PATHO- CH 28 – Flashcards
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What term is used to describe the capacity of some erythrocytes to vary in size, especially in relationship to some anemias?
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Anisocytosis Additional descriptors of erythrocytes associated with some anemias include poikilocytosis (assuming various shapes)
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What is the fundamental physiologic manifestation of anemia?
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Hypoxia
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The paresthesia that occurs in vitamin B12 deficiency anemia is a result of?
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Myelin degeneration in the spinal cord Effects on the nervous system can occur if a vitamin B12 deficiency causes the anemia. Myelin degeneration may occur with the resultant loss of fibers in the spinal cord, producing paresthesia (numbness), gait disturbances, extreme weakness, spasticity, and reflex abnormalities. This selection is the only option that accurately describes the cause of paresthesia in such anemias.
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Which of the following describes how the body compensates for anemia?
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Increasing rate and depth of breathing
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Which of the following is classified as a megaloblastic anemia?
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Pernicious Megaloblastic anemia (or megaloblastic anaemia) is an anemia (of macrocytic classification) that results from inhibition of DNA synthesis during red blood cell production. When DNA synthesis is impaired, the cell cycle cannot progress from the G2 growth stage to the mitosis (M) stage.
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Deficiencies in folate and vitamin B12 alter the synthesis of what?
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DNA Results in defective erythrocyte precursor DNA synthesis
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The underlying disorder of which anemia is a result of the defective secretion of the intrinsic factor, which is essential for the absorption of vitamin B12?
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Pernicious
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After a person has a subtotal gastrectomy for chronic gastritis, which type of anemia will result?
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Pernicious Often associated with the endstage type A chronic atrophic gastritis.
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What causes the atrophy of gastric mucosal cells that result in pernicious anemia?
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Vitamin B12 malabsorption Deficiency in intrinsic factor (IF) secretion may be congenital or may result from adult onset gastric mucosal atrophy and the destruction of parietal cells. In older adults, virtually all vitamin deficiency anemia is caused by a failure of IFrelated absorption. This selection is the only B12 option that accurately identifies the cause of gastric mucosal cell atrophy.
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Which statement best describes a Schilling test?
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Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency
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What is the treatment of choice for pernicious anemia (PA)?
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Vitamin B12 by injection
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Which condition resulting from untreated pernicious anemia (PA) is fatal?
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Heart failure
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How is the effectiveness of vitamin B12 therapy measured?
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(Rising) Reticulocyte count
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Which statement about folic acid is false?
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Folic acid absorption is dependent on the enzyme folacin. BUT THE FOLLOWING IS TRUE 1. Folic acid is stored in the liver. 2. Folic acid is essential for RNA and DNA synthesis within erythrocytes. 3. Folic acid is absorbed in the upper small intestine.
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Which anemia produces small, pale erythrocytes?
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Iron deficiency
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Which type of anemia is characterized by fatigue, weakness, and dyspnea, as well as conjunctiva of the eyes and brittle, concave nails?
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Iron deficiency Pale earlobes, palms, and conjunctivae are also common signs. Progressive IDA causes more severe alterations, with structural and functional changes apparent in epithelial tissue. The nails become brittle, thin, coarsely ridged, and spoon-shaped or concave (koilonychia) as a result of impaired capillary circulation. The tongue becomes red, sore, and painful.
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What is the most common cause of iron deficiency anemia (IDA)?
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Chronic blood loss and pregnancy
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Continued therapy of pernicious anemia (PA) generally lasts how long?
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The rest of one's life
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Sideroblastic anemia can occasionally result from an autosomal recessive transmission inherited from which relative?
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Mother
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Clinical manifestations of mild-tomoderate splenomegaly and hepatomegaly, bronzecolored skin, and cardiac dysrhythmias are indicative of which anemia?
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Sideroblastic
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Considering sideroblastic anemia, what would be the expected effect on the plasma iron levels?
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Plasma iron levels would be high.
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In aplastic anemia (AA), pancytopenia develops as a result of which of the following?
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Suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes
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What is the most common pathophysiologic process that triggers aplastic anemia (AA)?
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Autoimmune disease against hematopoiesis by activated cytotoxic T (Tc) cells
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An allogenic bone marrow transplantation remains the preferred method for treating which anemia?
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Sideroblastic (As well as peripheral blood stem cell transplantation from a histocompatible sibling)
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Which statement is true regarding warm autoimmune hemolytic anemia?
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Erythrocytes are bound to macrophages and sequestered in the spleen.
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When considering hemolytic anemia, which statement is true regarding the occurrence of jaundice?
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Heme destruction exceeds the liver's ability to conjugate and excrete bilirubin.
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Erythrocyte life span of less than 120 days, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiologic characteristics of which type of anemia?
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Anemia of chronic disease
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What is the primary cause of the symptoms of polycythemia vera?
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Increased blood viscosity
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Treatment for polycythemia vera involves which of the following?
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Therapeutic phlebotomy and radioactive phosphorus (In low risk individuals, the recommended therapy is phlebotomy and lowdose aspirin, whereas radioactive phosphorus has been used to suppress erythropoiesis.)
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Considering iron replacement therapy prescribed for iron deficiency anemia, who is likely to require long term daily maintenance dosage?
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A woman who has not yet experienced menopause
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Which statement is true regarding the physical manifestations of vitamin B12 deficiency anemia?
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Symptoms are a result of demyelination.
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A 2000 ml blood loss will produce which assessment finding?
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a. Air hunger c. Rapid thready pulse d. Cold clammy skin (With a 2000 ml loss of blood, central venous pressure, cardiac output, and arterial blood pressure are below normal, even when at rest and in the supine position. The person commonly has air hunger; a rapid, thready pulse; and cold, clammy skin. With a 1500 ml loss of blood, supine blood pressure and pulse can still be normal. Lactic acidosis is observed with a blood loss of 2500 ml or more.)
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Which medications are associated with an intermediate increase in a person's risk for developing aplastic anemia?
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b. Chloramphenicol (Chloromycetin) c. Phenytoin (Dilantin) d. Trimethoprimsulfamethoxazole (Bactrim)
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Which conditions are generally included in the symptoms of pernicious anemia (PA)?
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a. Weakness c. Low hemoglobin d. Paresthesias e. Low hematocrit
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What are the clinical manifestations of folate deficiency anemia?
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b. Flatulence c. Dysphagia d. Stomatitis e. Cheilosis
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Which diseases are commonly associated with anemia of chronic disease?
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a. Rheumatoid arthritis b. AIDS d. Systemic lupus erythematosus e. Chronic hepatitis
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Pernicious anemia
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Macrocyticnormochromic anemia
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Sideroblastic anemia
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Microcytichypochromic anemia
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Aplastic anemia
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Normocyticnormochromic anemia
