NR 507 Comprehensive Patho Midterm 2024

NR 507 Comprehensive Patho Midterm 2024 Phsyiologic manifestation of anemia - Severe fatigue, pallor, weakness, dyspnea, dizziness Increased RBC distribution on labs Microcytic anemia - MCV <80fL Small RBCs i.e. iron deficiency anemia, sideroblastic, thalassemia Macrocytic anemia - MCV >100fl Large RBCs i.e. B12 deficiency, folate deficiency Normocytic anemia - MCV 80 -99fl normal size RBCs i.e. hereditary spherocytos is, acute blood loss, paroxysmal nocturnal hemoglobinuria Hypochromic - decreased hemoglobin low MCHC RBCs pale color Hyperchromic - increased hemoglobin high MCHC dark color Normochromic - normal amount of hemoglobin normal MCHC Normal color Causes of vitamin B12 deficiency - Decreased nutritional intake, impaired absorption Risk factors for Vitamin B12 deficiency - vegetarian, GI issues (h. pylori), older adults S/S of Vitamin B12 deficiency - fatigue, peripheral neuropathy in BLE Causes of folic acid deficiency - decreased dietary intake, increased requirement, impaired utilization Risk factors for folic acid deficency - alcoholism Symptoms of folic acid defic iency - cheilosis, stomatitis, painful ulcerations of mucosa, GI tract sensitivity Iron deficiency anemia - Accompanied by low ferritin and transferrin levels Low MCHC Microcytic, hypochromic causes of iron deficiency anemia - dietary deficiency, impaire d absorption, increased requirement, chronic blood loss Thalassemia - Genetic with many possible mutations Low MCHC Anemia of chronic disease/inflammation - Initially normocytic -normochromic but changes to microcytic -hypochromic caused by decreased eryth ropoiesis and impaired iron utilization in those with chronic disease/inflammation i.e. CHF, CKD, infections Hemolytic anemia - premature accelerated destruction of erythrocytes Causes of hemolytic anemia - Acquired (transfusion reaction, hemolytic disea se of newborns, drug, infectious, etc.) Genetic (structural defects, plasma protein mutation, enzyme deficiencies) Aplastic anemia - normal MCHC Suspect if levels of circulating erythrocytes, leukocytes, and platelets are also diminished Sickle cell trait - Asymptomatic Carry only one copy of hemoglobin gene Sickle cell disease - Symptomatic Carries two abnormal hemoglobin genes Primary immunodeficiencies - Defect occurs during immune system development less common can involve antibody d eficiencies, B and T cell deficiencies, etc. Secondary immunodeficiencies - Immune system becomes compromised by something else More common i.e. cancer, drug effect, infections, malnutrition, HIV Type 1 Hypersensitivity Reaction - IgE mediated reaction Inflammation d/t mast cell degranulation S/S: wheezing, itching, rash i.e. atopic dermatitis, anaphylaxis Type 2 Hypersensitivity Reaction - Cytotoxic reaction Tissue specific Causes tissue damage or alters function