·
Lysis
or cell death
·
Hereditary
·
Occurs
if the marrow is unable to compensate therefore it becomes clinical
·
Intrinsic—factor
ionside the red cell causeng the anemia
·
Extrensic—factors
outside the red cell causing the anemia
·
Classification
·
Aplastic
·
Hemoglobin
SC
·
Hemolysis
due to G-6-Phosphate
·
Idiopathic
·
Autoimmune—due
to medications
·
Anemia
can be caised by medication, poor nutrition and heredity
·
Hemolytic
anemia
·
Associated
with jaudice and icterus or yellowing of the eyes, skin and mucous
membranes caused by too much billirubin
·
Occurs
due to breakdown of billirubin, which is broken into a heme and globin portion.
·
New
born jaundice can be normal
·
All
other forms of jaundice are due to liver failure and results form indirect or
conjugated billirubin build up.
Aplastic
anemia—idiopathic form
·
Absence
of cell growth
·
Idiopathic—bone
marrow fails to make all cell lines
·
Stem
cell—progenator cell that gives rise to all cell lines leading to pancytopenia
·
Pancytopenia—is
incompatible with life due to lacking in any of the cells.
·
Can
be due to lupus, toxins, radiation which all attack the stem cell.
·
Can
result in multi-organ failure.
·
Produces
fgatigue and weakness, as well as bleeding and may be acute or chronic.
·
Also
has dyspnea, tachycardia, easy brusing and bleeding gums
·
Splenomegaly
which is one of the terminal signs, and sternal pain may be present—seen on CT
scan.
·
¯ counts in all cell lines
·
hemolysis and billirubin
·
terminal
prognosis—if untreated, transplants may be successful in younger patients
·
treated
with bone marrow transplant in people under 40
·
over
40, antithymocyte globulin ATG is the preferred method of choice which
suppresses the immune system
Secondary
aplastic anemia—identifiable cause
·
Involves
stem cell injury—leading to pancytopenia
·
Chemotherapy
is the leading cause and is an expected
·
Radiation
and toxins (benzene) is the most common.
·
Pregnancy
may also cause this as well as lupus which can injure the stem cell
·
May
be acute or chronic
·
4
out 100,000 which is more common form
·
Prevention
may be unavoidable
·
Splenomagaly,
sternal tenderness
·
¯ hematocrit and hemoglobin.
·
Treatment:
conservative care in mild cases, as well as the same as above.
·
Prognosis—untreated
leads to rapid death
Leukocytes
·
Types
·
Granulocytes
·
Neutrophils—most
common 40-60%
·
Eosinophils—4%
·
Basophils—0-2%
·
Agranulocytes
·
Monocytes—10%
·
Lymphocytes—20-40%
dominant in children under 14
·
Count
is between 5-10 thousand
Case
·
Left
shift all white cells and bands are but lymphocytes are ¯àindicates bacterial infection or inflammation.
·
Lymphocytes
are ¯ relative to the other cell counts
·
Bands
are adolescent white cell
·
Right
shift—low or low normal white cells, with normal bands, and the lymphocytes are
à due to viral infection.
·
Bands
indicate a left shift