MCCN SDAP X - Pathophysiology Exam 5 Blueprint
Explains the etiology of anemias. - correct answer Anemia is a condition of a lack of normal red
blood cells, it has many etiologies.
Iron deficiency anemia - correct answer Related to slow, chronic blood loss or nutrient
deficiency, treat with iron supplements. Cells are often microcytic and hypochromic
Folic acid deficiency anemia - correct answer (Macrocytic) A shortage of folate can cause
anemia because folate plays an essential role in the formation of RBCs. Common in elderly and
with alcoholism.
B12 deficiency anemia - correct answer (Macrocytic) With loss of the distal stomach there is
loss of intrinsic factor which facilitates the absorption of B12. Can be autoimmune. It can be
pernicious anemia only if intrinsic factor is missing. It might simply be B12 deficiency anemia if
intrinsic factor is present but there is a deficiency in B12 due to insufficient intake.
Anemia of chronic disease - correct answer (normocytic) seen in chronic renal failure due to
erythropoietin deficiency, leads to ↓ bone marrow stimulation & ↓ RBC production. Synthetic
erythropoietin can be given to correct this situation.
Anemia in the elderly - correct answer (Normocytic, normochromic), RBC's are not being
replaced as fast as they are lost, stems cells fewer in number, bone marrow less responsive to
erythropoietin (can be seen w/ heart failure & MI)
Anemia of acute blood loss - correct answer (Normocytic, normochromic) decreased
hemoglobin, platelet count may go up as body is compensating for blood loss (reactive
thrombocytosis)- Gun shot wound, DIC
Hemolytic anemia - correct answer (Normocytic) hemoglobin & platelets would be low-
myelogenous leukemia, ITP, Von Willebrand (VW would be microcytic)
Recognizes laboratory data consistent with the anemias. (H/H &MCV) - correct answer
Hemoglobin will be low in any type of anemia. Hematocrit will generally be 3x the hemoglobin.
MCV=Mean Corpuscular Volume, which indicates the size of the RBC. Anemias are
differentiated by the size and color of the RBC.
Discusses the potential impact of anemia on cellular oxygenation - correct answer Anemia
causes hypoxia due to inefficient delivery to the tissues related to the reduced number of
"carriers" (low hemoglobin)
Discusses the potential impact of anemia on the development of fatigue - correct answer A
person might or might not have fatigue depending on how low the hemoglobin is, and how long
it took to drop.
, Discusses the potential impact of anemia on persons with CAD, angina, dysrhythmia... - correct
answer Anemia causes hypoxia. A person with anemia will have an increased HR because of its
effort to deliver more oxygen to the tissues. Increased HR causes higher demand for oxygen in
the heart tissue. Poor delivery of oxygen to heart tissue can cause angina. Hypoxic tissue can
also cause dysrhythmia.
Discusses how to treat the anemias. - correct answer The etiology for the anemia determines
the treatment. For example, microcytic, hypochromic anemia of iron deficiency requires
replacement of iron and a workup to determine if the person is losing RBCs. If it is determined
that the person is suffering a chronic blood loss then appropriate treatment has to be given to
stop the bleeding. Other treatments may include replacing red blood cells and blood volume.
B12 or folic acid supplement or B12 injection if intrinsic factor is not available, synthetic
erythropoietin.
Describes the role of intrinsic factor in the prevention of pernicious anemia. - correct answer
Intrinsic factor is necessary for the production of B12. If B12 is low in blood serum levels then it
will cause pernicious anemia. This can be from a weakening of the stomach lining or from an
autoimmune disorder.
Recognizes conditions that result in loss of intrinsic factor. - correct answer Because intrinsic
factor is produced by the parietal cells in the distal ⅓ of the stomach, any type of condition that
affects that portion of the stomach can cause loss of intrinsic factor.
Discusses the implications when intrinsic factor is lost. - correct answer Intrinsic factor is
necessary for the absorption of B12. It is the binding factor that allows it to be absorbed into
the body.
Describes the pathophysiology of sickle cell anemia. - correct answer A recessive inherited
disorder in which abnormal hemoglobin leads to chronic hemolytic anemia, pain, and organ
failure. Causes the red blood cells to go from oxygenated to deoxygenated - a reversible
process. It can progress to "irreversibly sickled." That leads to increased red cell adhesiveness
and adherence to vessel wall, hemolysis, vessel occlusion, tissue ischemia and infarction.
Reviews pathophysiologies discussed previously in this course, pathophysiologies that could
result in anemia. - correct answer Any condition that causes chronic blood loss or inefficient
production of healthy RBCs can result in anemia.
Anemia in penetrating peptic ulcer disease - correct answer Results in blood loss causing loss of
RBCs and lowered H&H count.
Anemia in myelogenous leukemia - correct answer Results in the bone marrow making an
enzyme that causes too many stem cells to become white blood cells (granulocytes or blasts).
When this happens, infection, anemia, or easy bleeding may occur. Crowding out effect.
Explains the etiology of anemias. - correct answer Anemia is a condition of a lack of normal red
blood cells, it has many etiologies.
Iron deficiency anemia - correct answer Related to slow, chronic blood loss or nutrient
deficiency, treat with iron supplements. Cells are often microcytic and hypochromic
Folic acid deficiency anemia - correct answer (Macrocytic) A shortage of folate can cause
anemia because folate plays an essential role in the formation of RBCs. Common in elderly and
with alcoholism.
B12 deficiency anemia - correct answer (Macrocytic) With loss of the distal stomach there is
loss of intrinsic factor which facilitates the absorption of B12. Can be autoimmune. It can be
pernicious anemia only if intrinsic factor is missing. It might simply be B12 deficiency anemia if
intrinsic factor is present but there is a deficiency in B12 due to insufficient intake.
Anemia of chronic disease - correct answer (normocytic) seen in chronic renal failure due to
erythropoietin deficiency, leads to ↓ bone marrow stimulation & ↓ RBC production. Synthetic
erythropoietin can be given to correct this situation.
Anemia in the elderly - correct answer (Normocytic, normochromic), RBC's are not being
replaced as fast as they are lost, stems cells fewer in number, bone marrow less responsive to
erythropoietin (can be seen w/ heart failure & MI)
Anemia of acute blood loss - correct answer (Normocytic, normochromic) decreased
hemoglobin, platelet count may go up as body is compensating for blood loss (reactive
thrombocytosis)- Gun shot wound, DIC
Hemolytic anemia - correct answer (Normocytic) hemoglobin & platelets would be low-
myelogenous leukemia, ITP, Von Willebrand (VW would be microcytic)
Recognizes laboratory data consistent with the anemias. (H/H &MCV) - correct answer
Hemoglobin will be low in any type of anemia. Hematocrit will generally be 3x the hemoglobin.
MCV=Mean Corpuscular Volume, which indicates the size of the RBC. Anemias are
differentiated by the size and color of the RBC.
Discusses the potential impact of anemia on cellular oxygenation - correct answer Anemia
causes hypoxia due to inefficient delivery to the tissues related to the reduced number of
"carriers" (low hemoglobin)
Discusses the potential impact of anemia on the development of fatigue - correct answer A
person might or might not have fatigue depending on how low the hemoglobin is, and how long
it took to drop.
, Discusses the potential impact of anemia on persons with CAD, angina, dysrhythmia... - correct
answer Anemia causes hypoxia. A person with anemia will have an increased HR because of its
effort to deliver more oxygen to the tissues. Increased HR causes higher demand for oxygen in
the heart tissue. Poor delivery of oxygen to heart tissue can cause angina. Hypoxic tissue can
also cause dysrhythmia.
Discusses how to treat the anemias. - correct answer The etiology for the anemia determines
the treatment. For example, microcytic, hypochromic anemia of iron deficiency requires
replacement of iron and a workup to determine if the person is losing RBCs. If it is determined
that the person is suffering a chronic blood loss then appropriate treatment has to be given to
stop the bleeding. Other treatments may include replacing red blood cells and blood volume.
B12 or folic acid supplement or B12 injection if intrinsic factor is not available, synthetic
erythropoietin.
Describes the role of intrinsic factor in the prevention of pernicious anemia. - correct answer
Intrinsic factor is necessary for the production of B12. If B12 is low in blood serum levels then it
will cause pernicious anemia. This can be from a weakening of the stomach lining or from an
autoimmune disorder.
Recognizes conditions that result in loss of intrinsic factor. - correct answer Because intrinsic
factor is produced by the parietal cells in the distal ⅓ of the stomach, any type of condition that
affects that portion of the stomach can cause loss of intrinsic factor.
Discusses the implications when intrinsic factor is lost. - correct answer Intrinsic factor is
necessary for the absorption of B12. It is the binding factor that allows it to be absorbed into
the body.
Describes the pathophysiology of sickle cell anemia. - correct answer A recessive inherited
disorder in which abnormal hemoglobin leads to chronic hemolytic anemia, pain, and organ
failure. Causes the red blood cells to go from oxygenated to deoxygenated - a reversible
process. It can progress to "irreversibly sickled." That leads to increased red cell adhesiveness
and adherence to vessel wall, hemolysis, vessel occlusion, tissue ischemia and infarction.
Reviews pathophysiologies discussed previously in this course, pathophysiologies that could
result in anemia. - correct answer Any condition that causes chronic blood loss or inefficient
production of healthy RBCs can result in anemia.
Anemia in penetrating peptic ulcer disease - correct answer Results in blood loss causing loss of
RBCs and lowered H&H count.
Anemia in myelogenous leukemia - correct answer Results in the bone marrow making an
enzyme that causes too many stem cells to become white blood cells (granulocytes or blasts).
When this happens, infection, anemia, or easy bleeding may occur. Crowding out effect.
