NSG 533 EXAM 4
• three causes of anemia: 1. blood loss
2. underproduction of erythrocytes
3. destruction of RBC
• three different types of Hemoglobin: Hemoglobin A, F, and S
• components of Hemoglobin A (HbA): - contains 2 alpha globin
- contains 2 beta globin
- major hemoglobin in adults (97%)
• components of Hemoglobin A2 (HbA2): - contains 2 alpha globin
- contains 2 delta globin
- unknown importance
- 3% of individuals
• components of Hemoglobin F (HbF): - contains 2 alpha globin
- contains 2 gamma globin
- fetal hemoglobin
- replaced by HbA at 6 months
• components of Hemoglobin S (HbS): dysfunctional beta gene in Sickle CellDisease
• normal RBC value and importance: # of erythrocytes in the blood
4.5-6
function: carry oxygen from the lungs and deliver it throughout the body
• normal Hemoglobin value and importance: 12-17mg/dL
function: oxygen-carrying protein of an erythrocyte that transports oxygen from thelungs to
tissues and facilitates the return transport of carbon dioxide to be exhaled
higher in men
• normal Hematocrit value and importance: men: 40-50%; women: 35-45%function: % of a
given volume of blood that is occupied by an erythrocyte
,higher in men
• normal Reticulocyte value and importance: 0.5% - 2%
function: % of reticulocytes in red cell count (low indicates underproduction in thebone
marrow; high indicates destruction or hemolysis
• normal total iron binding capacity value and importance: 240-450mcg/dLfunction:
amount of iron in the serum plus amount of transferring available in the serum
• normal haptoglobin value and importance: 41-165mg/dL
importance: measures how fast your RBCs are destroyed (low indicates RBCs beingdestroyed
quickly)
• normal Mean Corpuscular Volume (MCV) value and importance: 80-100function:
size/volume of the erythrocyte; not used for diagnosis
• normal RBC Distribution Width (RDW) value and importance: 11.5-15% importance:
index of variation of RBC size and shape (>15% can indicate evolvingmicrocytic or
macrocytic anemia)
• normal Mean Corpuscular Hemoglobin Concentration (MCHC) value andimportance: 32-
36
importance: how concentrated the hemoglobin is in the RBC
• normal Mean Corpuscular Hemoglobin (MCH) value and importance: 27-31importance:
amount of hemoglobin per RBC; looks at the color
• -cytic: cell size
• -chromic: hemoglobin content (color)
• what is anisocytosis?: variation in RBC size
• what is poikilocytosis?: variation in RBC shape
• what happens to reticulocytes in underproduction of RBCs?: decreasedreticulocytes
• what happens to reticulocytes in destruction of RBCs?: reticulocytes in-crease
• three categories of Decreased RBC Production anemia: 1. microcytic
2. normocytic
3. macrocytic
• common type of microcytic anemia: iron deficiency anemia
1. define hematopoiesis: production of blood cells
2. define erythropoiesis: production of RBC
3. where does erythropoiesis primarily occur?: bone marrow of flat bones
, • composition of blood (by %): 1. plasma 55% (90% water, then nutrients, elec-trolytes,
waste)
RBC 41%
WBC and platelets 4%
• requirements of RBC production: 1. amino acids
2. copper
3. cobalt
• vitamin B (2,3,6,12)
4. folate
5. iron
6. vitamin E
• what hormone stimulates RBC production: erythropoietin
• when and where is erythropoietin secreted?: secreted from juxtaglomerularcells in the
kidneys
when decreased oxygen is detected
• what is the last immature form of a RBC: reticulocyte (once it loses its riboso-mal network,
it becomes an RBC)
• life span of erythrocytes: 120 days then removed by macrophages
• oxyhemoglobin: hemoglobin bound to oxygen in the lungs (then binds with iron)
• deoxyhemoglobin: hemoglobin without oxygen (delivers the oxygen to bodytissues -->
blood becomes darker red)
• describe the degradation of RBCs: - after 120 days, macrophages degradeerythrocyte
- globin is broken down into amino acids and sent back to bone marrow
- iron (in the heme portion) is stored in the liver or spleen as ferritin
- non-iron portion of heme is degraded to biliverdin --> bilirubin --> liver --> excretedas bile --
> excreted in feces and urine
• define anemia: decrease in the total number of erythrocytes in the circulatingblood or a
decrease in the quality/quantity of hemoglobin
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