Exam 4 )NSG 533 Exam 4 Study Guide
Anemia can contribute to: - ANSWER:coronary ischemia
Composition of blood - ANSWER:5.5L total. 50-55% = plasma; 90% water
Erythropoesis is stimulated by... - ANSWER:erythropoetin
Hemoglobin A - ANSWER:the majority of adult hemoglobin. 97% of circulating hemoglobin. 2 alpha and 2
beta chains.
HbA2 - ANSWER:minor adult hemoglobin. 2-3% of circulating hemoglobin. 2 alpha and 2 delta chains.
Hemoglobin F - ANSWER:Fetal hemoglobin. 2 alpha and 2 gamma chains. Has a greater affinity for and
more regularly binds O2.
Anemia - ANSWER:a decrease in circulating red blood cells in the body, as reflected by a reduction in
hemoglobin, hematocrit, and/or RBCs. Less than 14 in men and less than 12 in women.
Normal RBC - ANSWER:4.5-6
Normal Hemoglobin - ANSWER:>13 in men, >12 in women.
Normal HCT - ANSWER:40-50in men; 35-45 in women. usually 3x the hemoglobin count.
Reticulocyte count - ANSWER:Low (<0.5%) High (>2%) if high, bone marrow is trying to compensate for
loss in hgb or red cells. problem exists outside of the bome marrow
MCV (mean corpuscular volume) - ANSWER:description of the volume of an RBC. NOT DIAGNOSTIC
RDW (red cell distribution width) - ANSWER:11.5-15 %; index of variation in RBC size and shape.
Indicates evolving macro/microcytic anemia.
MCH (mean corpuscular hemoglobin) - ANSWER:commonly used: 27 - 31 pg/ cell
Amount of hemoglobin per RBC
Microcytic anemia - ANSWER:Iron deficiency, thalassemia, inflammation. low MCV <80. Low reticulocyte
count. Underproduction.
macrocytic anemia - ANSWER:Underproduction. B12 deficiency, Folic Acid Deficiency, Antimetabolite
drugs. MCV > 100; low reticulocyte count
Normocytic Anemia - ANSWER:MCV 80-100; low reticulocyte count; ex: dilutional/iatrogenic secondary
to phlebotomy.
Folate Deficiency Anemia - ANSWER:Macrocytic anemia; poor intake; low retic, elevate MCV/MCH,
thrombocytopenia ad neutropenia, elevated homocysteine; low RBC folate. Eat orange fruits! Never
treat folate deficiency without testing for B12 deficiency - can worsen neurological symptoms specific to
B12 deficiency
, Vitamin B12 Deficiency - ANSWER:Macrocytic; malabsorption; occurs when B12 is not released from
food proteins due to impaired digestion; Elevated MCV/Macrocytic;
Pernicious Anemia - ANSWER:lack of mature erythrocytes caused by inability to absorb vitamin B12 into
the bloodstream
Destruction (Hemolytic anemia) - ANSWER:anemia with elevated reticulocytes; intrinsic and extrinsic
intrinsic hemolytic anemia (hereditary) - ANSWER:- Abnormal hemoglobin
- Enzyme deficiencies (pyruvate kinase, G6PD)
- RBC membrane abnormalities: sickle cell anemia, thalassemia
extrinsic hemolytic anemia (acquired) - ANSWER:(+) Coomb's
DIC: abnormal coags (prolonged PT/PTT)
TTP
HUS
paroxysmal nocturnal hemoglobinuria: dark urine worse in AM
hypersplenism
Traumatic 2/2 prosthetic valve;
elevated LDH, low haptoglobin; elevated indirect bilirubin
Sickle Cell Anemia - ANSWER:Hemolytic/hereditary. Identified at birth - 6 months when HbSS replaces
fetal hemoglobin. hereditary disorder of abnormal hemoglobin producing sickle-shaped erythrocytes
and hemolysis
Thalassemia Major - ANSWER:Hemolytic/microcytic; defective production of either alpha or beta globin.
leads to damage of the RBC membrane, resulting in ineffective erythropoesis and hemolysis
Alpha Thalassemia - ANSWER:4 genes determine synthesis of alpha chain. Silent carrier = 1 abnormal
allele; 2 abnormal alleles = alpha thalassemia minor; 3 abnormal alleles = Alpha Thalassemia Intermedia:
chronic anemia; 4 abnormal alleles not compatible with life, Hydrops Fetalis
Beta Thalassemia - ANSWER:mutations of the beta-globulin gene; no production of beta chain, absent
HgBA; common in mediterranean, african, indian, and asian ancestry.
Beta Thalassemia Major: Cooly's Anemia - ANSWER:Beta Thalassemia Major; symptomatic at 6 months;
deficient beta chains = excess alpha chains; ineffective erythropoesis; erythroid hyperplasia;
extramedullary hematopoesis. Low Hgb/HCT; low MCV, normal/elevated retic; increased RBC; need vit
C/folate supplementation; avoid excess iron. bone marrow transplant
Monroe-Kellie Doctrine - ANSWER:when one content in the skull increases, another must decrease to
compensate and maintain normal ICP
Anemia can contribute to: - ANSWER:coronary ischemia
Composition of blood - ANSWER:5.5L total. 50-55% = plasma; 90% water
Erythropoesis is stimulated by... - ANSWER:erythropoetin
Hemoglobin A - ANSWER:the majority of adult hemoglobin. 97% of circulating hemoglobin. 2 alpha and 2
beta chains.
HbA2 - ANSWER:minor adult hemoglobin. 2-3% of circulating hemoglobin. 2 alpha and 2 delta chains.
Hemoglobin F - ANSWER:Fetal hemoglobin. 2 alpha and 2 gamma chains. Has a greater affinity for and
more regularly binds O2.
Anemia - ANSWER:a decrease in circulating red blood cells in the body, as reflected by a reduction in
hemoglobin, hematocrit, and/or RBCs. Less than 14 in men and less than 12 in women.
Normal RBC - ANSWER:4.5-6
Normal Hemoglobin - ANSWER:>13 in men, >12 in women.
Normal HCT - ANSWER:40-50in men; 35-45 in women. usually 3x the hemoglobin count.
Reticulocyte count - ANSWER:Low (<0.5%) High (>2%) if high, bone marrow is trying to compensate for
loss in hgb or red cells. problem exists outside of the bome marrow
MCV (mean corpuscular volume) - ANSWER:description of the volume of an RBC. NOT DIAGNOSTIC
RDW (red cell distribution width) - ANSWER:11.5-15 %; index of variation in RBC size and shape.
Indicates evolving macro/microcytic anemia.
MCH (mean corpuscular hemoglobin) - ANSWER:commonly used: 27 - 31 pg/ cell
Amount of hemoglobin per RBC
Microcytic anemia - ANSWER:Iron deficiency, thalassemia, inflammation. low MCV <80. Low reticulocyte
count. Underproduction.
macrocytic anemia - ANSWER:Underproduction. B12 deficiency, Folic Acid Deficiency, Antimetabolite
drugs. MCV > 100; low reticulocyte count
Normocytic Anemia - ANSWER:MCV 80-100; low reticulocyte count; ex: dilutional/iatrogenic secondary
to phlebotomy.
Folate Deficiency Anemia - ANSWER:Macrocytic anemia; poor intake; low retic, elevate MCV/MCH,
thrombocytopenia ad neutropenia, elevated homocysteine; low RBC folate. Eat orange fruits! Never
treat folate deficiency without testing for B12 deficiency - can worsen neurological symptoms specific to
B12 deficiency
, Vitamin B12 Deficiency - ANSWER:Macrocytic; malabsorption; occurs when B12 is not released from
food proteins due to impaired digestion; Elevated MCV/Macrocytic;
Pernicious Anemia - ANSWER:lack of mature erythrocytes caused by inability to absorb vitamin B12 into
the bloodstream
Destruction (Hemolytic anemia) - ANSWER:anemia with elevated reticulocytes; intrinsic and extrinsic
intrinsic hemolytic anemia (hereditary) - ANSWER:- Abnormal hemoglobin
- Enzyme deficiencies (pyruvate kinase, G6PD)
- RBC membrane abnormalities: sickle cell anemia, thalassemia
extrinsic hemolytic anemia (acquired) - ANSWER:(+) Coomb's
DIC: abnormal coags (prolonged PT/PTT)
TTP
HUS
paroxysmal nocturnal hemoglobinuria: dark urine worse in AM
hypersplenism
Traumatic 2/2 prosthetic valve;
elevated LDH, low haptoglobin; elevated indirect bilirubin
Sickle Cell Anemia - ANSWER:Hemolytic/hereditary. Identified at birth - 6 months when HbSS replaces
fetal hemoglobin. hereditary disorder of abnormal hemoglobin producing sickle-shaped erythrocytes
and hemolysis
Thalassemia Major - ANSWER:Hemolytic/microcytic; defective production of either alpha or beta globin.
leads to damage of the RBC membrane, resulting in ineffective erythropoesis and hemolysis
Alpha Thalassemia - ANSWER:4 genes determine synthesis of alpha chain. Silent carrier = 1 abnormal
allele; 2 abnormal alleles = alpha thalassemia minor; 3 abnormal alleles = Alpha Thalassemia Intermedia:
chronic anemia; 4 abnormal alleles not compatible with life, Hydrops Fetalis
Beta Thalassemia - ANSWER:mutations of the beta-globulin gene; no production of beta chain, absent
HgBA; common in mediterranean, african, indian, and asian ancestry.
Beta Thalassemia Major: Cooly's Anemia - ANSWER:Beta Thalassemia Major; symptomatic at 6 months;
deficient beta chains = excess alpha chains; ineffective erythropoesis; erythroid hyperplasia;
extramedullary hematopoesis. Low Hgb/HCT; low MCV, normal/elevated retic; increased RBC; need vit
C/folate supplementation; avoid excess iron. bone marrow transplant
Monroe-Kellie Doctrine - ANSWER:when one content in the skull increases, another must decrease to
compensate and maintain normal ICP
