by acute infection or inflammation, especially in infants, leading to increased destruction or decreased production of RBCs.
• Examples of acute infections:
• Osteomyelitis
• Ulcerative colitis
• Management:
• Treat the underlying condition
• Blood values will return to normal when the condition is reversed

Anemia of Renal Disease

• Acute or chronic renal disease can cause loss of function in kidney cells, leading to decreased erythropoietin production and normocytic, normochromic anemia.
• Treatment:
• Administer recombinant human erythropoietin to increase RBC production

Anemia of Neoplastic Disease

• Leukemia and lymphoma can cause normochromic, normocytic anemias due to bone marrow invasion by neoplastic cells.
• Accompanying blood loss may occur if platelet formation is also decreased.
• Treatment:
• Achieve remission of the neoplastic process
• Transfusion to increase erythrocyte count

Anemia of Hypersplenism

• Enlarged spleen leads to increased destruction of RBCs, causing anemia and potentially pancytopenia.
• Underlying splenic conditions can cause this syndrome.
• Treatment:
• Treat the underlying splenic disorder
• Possible splenectomy

Aplastic Anemias

• Result from depression of hematopoietic activity in the bone marrow, affecting WBCs, platelets, and RBCs.
• Examples:
• Congenital aplastic anemia (Fanconi syndrome), inherited as an autosomal recessive trait, with congenital anomalies such as skeletal and renal abnormalities, hypogenitalism.