Blood and Lymph disorders Flashcards
Objectives:
Differentiate normal blood clotting processes and major clotting/platelet disorders.
List and describe major disorders of the blood
fyi
Blood clotting:
- Hemostasis
- Clot formation
- Aka platelets
- Fragments, not cells
- Stick to damaged tissue and themselves
- Form a plug
- Aspirin: reduces adhesion: increases bleeding
- Thrombocytes initiate coagulation process
thrombocytes
- Blood vessel vasoconstricts
- Thrombocytes adhere
- Blood clotting factors become activated
- Clot is formed
Hemostasis
Inhibitors are present that prevent unnecessary clotting
Fibrinolysis
- Hemophilia
- DIC- Disseminated intravascular coagulation
- Leukemia
BLOOD DISORDERS
- A clotting disorder
- Hemostasis takes place, but the fibrin mesh does not form.
- Prolonged, severe hemorrhage may occur following minor tissue trauma
-X-linked recessive disorder
Hemophilia
describe the difference of Hemophilia A, B, and C
A = Classic hemophilia – 90%
B = very similar to classic hemophilia
C = a milder form of hemophilia
Signs and symptoms of Hemophilia
- Spontaneous hemorrhage into joints can occur
- Painful crippling deformities
- Blood in urine or in feces
tx for what
Replacement therapy for blood clotting factors (blood products)
Not without complication
Contagious disease (from contaminated blood products)
Immune reactions to blood products
Hemophilia Treatment
- Aka Christmas disease
- Similar to hemophilia A
Hemophilia B
- AKA Rosenthal’s hemophilia
- Milder form
Hemophilia C
- Very often life threatening
- Involves excessive bleeding and excessive clotting
- Often leads to multiple organ failure and death
Disseminated Intravascular Coagulation (DIC)
Many disorders can initiate DIC
- Obstetric complication
- Infection
- Carcinomas
- Major trauma
Disseminated Intravascular Coagulation (DIC)
s/s
-Dependent on whether hemorrhage or thrombosis is dominant
-Often:
*Hypotension
*Mucosal bleeding
*Hematuria
*Infarcts
*Respiratory impairment
*Seizures, decreased responsiveness
*Renal failure
*Ecchymoses, petechiae
Disseminated Intravascular Coagulation (DIC)
tx for
- Underlying cause must be treated
- Fine balance to treat both thromboses and hemorrhages
- Prognosis often poor, but depends on severity of underlying problem.
DIC treatment
dark bruises
ecchymosis
- A group of neoplastic disorders involving the white blood cells
- 30,000 new cases each year
- Overall survival rate – 45%
Leukemia
pathophysiology
- Immature, nonfunctional leukocytes multiply uncontrollably in the bone marrow
- Large quantities of these leukocytes are released into general circulation
Leukemia
Leukemia categorization
Acute and Chronic types
Several subdivisions according to the type of cell that is malignant
6 of them
- Acute lymphocytic leukemia (ALL)
- Acute myelocytic leukemia (AML)
- Chronic lymphocytic leukemia
- Chronic myelogenous leukemia (CML)
- Acute monocytic leukemia
- Hairy cell leukemia
etiology of?
- Associations between leukemia and chromosomal abnormalities
- Exposure to radiation, chemicals, and certain viruses
- Chronic leukemias more often seen in older people, acute more often seen in children and young adults
Leukemia
Most common childhood cancer
Ages 2-5
80% of childhood
all leukemia
More common in adults
Radiation, benzene, viruses, chemo
AML
s/s of?
Multiple infections - due to nonfunctional WBCs
Hemorrhage – due to thrombocytopenia
Anemia – due to dropping of RBC counts
Severe bone pain
Weight loss, fatigue
Fever
Enlarged lymph nodes, liver, and spleen
CNS symptoms: headache, visual disturbance, drowsiness, vomiting
Leukemia
tx for
- Chemotherapy
- Bone marrow transplants – if chemotherapy is ineffective
Leukemia
- Lymphoma
- Multiple Myeloma
- Lymphedema
Lymphatic Disorders
Lymphoma
-Onset primarily in adults ages 20 to 40 and men over 50.
-Initially involves a single lymph node
-Cancer spreads to adjacent lymph nodes, and then to organs
-One type of atypical cell is used to diagnose this disorder
**Reed- Sternberg cell
Hodgkin’s Lymphoma
Prognosis of ???
If caught in early stages is good
If localized can be considered cured
Hodgkin’s Lymphoma
s/s of???
- Large, painless lymph node
- Enlarged lymph nodes, splenomegaly
- Weight loss, anemia, fever, fatigue
- Pruritus
- Recurrent infection – abnormal lymphocytes interfere with immune response
Hodgkin’s Lymphoma
Staging of ???
Stage I: single lymph node or region
Stage II: 2 or more LN regions same side of diaphragm
Stage III: nodes both sides of diaphragm and spleen
Stage IV: diffuse, extralymphatic involvement
Hodgkin’s Lymphoma
- Increasing in numbers
- Often associated with HIV
- Usually involve B-lymphocytes
- Initial manifestation: enlarged, painless lymph node
- Cancer spreads through lymph nodes scattered throughout the body
- Even in early stages, many lymph nodes and organs are often involved
Non-Hodgkin’s Lymphomas
tx of??
- Radiation, chemotherapy, surgery
- Difficult to treat because of widespread nature of this cancer, but prognosis is improving with new drugs
Non-Hodgkin’s Lymphomas
- 10,000 people die every year
- Less than 3% of people are diagnosed before age 40
- More common in men and african americans
know it causes fractures as per DrC
Multiple Myeloma
- Neoplastic disease which occurs in older adults
- Unknown etiology (idiopathic)
- Increased number of mature B lymphocytes known as plasma cells
- Proliferation of plasma cells replaces bone marrow, erodes bone
- Blood cell production, immune response impaired
Multiple Myeloma
Progression of ???
- Multiple spontaneous fractures at weakened sites in the bone
- Hypercalcemia due to bone breakdown
- Multiple tumors: vertebrae, ribs, pelvis, , skull
Multiple Myeloma
s/s of what?
- Insidious onset
- Frequent infections
- Bone pain, present at rest
- Pathologic fractures
- Anemia, bleeding
- Impaired kidney function
Multiple myeloma
tx of
- Chemotherapy
- Analgesics for bone pain
- Blood transfusions
- Median survival – three years
Multiple myeloma
An abnormal condition of lymph accumulation in the extremities due to a blockage of the lymphatic system
Lymphedema
these are causes of what?
Congenital -
Parasites – worms block vessels
Cancer – tumors or proliferating cells block lymphatic vessels
Lmyphangitis – inflammation of the lymphatic vessels caused by bacteria
lymphedema
- tropical worm infection called filariasis
- Worm larvae work way into lymph and develop into worms
- Worms block lymphatic vessels
- Worms can be 4-10cm long
Elephantiasis
Treatment of ??
- spraying to kill mosquitoes
- giving antibiotics to prevent infection, kill microfilariae circulating in the blood
- applying pressure bandages to reduce swelling
- surgically removing infected tissue
Elephantiasis
- Usually caused by a skin infection
- Most often acute streptococcal infection
- Less often staphylococcal infection
Lymphangitis
- Red streaks from infected area to the armpit or groin (may be faint or obvious)
- Enlarged lymph nodes (glands) above the area of red streaks – usually in the elbow, armpit, or groin
- Throbbing pain along the affected area
- Fever of 100 to 104 degrees Fahrenheit
- Chills
- General ill feeling (malaise)
- Headache
- Loss of appetite
- Muscle aches
Can be spread quickly, within hours
Lymphangitis
Treatment of ??
- Antibiotics
- Analgesics
- Warm compresses
- Anti-inflammatory medications to decrease inflammation and pain
- Sometimes may have to perform surgery to drain abscesses
Lymphangitis
- Child is born with too few lymphatic vessels
- Usually affects legs
- More often seen in women
- Can be mild or severe
- Various levels of compression bandages
Congenital lymphedema
PT for?
- Fitting of garments
- Manual lymph drainage
Lymphedema
