Gld Ch. 10 T2(Blood)

The typical early general signs and symptoms of anemia include pallor (pale skin), dyspnea (shortness of breath), and fatigue. Pallor occurs because anemia reduces the amount of oxygen-rich blood reaching the body's tissues, resulting in a paler appearance. Dyspnea is caused by the body's attempt to compensate for the reduced oxygen levels by increasing the respiratory rate. Fatigue is a common symptom of anemia as the body is not receiving enough oxygen to function properly. Chest pain, palpitations, jaundice, and stomatitis are not typical early signs of anemia.

Pancytopenia is the correct answer because it refers to a condition where there is a deficiency of all types of blood cells, including red blood cells, white blood cells, and platelets. Leucopenia and neutropenia specifically refer to a decrease in white blood cells, while erythrocytosis refers to an increase in red blood cells. Therefore, pancytopenia is the appropriate term to describe a deficit of all types of blood cells.

Untreated pernicious anemia leads to a deficiency of vitamin B12, which in turn causes peripheral nerve demyelination. This means that the protective covering of the nerves, called myelin, is damaged. The damaged myelin disrupts the normal transmission of nerve signals, resulting in numbness and tingling in the fingers.

The correct answer is "Deficit of oxygen for epithelial cell mitosis and metabolism." Severe anemia leads to a decrease in the oxygen-carrying capacity of the blood, resulting in a deficit of oxygen reaching the tissues. Epithelial cells, which line the oral mucosa, require oxygen for their normal growth and metabolism. Without sufficient oxygen, these cells cannot undergo mitosis (cell division) and metabolic processes properly, leading to oral ulcerations and delayed healing.

Pernicious anemia can result from a malabsorption problem. Malabsorption refers to the inability of the body to properly absorb nutrients from the digestive tract. In the case of pernicious anemia, the body is unable to absorb an adequate amount of vitamin B12, which is necessary for the production of healthy red blood cells. This can lead to a decrease in the number of red blood cells and cause symptoms such as fatigue, weakness, and shortness of breath.

Vitamin K is necessary for the liver to produce prothrombin, a protein that plays a crucial role in blood clotting. Without vitamin K, the liver cannot synthesize enough prothrombin, leading to impaired blood clotting and an increased risk of bleeding.

Pernicious anemia is a type of anemia that is caused by a deficiency of vitamin B12. The characteristic erythrocytes associated with pernicious anemia are megaloblastic or macrocytic nucleated cells. This means that the red blood cells are larger than normal (macrocytic) and have an abnormal shape with a larger nucleus (megaloblastic). This is due to impaired DNA synthesis in the bone marrow, leading to the production of immature red blood cells.

Microcytic and hypochromic erythrocytes refer to red blood cells that are smaller and paler than normal. This condition is commonly found in iron deficiency anemia, which occurs when there is a lack of iron in the body. Iron is necessary for the production of hemoglobin, the protein that carries oxygen in the blood. Without enough iron, the red blood cells cannot properly develop and become smaller and paler in appearance. Polycythemia, disseminated intravascular coagulation, and hemophilia A do not typically result in microcytic and hypochromic erythrocytes.

Heparin is a substance that acts as an anticoagulant. It works by inhibiting the activity of certain clotting factors in the blood, preventing the formation of blood clots. Prothrombin, fibrinogen, and vitamin K do not have anticoagulant properties. Prothrombin is a protein involved in the clotting process, fibrinogen is a protein that helps in the formation of blood clots, and vitamin K is necessary for the synthesis of clotting factors.

Iron deficiency anemia is a condition characterized by low levels of iron in the body, leading to decreased production of red blood cells. Certain vegetarian diets can contribute to iron deficiency anemia because plant-based sources of iron are less easily absorbed by the body. Excessive menstrual flow can cause iron deficiency anemia as well, as it leads to significant blood loss. Malabsorption syndromes can also result in iron deficiency anemia, as they impair the body's ability to absorb iron from the diet. However, diabetes mellitus is not directly related to iron deficiency anemia, making it the exception among the given options.

In individuals with pernicious anemia, antibodies form to intrinsic factor or parietal cells. Pernicious anemia is an autoimmune condition where the immune system mistakenly attacks the cells in the stomach that produce intrinsic factor or the intrinsic factor itself. Intrinsic factor is necessary for the absorption of vitamin B12 in the small intestine. Without intrinsic factor, vitamin B12 cannot be properly absorbed, leading to a deficiency and resulting in pernicious anemia. Therefore, the formation of antibodies against intrinsic factor or parietal cells disrupts the absorption of vitamin B12 and contributes to the development of pernicious anemia.

In cases of polycythemia vera, there is an abnormal increase in the number of red blood cells in the blood. This leads to an increase in blood volume, as there are more red blood cells circulating. Increased blood volume can cause an increase in blood pressure, as there is more blood flowing through the blood vessels. This is why the correct answer is increased blood volume.

Pancytopenia refers to a condition where there is a decrease in the number of all three types of blood cells - red blood cells, white blood cells, and platelets. Aplastic anemia is a blood dyscrasia characterized by bone marrow failure, leading to a decrease in the production of all blood cells. This condition can result in pancytopenia, explaining why aplastic anemia is the correct answer. Pernicious anemia is a type of anemia caused by vitamin B12 deficiency, iron deficiency anemia is characterized by a lack of iron, and sickle cell anemia is a genetic disorder affecting red blood cells.

Thalassemia is a genetic disorder that affects the production of hemoglobin, the protein responsible for carrying oxygen in red blood cells. The correct answer states that thalassemia is caused by a defect in one or more genes for hemoglobin. This means that there is a mutation or alteration in the genes responsible for producing hemoglobin, leading to abnormal or reduced production of this protein. As a result, individuals with thalassemia may experience anemia and other symptoms related to the inadequate functioning of red blood cells.

Vitamin K is used by the liver to produce prothrombin, which is essential for blood clotting. It is also a fat-soluble vitamin, meaning it dissolves in fat and can be stored in the body. However, the bone marrow does not require vitamin K to synthesize hemoglobin. Hemoglobin is a protein found in red blood cells that carries oxygen to the body's tissues. The production of hemoglobin is not directly influenced by vitamin K.

Disseminated intravascular coagulation (DIC) is a condition where the body's clotting system becomes overactive, leading to the formation of multiple small blood clots throughout the body. These clots can block blood vessels and disrupt normal blood flow. At the same time, the excessive clotting consumes clotting factors, which are necessary for normal blood clotting. Therefore, in DIC, there is a combination of multiple thrombi (clots) and a deficit of clotting factors. This can lead to both excessive clotting and bleeding tendencies, resulting in a complex and potentially life-threatening condition.

Exposure to radiation is a well-known predisposing factor for leukemia. Radiation can damage the DNA in cells, leading to genetic mutations that can increase the risk of developing leukemia. This can occur through occupational exposure, such as in nuclear power plant workers or radiologists, or through therapeutic radiation treatments for other medical conditions. Other factors mentioned, such as certain infections and familial tendency, may also play a role in some cases, but exposure to radiation is the most commonly recognized and significant predisposing factor for leukemia. Cigarette smoking, although a risk factor for many other types of cancer, is not directly associated with an increased risk of leukemia.

Leukemia is sometimes linked to chromosome abnormalities, and one such abnormality is the presence of Philadelphia chromosome translocation in cases of acute myelogenous leukemia (AML). This translocation involves the exchange of genetic material between chromosomes 9 and 22, resulting in the formation of a fusion gene called BCR-ABL. This fusion gene produces a protein that promotes uncontrolled cell growth and division, leading to the development of AML. The presence of Philadelphia chromosome translocation is a well-known characteristic of AML and provides evidence of its link to chromosome abnormalities.

Erythropoietin is a hormone that is produced by the kidneys in response to low oxygen levels in the body, known as hypoxia. It acts on the bone marrow to stimulate the production of red blood cells, which are responsible for carrying oxygen to the tissues. This helps to increase the oxygen-carrying capacity of the blood and restore normal oxygen levels in the body.

Excessive bleeding is a common occurrence with acute leukemia due to decreased platelets. Platelets are responsible for blood clotting, and when their numbers are reduced, it becomes difficult for the body to form clots and stop bleeding. This can lead to excessive bleeding even from minor injuries or cuts.

Sickle cell anemia is caused by a defective gene that is inherited from both parents. This gene mutation affects the hemoglobin in red blood cells, causing them to become rigid and form a sickle shape. These abnormal red blood cells can get stuck in blood vessels, leading to reduced oxygen flow and causing various complications. Inheriting the defective gene from only one parent results in sickle cell trait, which may not cause symptoms but can be passed on to future generations.

Von Willebrand disease is caused by the absence of a clotting factor that helps platelets clump and stick. This clotting factor, called von Willebrand factor, plays a crucial role in the formation of blood clots. Without it, the platelets are unable to adhere to the blood vessel walls and form a clot, leading to prolonged bleeding. This genetic disorder affects the normal functioning of the blood clotting process and can result in symptoms such as easy bruising, nosebleeds, and excessive bleeding after injury or surgery.

Chemotherapy is the primary treatment for leukemias because it involves the use of drugs to kill cancer cells throughout the body. Leukemias are cancers of the blood and bone marrow, and chemotherapy is effective in targeting and destroying the abnormal cells. Unlike surgery, which is typically used for solid tumors, leukemia cells are spread throughout the body and cannot be easily removed through surgery. Radiation therapy may be used in some cases, but chemotherapy is the mainstay of treatment for leukemias. Immunotherapy, on the other hand, is a newer treatment approach that uses the body's immune system to fight cancer and is not typically the primary treatment for leukemias.

A high percentage of blast cells in the leukocyte population is indicative of acute myelogenous leukemia (AML). Blast cells are immature cells that are typically found in the bone marrow, but in AML, they rapidly accumulate in the blood and bone marrow, crowding out healthy blood cells. A high percentage of blast cells suggests that the disease is aggressive and progressing rapidly, which is associated with a poor prognosis. Thalassemia, myelodysplastic syndrome, and multiple myeloma do not typically present with a high percentage of blast cells in the leukocyte population.

Thalassemia is a genetic disorder that affects the production of hemoglobin, the protein responsible for carrying oxygen in red blood cells. The basic abnormality in thalassemia is the failure to synthesize either the alpha or beta chains in the hemoglobin molecule. This leads to an imbalance in the production of these chains, resulting in abnormal hemoglobin formation and impaired oxygen transport.

Petechiae and purpura are both signs of increased bleeding. Petechiae are small, pinpoint-sized red or purple spots that appear on the skin due to bleeding under the skin. Purpura refers to larger patches of purple or red discoloration on the skin caused by bleeding. These signs can occur when there is a disruption in the blood vessels or a decrease in platelet function, leading to increased bleeding. Excessive hemolysis refers to the breakdown of red blood cells, leucopenia is a low white blood cell count, and hemoglobin deficit indicates a deficiency in hemoglobin, none of which directly cause increased bleeding.

Aplastic anemia is a condition characterized by a decrease in the production of red blood cells, white blood cells, and platelets. The etiology, or cause, of aplastic anemia can be idiopathic, meaning it is unknown in many cases. Additionally, exposure to myelotoxins, substances that are toxic to the bone marrow, can also predispose individuals to develop aplastic anemia. Therefore, the correct answer is that aplastic anemia can be both idiopathic and predisposed by exposure to myelotoxins.

A reduced number of erythrocytes in the blood would result in a decreased hematocrit. Hematocrit is the percentage of red blood cells in the total blood volume. When the number of erythrocytes decreases, the proportion of red blood cells in the blood decreases, leading to a lower hematocrit value.

Chronic blood loss causes anemia because it leads to a smaller amount of recycled iron available. Iron is essential for the production of hemoglobin, the protein in red blood cells that carries oxygen. When there is chronic blood loss, the body loses iron along with the blood, resulting in a decreased amount of iron available for the production of new red blood cells. This leads to a decrease in the number of red blood cells and subsequently causes anemia.

Pernicious anemia is a condition where the body is unable to absorb enough vitamin B12, leading to a decrease in red blood cell production. Hypochlorhydria, or low stomach acid, is commonly associated with pernicious anemia. This is because stomach acid is necessary for the absorption of vitamin B12. Pancytopenia refers to a decrease in all blood cell types, which can occur in pernicious anemia due to the decreased red blood cell production. Leukocytosis, an increase in white blood cells, is not typically seen in pernicious anemia. Multiple infarcts, or blockages of blood supply leading to tissue death, are not directly associated with pernicious anemia.

Secondary polycythemia is a condition characterized by an increase in the number of red blood cells due to factors outside of the bone marrow. It can be associated with various underlying conditions, including severe chronic bronchitis. In chronic bronchitis, the airways become inflamed and narrowed, leading to reduced oxygen levels in the blood. This stimulates the body to produce more red blood cells in an attempt to compensate for the decreased oxygen. Therefore, severe chronic bronchitis can be a potential cause of secondary polycythemia.

The correct answer is plasma cells. Multiple myeloma is a type of cancer that affects plasma cells, which are a type of white blood cell responsible for producing antibodies. In multiple myeloma, these plasma cells become cancerous and multiply uncontrollably, leading to the formation of tumors in the bone marrow. This can result in bone pain, weakened bones, and other complications. Granulocytes are a different type of white blood cell involved in the immune response, while bone cells and lymph nodes are not directly implicated in multiple myeloma.

Excessive bleeding and recurrent infections are common early signs of aplastic anemia. Aplastic anemia is a condition where the bone marrow does not produce enough new blood cells. The lack of red blood cells can cause bleeding, leading to symptoms such as easy bruising, nosebleeds, or prolonged bleeding from cuts. Additionally, the low white blood cell count makes individuals more susceptible to infections, resulting in recurrent infections. Therefore, excessive bleeding and recurrent infections are indicative of aplastic anemia.

In sickle cell anemia, the red blood cells change into a sickle shape when they are deprived of oxygen (hypoxia). This occurs due to a genetic mutation in the hemoglobin molecule, where the hemoglobin S (HbS) is unable to carry oxygen effectively. The sickle-shaped red blood cells can clump together and block blood vessels, leading to vascular occlusions and infarcts. This is why vascular occlusions and infarcts occur frequently in individuals with sickle cell anemia.

The capillary walls consist of a single endothelial layer. This is because capillaries are the smallest blood vessels in the body and their walls are designed to allow for the exchange of gases, nutrients, and waste products between the blood and surrounding tissues. The single layer of endothelial cells allows for a thin and permeable barrier, which facilitates the efficient diffusion of substances. Having multiple endothelial layers or a thick layer of smooth muscle would hinder this exchange process. Similarly, having two or three epithelial layers would not be suitable for the function of capillaries.

Pernicious anemia is caused by a deficiency of vitamin B12, which is essential for the production of healthy red blood cells. In this condition, the body is unable to absorb vitamin B12 from the diet due to a lack of intrinsic factor, a protein necessary for its absorption in the intestines. Therefore, injecting vitamin B12 bypasses the need for absorption in the intestines and allows it to directly enter the bloodstream, providing the necessary nutrient for red blood cell production.

Chronic leukemias are more common in older people because these types of leukemias develop slowly over time. They are typically diagnosed in adults, especially those over the age of 60. In contrast, acute leukemias, such as AML, are more common in children. Exposure to chemicals is not considered a predisposing factor for leukemias, and lymphoid tissue does not produce abnormal leukocytes.

The development of multiple opportunistic infections with acute leukemia is primarily due to the fact that many circulating leukocytes (white blood cells) are immature. In acute leukemia, there is an overproduction of immature white blood cells, which leads to a decrease in the number of mature and functional white blood cells. These immature cells are unable to effectively fight off infections, making the individual more susceptible to opportunistic infections.

Individuals with type O blood are considered to be universal donors because their blood contains A and B antibodies. This means that they do not have A or B antigens on their red blood cells, and therefore, their blood can be donated to individuals of any ABO blood type. The presence of A and B antibodies in their plasma ensures that their immune system will attack blood cells that have A or B antigens, which is why they can only receive type O blood.

Jaundice is a yellowing of the skin and eyes caused by a buildup of bilirubin, a yellow pigment produced by the breakdown of red blood cells. In sickle cell anemia, the red blood cells have an abnormal shape and are more likely to break down, leading to an increased production of bilirubin. This excess bilirubin can cause jaundice, making sickle cell anemia the correct answer. Aplastic anemia, iron deficiency anemia, and acute leukemia do not typically present with jaundice as a prominent sign.

Hemochromatosis is a condition that is characterized by a metabolic error, leading to the accumulation of excessive amounts of iron in the body. This excess iron is stored as hemosiderin, which can cause damage to various organs over time. It is not caused by excessive iron intake in the diet or excessive hemolysis of red blood cells. It is also not an inherited defect that results in abnormal hemoglobin.

An individual with hemophilia A has a deficiency in factor VIII, which is essential for blood clotting. Bleeding time measures the time it takes for bleeding to stop after a small incision, and it primarily assesses platelet function. Since hemophilia A is a clotting factor deficiency and not a platelet disorder, bleeding time would be within the normal range for an individual with this condition. Coagulation time, PTT time, and prothrombin time, on the other hand, assess the clotting cascade and would be prolonged in someone with hemophilia A.

Disseminated Intravascular Coagulation (DIC) is a condition characterized by abnormal blood clotting throughout the body's blood vessels. It is typically a secondary complication that arises as a result of an underlying condition or disease, such as sepsis, trauma, or cancer. DIC is not always initiated by excessive bleeding, as it can also lead to both excessive clotting and bleeding. The condition does not result in an inability of platelets to adhere, but rather causes the formation of small blood clots that consume platelets and clotting factors, leading to their depletion. DIC can be life-threatening if not promptly diagnosed and treated.

Sickle cell trait is a genetic condition where an individual carries one copy of the sickle cell gene. The correct answer states that sickling of erythrocytes (red blood cells) occurs with severe hypoxia. This means that under conditions of low oxygen levels in the body, the red blood cells can change shape and become sickle-shaped. This can cause blockages in blood vessels and lead to various complications. It is important to note that sickle cell trait is generally a milder form of the disease compared to sickle cell anemia, where an individual has two copies of the sickle cell gene.

The overall circulatory system consists of two circulations: pulmonary and systemic. The pulmonary circulation involves the flow of blood between the heart and the lungs, where oxygen is taken in and carbon dioxide is released. The systemic circulation, on the other hand, involves the flow of oxygenated blood from the heart to the rest of the body, delivering oxygen and nutrients to the tissues and removing waste products. These two circulations work together to ensure the proper functioning of the entire circulatory system.

Thrombophilia is a condition characterized by an increased tendency to form blood clots. Peripheral vascular disease refers to the narrowing or blockage of blood vessels that supply the legs and arms. Since thrombophilia increases the risk of blood clots, it can lead to the development of peripheral vascular disease. This is because the blood clots can obstruct the blood flow to the peripheral areas of the body, causing symptoms such as pain, numbness, and ulcers. Therefore, peripheral vascular disease is a potential consequence of thrombophilia.

Abnormally low hemoglobin values develop with pernicious anemia due to the shorter life span of erythrocytes. Pernicious anemia is a condition where the body cannot absorb enough vitamin B12, which is necessary for the production of healthy red blood cells. Without enough vitamin B12, the red blood cells become fragile and are destroyed more quickly than normal, leading to a shorter life span. This results in a decrease in hemoglobin values, as there are fewer healthy red blood cells carrying oxygen throughout the body.

Hemophilia A is a disorder characterized by a deficiency or lack of factor VIII, a clotting protein in the blood. This disorder is inherited as an X-linked recessive trait, which means it primarily affects males. Females can be carriers of the disorder, but they usually do not show symptoms. Hematomas (collections of blood outside of blood vessels) and hemarthroses (bleeding into joints) are common symptoms of hemophilia A due to the impaired clotting ability of the blood.