Group project for Pathophysiology class on Anemia. This presentation was a collaboration of Umbreen Bajwa, Jasmine Diaz, Vaittiare Ramirez , Lizth Romero, and Gerrie Rosario

1. Anemia
Pathophysiology Disease Project
Keiser University - Professor Martynyak
Jasmine Diaz, Lizth Romero, Vaittiare Ramirez, Umbreen Bajwa, Gerrie Rosario

2. Sickle Cell anemia
OVERVIEW, ETIOLOGY, PATHOPHYSIOLOGY
● An inherited disorder in which an abnormal hemoglobin [HbS] leads to
chronic hemolytic anemia, pain and organ failure
● Demographics: sub-Saharan Africa, India, Saudi Arabia & Mediterranean
● Sickle cell-trait VS. Sickle cell disease
● Major consequences: Chronic hemolytic anemia (8g/dL) & Blood vessel
occlusion
SIGNS & SYMPTOMS
● Severe hemolytic anemia
● Chronic hyperbilirubinemia (jaundice)
● Vaso-occlusive crises
● Frequent infection
● Delayed growth and puberty
● Vision problem
●

3. (cont’d.)
DIAGNOSTICS
● Hemoglobin electrophoresis - blood screening done to neonates;
confirms the presence or absence of abnormal hemoglobin
TREATMENTS
● Treatment strategies focus on prevention of sickling episode,
symptom management, and treatment of complications
○ Pain management: NSAIDs, opiates
○ Hydroxyurea
○ Preventing infection: penicillin, erythromycin, immunizations
○ Drug to inhibit hemolysis: Oxbryta®; voxelotor
○ Drug to inhibit sickling: Adakveo®; crizanlizumab
○ Blood transfusion and RBC exchange (crisis situation)
○ Gene therapy
○ Bone marrow or stem cell transplantation*

4. (CONT’D.)
PROGNOSIS
● No known cure; bone marrow or stem cell transplantation
● People with sickle cell anemia live long and productive lives
● Some can remain without symptoms for years
● Some have a reduced life expectancy
PREVENTION & EDUCATION
● Educate couples who are at risk of having affected children
(hemoglobin electrophoresis)
● Educate patient about preventing infections
● Prevent sickling and sickle cell crisis
● Get regular check-ups
● Seek emergency medical care

5. B12 (PERNICIOUS) Anemia
ETIOLOGY
● B12 deficiency can be caused by a lack of B12 in the diet or
malabsorption
○ Dietary deficiency of B12 develops slowly and is usually
seen in strict vegetarians who avoid all dairy products
as well as fish and meat.
○ Malabsorption of B12 can either be due to an antibody
formation toward intrinsic factor or parietal cells
both leading to the inability to absorb B12
Signs and symptoms
● Weak muscles.
● Numb or tingling feeling in hands and feet.
● Nausea.
● Decreased appetite.
● Weight loss
● Irritability.

6. B12 Diagnostic and treatments
Diagnostics
● B12 levels in serum (normal 190-950 pg/mL) <100 pg/mL
severely deficient
● Folate levels in serum (normal 2.7-17.0 ng/mL) >20 ng/mL
● Methylmalonic acid (normal 0.00-0.40 umol/mL) >0.40 umol/mL
● Homocysteine levels (normal 5-15 mmol/L) >50 mmol/L
● Detection of intrinsic factor and parietal cell antibodies
Treatment
● Lifelong treatment is required
○ B12 intramuscular injections, intranasal sprays, or high
oral doses of vitamin B12

7. B12 prognosis and education
Prognosis
● Most people live without any complications by receiving regular treatment
● For those who don't receive treatment within 6 months of onset of symptoms, they can suffer permanent
neurological complications
Education
● Educate about foods that contain vitamin B12
● Educate about regular blood work checkups to check for B12 deficiencies
● Educate about vitamins that contain vitamin B12

8. Aplastic Anemia
Etiology & Pathogenesis
- Exposure to high doses of radiation, chemicals, and toxins that
suppress hematopoiesis directly or through immune system
mechanisms.
● Examples: Chemotherapy and irradiation
- It has been reported most often as a complication of viral
hepatitis, mononucleosis, and other viral illnesses, including acquired
immunodeficiency syndrome.
Clinical Manifestations
- Insidious or sudden.
-can occur at any age
-weakness, fatigue, pallor
-petechiae (small skin hemorrhages) or ecchymosis (bruises)
-bleeding from nose, gums, vagina, or GI tract
-Susceptible to infection
What is aplastic anemia?
- Aplastic anemia describes a disorder of the bone marrow stem cells
that results in a reduction of RBCs, WBCs, and platelets.

9. APLASTIC ANEMIA
Diagnosis
● If the CBC test shows pancytopenia (low RBC, WBC, Platelet)
● Patient’s medical history (history of drugs or virus)
Treatment
● Discontinuing any drugs or chemicals
● Hematopoietic stem cell replacement or immunosuppressive therapy
Nursing Education
● Seek care immediately if you are short of breath, have trouble
thinking clearly, have fever and a stiff neck. If you have sores or
redness on your skin, blood in your urine, pain when you’re
urinating. Medicines may be given to manage your anemia, however,
do not take any medicine that contains ibuprofen or aspirin. Both
of these are anticoagulants and can increase your risk of bleeding.
Avoid people who are sick and wash your hands thoroughly &
often.

10. IRON DEFICIENCY ANEMIA
DEFINITION :
Diminished red blood cell production due to low iron stores
In the body.
ETIOLOGY :
● Decrease dietary intake of iron
● Decrease iron absorption .e.g., celiac disease, intestinal
Disorders, foods that decrease iron absorption
● Increase loss of iron (chronic blood loss .e.g., menstrual
bleeding, peptic ulcer, excessive use of NSAIDs,
Intestinal polyps, hemorrhoids, carcinomas
● Increase demand of iron .e.g., pregnancy, lactation,
Infancy and adolescence

11. IRON DEFICIENCY ANEMIA
SIGNS AND SYMPTOMS
● Fatigability, dyspnea
● Palpitations, tachycardia
● PICA - cravings for clay, ice
● Koilonychia - spoon-shaped nails
● Smooth tongue
● Angular cheilitis - cracks in the corners
Of mouth

12. IRON DEFICIENCY ANEMIA
DIAGNOSTICS
● CBC - Decrease Hb and hematocrit
● Red blood cell indices
Decrease MCV, MCH and MCHC
● Decreased serum iron
● Decreased serum ferritin
● Increased TIBC
● Peripheral film - microcytic and hypochromic
RBCs, poikilocytosis (irregular shape) and
anisocytosis (irregular size)

13. IRON DEFICIENCY ANEMIA
TREATMENT
● Identify the cause and increase dietary intake
● Oral iron supplements
● Blood transfusion if Hb is less than 6mg/dl
PROGNOSIS - It is a treatment disorder with excellent
outcome if underlying cause is identified
EDUCATION - Explain patient about signs and symptoms,
dietary sources of iron, foods that can decrease or
increase the absorptions of iron, oral supplements in
addition to modified diet, regular follow up visits.

14. REFERENCE
Centers for Disease Control and Prevention. (2020, December 16). Living well with sickle cell disease. Centers for Disease Control and Prevention. Retrieved October 31, 2021,
from https://www.cdc.gov/ncbddd/sicklecell/healthyliving-living-well.html.
Fisher, K. A. (2019, October 2). Patient education. Johns Hopkins Medicine, based in Baltimore, Maryland. Retrieved October 31, 2021, from
https://www.hopkinsmedicine.org/Medicine/sickle/patient/.
Mayo Foundation for Medical Education and Research. (2021, July 17). Sickle cell anemia. Mayo Clinic. Retrieved October 31, 2021, from
https://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/symptoms-causes/syc-20355876.
Norris, T. L. (2020). Disorder of Red Blood Cells. In Porth's Essentials of Pathophysiology (5th ed., pp. 561–585). essay, Wolters Kluwer.
Sickle cell disease. Cleveland Clinic. (2020, February 25). Retrieved October 31, 2021, from
https://my.clevelandclinic.org/health/diseases/12100-sickle-cell-disease#outlook--prognosis.
Winter, W. P. (n.d.). A brief history of sickle cell disease: Sickle cell center: Howard university. Howard University Health Care. Retrieved October 31, 2021, from
http://huhealthcare.com/healthcare/hospital/specialty-services/sickle-cell-disease-center/disease-information/breif-history.
Norris, T. E. (2020). Porth's Essentials of Pathophysiology (5th ed.). Wolters Kluwer.