Erythrocytosis vs. Anemia
Terms
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Erythrocytosis:
Polycythemia vera (primary) - Etiology
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- Disease of high absolute cells, produces more stem cells, or differentiate everything.
- increase in all blood cell types
- myeloproliferative disease
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Erythrocytosis:
Polycythemia vera - Clinical features
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- found in 50-70 yrs old (males)
- splenomegaly, hepatomegaly
- so many cells come out and need to be stored
- increase in dead RBC
- headaches (loss of O2), dizziness, breathlessness (unloading/loading hard w
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Erythrocytosis:
Polycythemia vera - Lab findings
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- increased RBC, WBC, platelets
- NRBC: pushed out early
- metarubricytes
- rubricytes
- poikilocytes, tear drop cells (pushing into tiny vessels)
- hypercellular bone marrow
- decreased erythropoietin (s
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Erythrocytosis:
Polycythemia vera - Treatment and prognosis
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- phlebotomy (1 bag)
- myelosuppressive drugs; depress all stem cells
- mean survival rate is 10-20 yrs with treatment; 1.5-3 yrs without
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Erythrocytosis:
Secondary erythrocytosis - Etiology
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- increased erythropoietin stimulation (in kidney)
- appropriate increases - reaction to hypoxia
- lung and heart disease
- live in high altitudes: less O2, need more RBC to carry O2 to tissues
- inappropriate increa
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Erythrocytosis:
Secondary erythrocytosis - Lab findings
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- RBC increase
- WBC and platelets are normal
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Erythrocytosis:
Relative erythrocytosis -
- "pseudo-polycythemia"
- Etiology:
- burns
- dehydration
- vomiting
- diarrhea
- Same clinical features as Polycythemia vera
- Increase in RBC because of decrease in plasma
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Anemia
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- Decrease in hemoglobin and/or RBC mass
- Decrease in hematocrit
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Anemia
Factors Affecting Diagnosis
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- gender
- age
- geography (low vs. high altitude)
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Anemia
Clinical features
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- fatigue: not enough RBC
- shortness of breath: not enough O2 carried
- headaches
- pale lips and nailbeds
- increased CO with palpitations (not expiring CO2 off)
- tachycardia: speed up muscle to get more CO2
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Anemia
Etiology
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- iron deficiency
- blood loss
- nutritional deficiencies
- hemolysis
- metastatic bone marrow replacement
- infections
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Anemia
Morphological Classifications
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- microcytic, hypochromic anemias
- hemoglobin, iron deficiencies
- Megaloblastic (macrocytic) anemias
- folic acid deficiency
- Normocytic, normochromic anemias
- lysing of cells
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Anemia
Lab findings
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- rbc count
- hgb
- hematocrit
- RBC indices
- peripheral blood smear
- reticulocyte count: test how bone marrow is responding to see if it is making cells. Will increase if making cells
- bone marrow smear, biosp