Download as PowerPoint Slide Figure 3. A In wild type mice, both platelets in the periphery and megakaryocytes in the bone marrow act as negative regulators of Tpo through absorption via surface Mpl, restricting the expansion of the megakaryocytic lineage.
There are plenty of definitions to choose from, said Dr. At the most basic level, she noted, anemia is a pathologic condition marked by a reduced capacity of blood to transport and deliver adequate oxygen to tissues. In short, anemia is a manifestation of disease, not a disease itself.
Perkins The most common CBC parameters used to establish anemia include hemoglobin concentration, hematocrit, red blood cell concentration, and mean corpuscular hemoglobin. Anemia is dependent on the RBC lifespan. The normal RBC lifespan is to days, so any alterations that affect RBC production or lifespan may cause anemia.
Replenishment requires adequate bone marrow hematopoietic pools, nutrients, and stimulation of proliferation by factors such as erythropoietin.
On a practical level, the various definitions and symptoms create an interesting classification challenge. Perkins, people used CBC data and red cell morphology, primarily the mean corpuscular volume i.
Under this scheme, anemias were determined to be microcytic 95 fL. This remains a common diagnostic approach because it provides useful pathophysiologic insights. Another useful way to think about anemia classification is pathogenetically.
Anemias can occur because of impaired proliferation or maturation. This could be related to the bone marrow, such as in diseases like aplastic anemia or myelodysplastic syndromes.
Tumors can also cause bone marrow infiltration, leading to less bone marrow capacity for red cell production. On the other hand, anemia can be caused by increased destruction i. Shortened RBC lifespan often results from inherent abnormalities of the red cells, such as membrane or enzyme defects.
It can also be caused by hemoglobinopathies, immune-based hemolytic anemia, infections of red cells e. Perkins divided pathogenetic classification into three basic categories: What parameters are useful for classifying anemia? Perkins, and is the best test to distinguish between hypoproliferative anemias and those related to problems with RBC lifespan or blood loss.
When done manually, there was a high degree—20 to 25 percent—of imprecision. To understand anemia in a useful way, said Dr. Perkins called immature reticulocytes an interesting new parameter.
The immature reticulocyte fraction or reticulocyte maturity index enables a comparison between immature reticulocytes which contain the most RNA and mature reticulocytes.
Perkins, in cases involving, say, recovery from chemotherapy or engraftment post-transplant. The IRF will increase in such cases. The IRF can also be used to monitor response to therapy in iron deficiency, though Dr.
Nucleated RBCs are commonly seen in neonates. A good place to start: Is the anemia associated with other hematologic abnormalities?
If not, then check to see if there is an appropriate reticulocyte response to anemia. Hypochromic microcytic anemias have a complex testing algorithm. If we see abnormal morphology, such as target cells, we would think about thalassemia or perhaps other hemoglobinopathies or liver disease.
Reticulocyte counts can also help identify the underlying cause of microcytic anemia.
Low or normal counts are more likely to be associated with iron deficiency, anemia of chronic disorders, some of the thalassemic traits, and sideroblastic anemia. Iron deficiency anemia is one of the most common nutritional deficiencies in the world, Dr.
The key proteins to think about are transferrin, transferrin receptor, and ferritin. Target cells are uncommon, but thrombocytosis may be present. Anemia of chronic disorders, or ACD, is the second most common cause of anemia and a common differential diagnostic consideration, especially in hospitals.The systems which have been designed for case simulations and teaching exercises for medical students  have often challenged the user to 64 L.
W. Diamond et al. / Computer Methods and Programs in Biomedicine 48 () answer questions about how they would work up the cases. A Case of Iron Deficiency Anemia. Hemoglobin, IDA. STUDY. PLAY - decreased oxygen carrying - increased iron binding capacity in blood.
What do blood read when a patient has IDA? - oral iron supplement Anemia and Iron Deficient Anemia. 71 terms. Anemias.
22 . Feb 15, · Play hematology quizzes on ProProfs, the most popular quiz resource. to a client whose anemia was caused by blood loss after surgery. Which action by the new RN requires that you, as charge nurse, intervene immediately? Answer will be revealed after each question. No time limit to finish the exam.
Good luck! Questions: 20 | Attempts. Case Study Progress. J.B. undergoes surgery, which ends up being complicated by pneumonia and poor wound healing. After being hospitalized for 6 weeks, he is discharged to a long-term care facility for care while recuperating and external radiation therapy.
Answer Key Answer keys for the cases in our collection are password-protected and access to them is limited to paid subscribed instructors. To become a paid . Snapshot: A 1-month-old infant is brought to his pediatrician. He has been having multiple mini nosebleeds. His parents have also noticed some bleeding along his gums.