Animia

number of erythrocyte
quality of hemeoglobin
volume of packed RBC
blood loss
impaired production of RBC
increase destruction of RBC

Transport
protection
regulation

Pallor (decrease blood flow and hemoglobin)
Jaundice (increase concentration of serum bilirubin)
Pruritus - increase serum and skin bile salt concentration
Fatigue, tachypnea, Increase HR due to maintain CO

Chronic disease
nutritional deficies

Fix the under cause of anemia
blood transfusion
volume replacement - dextran or IV
Oxygen therapy - hypoximia
nutritional and lifestyle change
Drug therapy - epogen

decrease production of hemoglobin
defective of DNA synthesis in RBC
loss erythrocyte precursor

decrease RBC production and hemoglobin synthesis

Inadequate dietry intake
malabsorption - GI surgery
Blood loss
hemolysis

pallor
glossitis
cholitis
paresthesia and burning sensation of tongue

Decrease: hb. hct, mvc, ferritin and bilirubin
Increase: MCH, MCHC, Reticulocyte, serum iron, TIBC
Stool gauatic test
endoscopy
colonscopy
bone marrow biospy

Intake iron
nutritional therapy
IRON supplement - oral or IV
Drug therapy: ferrous sulfate/ ferrous glyconate.
- Iron dextran, Na ferrous glyconate, iron sucrose = IV or IM
Transfusion

Genetic disorder - abnormal Hemoglobin synthesis = decrease alpha and beta globin = decrease alpha and beta thalassemia

Minor: Microcytosis; hypochromia and asymptomatic

Major: life threatening; palor; symptomatic; physical and mental growth retarded; enlarge liver and spleen; jaundice

minor: self adapt
major: blood transfusion and oral deferasious or IV deferoxamine

Hepatitis C - due to cirrhosis and hepatocellular carcinomia = stem cell transplantion
DO NOT GIVE IRON

Increase: MCV, serum Iron, Ferritin, bilirubin
Decrease: HB/HCT, reticulocyte

Megaloblastic anemia

IF is protien that secret by the partial cell of gastric mucosa
For IF to be absorb it need EF to be absorpt at Ileum

Pernicious anemia
gastrectomy
chronic alcoholism
hereditary enzyme deficiency
nutritional deficiency

Weakness and muscle weakness
Paresthesia of feet and hand
decrease vibratory and position senses
ataxia
impair thought process

large RBC
increase V. B12
normal serum folate
schilling test - radio active see in urine

parenteral and intranasal cobalamin B12
1000mg IM for 2 week than weakly until hemacrati is normal and then monthly for life
adequate dietry intake
high dose oral/ sublingual for pt with GI intact

malabsorption
alcoholism
drug
dietry deficiency
hemodialysis
anorexia

beefy red tongue
absent neuro - no tingling or numbness
big RBC size

normal V B 12
decrease in serum folate

replacement therapy: 1mg/daily PO
Malabsorption: 5mg/daily
Eat green leaf and vegetable, meat and whole grain

not enough RBC
Shortening of RBC survival

end stage renal disease
decrease erythrocytes
chronic liver disease
chronic inflammation
chronic endocrine disease
malignant tumor

normocytic (shape) and normochronic (color)
increase serum ferritin and Iron stores
normal folate and B12

give epogen/ darbepoetin

RBC cant produce bone marrow or other organ
decrease in RBC, WBC, PLT

abrupt and gradual develop
fatigue and dyspnea
Increase HR and MURMUR
roaring ear
dizziness
impair thought process
neutropenia - protect pt from us

stem cell transplant
immunosuppression therapy

100.4 degree
bleeding

sudden hemorrhage due:
trauma
complication surgery
disruption of vascular irregulatory

Type1: sudden reduction due to hypovolemic shock
type2: acute loss gradual loss

hypoxia
internal hemorrhage - pain distention
organ displacement
nerve compression
10% blood loss = none
20% = no s/s; tachycardia w// exercise
30% = HTN and tachycardia w/ exercise
40% = decrease CO, HR, CVS
50% = hypovolemic shock

replacing blood volumen to preven shock
find where hemorrhage
stop blood loss
Correct RBC loss
Give Iron supplement
IV fluid: dextran or hetastarch, albumin, cyrstalord electrolyte

Genetic disorder
Abnormal hemoglobin stiffen and take shape of sickle
Low oxygen binding
Hemoglobin S cause the stiffen and elongation in response to hypoxia
INCURABLE DISEASE

cause hypoxia/ deoxygenation of RBC due to viral and bacterial infection, high altitude, emotional, physical stress, surgery, blood loss

decrease concentration of hydrogen ion = increase plasma osmolality and cause decrease plasma volume lead to low body temperature

can't pass thru capillaries or small vessel lead to vascular occlusion cause acute/ chronic tissue damage

painful, acute exacerbation of sickling cause a vaso-occlusion crisis

capillaries hypoxia = change membrane permeability = plasma loss, thrombi, hypoconcentration

tissue ischemia, infarction and necrosis

life threatening
oxygen depletion of tissue lead to decrease fluid volume

pallor
gray
jaundice
gallstone
pain w/ fever
tenderness
tachypnea
HTN
N/V

peripheral blood smear
sickling test
decrease: Hb/hct reticulocyte
increase: serum iron, bilirium
x- ray
MRI dropper