Ch. 5 Blood Disorder

Question 1

In General- what to do/maintain with blood disorders

Answer 1

increase O2 sat, pH 7.4, normal thermal, use special CPG

Question 2

Cold Agglutinins

Answer 2

=cold temps activated antibodies to attach to antigens on RBC (IgM, G, A)
–on CPB- keep patient warm, hemodilution may help, don’t add blood to cold CPG (can use cold CPG, but start and end with warm CPG), plasmapheresis (separates plasma and removes antibodies)

Question 3

Sickle Cell Disease

Answer 3

= abnormal Hgb, cells sickle at <85% O2 sat
=htetozygous HgbS- not disease, sickle at < 40% sat
= blood clots, anemia, SOB
—on CPB= normal O2 sats, no acidosis, don’t cool, dilute, and use vasodilator to prevent clots

Question 4

Polycythemia

Answer 4

high RBC count

-due to high altitude, pulm/heart disease

Question 5

Thalassemia

Answer 5

low Hgb synthesis (lots of RBC destroyed)

• thalassemia major (Coley’s Anemia)- at infant, RBC destroyed, iron accumulates
• thalassemia minor- mild anemia, no symptoms

Question 6

Elliptocytosis

Answer 6

high number of elliptocytes (oval RBC)

Question 7

Spherocytosis

Answer 7

hight number of spherical RBC,

-treat with transfusion or splenectomy

Question 8

Hemosiderosis

Answer 8

high iron in tissue

-found if destruction of RBC (like thalassemia)

Question 9

Hemochromatosis

Answer 9

iron deposits >15 gram

-can feel in liver, bronze color, DM

Question 10

Erythroblastosis fetalis

Answer 10

anemia in newborns with Rh+, mom with Rh- and has antibodies

Question 11

Thrombocytopenia

Answer 11

low platelet count

-due to low bone marrow, spleen issues, cancer, anemia, liver, destruction on CPB/IABP

Question 12

Thrombocytopenia purpura

Answer 12

low platelets due to immune response

-treat with steroids, splenectomy

Question 13

von Willebrand’s Disease

Answer 13

-vW factor- platelet adhesion, carries VIII
-symptoms= nose bleed, bloody gums
Type 1)= low number of vWF
Type 2)= normal number of vWF but impaired= thrombocytopenia
Type 3)= very low number of vWF= hemarthroses (joint bleeding)
–correction= give crypopreciptiate after CPB or DDAVP for 1/3 type

Question 14

Hemophilias

Answer 14

bleeding order due to missing clotting factors

1) Hemophilias A= no factor VIII (80% have A)
2) Hemophilias B= no factor IX
- -give injections of missing factor

Question 15

Disseminated Intravascular Coagulation (DIC)

Answer 15

clotting factors used up very quickly= bleeding

• purple spots, petechial hemorrhage
• give blood components

Question 16

Vitamin K Dependent Deficiency

Answer 16

= low II, VII, IX, X= produced in liver

Question 17

Primary Fibrinolysis

Answer 17

continuously dissolving fibrin= give amicar on CPB