Chapter 17: Blood and Lymphatic Disorders Flashcards
What is the purpose of blood?
Blood provides the major transport system of the body for essentials such as oxygen, glucose and other nutrients, hormones, electrolytes, and cell wastes. It serves as a critical part of the body’s defense , carrying antibodies and white blood cells for the rapid removal of any foreign material.
What is hemostasis?
Blood maintain a stable pH of 7.35 to 7.45
What is hematocrit?
volume of red cell mass in 100 ml of plasma
What is plasma?
a clear yellowish fluid remaining after the cells have been removed(liquid component) carries antibodies and nutrients to tissues and carries waste away
What is hematopoiesis?
the differentiation process forms committed stem cells for each type of blood cell. These cells then proliferate and mature, providing the specialized functional cells needed by the body
What is hypoxia?
Insufficient oxygen
What is hemolysis?
destruction of RBC’s
What are erythrocytes?
red blood cells (donut like centers but with thin centers rather than holes) carries oxygen to the tissues and removes carbon dioxide from them.
What is leukopoiesis?
production of white blood cells
What are lymphocytes?
make up 30% to 40% of WBCs participate in the inflammatory and immune response
What is CBC?
Complete Blood Count
What is HGB?
Hemoglobin content of blood
What is WBC with differential?
indicates the proportions of specific types of WBCs in the blood and frequently assists in the making a diagnosis
What are neutrophils?
the most common leukocyte, comprising 50% to 60% of WBCs, they only service only 4 days, they are the first to respond to tissue damage
What is MCV?
mean corpuscular volume= Size of RBC
What are basophils?
appear to migrate from the blood and enter tissue to become mast cells that can release histamine into the blood and participate in delayed allergic reaction and heparin (anticoagulant).
What are eosinophils?
tend to combat the effects of histamine. They are increased by allergic reactions and fight lung and skin infections
What are monocytes?
can enter the tissue to become macrophages which act as phagocytes when tissue damage occurs participate in immunity
What are thrombocytes?
also called platelets, are an essential part of the blood-clotting process or hemostasis. Thrombocytes are not cells!
What is thrombocytopenia?
refers to a decreased number of circulating platelets( too few platelets)
What is thrombocytopenia associated with?
Decreased bone marrow production
Increased pooling in the spleen
Decreased of blood vessel integrity result from structurally weak vessels or vessel damage due to inflammation and immune mechanisms.
Infection
What are manifestations of thrombocytopenia?
Rapid drop in platelet count several days after resuming drug
Hemorrhagic diathesis
Splenomegaly
What is the diagnosis for thrombocytopenia?
History of taking drug before
Platelet count
S/S
What are treatments for thrombocytopenia?
Discontinue Drug
Splenectomy
What is Idiopathic Thrombocytopenic Purpura?
an auto immune disorder, results in platelet antibody formation and excess destruction of platelets.
What are manifestations of Idiopathic Thrombocytopenic Purpura?
Sudden onset of petechiae and purpura- acute condition
Bruising, bleeding from gums, epistaxis and abnormal menses
Splenomegaly
What is the diagnosis for Idiopathic Thrombocytopenic Purpura?
Platelet counts < 20,000/ml
What are the treatments for Idiopathic Thrombocytopenic Purpura?
corticosteroid drugs, Splenectomy and immunosuppressive agents
What is blood clotting?
When a blood vessel is injured, clotting begins within minutes to stop loss of blood. Coagulation factors are essential to normal blood clotting. Absent, decreased, or excess coagulation factors may lead to a clotting abnormality.
What are coagulation defects?
deficiencies of one or more of the known clotting factors
How can a person acquire coagulation defects?
Defective synthesis
Inherited disease
Increased consumption of the clotting factors
What are the manifestations of coagulation defects?
Bleeding typically occurs after injury or trauma
Large bruises, hematomas, or prolonged bleeding into GI or urinary tract or joints
What is agglutination?
(clumping) antigen-antibody reaction would occur with, for example, an incompatible blood transfusion
What are primary coagulation defects?
Hemophilias (Type a, b, and c)
What are secondary coagulation defects?
Clotting factors deficiencies or enhanced consumption or breakdown of factors
Prothrombin deficiency and or deficiency of other Vitamin K clotting factors
Drug induces- oral anticoagulants or heparin
Liver disease
Anemia
What are the diagnoses for secondary coagulation defects?
CBC, Clotting tests
What is PTT?
(partial thromboplastin time) measures the presence of plasma factors that act in a portion of the coagulation pathway
What is PT?
(prothrombin time) Test the ability of blood to clot (used to monitor patients take coumadin)
What are the types of blood therapies?
Whole blood, packed red blood cells, or packed platelets
What is anemia?
not a disease but an indication of a disease process or alteration in body function. (Blood dyscrasia- disease)
What are the categories of anemia?
- Impaired oxygen transport
- Changes in red cell structure
- Signs and Symptoms of pathological process causing anemia
What are the signs and symptoms of anemias?
- pallor
- Angina
- Fatigue
- dyspnea
- Tachycardia
- Jaundice
- Purpura, petechiae
What is an example of blood loss anemia?
Acute Hypovolemic Shock (caused by hemorrhage)
What is the diagnosis for hypovolemic shock?
Hemoglobin and Hematocrit
What are the treatments for hypovolemic shock?
blood replacement (transfusion), treat underlying problem(cause)
What is Chronic Hypovolemic Shock?
loss of blood leads to iron deficiency creating microcytic, hypochromic anemia
What is the diagnosis for Chronic Hypovolemic Shock?
H&H, CBC, blood smear
What are the treatments for Chronic Hypovolemic Shock?
iron replacement, ferrous sulfate, Imferon, blood replacement, treat underlying problem
What are hemolytic anemias?
Premature destruction of RBCs short life span of RBC with hemolysis
What are the signs and symptoms of hemolytic anemias?
jaundice, hemoglobinemia, hemglobinuria, and general symptoms
What are the causes of hemolytic anemias?
Primary or Intrinsic- genetic, hemoglobinopathy, defect in cell membrane
Acquired or extrinsic- drugs, bacteria, trauma
What are the diagnoses for hemolytic anemias?
CBC, H&H, bilirubin, blood smears, urine bilirubin
What are the treatments for hemolytic anemias?
Splenectomy- reduces RBC destruction and removal
What is sickle cell anemia?
genetic defect in the hemoglobin causes shape of the cell to change
What is the diagnosis for sickle cell anemia?
CBC, blood smear, genetic studies
What are the treatments for sickle cell anemia?
blood transfusions, palliative, pain meds, bone marrow transplant, counseling
What is Thalassemia?
absence of defective synthesis of hemoglobins, hereditary (found in the Mediterranean population)
What are the signs and symptoms of Thalassemia?
splenomegaly, hepatomegaly
What is the diagnosis for Thalassemia?
CBC, blood smear
What are the treatments for Thalassemia?
Blood replacement
What are iron deficiency anemias?
Associated with inadequate dietary iron, chronic blood loss
What are the signs and symptoms of iron deficiency anemias?
Fatigue dysphagia Brittle hair and nails
Angina SOB pallor
What are the causes of iron deficient anemia?
blood loss, decreased dietary intake of iron
What are the diagnoses for iron deficient anemia?
CBC, blood smear
What are the treatments for iron deficient anemia?
ferrous sulfate, Imferon
What is vitamin B-12 deficiency anemia?
Lack of mature erythrocytes
What causes vitamin B-12 deficiency anemia?
lack of intestinal absorption of B-12. B-12 cannot be absorbed into the bloodstream without the aid of a special substance intrinsic factor that normally found in gastric juice
What are the diagnoses for vitamin B-12 deficiency anemia?
CBC, blood smear, serum B12
What are the treatments for vitamin B-12 deficiency anemia?
Vitamin B-12 injections, treat underlying intestinal disorder if present
What is folic acid deficiency anemia?
Caused by malnutrition, found in alcoholics and debilitated patients
What are the diagnoses and treatments for folic acid deficient anemia?
Dx: CBC
Trx: Folic Acid 1-5mg/day
What is aplastic anemia?
Failure of blood cell production due to aplasia (absence of development, formation) of bone marrow cells
What is the cause of aplastic anemia?
unknown in 66% of cases, drugs, radiation, chemicals
What are the diagnosis for aplastic anemia?
CBC, blood smear, bone marrow aspiration
What are the treatments for aplastic anemia?
Blood Transfusions, bone marrow transplant
What is polycythemia vera?
An increase in RBCs from over production in the bone marrow
What is the diagnosis for polycythemia vera?
CBC, bone marrow, aspiration
What are the treatments for polycythemia vera?
phlebotomy, chemotherapy
What are the signs and symptoms of polycythemia vera?
headache, hypertension, weight loss,
What are the signs and symptoms of thrombocytopenia?
bruising, bleeding, splenomegaly
What are the diagnosis for thrombocytopenia?
platelet count is below 10,000
What are the treatments for thrombocytopenia?
Splenectomy, remove drug, replace the platelets
What is Myelodysplastic Syndrome?
involve inadequate production of cells by the bone marrow
What causes Myelodysplastic Syndrome?
idiopathic or following chemotherapy or radiation treatment
What are the diagnoses for Myelodysplastic Syndrome?
Blood test, Bone Marrow Biopsy
What are the treatments for Myelodysplastic Syndrome?
transfusion replacements, bone marrow transplants
What is Leukemia?
A malignant neoplasm of hematopoietic stem cells causes replacement of bone marrow with immature neoplastic cells in large numbers
What are the classifications of lymphocytic leukemia?
Acute lymphocytic leukemia (ALL) kids ages 2-4
Chronic lymphocytic leukemia (AML) adults over the age of 50
What are the classifications of Myelocytic leukemia?
Acute myelocytic leukemia (AML) ages 13-39
Chronic myelocytic leukemia (CML) ages 30-50
Dx: Blood smear and bone marrow aspiration(bx)
Trx: Chemotherapy and supportive trx, bone marrow transplant
What are the chemo protocols for leukemia?
Cytoxan
Prednisone
Vincristine
Asparaginase
What are lymphoma’s?
Malignant neoplasm of cells native to lymphoid tissue, lymphocytes and histiocytes