NR 507
WEEK 2 STUDY GUIDE;
HEMATOLOGICAL DISORDERS
,Hematological Disorders
Anemia
Questions
1. MCV is the index that measures the average size of RBCs
2. Hereditary spherocytosis is a microcytic anemia characterized by hyperchromic RBCs
3. Anemia can be caused by impaired RBC production, excessive blood loss, and increased RBC
production
4. Bradycardia is not characteristic of anemia; tachycardia is present due to hypoxemia
Definition
• Hematological disorder characterized by a
reduction in the total number of circulating
RBCs and/or a decrease in hemoglobin (Hb)
amount or function
• Capacity of blood to transport oxygen to the
tissues is reduced
Etiology
• Excessive blood loss
o Acute
▪ Trauma, surgery, postpartum
hemorrhage
o Chronic
▪ GI bleed, cancer
• Decreased RBC production
o Abnormal proliferation or differentiation of stem cells
▪ Aplastic anemia
o Defective DNA synthesis in erythroblasts
▪ Vitamin B12 deficiency, folate deficiency
o Defective Hb synthesis
▪ Defective heme synthesis
• Iron deficiency anemia
▪ Defective globin chains
• Hemoglobinopathies (including sickle cell anemia), thalassemia
▪ Unknown or multiple mechanisms
• Sideroblastic anemia
• Increased RBC destruction (hemolysis)
o Abnormal Hb
▪ Sickle cell anemia, thalassemia
o Enzyme deficiencies
▪ Glucose-6-phosphage dehydrogenase (G6PD)
o Membrane disorders
▪ Spherocytosis, paroxysmal nocturnal hemoglobinuria
• Any combination of the three
Clinical Manifestations of Anemia
Decreased tissue oxygenation from anemia can manifest as signs and symptoms of the following:
• Severe fatigue, pallor, weakness, dyspnea, dizziness
↓RBC level will ↓ blood volume, activating the renin-angiotensin-aldosterone (RAAS) system, which
promotes fluid retention and movement of interstitial fluid into the capillaries. This wil l result in
↑plasma volume and dilute plasma. The dilute blood flows faster, which creates a hyp erdynamic state.
, Anemia Classification
Anemias can be classified according to the size (-cytic) of the RBCs:
• Microcytic anemia (MCV <80fL) describes RBCs that are small
• Normocytic anemia (MCV 80-99fL) describes RBCs that are normal in size
• Macrocytic anemia (MCV >100fL) describes RBCs that are large
Microcytic (MCV <80 fl) Normocytic (MCV 80-99 fL) Macrocytic (MCV >100 fL)
Thalassemia G6PD deficiency B12 deficiency (pernicious
Anemia of chronic disease Paroxysmal nocturnal anemia)
Iron deficiency hemoglobinuria Folate deficiency
(Lead poisoning) Posthemorrhagic anemia
Sideroblastic Aplastic anemia
*remember TAILS
Anemias can also be classified according to the color (-chromic) of the RBCs:
• Hypochromic anemia (↓ MCHC) RBCs with less hemoglobin than normal, RBC pale in color
• Normochromic anemia (normal MCHC) RBCs that have a normal amount of hemoglobin
• Hyperchromic anemia (↑ MCHC) RBCs with more hemoglobin than normal, RBC dark in color
Hypochromic (↓MCHC) Normochromic Hyperchromic (↑ MCHC)
Pale RBC with ↓ hgb Normal hgb Dark RBC with ↑ hgb
Iron deficiency Anemia of chronic disease Hereditary spherocytosis
Sideroblastic Posthemorrhagic anemia
Thalassemia
Questions
1. Which of the following symptoms reflect decreased tissue oxygenation as an effect of anemia?
a. Dyspnea, dizziness, weakness
2. Which of the following is a type of macrocytic anemia?
a. Vitamin B-12 deficiency
3. The terms normocytic, microcytic, and macrocytic characterizes red blood cells by their:
a. Size
4. Identification of the type of anemia involves an examination of the size of the RBC only
a. False; determining both size and color of the RBCs is an important step in identifying the
type and source of the anemia
Microcytic Anemias
Questions
1. The treatment of iron deficiency anemia includes:
a. Iron supplementation
2. Which of the following anemias can be categorized as microcytic-hypochromic? (SATA)
a. Sideroblastic anemia, iron deficiency anemia, anemia of inflammation and chronic
disease
3. Which of the following would indicate that the patient’s iron stores are depleted?
a. Ferritin level (low ferritin level)
4. The most common type of anemia is
a. Iron deficiency anemia
Iron Deficiency Anemia
• Microcytic (↓MCV) and hypochromic (↓MCHC)
• Most common type of anemia, affecting almost 20% of the world population
• Most common problem contributing to this is the insufficient amount of iron availability
Pathophysiology
WEEK 2 STUDY GUIDE;
HEMATOLOGICAL DISORDERS
,Hematological Disorders
Anemia
Questions
1. MCV is the index that measures the average size of RBCs
2. Hereditary spherocytosis is a microcytic anemia characterized by hyperchromic RBCs
3. Anemia can be caused by impaired RBC production, excessive blood loss, and increased RBC
production
4. Bradycardia is not characteristic of anemia; tachycardia is present due to hypoxemia
Definition
• Hematological disorder characterized by a
reduction in the total number of circulating
RBCs and/or a decrease in hemoglobin (Hb)
amount or function
• Capacity of blood to transport oxygen to the
tissues is reduced
Etiology
• Excessive blood loss
o Acute
▪ Trauma, surgery, postpartum
hemorrhage
o Chronic
▪ GI bleed, cancer
• Decreased RBC production
o Abnormal proliferation or differentiation of stem cells
▪ Aplastic anemia
o Defective DNA synthesis in erythroblasts
▪ Vitamin B12 deficiency, folate deficiency
o Defective Hb synthesis
▪ Defective heme synthesis
• Iron deficiency anemia
▪ Defective globin chains
• Hemoglobinopathies (including sickle cell anemia), thalassemia
▪ Unknown or multiple mechanisms
• Sideroblastic anemia
• Increased RBC destruction (hemolysis)
o Abnormal Hb
▪ Sickle cell anemia, thalassemia
o Enzyme deficiencies
▪ Glucose-6-phosphage dehydrogenase (G6PD)
o Membrane disorders
▪ Spherocytosis, paroxysmal nocturnal hemoglobinuria
• Any combination of the three
Clinical Manifestations of Anemia
Decreased tissue oxygenation from anemia can manifest as signs and symptoms of the following:
• Severe fatigue, pallor, weakness, dyspnea, dizziness
↓RBC level will ↓ blood volume, activating the renin-angiotensin-aldosterone (RAAS) system, which
promotes fluid retention and movement of interstitial fluid into the capillaries. This wil l result in
↑plasma volume and dilute plasma. The dilute blood flows faster, which creates a hyp erdynamic state.
, Anemia Classification
Anemias can be classified according to the size (-cytic) of the RBCs:
• Microcytic anemia (MCV <80fL) describes RBCs that are small
• Normocytic anemia (MCV 80-99fL) describes RBCs that are normal in size
• Macrocytic anemia (MCV >100fL) describes RBCs that are large
Microcytic (MCV <80 fl) Normocytic (MCV 80-99 fL) Macrocytic (MCV >100 fL)
Thalassemia G6PD deficiency B12 deficiency (pernicious
Anemia of chronic disease Paroxysmal nocturnal anemia)
Iron deficiency hemoglobinuria Folate deficiency
(Lead poisoning) Posthemorrhagic anemia
Sideroblastic Aplastic anemia
*remember TAILS
Anemias can also be classified according to the color (-chromic) of the RBCs:
• Hypochromic anemia (↓ MCHC) RBCs with less hemoglobin than normal, RBC pale in color
• Normochromic anemia (normal MCHC) RBCs that have a normal amount of hemoglobin
• Hyperchromic anemia (↑ MCHC) RBCs with more hemoglobin than normal, RBC dark in color
Hypochromic (↓MCHC) Normochromic Hyperchromic (↑ MCHC)
Pale RBC with ↓ hgb Normal hgb Dark RBC with ↑ hgb
Iron deficiency Anemia of chronic disease Hereditary spherocytosis
Sideroblastic Posthemorrhagic anemia
Thalassemia
Questions
1. Which of the following symptoms reflect decreased tissue oxygenation as an effect of anemia?
a. Dyspnea, dizziness, weakness
2. Which of the following is a type of macrocytic anemia?
a. Vitamin B-12 deficiency
3. The terms normocytic, microcytic, and macrocytic characterizes red blood cells by their:
a. Size
4. Identification of the type of anemia involves an examination of the size of the RBC only
a. False; determining both size and color of the RBCs is an important step in identifying the
type and source of the anemia
Microcytic Anemias
Questions
1. The treatment of iron deficiency anemia includes:
a. Iron supplementation
2. Which of the following anemias can be categorized as microcytic-hypochromic? (SATA)
a. Sideroblastic anemia, iron deficiency anemia, anemia of inflammation and chronic
disease
3. Which of the following would indicate that the patient’s iron stores are depleted?
a. Ferritin level (low ferritin level)
4. The most common type of anemia is
a. Iron deficiency anemia
Iron Deficiency Anemia
• Microcytic (↓MCV) and hypochromic (↓MCHC)
• Most common type of anemia, affecting almost 20% of the world population
• Most common problem contributing to this is the insufficient amount of iron availability
Pathophysiology
