NSG 533 - EXAM 4 WITH COMPLETE
QUESTIONS AND ANSWERS { GRADED
A+}
Anemia can contribute to: - ✔✔coronary ischemia
Composition of blood - ✔✔5.5L total. 50-55% = plasma; 90% water
Erythropoesis is stimulated by... - ✔✔erythropoetin
Hemoglobin A - ✔✔the majority of adult hemoglobin. 97% of circulating
hemoglobin. 2 alpha and 2 beta chains.
HbA2 - ✔✔minor adult hemoglobin. 2-3% of circulating hemoglobin. 2 alpha and
2 delta chains.
Hemoglobin F - ✔✔Fetal hemoglobin. 2 alpha and 2 gamma chains. Has a greater
affinity for and more regularly binds O2.
,Anemia - ✔✔a decrease in circulating red blood cells in the body, as reflected by
a reduction in hemoglobin, hematocrit, and/or RBCs. Less than 14 in men and less
than 12 in women.
Normal RBC - ✔✔4.5-6
Normal Hemoglobin - ✔✔>13 in men, >12 in women.
Normal HCT - ✔✔40-50in men; 35-45 in women. usually 3x the hemoglobin
count.
Reticulocyte count - ✔✔Low (<0.5%) High (>2%) if high, bone marrow is trying
to compensate for loss in hgb or red cells. problem exists outside of the bome
marrow
MCV (mean corpuscular volume) - ✔✔description of the volume of an RBC.
NOT DIAGNOSTIC
RDW (red cell distribution width) - ✔✔11.5-15 %; index of variation in RBC size
and shape. Indicates evolving macro/microcytic anemia.
MCH (mean corpuscular hemoglobin) - ✔✔commonly used: 27 - 31 pg/ cell
Amount of hemoglobin per RBC
, Microcytic anemia - ✔✔Iron deficiency, thalassemia, inflammation. low MCV
<80. Low reticulocyte count. Underproduction.
macrocytic anemia - ✔✔Underproduction. B12 deficiency, Folic Acid
Deficiency, Antimetabolite drugs. MCV > 100; low reticulocyte count
Normocytic Anemia - ✔✔MCV 80-100; low reticulocyte count; ex:
dilutional/iatrogenic secondary to phlebotomy.
Folate Deficiency Anemia - ✔✔Macrocytic anemia; poor intake; low retic,
elevate MCV/MCH, thrombocytopenia ad neutropenia, elevated homocysteine;
low RBC folate. Eat orange fruits! Never treat folate deficiency without testing for
B12 deficiency - can worsen neurological symptoms specific to B12 deficiency
Vitamin B12 Deficiency - ✔✔Macrocytic; malabsorption; occurs when B12 is not
released from food proteins due to impaired digestion; Elevated MCV/Macrocytic;
Pernicious Anemia - ✔✔lack of mature erythrocytes caused by inability to absorb
vitamin B12 into the bloodstream
Destruction (Hemolytic anemia) - ✔✔anemia with elevated reticulocytes;
intrinsic and extrinsic
intrinsic hemolytic anemia (hereditary) - ✔✔- Abnormal hemoglobin
QUESTIONS AND ANSWERS { GRADED
A+}
Anemia can contribute to: - ✔✔coronary ischemia
Composition of blood - ✔✔5.5L total. 50-55% = plasma; 90% water
Erythropoesis is stimulated by... - ✔✔erythropoetin
Hemoglobin A - ✔✔the majority of adult hemoglobin. 97% of circulating
hemoglobin. 2 alpha and 2 beta chains.
HbA2 - ✔✔minor adult hemoglobin. 2-3% of circulating hemoglobin. 2 alpha and
2 delta chains.
Hemoglobin F - ✔✔Fetal hemoglobin. 2 alpha and 2 gamma chains. Has a greater
affinity for and more regularly binds O2.
,Anemia - ✔✔a decrease in circulating red blood cells in the body, as reflected by
a reduction in hemoglobin, hematocrit, and/or RBCs. Less than 14 in men and less
than 12 in women.
Normal RBC - ✔✔4.5-6
Normal Hemoglobin - ✔✔>13 in men, >12 in women.
Normal HCT - ✔✔40-50in men; 35-45 in women. usually 3x the hemoglobin
count.
Reticulocyte count - ✔✔Low (<0.5%) High (>2%) if high, bone marrow is trying
to compensate for loss in hgb or red cells. problem exists outside of the bome
marrow
MCV (mean corpuscular volume) - ✔✔description of the volume of an RBC.
NOT DIAGNOSTIC
RDW (red cell distribution width) - ✔✔11.5-15 %; index of variation in RBC size
and shape. Indicates evolving macro/microcytic anemia.
MCH (mean corpuscular hemoglobin) - ✔✔commonly used: 27 - 31 pg/ cell
Amount of hemoglobin per RBC
, Microcytic anemia - ✔✔Iron deficiency, thalassemia, inflammation. low MCV
<80. Low reticulocyte count. Underproduction.
macrocytic anemia - ✔✔Underproduction. B12 deficiency, Folic Acid
Deficiency, Antimetabolite drugs. MCV > 100; low reticulocyte count
Normocytic Anemia - ✔✔MCV 80-100; low reticulocyte count; ex:
dilutional/iatrogenic secondary to phlebotomy.
Folate Deficiency Anemia - ✔✔Macrocytic anemia; poor intake; low retic,
elevate MCV/MCH, thrombocytopenia ad neutropenia, elevated homocysteine;
low RBC folate. Eat orange fruits! Never treat folate deficiency without testing for
B12 deficiency - can worsen neurological symptoms specific to B12 deficiency
Vitamin B12 Deficiency - ✔✔Macrocytic; malabsorption; occurs when B12 is not
released from food proteins due to impaired digestion; Elevated MCV/Macrocytic;
Pernicious Anemia - ✔✔lack of mature erythrocytes caused by inability to absorb
vitamin B12 into the bloodstream
Destruction (Hemolytic anemia) - ✔✔anemia with elevated reticulocytes;
intrinsic and extrinsic
intrinsic hemolytic anemia (hereditary) - ✔✔- Abnormal hemoglobin
