ch 28 hematology and immunology Flashcards
lifecycle of RBCs
120 days
function of reticulocytes
indicates active RBC production
reticulocyte = new immature RBC
if you have hemolytic anemia would reticulocytes be high or low
high
*be concerned if its low because their anemia is more profound
type of WBC: primary defense of bacterial infection
neutrophils
cut off point for high risk of bleeding in platelet count
50,000
types anemia
-decrease in number
-morphology (change in shape, size, color)
S+S anemia
-paleness
-fatigue
-headache, dizziness
-murmur, tachycardia
-CBC: decreased RBC, Hgb and Hct, high reticulocytes
how to prevent iron deficiency anemia in young children
-iron fortified cereals and formulas for infants
-don’t have excessive milk intake (prevents iron production)
3 types anemias caused by increased destruction of RBCs
-hereditary spherocytosis (HS)
-sickle cell disease (*genetic)
-thalassemia
Tx hereditary spherocytosis
-splenectomy
-usually not before 5 yo
all hereditary disorders whose clinical, hematologic, and pathologic features are related to presence of HEMOGLOBIN S
sickle cell disease
what type of hereditary disease is sickle cell disease
autosomal recessive
(1 parent carrier, 1 parent not = 25% chance)
what disease is protected against if a pt has thalassemia and sickle cell disease
malaria
test for diagnosing sickle cell disease in newborns
hemoglobin electrophoresis
when do babies start showing signs of sickle cell anemia
6 mos (Hgb S increases)
S+S sickled hemoglobin
-decreased kidney function (incontinence, hematuria)
-stroke
-priapism (painful constant erection)
-chronic ulcers
-hepatomegaly (gallstones)
-tissue death
-bone pain
-
chronic effects sickle cell anemia
-cardiomegaly and murmur
-decreased lung function
-kidneys - inability to concentrate urine
-decreased blood flow all organs
S+S vasoocclusive crises
pain
priapism
acute chest syndrome
stroke
med that encourages body to increase fetal hemoglobin to help with sickle cell anemia
hydroxyurea
factors that can trigger vasoocclusive crisis
extreme temp changes
illness
stress
Tx sickle cell anemia
living with and managing it
bone marrow transplant
sepsis Tx/prevention for sickle cell anemia pts
prophylactic penicillin until 5 yo
(5 yo bc then completely vaccinated against pneumococcal)
should you use cold or warm packs for comfort in sickle cell disease
warm
(cold can trigger crises)
Tx thalassemia
*blood transfusion
meds to treat iron overload:
-deferoxamine
-deferasirox
possible bone marrow transplant
meds to treat iron overload
deferoxamine
deferasirox
anemia: whites, reds, and platelets are low (pancytopenia)
aplastic anemia
Tx aplastic anemia
bone marrow transplant
stem cell transplant
immunosuppressive therapy
group of hereditary bleeding disorders that result from deficiencies of specific clotting factors
-deficiency factor 8
hemophilia A
are platelets high low or normal in hemophilia a
are aPTT times impacted
normal (missing other clotting factor)
PTT prolonged
genetic component of hemophilia a
x-linked recessive
-males affected
S+S hemophilia a
-prolonged bleeding (*circumcision for males)
-bruising
-symptoms may not show until 6 mo
-hemarthrosis (bleeding into joint spaces)
should you use cold or heat for treating hemophilia a
cold
Tx hemophilia a
-maintain mobility
-cold packs
-replace missing clotting factor
*med: DDAVP
med for mild hemophilia that replaces missing clotting factor
DDAVP
prevent bleeding in hemophilia
-ice and pressure for bleeding
-electric razors
-controlled dental procedures
managing hemarthrosis in hemophilia
-elevate and immobilize joint
-ice
-analgesics
-ROM after bleeding stops
-PT
-avoid obesity (minimize joint stress)
genetic passing on von willebrand disease (vWD)
autosomal dominant
Tx von willebrand disease
DDAVP
ITP
idiopathic thrombocytopenia (low platelets that have a sudden unknown onset)
2 forms ITP
-acute (after viral illness)
-chronic (6+ mos)
Tx ITP
rest
IVIG (stimulates platelet production)
-possible splenectomy
consequence of splenectomy
weakened immune system
