Red blood cells
Red blood cell production
Kidney
Produces and secretes erythropoietin
Small portion produced in the liver
Erthyropoiesis
Red blood cell destruction
RBC life span 120 days
Phagocytic cells break down old RBC
Spleen
Liver
Bone marrow
Lymph nodes
Heme and iron units are saved to be reused
Bilirubin
Removed by the liver in the form of bile
Binds to apoferrtin
Converted to transferrin
Taken back to bone marrow to be recycled and reused
1.Metabolic activity decreases
2.ATP decreases
3.Fragile
Anemia
RBC
HGB
O2 carrying capacity
S/S
Fatigue
Weakness
Dyspnea
Angina
HA
Faint
Confusion
Vision problems
Tachycardia
Palpitations
Ventricular hypertropy
CHF
Pallor
Nail beds
Mucous membrane
Conjunctiva
Jaundice
Petechiae & Purpura
Bone pain
Sternal tenderness
Blood loos anemia
Internal and External
External leads to iron loss
Problematic for restoration of RBC
Trauma
Hemorrhage
Chronic blood loss
Iron deficiency anemia
Iron stores depleted
GI bleed
Menstruation
Hemolytic Anemia
Premature destruction of RBC
Intravascular hemolysis
Hemoglobinemia/uria
Extravascular hemolysis
Jaundice
Intrinsic
Defective membrane
Sickle cell
Abnormal HGB
Pain
vasoocclusion
Respiratory dysfunction
Spleenic injury
"Sickled" shaped cells
Extrinsic
Drugs, toxins, antibodies
Retention of iron and other byproducts
Increased erythropoiesis
Hyperactive bone marrow
Increased reticulocytes
Iron deficiency anemia
Dietary deficiency
Mostly derived from meat
Vegetarians and deprived populations
Loss of iron
Bleeding
GI
Menstruation
Pregnant women have increased iron needs
Increased demand
Children have increased demand due to growth
Maternal deficiency
Dietary deficiency
Cows milk has low absorbable iron
Iron is reused to form new RBC
Decreased iron = decreased O2 capacity
S/S
Epithelial atrophy
waxy pallor
Brittle hair and nails
Spoon shaped finger deformity
Aplastic anemia
Dysfunction bone marrow
Can't replace RBC that have been destroyed
Radiation, chemicals and toxins
Hematopoiesis
Chemo
Benzene
Chloramphenicol
Hepatitis, AIDs,
S/S
Increased bleeding
Decreased platelet level
Nose
Vagina
GI tract
Gums
Chronic disease anemia
CKD
Dyfunctional kidneys
Decreased erythropoietin
AIDS
Osteomylitis
Dysfunction bone marrow
Autoimmune
T-cell activation
Suppress erythropoietin
Bone marrow
Pluripotent stem cells
Erythroblasts
Reticulocyte
Released into blood stream to mature
Mature RBC = erythrocyte
Vitamin B12 deficiency
Essential for DNA synthesis
Normal RBC maturation
Malabsorption
Mainly absorbed in the gut
Deficiency
Pernicious anemia
Atrophic gastritis
Failure to absorb B12
Long term PPI
Metformin
Gastric bypass
Gastrectomy
Megaloblastic
Large RBC
Excess cytoplasmic growth
Oval
Immature nuclei
Flimsy membranes
Short life span
S/S
Neuro changes
Demylination
Paresthesia
Ataxia
Folic acid deficiency anemia
Malnutrition
Very similar to Vit B12 deficiency
NO neuro s/s