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NR 507 EDAPT UNIT 2 HEMATOLOGICAL DISORDERS
2025/2026 EDITION
true or false: identification of the type of anemia involves an exemption of size of the red blood cell only. false Determining both the size and color of RBCs is an important step in identifying the type and source of anemia. which anemia is a type of macrocytic anemia? vitamin B12 deficiency (pernicious anemia) which lab value indicates the patient's iron stores are depleted? ferritin level A low ferritin level indicates that the patient's iron stores are depleted. which anemias can be categorized as microcytic-hypochromic? iron-deficiency anemia , sideroblastic anemia , and anemia of inflammation and chronic disease what is the most common type of anemia? iron-deficiency anemia IDA is the most common type of anemia worldwide. what condition could result in iron-deficiency anemia? excessive bleeding Excessive bleeding is one of the causes of iron-deficiency anemia. Other causes of anemia include dietary deficiency, impaired absorption, and increased requirement. microcytic hypochromic anemias
microcytic (MCV < 80 dL) = small RBCs hypochromic (low MCHC/low amount of hemoglobin per RBC) = pale RBCs
- iron-deficiency anemia
- sideroblastic anemia
- thalassemia microcytic normochromic anemia microcytic (MCV < 80 dL) = small RBCs normochromic (normal MCHC/normal amount of hemoglobin per RBC) = neither pale nor dark color of RBCs
- anemia of inflammation and chronic disease microcytic hyperchromic anemia microcytic (MCV < 80 dL) = small RBCs hyperchromic (high MCHC/high amount of hemoglobin per RBC) = deeper hue of red than normal RBCs
- hereditary spheroytosis causes of iron-deficiency anemia
- inadequate dietary intake
- chronic or occult bleeding (hemorrhage, colitis, cirrhosis, GI ulcers, esophageal lesions, or menorrhagia - it only takes 2-4 mL (about 1 tsp) of blood loss per day to lose 1-2 mg of iron)
- decreased ability to utilize iron for heme synthesis (transferrin deficiencies and mitochondrial defects - these are a less common cause of IDA) pathophysiology of iron-deficiency anemia insufficient iron levels or inability for mitochondria to utilize iron effectively leads to decreased hemoglobin synthesis and the formation of smaller, paler cells lab results for microcytic hypochromic anemias
true or false: when the iron stores are depleted, the cell's mitochondria are still able to utilize iron effectively due to compensatory mechanisms. false when iron stores are depleted, the cell's mitochondria are unable to utilize iron effectively. a transferrin deficiency will most likely result in _______. iron-deficiency anemia Transferrin saturation checks how many places on transferrin that can hold iron. Normal values are 20% to 50%. In severe cases of iron-deficiency anemia, this number may fall below 10%. what are some iron-rich foods? spinach , meat , and lima beans true or false: although less common, transferrin deficiencies and mitochondrial defects can lead to iron deficiency anemia. true folic acid is essential to the body because it _______. plays a major role in the maturing of RBCs Folate (folic acid) is an essential vitamin for RNA and DNA synthesis within the maturing erythrocyte (McCance, Ch 29, p. 933). true or false: one of the common precipitating factors of folate deficiency is alcohol abuse. true Absorption of folate occurs primarily in the upper small intestine and does not depend on the presence of any other facilitating factor, such as intrinsic factor (IF).
Folate deficiency is more common than vitamin B12 deficiency, particularly in alcoholics and individuals with chronic malnourishment. Alcohol interferes with folate metabolism in the liver, causing a profound depletion of folate stores. Fad diets and diets low in vegetables also may cause folate deficiency because of the absence of plant sources of folate. Box 29.1 lists the various causes of folic acid deficiency including (1) decreased intake, (2) increase requirement, and (3) impaired utilization (McCance, Ch 29, p. 932, 934). Loss of vibratory sense in a patient with vitamin B12 deficiency is due to what pathophysiological changes? posterior and lateral column spinal cord changes due to nerve demyelination Neurologic manifestations result from nerve demyelination that may produce neuronal death. The posterior and lateral columns of the spinal cord are affected, causing a loss of position and vibration sense, ataxia, and spasticity. The cerebrum also may be involved with manifestations of affective disorders, most commonly of the depressive types. Low levels of vitamin B12 have been associated with neurocognitive disorders. Overall, the consequences of vitamin B12 deficiency can include encephalopathy, myelopathy, and peripheral and optic neuropathy. (McCance, Ch 29, p. 933). a non-megaloblastic anemia would be caused by a ________. liver disease Liver disease causes a non-megaloblastic anemia. Megaloblastic anemia is caused by a deficiency or impaired utilization of vitamin B12 and/or folate, whereas nonmegaloblastic macrocytic anemia is caused by various diseases such as myelodysplastic syndrome (MDS), liver dysfunction, alcoholism, hypothyroidism, certain drugs, and less commonly by inherited disorders of DNA synthesis (Nagao & Hirokawa, 2017). two categories of macrocytic anemia megaloblastic:
microcytic anemia MCV<80 fL
- RBCs are small
- iron-deficiency anemia
- sideroblastic anemia
- thalassemia
- anemia of chronic disease normocytic anemia MCV 80-99 fL
- RBCs are normal in size
- anemia of inflammation and chronic disease
- hereditary spherocytosis
- G6PD deficiency
- paroxysmal nocturnal hemoglobinuria macrocytic anemia MCV > 100 fL
- RBCs are large
- B12 deficiency (pernicious anemia)
- folate deficiency hypochromic anemia
low MCHC
- RBCs have less hemoglobin than normal
- RBCs appear pale in color normochromic normal MCHC
- RBCs have a normal amount of hemoglobin
- RBCs appear neither pale nor dark hyperchromic high MCHC
- RBCs have more hemoglobin than normal
- RBCs appear a deeper hue of red than normal clinical manifestations of anemia
- severe fatigue
- pallor
- weakness
- dyspnea
- dizziness Furthermore, the reduction in RBC level will decrease blood volume, activating the renin-angiotensin-aldosterone (RAA) system, which promotes fluid retention and movement of interstitial fluid into the capillaries. This will not only increase plasma volume, but also dilute the plasma further. The dilute blood flows faster, which creates a hyperdynamic state. This "stresses" the cardiac system and can result in tachycardia or even heart failure. the terms normocytic, microcytic, and macrocytic characterizes red blood cells by their _______. size Terms that end with "-cytic" refer to cell size. what symptoms reflect decreased tissue oxygenation as an effect of anemia?
