Question

CASE STUDY:

A 42-year-old premenopausal woman has emphysema. This lung disease impairs the ability to oxygenate the blood, so patients experience significant fatigue and tiredness. To alleviate these symptoms, oxygen is typically prescribed, and this patient has a portable oxygen tank she carries with her at all times, breathing through nasal cannula. Before she began using oxygen, a complete blood count showed her red blood cell (RBC) count to be 5.8 × 1012/L. After she has received oxygen for several months, her RBC count is 5.0 × 1012/L.

1.   What explains the elevation of the first RBC count?
2.   What hormone is responsible? How is its production stimulated? What is the major way in which it acts?
3.   What explains the decline in RBC count with oxygen therapy for this patient?

Answer 1

A 42 tear old premenopàusal woman has emphysema.

She is facing fatigue and tieredness due to impaired oxygenation.

She was put on Oxygen theraphy via nasal cannula(portable oxygen cylinder which she carries wherever she goes.)

Before she was put on Oxygen theraphy her baseline RBC count was 5.8×1012/L

After she received oxygen theraphy for months her RBC count was 5 .1012/L

1)The reason for elevation of RBC count before :

The 42 year old pre menopausal women has emphysema.

Emphysema is a type of chronic obstructive pulmonary disaese which is characterized by enlargement of air spaces distal to the terminal bronchioles,with destruction of their walls of alveoli.

Due to destruction of alveoli,oxygenation of blood is impaired.The body tries to componset this by increasing red blood cell production.This componsetory mechanism usualy happens in COPD,heart diseases,Herat failure,hight altitude,pulmonary fibrosis.In above all conditions hypoxemia occurs,which stimulate the kidney to release more amount of Erythropoietin,hence the production of Red blood cell increases.

2) Erythropoietin is the Harmon which s responsible for increased production of RBC.

With presence of a chronic lung diseases like emphysema it cuases tissue hypoxia,which inturn stimulates kidney to produce more erythropoietin harmone.This erythropoietin it stimulates bone marrow to produce more number of RBC through a process called erythropoiesis.

With the increase in RBC production ,tissue oxygenation improves.

3)Decline in RBC count with oxygen theraphy.

By using oxygen theraphy,the oxygen level in blood improves.With increased amount of oxygen in blood the stimulation from kidney to produce erythropoietin

declines, erythropoiesis slows own,which results in decline in RBC count.