Anemia

heavy periods surgery blood pregnancy a diet low in folic acid, iron, vitamin b12 sickle cell anemia lack of erythropoeitin kidney disease requiring dialysis hemolytic anemia

blood loss red blood cell destruction inadequate production of RBC

fast heart rate, palpitations hypotension, lightheadedness SoB

weakness, fatigue headache, vertigo, faintness sensitivity to cold, pallor, loss of skin tone

tongue pain smooth tongue pica pagophagia

production of red blood cells

1. pluripotent stem cell in the bone marrow will turn into an erythroid burst unit and then into an erythroid colony forming unit. under the influence of GM-CSF, IL-3, EPO.
2. next is the proerythroblast and this is the first step of forming the RBC. Hgb is produced and iron is being absorbed into the cell. the proerythroblast is maturing into a basophilic erythroblast and the cell is making lots of ribosomes so more Hgb can be made.
3. basophilic erythroblast will turn into a polychromatic erythroblast and this is where the nucleus shrinks as cell matures.
4. then it will turn into a pyknotic erythroblast, where the nucelus becomes dense and small and leaves the cell
5. the cell becomes a reticulocyte (immature RBC) and this will mature into an erythrocyte.

1 week

120 days

vertebrae, ribs, sternum, clavicle, pelvic crest, long bones

polychromatic erythroblast

turns stem cells into proerythroblasts increases mitosis prevents apoptosis increases release of reticulocytes increases hemoglobin formation

when oxygen levels are low, kidneys will sense this and they will release EPO. EPO will go to the bone marrow and stimulate the production of RBC and goes to the blood stream so that it can increase oxygen carrying capacity. when oxygen levels are normal, EPO release stops.

Aranesp - injection for patients who have chronic kidney disease or on kidney dialysis

it is an iron transporter and it takes the iron to the bone marrow so that it can be incorportaed in the RBC production. when our body doesn't need iron, then it becomes extra iron so the transferrin will take it to these sites for storage which are the liver cells and to the macrophages in liver, spleen, bone marrow (RES).

Ferritin - most accessible of getting iron Hemosiderin - the less available access to get iron

This is through the Bohr effect. it release oxygen when there is high amounts of carbon dioxide, an acidic environment is present, increase in temperature, and an increase in 2,3-DPG.

RBC are destroyed in the spleen and bone marrow by the phagocytes (part of RES) and the hemoglobin is released. the hemoglobin is broken into the heme and the globin. the globin gets broken down into amino acids and the heme is broken down further by the heme oxygenase that releases the porphyrin ring that holds the iron and releases the iron and the rest into biliverdin this gets converted into the unconjugated (indirect) bilirubin. the unconjugated bilirubin will go to the liver and will be converted into conjugated bilirubin which is then gets excreted into bile.

liver disease

when the bile excretion is blocked

it is the average size of a red blood cell. you calculate it by dividing hematocrit by RBC count. a small RBC has low MCV a big RBC has high MCV

Signup and view all the flashcards