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Pathophysiology > Chapter 23: Alterations Hematologic Function > Flashcards

Chapter 23: Alterations Hematologic Function Flashcards

1
Q

anemia

A

reduced total erythrocytes in circulating blood or decrease in quality/quantity of hgb

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2
Q

anisocytosis

A

RBC assuming various sizes; seen in some anemias
having red blood cells (RBCs) that are unequal in size.

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3
Q

poikilocytosis

A

RBC assuming various shapes; seen in some anemias

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4
Q

patho of anemia

A

reduced O2 carrying capacity= tissue hypoxia
reduced consistency/volume blood
compensation for cell loss is movement of interstitial fluid into blood, increase plasma volume= adequate volume but viscosity decreases
thinner blood=faster= hyperdynamic= increase HR & SV= cardiac dilation, heart valve insufficiency if not corrected

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5
Q

S/S anemia

A

increase rate/depth breathing
SOB (dyspnea)
rapid/pounding heartbeat
dizziness
fatigue
mild chronic= maybe only present during physical activity when need O2
pale or jaundiced skin/mm/nails/conjunctiva
impaired healing
loss skin elasticity
thinking/graying hair

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6
Q

leading cause preventable death in injured

A

uncontrolled posttraumatic bleeding

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7
Q

Labs acute blood loss

A

low hematocrit
elevated neutrophils & platelets
low iron

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8
Q

Macrocytic (megaloblastic) anemias

A

diminished RBC production d/t ineffective erythrocyte DNA synthesis d/t nutritional deficiencies of B12 (cobalamin) or folate (folic acid)

unusually large stem cells (megaloblasts) in marrow mature into erythrocytes large in size (macrocytic), thickness, volume
megaloblastic erythrocytes DIE prematurely

Pernicious anemia is a type of megaloblastic anemia in which the body isn’t able to absorb vitamin B12 due to a lack of intrinsic factor in stomach secretions.

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9
Q

Pernicious anemia

A

type of megaloblastic anemia d/t B12 deficiency
autoimmune gastritis ****impedes production of IF (instrinsic factor) ** which is required for b12 uptake from gut

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10
Q

diseases and risk factors associated w/ pernicious anemia

A

DM 1
autoimmune thyroiditis
surgical removal stomach
resection ileum
tapeworm
H.Pylori
ETOH, hot tea, smoking d/t risk gastritis
increased b12 demand: pregnancy, hyperthyroid, chronic infection, cancer

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11
Q

s/s pernicious anemia

A

slowly over 20-30 years
initially vague sx: infections, mood swings, GI/cardiac/kidney ailments

Hgb 7-8: weakness, fatigue, paresthesias feet/fingers, difficulty walking, loss appetite, abd. pain, weight loss, sore tongue smooth/beefy red
“lemon yellow” (sallow) skin (pallor+jaundice)
hepatomegaly (right HF)
splenomegaly
neuro (d/t nerve demylenation)= loss of position/vibration sense, ataxia, spasticity

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12
Q

folate deficiency anemia

A

megaloblastic anemia; folate essential for RNA/DNA synthesis w/ maturing erythrocyte

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13
Q

common people w/ folate anemia

A

alcoholics
chronic malnourishment

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14
Q

s/s folate anemia

A

cheilosis (scales/fissures in mouth)
stomatitis (inflam. mouth)
painful ulcerations buccal mucosa and tongue characteristic burning mouth syndrome
dysphagia
flatulence
watery diarrhea
neuro sometimes d/t thiamine deficiency

*disappear 1-2 week after tx

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15
Q

microcytic-hypochromatic anemias

A

abnormally small erythrocytes contain reduced hgb.
impairs the normal transport of iron in cells
**iron deficiency anemia most common nutritional disorder

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16
Q

iron deficiency anemia

A

most common nutritional disorder worldwide
NO intrinsic dysfunction

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17
Q

cause iron deficiency anemia

A
  1. dietary deficiency
  2. impaired absorption
  3. increased req.
  4. chronic blood loss
  5. chronic diarrhea
  6. meds cause bleed (NSAIDs)
  7. surgery
  8. ED
  9. parasite
  10. H Pylori
18
Q

iron deficiency anemia population

A

toddlers
adolescent girls
women childbearing age
poverty
infant consume cow milk
older adult restricted diet
teenagers poor diet

19
Q

early s/s iron deficiency anemia

A

gradual; seek help level 7-8
fatigue
weak
SOB
pale earlobes palms conjunctivae

20
Q

progressive s/s iron deficiency anemia

A

low h/h
koilonychia (spoon-shaped fingernails, brittle, thin, ridged)
cheilosis (inflammatory condition that causes cracking, crusting, and scaling of the corners of the mouth)
stomatitis (inflammation of the oral mucosa, which presents with ulcers)
painful ulcer mouth
dysphagia
hyposalivation
gastritis
neuromuscular changes
HA
irritable
tingle/numb
vasomotor disturb
children= cognition

21
Q

anemia chronic disease

A

mild-mod from decreased erythropoeisis & impaired iron utilization d/t chronic systemic disease/inflam.

22
Q

s/s anemia of chronic disease (ACD)

A

decreased erythropoiesis or iron utilization from chronic inflamm. disease
older adult
similar COPD, critical illness after acute event (surgery), trauma, MI, sepsis, elderly, cancers
significant drop hgb= sx
low iron, low transferrin
***very high total body iron storage
low/normal TIBC
norm/high ferritin

23
Q

why elderly predisposed to anemia chronic disease

A

age-associated hematopoetic changes w/ increased inflam. cytokines

24
Q

aplastic and hemolytic anemia

A

aplastic=
Cardiac/respiratory sx, infection
hematopoietic fail/bone marrow aplasia w/ reduction in effective production of mature cells by marrow causing peripheral panacytopenia (reduction all 3 blood cells: RBC, neutrophils, thrombocytes)

hemolytic=
splenomegaly, jaundice, bone disease/fx, cardiac/resp. if severe
premature accelerated destruction of erythrocytes

25
Q

*polycythemia vera

A

aka primary polycythemia a type of chronic myeloproliferative disorder (Type of chronic leukemia)
slowly growing blood cancer in which bone marrow makes too MANY RBC
increase blood volume & viscosity > blot clots!
JAK2 gene
60-80 y/o
males

26
Q

labs in polycythemia vera

A

elevated WBC, RBC, platelets
increased hematocrit

27
Q

*s/s polycythemia vera

A

increased blood viscosity= hypercoagulable= clogging/occlusion of vessels
ischemia/infarction
plethora (ruddy, red color of face, hands, feet, ears, mm)
engorgement retinal & cerebral veins
*intense, painful itching intensified by heat or water
HTN
angina
neuro: HA, drowsy, delirium, mania, psychotic depression, chorea, visual disturb
elevated WBC, RBC, platelets
splenomegaly w/ abdominal pain

28
Q

why itching in polycythemia vera

A

exacerbated by heat and water
concentration of mast cells in skin; not responsive to antihistamines or topicals

29
Q

*leukemia/lymphoid neoplasm

A

clonal malignant disorder bone marrow, usually not always, of blood
uncontrolled proliferation of malignant leukocytes causing overcrowding of bone marrow and decreased production & function normal hematopoietic cells

30
Q

acute leukemias

A

aggressive, rapid
ALL in kids
AML in adults

31
Q

s/s acute leukemia

A

abrupt stormy onset, esp. ALL
anemia
bleeding (purpura, petechiae, ecchymosis, hemorrhage; gums, heavy menses)
infection (oral, throat, colon, urinary, lungs, skin)
weight loss
bone pain
liver, spleen, lymph enlargement
diminished sensitivity sour/sweet
neuro: HA, vomit, meningeal irritation
elevated uric acid

32
Q

chronic leukemia: CML & CLL

A

CLL most common in western world; slow-growing, too many immature lymphocytes bone & bone marrow

33
Q

s/s chronic leukemia

A

slow, insidious
*lymphadenopathy
infection w/ encapsulated bacteria

34
Q

*Hodgkin lymphoma

A

malignant lymphoma progresses from one group of lymph nodes to another and includes development of systemic sx and presence of B cells called Reed-Sternberg (RS) cells

35
Q

risk for hodgkin lymphoma

A

males
whites
early in life (20/30) then later in life (60/70)
EBV in 70% cases

36
Q

s/s Hodgkin lymphoma

A

*enlarged painLESS lymph nose in neck
lymphadenopathy
intermittent fever w/o other signs infection
drenching night sweats
itchy skin
fatigue
weight loss
anemia
high sed. rate

37
Q

*multiple myeloma

A

clonal plasma cell cancer characterized by slow proliferation of tumor cell masses in bone marrow
masses associated w/ lytic bone lesions (round, punched out regions of bone)
Multiple myeloma cells found in BONE MARROW not peripheral blood

38
Q

s/s multiple myeloma

A

elevated serum Ca
renal fail
anemia
bone lesions
pain
pathologic fx
amyloidosis (antibody proteins stick in peripheral nerves & organs)
proteinuria
hyperviscosity
neuro= confusion, HA, blurred vision
repeated infection (PNA)
*overwhelming infection leading cause of death

39
Q

Immune thrombocytopenia purpura (ITP)

A

most common thrombocytopenia (platelets < 150,000 to MD significant if < 100,000) secondary to increased platelet destruction
acute (infection or allergy) or chronic (autoantibodies against platelet antigens)

40
Q

clinical manifestations ITP
immune thrombocytopenic purpura

A

minor bleeding: petechiae & purpura
hemorrhage from mucosal sites (epitaxis, hematuria, menorrhagia, bleeding gums)
pregnancy= infant w/ thrombocytopenia
bleeding & associated sx (weight loss, fever, HA)
chronic= remissions & exacerbations

Pathophysiology (7 decks)

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