Advanced pathophysiology DB 7 Essay

Posted: November 2nd, 2022

Advanced pathophysiology DB 7 Essay

In clinical settings, advanced practice nurses often encounter patients with blood disorders such as anemia. Consider the case of a 17-year-old girl who is rushed to the emergency room after suddenly fainting. The girl’s mother reports that her daughter has had difficulty concentrating for the past week, frequently becomes dizzy, and has not been eating normally due to digestion problems. The mother also informs the nurse that their family has a history of anemia. With the family history of anemia, it appears that this is the likely diagnosis. However, in order to properly diagnose and treat the patient, not only must her symptoms and family history be considered, but also factors such as gender, ethnicity, age, and behavior. This poses the question: How do patient factors impact the incidence and prevalence of different types of anemia? To Prepare Review Chapter 21 in the Huether and McCance text. Reflect on the pathophysiological mechanisms of iron deficiency anemia. Advanced pathophysiology DB 7 Essay. Select one of the following types of anemia: pernicious anemia, folate deficiency anemia, sideroblastic anemia, chronic inflammation anemia, or post-hemorrhagic anemia. Identify the pathophysiological mechanisms of the anemia you selected. Consider the similarities and differences between iron deficiency anemia and the type of anemia you selected. Reflect on how patient factors such as genetics, gender, ethnicity, age, and behavior might impact these anemic disorders. Post an explanation of the pathophysiological mechanisms of iron deficiency anemia and the anemia you selected. Compare these two types of anemia, as well as their potential causes. Finally, explain how genetics, gender, ethnicity, age, and behavior might impact the anemic disorders you selected.

According to the World Health Organization, anemia is described as a reduction in the mass of circulating red blood cells and is considered to be a major cause of mortality and morbidity globally. Although there are many types of anemia, the most prevalent is an iron deficiency which accounts for 10% of anemia cases in the United States. Anemia is commonly classified in terms of cell size changes and content of hemoglobin (Camaschella, 2015).   Hemoglobin basically refers to the oxygen-carrying capacity of erythrocyte proteins that enable blood to transport more oxygen as compared to plasma alone. Clinically, anemia can manifest in all tissues and organs since a reduction in the oxygen-carrying capacity of red blood cells often leads to syncope, dyspnea, fatigue, dysfunction of vital organs and tachycardia. Advanced pathophysiology DB 7 Essay

Pathophysiology of Iron Deficiency Anemia

Iron deficiency anemia occurs when the stores, intake, and loss of iron are generally insufficient to fully support the continuous production of erythrocytes. On average, the human body holds 4 grams of stored iron. This amount is usually balanced in terms of dietary iron intake and iron lost physiologically. A lot of iron is usually integrated into hemoglobin and the rest is stored in the forms of myoglobin or ferritin (Camaschella, 2015).  On a daily basis, about 20 mg of iron is needed for the synthesis of hemoglobin. Dietary iron contributes up to 2 mg of this and the remainder is obtained through from erythrocytes where iron is recycled. On a daily basis, the average loss of iron is approximately 2 mg and this is often through cellular desquamation of the intestines and the skin and also through feces (Gupta et al., 2016).

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            Before a person develops anemia, iron stores are often lost or reduced. This means that the erythrocyte production demand should be met amount of iron provided by the iron recycled by erythrocytes and iron obtained from dietary intake. In case the loss of iron is persistent, newly produced erythrocytes will have small amounts of hemoglobin resulting to a reduction in the amount of iron provided by the same erythrocytes (Gupta et al., 2016). Advanced pathophysiology DB 7 Essay

Causes

Potential causes of iron deficiency anemia include chronic loss of blood, malaria, reduced dietary intake, iron malabsorption, and hookworm infection. It usually develops gradually with an insidious onset of symptoms such as dyspnea, general body malaise, weakness, epithelial tissue changes and fatigue (Camaschella, 2015). When the source of blood loss is immediately identified and corrected, the initiation of iron replacement therapy should not be delayed.

Age as a Patient Factor

Iron deficiency anemia is a common nutritional deficiency disorder among children aged 6 months-2 years. It often results from reduced dietary intake or hookworm infection among other causes. Iron is important for developing children, without which it can result in t irreversible damage in growth and development (Gupta et al., 2016). Advanced pathophysiology DB 7 Essay

Pathophysiology of Pernicious Anemia

Pernicious anemia, also known as Biermer’s disease is a form of megaloblastic anemia where the red blood cells are abnormally large due to a deficiency in vitamin B-12 and folic acid in the bone marrow. It occurs when the body lacks a number of intrinsic factors to absorb vitamin B12 from food (Toh, 2017). With inadequate vitamin B12, there is inadequate production of red blood cells. Thus, entire cells in the body do not get enough oxygen that is needed to maintain physiologic functions.

When it comes to pernicious anemia, antibodies are produced by the body that destroys cells lining the gastric walls reducing the absorption of vitamin B12 from the GI tract. It is believed to be an autoimmune process where the gastric lining keeps being attacked by the body’s immune system. The antibodies produced are often against intrinsic factor which a protein is made in the stomach that’s essential for vitamin B12 absorption (Toh, 2017). Advanced pathophysiology DB 7 Essay

Under normal circumstances, vitamin B12usually binds to the intrinsic factor which promotes absorption. Instead, when the intrinsic factor protein is attacked by the immune system, it lowers the levels of the intrinsic factor in gastric secretions.

Causes

Chronic atrophic gastritis that is autoimmune mediated can cause pernicious anemia leading to the deficiency of vitamin B12.  Additional common causes are post-surgical stomach removal leading to gastrointestinal conditions such as Crohn’s disease, celiac disease or vitamin B12 malabsorption (Toh, 2017).  Due to huge stores of vitamin B12 in the hepatic system, it is likely that a delay of 5-10 years may occur with regards to the deficiency onset and clinical appearance of symptoms.Advanced pathophysiology DB 7 Essay

Age As A patient Factor

Elderly populations, more so Caucasians with a European Scandinavia decent are at high risk of suffering from pernicious anemia. This is attributed to the fact that age and taking many drugs for co-morbid conditions increases the risk of atrophic gastritis (Toh, 2017).

References

Camaschella, C. (2015). Iron-deficiency anemia. New England journal of medicine, 372(19), 1832-1843.

Gupta, P. M., Perrine, C. G., Mei, Z., & Scanlon, K. S. (2016). Iron, anemia, and iron deficiency anemia among young children in the United States. Nutrients, 8(6), 330.

Toh, B. H. (2017). Pathophysiology and laboratory diagnosis of pernicious anemia. Immunologic research, 65(1), 326-330. Advanced pathophysiology DB 7 Essay