Guided Lecture Notes
Chapter 11: The Red Blood Cell and Alterations in Oxygen Transport
Learning Objective 1. Trace the development of a red blood cell from erythroblast to
erythrocyte.

Explain the process of erythropoiesis, and explain where it occurs (refer to
PowerPoint Slide 5 and Fig. 11-4).

Describe how long it takes to make an RBC (refer to PowerPoint Slide 6).
Learning Objective 2. Discuss the function of iron in the formation of hemoglobin.

Describe the iron cycle (refer to Fig. 11-3).

Explain how iron deficiencies affect the production of hemoglobin.
Learning Objective 3. Describe the formation, transport, and elimination of bilirubin
(refer to PowerPoint Slides 8–9).

Define bilirubin, and describe how it is formed when RBCs are destroyed in the
spleen (refer to Fig. 11-5).

Explain how bilirubin is normally eliminated from the body (refer to Fig. 11-5).

Discuss disorders associated with hyperbilirubinemia.
Learning Objective 4. Explain the function of the enzyme glucose-6-phosphate
dehydrogenase (G6PD) in the red blood cell (refer to PowerPoint Slide 21).

Discuss the importance of glycogen breakdown as the only energy source for the
RBC.

Identify populations likely to have G6PD deficiency.

Explain the clinical manifestations of G6PD deficiency.
Learning Objective 5. State the meanings of the red blood cell count, percentage of
reticulocytes, hemoglobin, hematocrit, mean corpuscular volume, and mean corpuscular
hemoglobin concentration as they relate to the diagnosis of anemia.

Define anemia.

Describe standard lab values for RBCs as well as typical lab results present in
anemia, including RBC, Hb, Hct%, and MCV (refer to Table 11-1 and Fig. 11-6).
Learning Objective 6. Describe the manifestations of anemia and their mechanisms.

List the causes of anemia (refer to PowerPoint Slide 13).

Describe the clinical presentation of a patient suffering from anemia, and link
each sign/symptom to one of the causes of anemia.
Learning Objective 7. Define and compare the hemoglobinopathies associated with
sickle cell disease and thalassemia (refer to PowerPoint Slide 21).

Describe the pathophysiology of sickle cell disease and thalassemia.

Explain the differences in pathology between sickle cell disease and thalassemia
(refer to PowerPoint Slides 22 and 28).
Learning Objective 8. Explain the cause of sickling in sickle cell disease.

Explain the mechanism of sickling (refer to PowerPoint Slide 22), and describe
its consequences (refer to PowerPoint Slide 23 and Fig. 11-8).

Identify factors that may lead to increased sickling.
Learning Objective 9. Cite common causes of iron deficiency in infancy, adolescence,
and adulthood (refer to PowerPoint Slide 16).

List the most common causes of iron-deficiency anemia in infants, growing teens,
and adults (refer to Fig. 11-7 A).

Discuss treatment options for anemia in the various age groups.

Discuss ways to prevent iron deficiencies in each age group.
Learning Objective 10. Describe the relationship between vitamin B12 deficiency and
megaloblastic anemia (refer to PowerPoint Slide 17 and Fig. 11-7 B).

Explain the role of vitamin B12 in maintaining normal hemoglobin levels (refer to
Fig. 11-9).

Explain how pernicious anemia leads to vitamin B12 deficiency.

Describe the treatment for pernicious anemia.
Learning Objective 11. List three causes of aplastic anemia.

Identify the three hematopoietic cell lines that are replaced with fat in aplastic
anemia.

Describe the causes of and treatments for aplastic anemia.
Learning Objective 12. List chronic diseases and conditions that are commonly
associated with anemia.

Identify chronic diseases that often result in anemia (refer to PowerPoint Slide
15).

Explain how these chronic diseases lead to anemia.

Discuss treatment options for anemia that results from chronic disease.
Learning Objective 13. Cite the function of hemoglobin F in the neonate, and describe
the red blood cell changes that occur during the early neonatal period.

Describe what makes HbF unique, and explain why it is useful in utero (refer to
PowerPoint Slide 27).

Discuss the changes that occur as HbF is converted to HbA.
Learning Objective 14. Discuss hyperbilirubinemia in the neonate in regard to
pathogenesis, manifestations, and treatment.

Define hyperbilirubinemia, and list the most common causes.

Describe the signs and symptoms of hyperbilirubinemia, and discuss its treatment.
Learning Objective 15. Describe the pathogenesis of hemolytic disease in the newborn.

Explain the process by which erythroblastosis fetalis occurs in Rh-positive infants
with Rh-negative mothers.

Discuss methods to decrease the incidence of erythroblastosis fetalis.