MCV mean cell volume, determines if a cell is microcytic, normocytic, or macrocytic
MCHC mean cell hemoglobin concentration, determines if cell is hypochromic or
normochromic
acute blood loss anemia cause bleeding (GI bleed, trauma, ulcer..)
acute blood loss anemia S/S decreased hematocrit, normocytic normochromic (normal MCV, normal MCHC)
erythropoietin produced by kidney
chronic blood loss anemia patho -ability to produce RBCs<RBC loss
-iron stores run out -> iron deficiency anemia
chronic blood loss anemia S/S microcytic hypochromic (low MCV, low MCH, low MCHC)
iron deficiency anemia causes -decreased Fe intake ->dietary lack, impaired absorption (celiac disease)
-chronic blood loss -> chronic NSAID use, menorrhagia, PUD
iron deficiency anemia S/S fatigue, pallor, koilonychia, angular cheilitis, pica (ED)
macrocytic normochromic anemia patho -megaloblasts (unusually large stem cells)
-too big of RBCs -> RBCs die sooner -> anemia
-caused by B9 or B12 deficiency
B12 deficiency causes -vegetarians (B12 lacks in diet)
-impaired GI absorption (celiac disease)
-intrinsic factor deficiency (pernicious anemia) (IF needed to absorb B12 at ileum)
B9 (folate) deficiency causes -alcoholic
-pregnant
-MCC: inadequate intake
B9 deficiency S/S -increased levels of homocysteine
-causes spine ibifida in newborns
B12 deficiency S/S -beefy red tongue
-demyelination ->CNS symptoms
-increased levels of homocysteine
sickle cell anemia -autosomal recessive
-normocytic hyprochromic
-increased MCHC
-Howell-jolly bodies
, von Willebrand Factor -released from platelets and damaged endothelial cells
-binds platelets to platelets
-binds platelets to exposed subendothelial collagen
platelet aggregation -platelet plug
-bleeding time (BT)
-vWF
clotting factors plasma proteins synthesized in the liver
extrinsic pathway -factor V11 + tissue factor
-prothrombin time (PT)
-fast
intrinsic factor -factor VIII (hemophilia a) + factor IX (hemophilia B)
-activated partial thromboplastin time (aPTT)
-slow
common pathway -factor X converts prothrombin -> thrombin
-thrombin converts fibrinogen -> fibrin ->fibrin mesh stabalizes platelet plug
tissue factor -TF= tissue thromboplastin= factor III
-released from damaged endothelial cells and tissue
-stimulates platelet aggregation
-initiates extrinsic pathway
-depleted TF -> DIC
platelet type bleeding cause -von Willebrand's disease
-thrombocytopenia (low platelets)
platelet type bleeding S/S superficial bleeding (petechia) from skin and mucosal surfaces -> epistaxis,
purpura
platelet type bleeding labs -increased bleeding time (BT)
factor type bleeding -ex: hemophilia
-S/S: hematoma, hemarthrosis
-Labs: normal BT, high PT or aPTT
hemophilia patho -rare x-linked recessive disorder
-type A (80%) = factor VIII
-type B (15%) = factor IX
hemophilia S/S hematomas, hemarthrosis (severe joint pain due to blood in joint cavities)
hemophilia labs increased aPTT, normal: BT, PT, PLT count
von willebrand's disease patho -decreased or abnormal vWF
-autosomal dominant
-decreased platelet aggregation time
-decreased adherence to injury