-vitamin B12 (only comes from animal sources)
– If this passes the stomach and moves into the intestines, its gone. The hydrochloric acid will destroy it.
– this vitamin must be absorbed into the bloodstream immediately by crossing the wall of the stomach and wall of capillary.
-intrinsic factor binds to this vitamin and pulls it across the stomach wall and capillary wall into the bloodstream.
– parietal cells line the inside of the stomach and make this.
– if there is a problem creating this, an injection of Vitamin B12 will be given directly into the bloodstream.
-When there is a decreased amount of this vitamin obtained through meat products. This vitamin is needed for the synthesis of hemoglobin. Vegetarians have this as they do not consume meat. This deficiency can be specifically called pernicious anemia when this vitamin isn’t being carried into the blood stream by the intrinsic factor
– Factors affecting maturation in bone marrow: vitamin B12, folic acid, formation of Hgb, trace elements
Acute blood loss: If you lose 1000 ml of blood or more you experience hypovolemic shock. A person can lose 500 ml of blood and be ok (i.e. donating blood)
Chronic blood loss: most common cause of iron deficiency anemia
Causes: unsuspected GI tract malignancy, slowly bleeding peptic ulcer, hemorrhages
– when you don’t have enough porphyrin resulting in not making enough “heme”. MCH will be decreased. The cells do not contain enough hemoglobin to carry enough oxygen because you ran out of porphyrin.
-this can be genetic (rare, sex linked) or acquired due to overexposure to alcohol, lead, or isoniazid (used to treat TB)
– treatment: if cause is genetic –> pyridine drug; if cause is acquired –> no medicine work???
– chronic alcoholism can cause this deficiency as alcohol washes out all the water soluble vitamins.
– severe deficiency of this can lead to anencephaly (when a child is born without a brain and dies immediately).
This acid helps in the synthesis in hemoglobin and is necessary for the normal function of the central nervous system.
– autosomal dominant trait
A genetically inherited disease in which the Ca and Na pumps in the wall of the RBC’s membrane doesn’t pump out water, changing the bi-concave disks into spheres (round balls). It becomes large enough to get trapped in the spleen and therefore gets taken out of circulation before 120 days lifecycle.
Treatment: splenectomy (removing the spleen and letting the liver take on the role of the spleen. Larger cells will be able to pass through the liver letting them live longer.
– this is a type of hemolytic anemia
– high 10% of blacks have this (usually this form is mildy expressed and not associated with chronic hemolytic anemia unless exposed to antioxidant drugs)
– G6PD trait has an increased resistance to malaria
– sulfonamides and aspirin will make this situation worse; it can aggravate it.
– increase fluid intake to push cells through capillary
– the more thrombotic crises, the more damage to tissue over time.
– heart may enlarge, kidney problems may occur, more susceptible to strokes, spleen may enlarge, and increased incidents of clots.
– people may have a shorter life span
– bone marrow may stop producing adequate amount of WBC which leads to increased susceptibility to infection.
an inherited anemia; a genetic disorder. There is a quantity problem where the body cannot produce enough of one or the other globin polypeptide chains leading to beta thalassemia or alpha thalassemia. This can lead to hemosiderosis (deposition of iron in tissues) leading to cardiac failure
I = input of new RBC from bone marrow (in avg man = 0.8% of M)
T = time representing RBC life span (120 days)
One definition of anemia is when M is below normal and is the result of either decreased I or decreased T or combination of both. Anemia can also exist if RBC are inefficient in delivery of oxygen.
– Sideroblastic Anemia
– Iron Deficiency Anemia
– Vitamin B12 and Folic Acid Deficiency Anemias
– avg adult body has approximately 4 grams of Fe of which 3 grams is in Hgb, 500mg – 1 gram in Fe stores in liver and bone marrow and remainder stored in tissues and enzyme systems. Avg daily loss of iron is about 1.5 mg which is compensated for from diet.
Causes: blood loss, gastrointestinal (malabsorption), gynecologic, urinary tract (rare), paroxysmal nocturnal hemoglobinemia
Severe clinical manifestations: koilonychia (spoon shaped nails), cheilosis (cracked corners on lips), bright red tongue
– Sickle Cell Disease
– This is when too much iron is deposited and building up in tissues especially in the heart tissue. This will ruin the heart tissue and the heart will begin to malfunction leading to cardiac failure
– symptoms: weak, fatigue, tissue damage, heart failure
– give iron keynoting drugs to act as a magnet to pull the iron away from the tissues.
-plueropotential stem cells are creating too many RBC’s
-too many RBCs bumping into each other can cause platelets to bump into each other causing blood clots.
-symptoms such as fingers becoming itchy, extremities becoming cold, begin to clot off the capillaries to your fingers, and clots may damage other organs. This disease can be deadly.