ch 28 hematology and immunology

Question 1

lifecycle of RBCs

Answer 1

120 days

Question 2

function of reticulocytes

Answer 2

indicates active RBC production
reticulocyte = new immature RBC

Question 3

if you have hemolytic anemia would reticulocytes be high or low

Answer 3

high
*be concerned if its low because their anemia is more profound

Question 4

type of WBC: primary defense of bacterial infection

Answer 4

neutrophils

Question 5

cut off point for high risk of bleeding in platelet count

Answer 5

50,000

Question 6

types anemia

Answer 6

-decrease in number
-morphology (change in shape, size, color)

Question 7

S+S anemia

Answer 7

-paleness
-fatigue
-headache, dizziness
-murmur, tachycardia
-CBC: decreased RBC, Hgb and Hct, high reticulocytes

Question 8

how to prevent iron deficiency anemia in young children

Answer 8

-iron fortified cereals and formulas for infants
-don’t have excessive milk intake (prevents iron production)

Question 9

3 types anemias caused by increased destruction of RBCs

Answer 9

-hereditary spherocytosis (HS)
-sickle cell disease (*genetic)
-thalassemia

Question 10

Tx hereditary spherocytosis

Answer 10

-splenectomy
-usually not before 5 yo

Question 11

all hereditary disorders whose clinical, hematologic, and pathologic features are related to presence of HEMOGLOBIN S

Answer 11

sickle cell disease

Question 12

what type of hereditary disease is sickle cell disease

Answer 12

autosomal recessive
(1 parent carrier, 1 parent not = 25% chance)

Question 13

what disease is protected against if a pt has thalassemia and sickle cell disease

Answer 13

malaria

Question 14

test for diagnosing sickle cell disease in newborns

Answer 14

hemoglobin electrophoresis

Question 15

when do babies start showing signs of sickle cell anemia

Answer 15

6 mos (Hgb S increases)

Question 16

S+S sickled hemoglobin

Answer 16

-decreased kidney function (incontinence, hematuria)
-stroke
-priapism (painful constant erection)
-chronic ulcers
-hepatomegaly (gallstones)
-tissue death
-bone pain
-

Question 17

chronic effects sickle cell anemia

Answer 17

-cardiomegaly and murmur
-decreased lung function
-kidneys - inability to concentrate urine
-decreased blood flow all organs

Question 18

S+S vasoocclusive crises

Answer 18

pain
priapism
acute chest syndrome
stroke

Question 19

med that encourages body to increase fetal hemoglobin to help with sickle cell anemia

Answer 19

hydroxyurea

Question 20

factors that can trigger vasoocclusive crisis

Answer 20

extreme temp changes
illness
stress

Question 21

Tx sickle cell anemia

Answer 21

living with and managing it
bone marrow transplant

Question 22

sepsis Tx/prevention for sickle cell anemia pts

Answer 22

prophylactic penicillin until 5 yo
(5 yo bc then completely vaccinated against pneumococcal)

Question 23

should you use cold or warm packs for comfort in sickle cell disease

Answer 23

warm
(cold can trigger crises)

Question 24

Tx thalassemia

Answer 24

*blood transfusion
meds to treat iron overload:
-deferoxamine
-deferasirox
possible bone marrow transplant

Question 25

meds to treat iron overload

Answer 25

deferoxamine
deferasirox

Question 26

anemia: whites, reds, and platelets are low (pancytopenia)

Answer 26

aplastic anemia

Question 27

Tx aplastic anemia

Answer 27

bone marrow transplant
stem cell transplant
immunosuppressive therapy

Question 28

group of hereditary bleeding disorders that result from deficiencies of specific clotting factors
-deficiency factor 8

Answer 28

hemophilia A

Question 29

are platelets high low or normal in hemophilia a
are aPTT times impacted

Answer 29

normal (missing other clotting factor)
PTT prolonged

Question 30

genetic component of hemophilia a

Answer 30

x-linked recessive
-males affected

Question 31

S+S hemophilia a

Answer 31

-prolonged bleeding (*circumcision for males)
-bruising
-symptoms may not show until 6 mo
-hemarthrosis (bleeding into joint spaces)

Question 32

should you use cold or heat for treating hemophilia a

Answer 32

cold

Question 33

Tx hemophilia a

Answer 33

-maintain mobility
-cold packs
-replace missing clotting factor
*med: DDAVP

Question 34

med for mild hemophilia that replaces missing clotting factor

Answer 34

DDAVP

Question 35

prevent bleeding in hemophilia

Answer 35

-ice and pressure for bleeding
-electric razors
-controlled dental procedures

Question 36

managing hemarthrosis in hemophilia

Answer 36

-elevate and immobilize joint
-ice
-analgesics
-ROM after bleeding stops
-PT
-avoid obesity (minimize joint stress)

Question 37

genetic passing on von willebrand disease (vWD)

Answer 37

autosomal dominant

Question 38

Tx von willebrand disease

Answer 38

DDAVP

Question 39

ITP

Answer 39

idiopathic thrombocytopenia (low platelets that have a sudden unknown onset)

Question 40

2 forms ITP

Answer 40

-acute (after viral illness)
-chronic (6+ mos)

Question 41

Tx ITP

Answer 41

rest
IVIG (stimulates platelet production)
-possible splenectomy

Question 42

consequence of splenectomy

Answer 42

weakened immune system