NGR 5141 - Module 14 QUESTIONS AND ANSWERS. LATEST 2023

1. Joe Smith has had his spleen removed following a motor vehicle accident. What physiologic changes will develop as a result of this? The spleen is not absolutely necessary for life or adequate hematologic function, however, its absence does have effects on the body. Leukocytosis often occurs after splenomegaly suggesting that the spleen has some control over the rate of proliferation of leukocyte stem cells in the bone marrow or their release into the bloodstream. Iron levels may also decrease since the spleen plays a role in the iron cycle. A person without a spleen also has a diminished immune response which may cause them to be more susceptible to infections. Loss of the spleen also results in an increase in morphologically defective blood cells in the circulation which supports the premise that the spleen plays a role in removing old or damaged cells. 2. How does malnutrition affect erythropoiesis? The normal development of erythrocytes and synthesis of hemoglobin depends on an optimal biochemical milieu and adequate supplies of the necessary building buildings which include protein, vitamins, and minerals. In their prolonged absence, erythrocyte production slows and anemia may result. Erythropoiesis cannot occur in the absence of vitamins, especially B12, folate, B6, riboflavin, pantothenic acid, niacin, ascorbic acid, and vitamin E. A defect in the intrinsic factor production can cause a decrease in vitamin B12 absorption and pernicious anemia. Folate is also important because of its role in DNA synthesis, being a component of three of the four DNA bases, and RNA synthesis. 3. How does defective gastric secretion of intrinsic factor (IF) cause anemia? What is this type of anemia called, and how do you get it? Dietary vitamin B12 is a large molecule that requires a protein secreted by parietal cells into the stomach, known as the intrinsic factor. It is used for transport across the ileum. Once vitamin B12 is absorbed, it is stored in the liver and used when needed in erythropoiesis. Defects in intrinsic factor production lead to decreased B12 absorption and causes pernicious anemia. The principal disorder in pernicious anemia is the absence of the intrinsic factor. Intrinsic factor is secreted by gastric parietal cells and complexes with dietary vitamin B12 in the small intestine. The deficiency of intrinsic factor can be congenital or due to adult onset gastric mucosal atrophy and destruction of parietal cells. 4. Ms. Blankenship has iron deficiency anemia. She has just had a total abdominal hysterectomy. Her postoperative hemoglob