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Primary Care > Chapter 5 > Flashcards

Chapter 5 Flashcards

0
Q

Primary hematologic diseases are _____ but hematologic manifestations secondary to other diseases are _____

A

Uncommon, common

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1
Q

Blood consists of what two things

A

Plasma and formed elements (rbc, wbc, platelet)

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2
Q

Som of the most important indicators of dysfunction in the hematologic system include problems associated with

A

Exertion

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3
Q

The signs and symptoms associated with exertions include

A

Dyspnea, chest pain, palpitations, severe weakness, and fatigue

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4
Q

Neurological symptoms associated with hematologic problems

A

Headache, drowsiness, dizziness, syncope or poly neuropathy

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5
Q

Symptoms of the skin and fingernail beds with hematologic problems

A

Pallor of the face, hands, nail beds and leaps, cyanosis, clubbing of the fingernail beds and wounds, easy bruising or bleeding

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6
Q

What are the critical possible life threatening indicators of hematologic disorder

A

Blood in stool or emesis, or severe pain and swelling in joints and muscles

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7
Q

Many hematologic induced signs and symptoms seen in the PT clinic are side effects of

A

Medication

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8
Q

Chronic use of steroids and NSAIDs can lead to

A

Gastritis, peptic ulcer causing gastrointestinal bleeding and iron deficiency anemia

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9
Q

Leukopenia is a common problem after

A

Chemotherapy

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10
Q

Leukopenia can present as signs of

A

Infection

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11
Q

What is thrombocytopenia

A

Low platelet count

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12
Q

Thrombocytopenia can be a result of medications from

A

RA and cancer

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13
Q

Erythrocytes consist of

A

Hemoglobin and support framework

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14
Q

Erythrocytes number is dependent on

A

Gender, elevation, physical activity

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15
Q

What is anemia

A

Too few erythrocytes

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16
Q

What is polycythemia

A

Too many erythrocytes

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17
Q

What is poikilocytosis

A

Abnormally shaped erythrocytes

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18
Q

Anisocytosis is

A

Abnormal variations in size of erythrocytes

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19
Q

What is hypochromia

A

Erythrocytes deficient in hemoglobin

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20
Q

In anemia which blood pressure value may be lower

A

Diastolic

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21
Q

In those with anemia there may be an increase in

A

Resting pulse rate

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22
Q

Resting cardiac output is effected by anemia true or false

A

False

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23
Q

Cardiac output_____ more than it does in people without anemia

A

Increases

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24
Q

If there is severe anemia usually rating cardiac output ____

A

Increases

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25
Q

What is primary polycythemia

A

Uncommon neoplasticism disease of the bone marrow of unknowns etiology

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26
Q

What is secondary polycythemia

A

Physiologic condition resulting from a decreased oxygen supply to the tissues

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27
Q

Symptoms of polycythemia progress insidiously or quickly

A

Insidiously

28
Q

Most common first signs of polycythemia are

A

Shortness of breath and fatigue

29
Q

Skin color and BP change in those with polycythemia

A

Increased skin coloration and increased BP

30
Q

_____ can sometimes be the first symptom of polycythemia

A

Gout

31
Q

Clinical signs and symptoms of polycythemia - from box

A

General malaise and fatigue, shortness of breath, intolerable pruritus, headache, dizziness, irritability, blurred vision, fainting, decreased mental acuity, feeling of fullness in head, disturbances of sensation in hands And feet, weight loss, easy bruising, cyanosis, clubbing of the fingers, splenomegaly, gout, hypertension

32
Q

What is intolerable pruritus

A

Skin itching - indicative of primary polycythemia

33
Q

What is sickle cell anemia

A

Generic term for a group of inherited, autosomal recessive disorders characterized by the presence of an abnormal form of hemoglobin

34
Q

Mechanism of sickle cell anemia

A

Genetic mutation results in single amino acid substitution of hemoglobin, changes its shape causing it to lose the ability to deform and squeeze through tiny blood vessels

35
Q

The two main features of sickle cell anemia

A

Chronic hemolytic anemia and vaso occlusion

36
Q

Most common symptom of sickle cell anemia

A

Pain caused by blockage of sickle cells in an organ, bone or joint

37
Q

Pain in sickle cell can last

A

Hours to 5 or 6 days and subsides gradually

38
Q

Hand foot syndrome associated with sickle cell is associated with

A

Fever, pain and dactylitis

39
Q

Leukocytosis is recognized by a count of more than

A

10,000 leakocytes/mm^3

40
Q

The three clinical signs and symptoms associated with leukocytosis

A

Fever, infection, inflammation or trauma

41
Q

What is leukopenia

A

Reduction in leukocytes below 5000 per microliter

42
Q

Explain Nadir

A

The lowest point the white blood cell count reaches, 7-14 days after Chemotherapy or radiation therapy - must be most careful here with hygiene

43
Q

Clinical signs and symptoms of leukopenia

A

Sore throat, cough, fever,,chills, sweating, persistent infections, frequent and painful urination, ulcerations of mucous membranes

44
Q

Define leukemia

A

Uncontrolled growth of immature or dysfunctional white blood cells

45
Q

Platelets survive _____ in circulation

A

8-10 days

46
Q

Platelets are most effected by

A

Anticoagulant drugs, diet (lecithin and vitamin K) , exercise, liver disease, radiation

47
Q

Thrombocytosis is associated with the tendency to

A

Clot

48
Q

Clinical signs and symptoms of thrombocytosis

A

Thrombosis, splenomegaly, easy bruising

49
Q

Most common cause of thrombocytopenia seen by pt’s

A

Cancer related

50
Q

Severe thrombocytopenia results in

A

Petechiae most commonly on the lower legs

51
Q

Clinical signs and symptoms of thrombocytopenia

A

Bleeding after minor trauma, spontaneous bleeding (petechiae, ecchymoses, purpura spots, epistaxis), menorrhagiA, gingival bleeding, Melena( black tarry stools)

52
Q

What is hemophilia

A

A hereditary blood clotting disorder caused by an abnormality of functional plasma clotting proteins known as factors VIII and IX

53
Q

___ is one of the most common manifestations of hemophilia

A

Hemarthrosis

54
Q

______ is the second most common site of bleeding in those with hemophilia

A

Bleeding into the muscles

55
Q

Bleeding into muscles is most common in

A

Flexors

56
Q

When there is bleeding in psoas or iliacus ____

A

Compression of femoral artery may occur causing decreased sensation and referred pain to abdomen - they will have a position of flexion to reduce pain

57
Q

Clinical signs and symptoms of acute hemarthrosis

A

Aura, tingling or prickling sensation, stiffening into position of comfort, decreased range of motion, pain, swelling,,tenderness and heat

58
Q

Signs and symptoms of muscle hemorrhage

A

Gradually intensifying pain, protective spasm of the muscle, limitation of movement at the surrounding joints, muscle assumes position of comfort and loss of sensation

59
Q

Clinical signs and symptoms of gastrointestinal involvement

A

Abdominal pain and distention, Melena ( blood in stool), hematemesis (vomiting blood), fever, lower abdominal or groin pain, flexion contracture of the hip due to spasm of the iliopsoas muscle secondary to retro peritoneal hemorrhage

60
Q

How do you distinguish an iliopsoas bleed from a hip bleed

A

Flexion of the truck would cause severe pain if it was iliopsoas and just mild pain if it was hip whereas there would be severe pain with ER and IR if it was hip bleeding and just mild pain if iliopsoas

61
Q

Exercise for those with anemia must be

A

Approved by physician

62
Q

Clients with undiagnosed thrombocytopenia need

A

Immediate physician referral

63
Q

Avoid this maneuver in those with thrombocytopenia

A

Valsalva maneuver

64
Q

If rapid onset of anemia were to occur after major surgery what might you see

A

Exertional dyspnea and fatigue with increased heart rate

65
Q

Chronic GI blood loss sometimes associated with use of NSAIDS can result in

A

Iron deficiency

66
Q

Preoperatively clients cannot take aspirin or anti inflammatories because these

A

Decrease platelets

67
Q

Bleeding under the skin, nosebleeds, bleeding gums and black stools require medical evaluation as these may be indicative of

A

Thrombocytopenia

Primary Care (8 decks)

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