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robbypowell's version from 2015-11-20 18:24

RBC disorders

Question Answer
Are red blood cell deficiencies common?YES (that's why it's important for us to know about them)
What are 5 potential dental complications for patients with RBC deficiencies?1. Susceptibility to INFECTIONS; 2. mucosal epithelial ATROPHY; 3. BLEEDING problems
What two organs functions are especially affected by RBC deficiencies (listed in complication)Liver & Spleen
Do RBC disorders manifest in the head and neck?Yes
General umbrella term for RBC disorders involving deficienciesAnemia
"lack of blood" (latin); term means something deficient in bloodAnemia
What is the (first) ORIGIN of Erythrocytes?Pluripotent Hematopoietic Stem Cells (Or Pluripotent Stem Cells) in Bone Marrow
Pluripotent Hematopoietic Stem Cells can differentiate directly into what two types of cells?Common Myeloid SC (Stem Cell) & Common Lymphoid SC
T/F: Erythrocytes develop from Common Lymphoid Stem CellsFALSE (Lymphocytes not RBC's come from Lymphoid Stem Cells)
T/F: Erythrocytes develop from Common Myeloid Stem CellsTRUE (and these develop from Pluripotent Hematopoietic SC's)
decreased oxygen carrying capacity of the peripheral blood is a type of ____Anemia
according to WHO, severe anemia = anyone with Hb < ___ g/dL7.0 g/dL
T/F: Hemoglobin concentration varies by Age, Sex & Pregnancy StatusTrue (normal ranging from 11-13 g/dL)
Normal range for Hemoglobin concentration is ___ to ___ g/dL11-13 (6 mo-5yo children & pregnant women have 11; adult males have 13)
3 mechanisms of Anemia1. Blood Loss 2. Decreased Production 3. Increased Destruction (Hemolysis)
Term describing RBC's with low hemoglobinationHypochromic
Term describing RBC's with normal hemoglobination
____-blasts are relevant to bleeding disordersMegakaryocytes
____-blasts are relevant to AnemiasPro-erythroblasts (and Erythroblasts)
What is the very last step in development before becoming a mature RBC?Reticulocyte
What is the immediate precursor of mature RBC's?Reticulocyte
These cells can be differentiated from RBC's b/c they're bigger, bluer, and have Nucleic acids stillReticulocytes
After losing a lot of blood... what cell would be seen in abnormally high values in the periphery following the body's response?Reticulocytes (baby red blood cells)
What molecule makes up most of RBC's content?Hemoglobin
Concentration of what is used by WHO to classify Anemias?Hemoglobin
Packed RBC volume is akaHematocrit
What Lab test is useful for detecting abnormalities in RBC size and number?Hematocrit
T/F: Red blood cells and all their precursors have nucleiFALSE (RBC's don't but precursors do)
T/F: Red blood cells lack nuclei, but their precursors have nucleiTRUE
Term for abnormal variation in RBC shapePoi-kilo-cytosis
Term for excessive variation in RBC sizeAniso-cytosis
RBC's that are abnormally small in size are referred to as ______MICRO-CYTIC
RBC's that are abnormally large in size are referred to as ______MACRO-CYTIC
3 Compensatory mechanisms for Anemia (all increases)Increase in Plasma Volume, Cardiac Output, & Respiratory Rate
3 Main organs affected by long term anemiaLiver, Myocardium, & Kidneys (cells involved in lipid metabolism)
accumulation of fatty vacuoles in the cell cytoplasm in response to hypoxia is a ____ (reversible/irreversible) consequence of long term anemiaReversible
T/F: There is a reversible accumulation of fatty vacuoles in the cell cytoplasm in response to long term anemiaTrue
Around the world, the most common mechanistic cause of Anemia is ___ ____ of RBC'sDecreased Production (often malnutrition, iron deficiency)
RBC's whose pale area makes up 1/3rd diameter of cell (under microscope) would be referred to as ____Normochromic
RBC's whose pale area makes up 2/3rd's diameter of cell (under microscope) would be referred to as ____Hypochromic
Normal RBC cell size is _________ to ___ microns6-8 microns (7 is safe avg)
Inadequate intake of iron results in insufficient hemoglobin synthesis and ____ (color) and ____ (size) RBC's.Hypochromic; Microcytic
Inadequate intake of ___ results in insufficient hemoglobin synthesis and hypochromic and microcytic RBC.Iron
Caused by production of inflammatory cytokines, which cause iron to be sequestered in macrophages, and deregulate iron absorption, usually resulting in ___ (color) and ___(size) RBC's.Normo-chromic; Normocytic
Which Anemia is Caused by deficiencies of folate or vitamin B12Megaloblastic Anemia
Which anemia results in enlarged abnormal hematopoietic precursors in the bone marrow, ineffective hematopoiesis, and (in most cases) pancytopeniaMegaloblastic Anemia (Folate or B12 deficiency)
Which anemia Caused by bone marrow failure (hypocellularity)Aplastic Anemia
inherited defects in DNA repair and the enzyme telomerase can lead to which Anemia?Aplastic Anemia (bone marrow failure; hypocellularity)
exposures to toxins and radiation can lead to which Anemia?Aplastic Anemia (bone marrow failure; hypocellularity)
Which anemia is caused by replacement of the bone marrow by infiltrative processes such as metastatic cancer and granulomatous diseaseMyelophthisic Anemia
Which anemia release of early erythroid and granulocytic precursors (leukoerythroblastosis) and the appearance of tear-drop red cells in the peripheral bloodMyelopthisic Anemia
leukoerythroblastosis is a sign associated with which anemia?Myelopthisic Anemia (metastatic infiltration of bone marrow)
term for release of early erythroid and granulocytic precursors into bloodLeuko-erythro-blastosis
3 non-specific symptoms of anemiaPallor (pale), Tired, & Weak
Hyperbilirubinemia, jaundice & pigment gallstones are specific to what type of Anemia?Hemolytic
In Anemia of Chronic Disease, what is problematic about RBC's?Low Quantity (cells are NORMAL but their production is down regulated)
In Iron Deficiency Anemia, what is problematic about RBC's?Hypochromic & Microcytic (Low Hemoglobin content & Small)
In Iron Deficiency Anemia you don't make enough ____ and RBC's appear ____ & ____ under microscopeHemoglobin; Hypochromic (low hemoglobin) & Microcytic (small size)
In Anemia of Chronic Disease (cytokine causation) you don't make enough ____ and RBC's appear ____ under microscopeRBC's; Normal (but low quantity)
an example of a Microcytic AnemiaMegaloblastic Anemia (RBC's are too big)
These 2 essential nutrients are important for DNA synthesis, and their deficiency results in large, immature circulating RBC'sB12 & Folate
Liver product that regulates Iron absorptionHepcidin
Hepcidin is produced by the ____ and regulates ____ absorptionLiver; Iron
Approximately ___ mg of Iron is absorbed daily... or _________% of dietary intake1 mg; 10%
Normally, most ____ is lost through shedding surface cellsIron
T/F: Inorganic iron in non-animal food is absorbed inefficientlyTrue
T/F: Inorganic iron in non-animal food is absorbed efficientlyFalse
molecule responsible for transport of ironTransferrin
2 molecules responsible for storing ironFerritin & Hemosiderin
2 conditions that can lead to impaired Iron absorption in DuodenumChronic Diarrhea & Gastrectomy
3 conditions that increase demand for ironGrowth, Pregnancy, (physiologic regular) Blood loss
northern European women 30-50 yrs with anemia, glossitis, and dysphagia have what Syndrome and are at greater risk for what serious condition?Plummer-Vinson syndrome; Squamos Cell Carcinoma
cobalamin is akavit B12
vit B12 is akacobalamin
term meaning reduction in the number of red and white blood cells, as well as plateletsPancytopenia
blood count cutoff for Aplastic Anemia <___PMN's / microL, < _________ platelets / microL, & < ___ reticulocytes / microL500; 20,000; 10,000
Sickle cell anemia has similar features to Thalassemia... but have the added complication of what?Ischemic Necrosis (stressed conditions lead to sickling of cells which can form "stacks" or polymerize to block blood vessels leading to infarction)
memorize
Sickle cell anemia crises has major effect

 

Normal Values for Lab #'s
Question Answer
***Red Blood Cells / mL***(N = 3.5-6 million/ml)
***Reticulocyte count (%)***(N = 0.5-1.5%)
***Hemoglobin (g/dL)***(N = 12-18 g/dl)
***Hematocrit (or packed RBCs/ volume)*** (%)(N = 37-54%)
Mean Cell Volume (mm3)(N = 82-96 mm3)
Red Blood Cell Distribution Width (i.e. coefficient of variation in cell volume)(11.5-14.5)
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WBC disorders

Question Answer
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Bleeding Disorders

Question Answer
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Describe key mechanisms of common anemias

Question Answer
Due to a defect in the hematopoietic stem cellAplastic Anemia
Due to defective synthesis of hemoglobin thalassemia
Due to defective DNA synthesisMegaloblastic Anemia (B12 or Folate deficiency)
lack of intrinsic factorB12 deficiency --> Megaloblastic Anemia
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clinical features of common anemias

Question Answer
Hypochromic & Microcytic RBC'sIron Deficiency Anemia (insufficient intake or failure to retain)
Normal RBC's but low quantityAnemia of Chronic Disease (cytokine causation)
Enlarged and relatively immature circulating RBC'sMegaloblastic Anemia (B12 or Folate deficiency)
(mechanistic class of Anemias) Hyperbilirubenemia & JaundiceHemolytic Anemia
LeukoerythroblastosisMyelophthisic Anemia (metastatic cancer or granulomatous disease infiltrate of bone marrow)
tear-drop red cells in the peripheral blood.Myelophthisic Anemia (metastatic cancer or granulomatous disease infiltrate of bone marrow)
Low concentrations of WBC's, RBC's & PlateletsAplastic Anemia (original stem cell affected)
Extreme susceptibility to infections, Anemia & Bleeding disorderAplastic Anemia (stem cell progenitor of WBC's, platelets & RBC's affected)
Hypocellularity of bone marrowAplastic Anemia (stem cell progenitor of WBC's, platelets & RBC's affected)
Altered Erythrocyte production --> increased HemolysisThalassemia
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