Anemia, HIV, and DIC Flashcards
Anemia is defined as a reduction in _____, _____, or _____ that leads to decreased oxygenation
RBCs, Hgb, or HCT
Iron deficiency anemia:
-type
-causes
-specific S/S (incl. labs)
-treatment
-microcytic
-malnutrition, malabsorption, chronic blood loss
-s/s: glossitis, low ferritin
-Rx: oral or IV iron, dietary changes
A patient is starting a course of oral iron supplements. What education will you give them?
-if liquid, use a straw
-take w vitamin C and food
-take at night to avoid nausea
Poop stuff:
-take stool softener to avoid constipation
-melena (dark, tarry stool) is common side effect
Thalassemic anemia:
-type
-cause
-specific S/S (incl. labs)
-treatment
-microcytic
-low production of a or b protein used for Hgb, also aggregation of non-missing protein –> hemolysis
-S/S: high bilirubin/jaundice, high reticulocytes
-Rx: folic acid, blood infusions, splenectomy, genetic counseling, stem cell transplant
Aplastic anemia
-type
-causes
-specific S/S (incl. labs)
-treatment
-normocytic
-disease/medication –> bone marrow malfunction
-S/S: low reticulocytes, platelets, RBCs, WBCs
-Rx: d/c med/cause, blood and iron infusion, CONSIDER INFECTION RISK w/ low WBCs
Tests for occult stool bleeding: when would this occur, & considerations
-if trying to determine chronic blood loss
-good negative predictive ability, poor positive (could be many reasons for trace blood in stool)
Blood loss anemia
-type
-causes
-treatment
-normocytic
-trauma, chronic bleeding
-Rx: treat cause, fluid, RBCs + blood
Hemolytic anemia:
-type
-causes
-specific S/S
-treatment
-normocytic
-autoimmune/medication reaction –> hemolysis
-S/S: elevated bilirubin/jaundice, elevated iron (d/t hemolysis)
-Rx: treat cause, steroids, protect renal system!
Megaloblastic anemia:
-type
-causes
-treatment
-macrocytic
-b12 (cobalamin), folate deficiency (alcoholism) –> huge, weak RBCs
-Rx: supplement B12/folate
Polycythemia vera:
-causes
-specific S/S
-labs
-treatment
-cancer –> increased bone marrow cell production –> DVTs, organ enlargement…
-S/S: headache, tinnitus, pruritis, paresthesia, erythromelalgia (red/burning peripheries), bleeding.
-labs: High uric acid, RBCs/WBCs, histamines, thrombocytosis
-Rx: hydration, myelosuppressive drugs
Nutrition for anemia
-PROTEIN!
-folate, B12, B5, niacin
-iron, copper
Labs that indicate DIC
-LOW platelets, like 2k-3k (normal 150k-400k)
-LOW Hgb
-bilirubin d/t hemolysis
-high reticulocytes
-high lactate (d/t hypoperfusion)
-high schistocytes
-prolonged PT, aPTT
What condition is characterized by low platelets and prolonged PT/aPTT?
DIC
If DIC is suspected, first interventions:
-respiratory stabilization (O2/intubate)
-control bleeding–heparin/transfusions
-VERY GENTLE CARES
-assess for internal bleeding/clotting (bloating, urinary output, hematoma)
Chronic DIC does not respond to:
Acute DIC does not respond to:
-oral anticoagulants
-any oral medication
Describe the CDC AIDs diagnosis protocol
One or more of:
-CD4T count < 200
-opportunistic infection present
-wasting/cachexia (loss of >10% BW)
HIV/AIDs: name the four most common opportunistic infections
-Kaposi Sarcoma (dark spots)
-PCP (pneumonia)
-Cytomegalovirus
-Thrush (yeast infection)
PEP should be taken…
72 hours - 28 days post exposure to HIV
Taking ART for HIV during pregnancy reduces transmission rate from ___% to ___%.
from 25% to 1%
A parent with HIV took ART throughout their pregnancy has just given birth. What information might you tell them to reduce further transmission risk?
Opt for formula over breastfeeding
What distinguishes acute HIV from chronic HIV?
Acute (2-12 wks): flu-like symptoms, slight CD4T count drop then normalization, high HIV viral load
Chronic 2-10 years): asymptomatic/general weakness, drop in CD4T and slow increase in viral load, increased risk of opportunistic infection
Acute HIV infection can carry a risk of __________ complications
neurologic: palsy, Gullain-Barre syndrome, meningitis
