Questions and Answers
What are the normal ranges of RBC count, Hemoglobin concentration, and Hematocrit value in males?
RBC count: 4.5-6 million/cmm, Hemoglobin concentration: 15 gm% (13.5-17.5), Hematocrit value: 45%
How does the O2 dissociation curve shift in anemia and why?
The O2 dissociation curve shifts to the right due to excess production of 2,3 DPG which weakens the binding between O2 and Hb.
Why do females generally have lower values of Hemoglobin and RBC count compared to males?
Females have lower values due to the effect of androgen in females plus the effect of menstruation.
Describe the cardiovascular symptoms associated with anemia.
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What role does erythropoietin play in anemia?
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What are the general symptoms of anemia regardless of the absolute value of Hemoglobin?
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What physiological mechanism causes a shift of O2 dissociation curve to the right in anemia, and how does this affect O2 delivery?
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Describe the effect of hyperdynamic circulation in the context of anemia?
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How does the redistribution of blood in anemia preferentially affect brain function?
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What is the role of erythropoietin in the context of anemia, and which organ is responsible for its production?
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Why might anemic patients experience cardiovascular symptoms despite having high cardiac output?
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What are the CNS symptoms associated with anemia, and why do they occur?
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Explain the hyperdynamic circulation observed in individuals with anemia.
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How does the production of 2,3 DPG affect oxygen binding to hemoglobin in anemic patients?
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What role does redistribution of blood play in the pathophysiology of anemia?
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Describe the effects of anemia on the cardiovascular system and explain why these effects occur.
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How does erythropoietin contribute to the management of anemia?
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What is the clinical significance of the rate of reduction in hemoglobin levels in patients with anemia?
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Study Notes
Anemia Scheme
Definition
- Anemia is characterized by a reduction in one of the following parameters:
- RBCs count: normally 4.5-6 million/cmm in males
- Hb concentration: normally 15 gm% (13.5-17.5) in females
- Hematocrite value (packed cell volume): normally 45%
Gender Differences
- Females typically have 1-2 gm Hb and approximately one million RBCs per cmm less than males due to:
- The effect of androgen in females
- The effect of menstruation
Pathophysiology
- Hyperdynamic circulation leads to:
- Short circulation time
- High cardiac output
- The kidney produces erythropoietin, which stimulates the production of RBCs
- Increased 2,3 DPG production causes:
- Shift of O2 dissociation curve to the right
- Weaker binding between O2 and Hb
- Enhanced O2 delivery to tissues
Compensation Mechanisms
- Redistribution of blood to vital organs, such as the brain
Clinical Picture
- Symptoms depend on the rate of reduction rather than the absolute value of Hb
Symptoms
- General: Fatigue and lassitude
- CVS: Manifestations of low cardiac output despite high CO
- CNS: Loss of concentration, headache, and dizziness
- Genital: Impotence, menstrual irregularities
Anemia Scheme
Definition
- Anemia is characterized by a reduction in one of the following parameters:
- RBCs count: normally 4.5-6 million/cmm in males
- Hb concentration: normally 15 gm% (13.5-17.5) in females
- Hematocrite value (packed cell volume): normally 45%
Gender Differences
- Females typically have 1-2 gm Hb and approximately one million RBCs per cmm less than males due to:
- The effect of androgen in females
- The effect of menstruation
Pathophysiology
- Hyperdynamic circulation leads to:
- Short circulation time
- High cardiac output
- The kidney produces erythropoietin, which stimulates the production of RBCs
- Increased 2,3 DPG production causes:
- Shift of O2 dissociation curve to the right
- Weaker binding between O2 and Hb
- Enhanced O2 delivery to tissues
Compensation Mechanisms
- Redistribution of blood to vital organs, such as the brain
Clinical Picture
- Symptoms depend on the rate of reduction rather than the absolute value of Hb
Symptoms
- General: Fatigue and lassitude
- CVS: Manifestations of low cardiac output despite high CO
- CNS: Loss of concentration, headache, and dizziness
- Genital: Impotence, menstrual irregularities
Anemia Scheme
Definition
- Anemia is characterized by a reduction in one of the following parameters:
- RBCs count: normally 4.5-6 million/cmm in males
- Hb concentration: normally 15 gm% (13.5-17.5) in females
- Hematocrite value (packed cell volume): normally 45%
Gender Differences
- Females typically have 1-2 gm Hb and approximately one million RBCs per cmm less than males due to:
- The effect of androgen in females
- The effect of menstruation
Pathophysiology
- Hyperdynamic circulation leads to:
- Short circulation time
- High cardiac output
- The kidney produces erythropoietin, which stimulates the production of RBCs
- Increased 2,3 DPG production causes:
- Shift of O2 dissociation curve to the right
- Weaker binding between O2 and Hb
- Enhanced O2 delivery to tissues
Compensation Mechanisms
- Redistribution of blood to vital organs, such as the brain
Clinical Picture
- Symptoms depend on the rate of reduction rather than the absolute value of Hb
Symptoms
- General: Fatigue and lassitude
- CVS: Manifestations of low cardiac output despite high CO
- CNS: Loss of concentration, headache, and dizziness
- Genital: Impotence, menstrual irregularities
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