120. Anemia: definition, classification, types, causes, pathological anatomy, outcomes, complications.

1) Anemia (anemia) is a condition characterized by a decrease in the number of red blood cells or hemoglobin content, or both in a unit of blood volume.

Etiology and pathogenesis of anemia:

a) blood loss if the loss of red blood cells exceeds the regenerative capabilities of the red bone marrow

b) endogenous and exogenous factors leading to hemolysis

c) deficiency of substances necessary for hematopoiesis (B12, folic acid, iron), their indigestion by the bone marrow, anemia due to insufficient erythropoietic function of the bone marrow

2) Classification:

1. Depending on the morphology of red blood cells:

macrocytic

microcytic

normacitarian

2. Depending on the value of the color indicator:

hyperchromic

hypochromic

normochromic

3. Downstream:

sharp

chronic

4. On etiology and pathogenesis:

a) Due to blood loss (posthemorrhagic). Cause: injury, vascular erosion by tumor, necrosis, inflammation.

b) Due to increased hemorrhage (hemolysis):

1) endogenous origin – intracellular abnormalities of erythrocytes – hereditary and acquired (hereditary erythropathies, enzymopathies, hemoglobinopathies)

2) exogenous origin

c) Due to impaired hematopoiesis

1) disorders of stem cell proliferation and differentiation (hypo- and aplastic) (exposure to radiation, drugs, hereditary anemia of Fanconi and Ehrlich, in patients with CRF with a lack of erythropoietin)

2) violations of the processes of proliferation and maturation of erythroblasts (megaloblastic anemia of Addison-Biermer, deficiency of heme synthesis, globin)

3) General morphological characteristics of anemia:

red bone marrow hyperplasia, yellow metaplasia

the appearance of foci of extramedullary hematopoiesis in the liver, spleen, L.U., etc. organs

hemorrhagic diathesis

fatty degeneration of parenchymal organs (a sign of hypoxia)

jaundice

Pathological anatomy: the skin and internal organs are pale. Bone moss of the usual type, the phenomena of regeneration and transformation of fatty CM into red, expressed to one degree or another, are observed, multiple foci of extracostomosebral hematopoiesis are noted. Due to chronic blood loss, hypoxia of organs and tissues occurs, which causes the development of fatty degeneration of the myocardium, liver, kidneys, and dystrophic changes in brain cells. Multiple spot hemorrhages appear in the serous and mucous membranes, in the internal organs

121. Posthemorrhagic anemia: definition, causes, pathological anatomy, outcomes, causes of death.

Causes of acute posthemorrhagic anemia: massive bleeding (with rupture of the fallopian tube, gastric ulcer, branches of the pulmonary artery, aortic aneurysm).

Damage to the aorta  loss of 1 liter of blood  death due to a sharp drop in blood pressure and a shortage of filling of the heart cavities.

Damage to smaller vessels  loss of more than half of blood  death from acute heart failure with severe anemia of internal organs.

Pathomophology of acute posthemorrhagic anemia:

pallor of the skin and internal organs (acute anemia)

pale red bone marrow of flat bones

Causes of death: due to severe blood loss and the development of hypoxia

Causes of chronic posthemorrhagic anemia: prolonged blood loss in

tumors, dilated hemorrhoidal veins

bleeding from the uterine cavity, stomach ulcers

hemophilia, severe hemorrhagic syndrome

Pathomorphology of chronic posthemorrhagic anemia:

pallor of the skin, anemia of internal organs

fatty degeneration of the myocardium, liver

severe hemorrhagic syndrome (multiple spot hemorrhages in serous and mucous membranes, in internal organs)

the bone marrow of flat and tubular bones is bright red

foci of extramedullary hematopoiesis