I Always Feel Tired

Red Blood Cells
1. Features
  1. Anucleated & biconcave discs
    1. Filled with hemoglobin
  2. Mean diameter 7.8 µm &Volume is 90-95 cubic µm.
2. Membrane
3. Concentration
  1. In Healthy men → 5,200,000 cells/cu µm &in healthy women → 4,700,000 cells/cu µm.
4. Function
  1. Transport hemoglobin which carries respiratory gases.
5. Formation
Hemoglobin
1. Structure
  1. 4 globin chains
    1. α, β, γ and δ
  2. 4 heme groups
    1. Prphyrin ring with central iron
2. Function
  1. Transport of O2 from lungs to tissues &CO2 and H+ from tissues to the lungs for excretion
  2. Antioxidant and a regulator of iron metabolism.
  3. Act as buffer
3. Synthesis
  1. Heme
  2. Globin
4. Ranges
  1. Adult male = 13.5 to 17.5 grams per deciliter
  2. Adult female = 12.0 to 15.5 grams per deciliter
Anemia
1. Definition
  1. Reduction in the Red cell mass resulting in decreased oxygen transporting capacity of the blood
2. Classification
  1. Microcytic - MCV<80 fl
    1. Iron deficiency
      1. Causes
        Increased loss or dietary deficiency
      2. Signs & Symptoms
        Angular stomatitis, Epithelial atrophy, Koilonichi, & Pica
      3. Investigation
        Laboratory findings
        Decrease: serum ferritin, serum iron, and %saturation
        Increase: TIBC
        Other Diagnostic techniques
        Gel electrophoresis - PCR - RFLP
      4. Risk Factors
        Women because they lose blood during menstruation - Infants and children - Vegetarians - Frequent blood donors
      5. Complications
        Heart problems (increase heart rate = heart failure) - Problems during pregnancy - Growth problems
      6. Treatment
        Oral or parenteral iron preparations, red cell transfusions, or recombinant EPO therapy
    2. Anaemia of chronic disease (some cases)
      1. Causes
        Rheumatoid arthritis-Tuberculosis- Chronic alcoholism- Malignancy
      2. Iron is trapped in BM macrophages
      3. Laboratory findings
        Decrease: MCV, serum iron,TIBC, & % saturation
        Increased: serum ferritin
    3. Sideroblastic anaemia
      1. Causes
        Chronic alcoholism - VB6 deficiency - Lead poisoning - INH therapy - Hereditary types (x- linked)
      2. Iron overload type of anemia (RING SIDEROBLASTS )
    4. Thalassaemia
  2. Normocytic - MCV 80-100 fl
    1. Many haemolytic anaemias
    2. Anaemia of chronic disease (some cases)
    3. After acute blood loss
    4. Renal disease
    5. BM failure, post chemotherapy, infiltration by CA
  3. Macrocytic - MCV>100 fl
    1. Megaloblastic
      1. V B12 deficiency
        Causes
        Decreased intake (vegan) Impaired absorption
        Associated with neurological problems
      2. Folate deficiency
        Causes
        Dietary deficiency (alcohol-elderly) - Increased demand ( pregnancy- cancer patients) - Limited body stores
    2. Non-megaloblastic
      1. Alcoholism Drugs (Ex- 5 FU) Liver disease
3. Signs & Symptoms

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I Always Feel Tired

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	Erstellt von Noree Alii vor mehr als 7 Jahre