Anaemia And Drug Treatment Flashcards by Iseoluwa Ojo

Key components of hematologic system are:
•Blood
•Blood forming tissues
__________
_______
______ system

Bone marrow

Spleen

Lymph

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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

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Erythrocytes/Red Blood Cells

•Composed of _________

•Erythropoiesis
 Stimulated by______
 Controlled by _______
Hormone synthesized in ______

hemoglobin

hypoxia; erythropoietin

kidney

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Erythrocytes/Red Blood Cells

Hemolysis

Releases _______ into blood stream

Normal lifespan of RBC = ________

bilirubin

120 days

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White blood cells

___ types

List them

5 types
Basophils Eosinophils Neutrophils Monocytes Lymphocytes

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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

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Types and Functions of Leukocytes

Agranulocytes

Lymphocyte : ______,_______ immune response

Monocyte: __________, _______ immune response

Cellular, humoral immune response

Phagocytosis; cellular immune response

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Thrombocytes/Platelets
Must be present for ______ to occur

Involved in ________

clotting

hemostasis

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Normal Clotting Mechanisms: Hemostasis

Goal: ________________ when injured

Minimizing blood loss

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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

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Liver

Receives ____% of the cardiac output (_____ ml of blood each minute)

1500

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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

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Spleen
Located in _________ of abdomen

upper L quadrant

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Spleen

Functions
Hematopoietic function
 Produces ______

Filter function
 ______ and ______ certain cells

fetal RBCs

Filter and reuse

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Spleen

Functions

Immune function
________,________

Storage function
____% platelets stored in spleen

Lymphocytes, monocytes

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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

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Hematocrit (Hct)
The hematocrit is the percent of ______ that is composed of _______.

whole blood

red blood cells

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The hematocrit is a measure of both the ______________ and ____________

number of red blood cells and the size of red blood cells.

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Diagnostic Studies of the Hematologic System: Complete Blood Count (CBC)

Platelet count
Normal = ________ -________

150,000- 400,000

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Spontaneous hemorrhage likely when count is below ______

20,000

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Pancytopenia
 ______ease in number of _______________________________________

Decr

RBCs, WBCs, and platelets

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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