Ch 34 hematology disorders Flashcards

1
Q

Wbc

A

Basophils-(bone marrow) release histamine in inflammatoryreactions
Esinnophils- (bone marrow) respond during allergic reaction to detoxify he foreign proteins
Neutophils- (bone marrow) fight off infection by destroying pathogens
Monocytes-(lymphatic tissue) eat dead tissue and pathogens
Lymphocytes-(lymhatic tissue) B cells-produce antibodies to foreign substances
T cells-helper (thymus) mature the immune system
Natural killer

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2
Q

thymus is larger in children

A

because it shrinks with age

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3
Q

thrombocytopenia

A

is a reduction in the number of platelets
-less than 150,000
Risk Factors
-infection
-sulfa drugs
-tumors
dic
-Heparin-induced thrombocytopenia
Immune response to heparin
-Glucocorticoids are beneficial increases platelet count

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4
Q

thrombocytosis

A

is an increase in platelet production
-more than 450,000

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5
Q

Iron deficiency anemia risk factors

A

Highest among non Caucasian mostly Mexican and African American women in us
-Lower socioeconomic (lead exposure) status children, pregnant women
-Females because of blood loss during period
-Gastrointestinal problems (gastric bypass-can lead to poor absorption of iron
-Hemorrhage
Daily iron requirement for men 8mg women18-22mg
Pica-causing the iron depleted individual to ingest nonnutritive substances- paint, dirt, clay,ice ,laundry starch
-Certain types of cancers (esophageal colon stomach)

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6
Q

Iron deficiency anemia (clinical manifestations)

A

fatigue
pallor
tachypnea
tachycardia
hypoxia
*Glossitis
*koilonychias

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7
Q

IDA treatment

A

increase iron intake
-foods Meat especially red meat
Dark green leafy vegetables Spinach ,broccoli,peas cereals, cream of wheat
Beets, dried beans legumes oranges grapefruit vitamin c improves absorption of iron

-iron supplements-(orally,im,iv monitor for nausea constipation or diarrhea)
-dextran should only be used if patient can’t take by mouth known cardiac and allergic reactions

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8
Q

IDA complications

A

Heart failure
Renal failure
Impaired thermoregulation
Impaired immune function
Psychomotor and cognitive impairment – occur in children
-IDA in pregnancy effects low birth weight,preterm labor, or mortality of mother or infant

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9
Q

Vitamin B12 (Cobalamin) Anemia risk factors

A

Older adults
G I resections
Autoimmune disorders
Crohn’s disease
Celiac disease
Long-term use of medications that decrease gastric acid
-vegetarians
-aids
-chronic alcohol abuse

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10
Q

Vitamin B12 is required for

A

normal function of the central nervous system,formation of rbcs, synthesis and regulation of DNA
-Vitamin b12 is also used for conversion of methylmalonyl

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11
Q

Vitamin B12 Anemia clinical manifestations

A

Clinical manifestations may take years to develop
-Can cause neuro- can worsen and be irreversible and psychiatric dysfunction
-Lhermittes sign rare but is shown in neck with someone with vitamin b12 defiency
Severe cases of vitamin b 12 cause dementia
-Visual changes-distinguish yellows and blues
-Spinal cord degeneration
-Tachycardia
-Shortness of breath
-Dizziness
-Fatigue

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12
Q

vitamin b12 diagnosis

A

labs
cbc
Vitamin b12 normal range 200-1000 patients with liver disease might have false negatives
-Excess of mma indicates lack of vitamin b12 urine sample needed because of possible false elevated serum mma levels
-Schilling test 24hr urine test intrinsic factor

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13
Q

treatment for vitamin b12

A

B12 injections-severe deficiency weekly injections
-prevention

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14
Q

impaired functional ability and orthostatic hypotension are complications of?

A

Vitamin b12 anemia

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15
Q

Folic Acid Deficiency (vitamin b9) risk factors

A

Older adults
Chronic illness
Alcohol abuse- can cause pancytopenia decreases rbc,wbc,platelets
Extreme diets
-Need foods dark green vegetables, dried beans,cereal,nuts,yeast,bran
-Pregnancy has been linked to fetal neural tube defects oroalfacial abnormalities
-take 400mcg daily of folic acid recommendation

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16
Q

Folic acid is necessary for?

A

cell maturation and replication
side note-Oral contraceptives, meteformin interfere with folic acid absorption
*Phenytonin may increase the incidence of seizure activity

17
Q

Folic Acid Deficiency clinical manifestations

A

Pallor, tachycardia, tachypnea, dizziness, and fatigue
-increase risk of bleeding
-

18
Q

Give orange juice with iron to help with?

A

absorption

19
Q

iron replacement can take how long?

A

minimum 3-4 months

20
Q

symptoms of anemia

A

-weakness
-fatigue
-headache
-irritability
-exercise intolerance

21
Q

labs for anemia (normal levels

A

-hemoglobin Males-14-17.3
Females-11.7-15.5
-Hematocrit Males 42-52% Females 36-48%
-RBC males- 4.21-5.81
females 3.61-5.11

22
Q

RBC size =(mean corpuscular volume)

A

Microcytic less than 80, normocytic 80-96 macrocytic greater than 96

23
Q

RBC color- (mean corpuscular hemoglobin)

A

Hypochromic (low in color) less than 27 , Normochromic (normal color) 27-33, Hyperchromic too much color greater than 33

24
Q

IDA and Thalassemia (genetic disorder) are both

A

microcytic, hypochromic
Thalassemia alpha known in Asians- both alpha and beta avoid too much exposure to iron can lead to hepatoxcity – liver not working

25
Q

Normocytic diseases

A

Diabetes and chronic kidney disease

26
Q

Macrocytic diseases

A

b12 deficiency, folate deficiency

27
Q

polycythemia

A

overproduction of rbc
primary mutation in jak2 gene
-Difficulty breathing when lying flat
-gum and nosebleeds
-Splenomegaly-Feeling of fullness in left upper abdomen because of spleen
-Blurred vision
blood thick
complication
-hemorrhage
Avoid tight, restrictive clothing
Avoid extreme temperatures

28
Q

Acute lymphoblastic leukemia

A

most common in children
-down syndrome risk factor

29
Q

Acute myelogenous leukemia

A

exposure to radiation

30
Q

Chronic myelogenous leukemia

A

Philadelphia chromosome 22

31
Q

Hodgkin’s lymphoma

A

Reed Sternberg cells
Hodgkins higher rate for survival
-More in Caucasians higher socioeconomic

32
Q

Multiple Myeloma

A

african americans average age 62

33
Q

pernicious anemia

A

decreases in red blood cells can’t absorb vitamin b12 lack of intrinsic factor
-weight loss
-sob during exercise
-swollen tongue bleeding gums