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Folic acid deficiency anemia

Very similar to Vit B12 deficiency

NO neuro s/s

Malnutrition

Vitamin B12 deficiency

Neuro changes

Ataxia

Paresthesia

Demylination

Megaloblastic

Large RBC

Excess cytoplasmic growth

Short life span

Flimsy membranes

Immature nuclei

Oval

Malabsorption

Long term PPI

Gastric bypass

Gastrectomy

Metformin

Mainly absorbed in the gut

Deficiency

Pernicious anemia

Atrophic gastritis

Failure to absorb B12

Essential for DNA synthesis

Normal RBC maturation

Pluripotent stem cells

Erythroblasts

Reticulocyte

Released into blood stream to mature

Mature RBC = erythrocyte

Red blood cells

Chronic disease anemia

Autoimmune

T-cell activation

Suppress erythropoietin

Osteomylitis

AIDS

CKD

Dyfunctional kidneys

Decreased erythropoietin

Aplastic anemia

Increased bleeding

Gums

GI tract

Vagina

Nose

Decreased platelet level

Dysfunction bone marrow

Can't replace RBC that have been destroyed

Radiation, chemicals and toxins

Hepatitis, AIDs,

Chloramphenicol

Benzene

Chemo

Hematopoiesis

Epithelial atrophy

Brittle hair and nails

Spoon shaped finger deformity

waxy pallor

Iron is reused to form new RBC

Decreased iron = decreased O2 capacity

Increased demand

Children have increased demand due to growth

Cows milk has low absorbable iron

Maternal deficiency

Loss of iron

Bleeding

Menstruation

Pregnant women have increased iron needs

GI

Dietary deficiency

Mostly derived from meat

Vegetarians and deprived populations

Hemolytic Anemia

Increased erythropoiesis

Hyperactive bone marrow

Increased reticulocytes

Retention of iron and other byproducts

Premature destruction of RBC

Extrinsic

Drugs, toxins, antibodies

Intrinsic

Defective membrane

Sickle cell

"Sickled" shaped cells

Pain

Spleenic injury

Respiratory dysfunction

vasoocclusion

Abnormal HGB

Extravascular hemolysis

Intravascular hemolysis

Hemoglobinemia/uria

Blood loos anemia

Internal and External

Chronic blood loss

Iron deficiency anemia

GI bleed Menstruation

Iron stores depleted

External leads to iron loss

Trauma Hemorrhage

Problematic for restoration of RBC

Anemia

RBC HGB

O2 carrying capacity

S/S

Bone pain

Sternal tenderness

Petechiae & Purpura

Jaundice

Pallor

Conjunctiva

Mucous membrane

Nail beds

Tachycardia

Ventricular hypertropy

CHF

Palpitations

HA

Vision problems

Confusion

Faint

Fatigue

Angina

Dyspnea

Weakness

Red blood cell destruction

1.Metabolic activity decreases 2.ATP decreases 3.Fragile

RBC life span 120 days

Phagocytic cells break down old RBC

Heme and iron units are saved to be reused

Binds to apoferrtin

Converted to transferrin

Taken back to bone marrow to be recycled and reused

Bilirubin

Removed by the liver in the form of bile

Lymph nodes

Bone marrow

Liver

Spleen

Red blood cell production

Erthyropoiesis

Kidney

Produces and secretes erythropoietin

Small portion produced in the liver