Scenario 1: Jane is a 25-year-old healthy woman. She presents to the clinic with a 6- month history of heavy irregular menstrual cycles, fatigue,
... [Show More] dizziness, and mild shortness of breath on exertion. She has also noticed a cold intolerance to her hands and feet. Over the past year she has decided to follow a vegetarian diet.
The PCP sends her for routine blood work at the local lab which includes a CBC, electrolytes, creatinine, TSH, Vitamin B12 and RBC folate.
CBC: WBC – 9000/µL, Hg – 8.2g/dL, Hct. - 28%, Platelets – 200, 000/µL MCV-68 fl, Reticulocytes-N
Electrolytes – normal
TSH - normal, Serum Vit. B12 - normal, RBC folate – normal, Ferritin – Low
1) Review the main components and functions of blood. What are the normal values of a CBC (Hg, Hct, RBC count, WBC, Plts, MCV), What are reticulocytes?
The main components of blood are plasma, red blood cells, white blood cells, and platelets. The main function of blood is to transport oxygen and nutrients to the cells of the body and to remove waste products.
The normal values of a CBC are: Hg - 82 g/dL, Hct - 28%, RBC count - 4.5 million/µL, WBC - 5,000-10,000/µL, Plts - 150,000-450,000/µL, MCV - 80-100 fl. Reticulocytes are immature red blood cells.
2) Discuss the process of erythropoiesis. What building blocks are required to produce RBCs? What are the components of hemoglobin? Discuss the life cycle of an RBC and how it is recycled.
Erythropoiesis is the process by which red blood cells are produced. The building blocks required to produce red blood cells are iron, vitamin B12, and folic acid. The components of hemoglobin are iron and globin. The life cycle of a red blood cell is approximately 120 days. Once a red blood cell reaches the end of its life cycle, it is broken down and recycled by the body.
3) What does the term anemia mean? Describe the general 3 pathophysiological mechanisms of developing anemia. Review the 2 ways to classify anemias.
The term anemia means a deficiency of red blood cells or hemoglobin. The three general pathophysiological mechanisms of developing anemia are decreased
production of RBCs, increased destruction of RBCs, and blood loss. Anemias can be classified by their cause (e.g., iron deficiency anemia) or by their severity (e.g., mild, moderate, or severe anemia).
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