Anaemia And Drug Treatment Flashcards
Key components of hematologic system are:
•Blood
•Blood forming tissues
__________
_______
______ system
Bone marrow
Spleen
Lymph
The main components of the haemopoietic system are the
_______
________
_________ and _______
______,_______, and _______ are important accessory organs.
blood,
bone marrow,
lymph nodes and thymus
spleen, liver and kidneys
Erythrocytes/Red Blood Cells
•Composed of _________
•Erythropoiesis
Stimulated by______
Controlled by _______
Hormone synthesized in ______
hemoglobin
hypoxia; erythropoietin
kidney
Erythrocytes/Red Blood Cells
Hemolysis
Releases _______ into blood stream
Normal lifespan of RBC = ________
bilirubin
120 days
White blood cells
___ types
List them
5 types
Basophils Eosinophils Neutrophils Monocytes Lymphocytes
Types and Functions of Leukocytes
Granulocytes
Neutrophil : _______, _____ phase of ______
Eosinophil : ________, _______ infections
Basophil: _________ response , _____ response
Phagocytosis, early phase of inflammation
Phagocytosis, parasitic infections
Inflammatory response, allergic response
Types and Functions of Leukocytes
Agranulocytes
Lymphocyte : ______,_______ immune response
Monocyte: __________, _______ immune response
Cellular, humoral immune response
Phagocytosis; cellular immune response
Thrombocytes/Platelets
Must be present for ______ to occur
Involved in ________
clotting
hemostasis
Normal Clotting Mechanisms: Hemostasis
Goal: ________________ when injured
Minimizing blood loss
Normal Clotting Mechanisms: Hemostasis
Vascular Response
______________
Platelet response
Activated during injury to Form ______ (________)
Plasma Clotting Factors
Factors I – XIII
__________
__________
vasoconstriction
clumps; agglutination
Intrinsic pathway
Extrinsic pathway
Liver
Receives ____% of the cardiac output (_____ ml of blood each minute)
24
1500
Liver
Liver has many functions Hematologic functions:
Liver synthesizes plasma proteins including _______ and ______
Liver clears _______ and _________ from circulation
clotting factors and albumin
damaged and non- functioning RBCs/erythrocytes
Spleen
Located in _________ of abdomen
upper L quadrant
Spleen
Functions
Hematopoietic function
Produces ______
Filter function
______ and ______ certain cells
fetal RBCs
Filter and reuse
Spleen
Functions
Immune function
________,________
Storage function
____% platelets stored in spleen
Lymphocytes, monocytes
30
Diagnostic Studies of the Hematologic System: Complete Blood Count (CBC)
WBCs
Normal = ______-______ μ/l
RBC
♂ ____-_____ x 106/l
♀ _____-_____ x 106/l
4,000 -11,000
4.5 – 5.5
4.0 – 5.0
Hematocrit (Hct)
The hematocrit is the percent of ______ that is composed of _______.
whole blood
red blood cells
The hematocrit is a measure of both the ______________ and ____________
number of red blood cells and the size of red blood cells.
Diagnostic Studies of the Hematologic System: Complete Blood Count (CBC)
Platelet count
Normal = ________ -________
150,000- 400,000
Spontaneous hemorrhage likely when count is below ______
20,000
Pancytopenia
______ease in number of _______________________________________
Decr
RBCs, WBCs, and platelets
Anemia is a reduction in _____________,___________ or __________
the number of RBCs, the concentration of hemoglobin, or the volume of RBCs
Because the main function of RBCs is __________, anemia results in varying degrees of ______
oxygenation
hypoxia
Anemia: Prevalent conditions
___________
________ ————- of erythrocytes
________ ————- of erythrocytes
Blood loss
Decreased production
Increased destruction
Anemia
Clinical Manifestations:
1._____.
2. ______,_______
3._______.
4. Palpitations, _____cardia.
5. Headache, dizziness, and restlessness. 6. ______ of thought.
7. ________.
8. _____________ (chronic)
Pallor
Fatigue, weakness.
Dyspnea
Tachy
Slowing
Paresthesia
Asymptomatic
Different types of anaemia
hypochromic, microcytic anaemia (____ sized red cells with ____ haemoglobin; caused by __________)
macrocytic anaemia (____ sized red cells,____ in number)
normochromic normocytic anaemia (_____ in number , ______-sized red cells, each with a _______ haemoglobin content)
mixed pictures.
small; low; iron deficiency
large; few
fewer; normal; normal
Anemia Caused by Decreased Erythrocyte Production
_____ Deficiency Anemia
_________ Anemia
___________
Iron
Megaloblastic
Thalassemia
More precise diagnostic groupings of anaemias
deficiency of nutrients necessary for haemopoiesis, most importantly:
_______
___________ and ___________
______,__________
iron
folic acid and vitamin B12
pyridoxine, vitamin C.
Important to note
Use of haematinic agents is often only __________ to treatment of the underlying cause of the anaemia
________ for colon cancer
_____________ for hookworm
Withdrawing NSAIDs is used to reduce GI _________
an adjunct
Surgery
Antihelminthics
blood loss
Iron-Deficiency Anemia
Etiology
•Inadequate dietary intake
Found in _____% of the world’s population
•Malabsorption
Absorbed in ______
GI surgery
•Blood loss
___ mls blood contain __ mg iron
GI losses
•__________
30
duodenum
2; 1
Hemolysis
Iron-Deficiency Anemia: Clinical Manifestations
Most common: _______
Second most common: __________ of _____________(________)
___________
Sensitivity to _____
Weakness and fatigue
pallor
inflammation of the tongue (glossitis)
Cheilitis; cold
Cheilitis= ________/________ of _____
inflammation/fissures of lips
Diagnostic Studies
CBC
Iron studies Diagnostics:
Iron levels: ___________ (TIBC), Serum ________.
Total iron-binding capacity
Ferritin
Iron-Deficiency Anemia
Collaborative Care
Treatment of __________/problem
__________
Diet
_______
underlying disease
Replacing iron
Drug Therapy
Iron-Deficiency Anemia
Drug Therapy
•Iron replacement
-Oral iron
_____ ,________ etc
Absorbed best in ______ environment
•Parenteral iron
IM or IV
(More or Less?) desirable than PO
Fesulf, Fergon; acidic
Less
Drug Interactions with Fe
Antacids
Colestyramine
Neomycin
Quinolones
Tetracyclines
Levodopa
carbidopa
levothyroxine
Moveeeeeee
Megaloblastic Anemias
Characterized by (small or large ?) RBCs which are _____ and easily _______
Large
fragile; destroyed
Common forms of megaloblastic anemia
__________ deficiency
___________ deficiency
Cobalamin
Folic acid
Cobalamin (Vitamin B12) Deficiency
Cobalamin Deficiency–formerly known as _______ anemia
pernicious
Cobalamin (Vitamin B12) Deficiency
____________ is required for cobalamin absorption
Intrinsic factor (IF)
Causes of cobalamin deficiency
Gastric mucosa ____________
GI surgery leads to _____________________
Long-term use of _______________ cause atrophy or loss of gastric mucosa.
__________ deficiency
Hereditary defects of cobalamine utilization
not secreting IF
loss of IF-secreting gastric mucosal cells
H2-histamine receptor blockers
Nutritional
Cobalamin Deficiency
Diagnostic Studies
Schilling Test: a medical investigation used for patients with vitamin B12 deficiency. The purpose of the test is to determine if _________________________
the patient has pernicious anemia.
Cobalamin Deficiency
Collaborative Care
__________ administration of cobalamin
______cobalamin does not correct the anemia
(High or Low ?) dose oral cobalamin can be used
Drug int: H2 receptor antagonists reduce its absorption
Parenteral
↑ Dietary
High
Folic Acid Deficiency
Folic Acid Deficiency also causes ________ anemia
Folic Acid required for RBC formation and maturation
megaloblastic
Folic Acid Deficiency
Causes
Poor_________
Malabsorption syndromes
Drugs that inhibit absorption
_______ abuse
Hemodialysis
dietary intake
Alcohol
Folic Acid Deficiency
Clinical manifestations are similar to those of ________ deficiency
Insidious onset: progress (slowly or rapidly?)
(Presence or Absence?) of neurologic problems
Treated by ________ therapy
Encourage patient to eat foods with large amounts of folic acid
cobalamin
Slowly ; Absence
folate replacement
Drug Interactions with Folic Acid
________ impaired (seizure control)
_______
____________,_________
MMT
Sulphasalazine
Phenytoin
Phenobarbitone
Co trimoxazole, trimethoprim
Thalassemia
Etiology
_____________________ genetic disorder of _________________ of normal hemoglobin
Found in Mediterranean ethnic groups
Autosomal recessive
inadequate production
Thalassemia
Clinical Manifestations
________ then major _______ then life threatening
________,_________
Asymptomatic
retardation
Splenomegaly, hepatomegaly
Thalassemia
Collaborative Care
________ drug or diet are effective in treating thalassemia
Thalassemia minor
____________________
Thalassemia major
___________ with ________ (used to remove excess iron from the body)
No specific
Body adapts to ↓ Hgb
Blood transfusions with IV deferoxamine
Thalassemia
Collaborative Care
No specific drug or diet are effective in treating thalassemia
Thalassemia minor
Body adapts to ↓ Hgb Thalassemia major
Blood transfusions with IV deferoxamine (used to remove excess iron from the body)
Anemia of Chronic Disease
____________ of RBCs, _________[ of RBC survival
Generally develops after ____________ of sustained disease
Underproduction
shortening
1-2 months
___________ is 2nd most common cause of anemia after _______________ anemia
Anemia of Chronic Disease
iron deficiency
Aplastic Anemia: Treatment
Blood transfusions
Antibiotics
Immunosuppressants __________
Bone marrow stimulants _________, _________
Bone marrow transplantation
Corticosteroids
Filgrastim, Epoetin alfa