Chp 34 hematology key points Flashcards
What is anemia?
A deficiency in the number of erythrocytes, the quantity of hemoglobin, and/or the volume of packed RBCs.
Anemia is a manifestation of several pathologic processes and not a specific disease.
How are the types of anemia grouped?
According to either morphology or etiology.
Morphology refers to cellular characteristics, while etiology refers to underlying causes.
What causes the clinical manifestations of anemia?
The body’s response to tissue hypoxia.
What is the primary goal of therapy for anemia?
Correcting the cause of the anemia.
What are the main causes of iron-deficiency anemia?
- Inadequate dietary intake
- Malabsorption
- Blood loss
- Hemolysis
What is thalassemia?
A group of diseases with an autosomal recessive genetic basis involving inadequate production of normal hemoglobin.
What are the two forms of thalassemia?
- Heterozygous
- Homozygous
What is megaloblastic anemia characterized by?
Impaired DNA synthesis and the presence of large RBCs.
What are two common forms of megaloblastic anemia?
- Cobalamin deficiency
- Folic acid deficiency
What is the primary treatment for cobalamin deficiency?
Parenteral or intranasal administration of cobalamin.
What is anemia of chronic disease caused by?
Chronic inflammatory, autoimmune, infectious, or cancerous diseases.
What is aplastic anemia?
A disease with peripheral blood pancytopenia and hypocellular bone marrow.
What are the sources of acute blood loss?
- Trauma
- Complications of surgery
- Conditions that disrupt vascular integrity
What is sickle cell disease characterized by?
The presence of an abnormal form of hemoglobin in the erythrocyte.
What are the three categories of extrinsic causes of hemolysis?
- Physical trauma
- Antibodies
- Infectious agents and toxins
What is hemochromatosis?
An autosomal recessive disease characterized by increased intestinal iron absorption.
What is polycythemia?
The production and presence of increased numbers of RBCs.
What is thrombocytopenia?
A reduction of platelets below 150,000/μL.
What is the most common acquired thrombocytopenia?
Immune thrombocytopenic purpura (ITP).
What is the primary treatment for hemophilia?
Replacement of deficient clotting factors.
What is disseminated intravascular coagulation (DIC)?
A serious bleeding and thrombotic disorder resulting from abnormally initiated and accelerated clotting.
What is neutropenia?
A reduction in neutrophils, a type of granulocyte.
What is myelodysplastic syndrome (MDS)?
A group of related hematologic disorders characterized by changes in the quantity and quality of bone marrow elements.
How is leukemia classified?
Based on acute versus chronic disease and the type of WBC involved.
What is the most common type of leukemia in children?
Acute lymphocytic leukemia (ALL).
What are the two major types of lymphoma?
- Hodgkin’s lymphoma
- Non-Hodgkin’s lymphoma (NHL)
What characterizes Hodgkin’s lymphoma?
Proliferation of abnormal giant, multinucleated cells called Reed-Sternberg cells.
What is multiple myeloma?
A condition in which cancerous plasma cells infiltrate the bone marrow and destroy bone.
What is splenomegaly?
Enlargement of the spleen.
What is splenomegaly?
Enlargement of the spleen
It is associated with increased filtering and sequestering capacity, lowering the number of circulating blood cells.
What are common symptoms of splenomegaly?
Abdominal pain and early satiety
An enlarged spleen is easily palpable on physical examination.
When might a splenectomy be necessary?
To evaluate or treat splenomegaly or if the spleen ruptures from trauma
What is blood component therapy?
A treatment used in managing hematologic diseases that temporarily supports the patient
It is not a permanent solution and should be followed by resolving the underlying problem.
What must be done when blood or blood components are obtained from the blood bank?
Positive identification of the donor blood and recipient must be made
Improper product-to-patient identification causes most hemolytic transfusion reactions.
How should blood be handled once brought to the patient?
It should be started as soon as it is brought and not refrigerated on the nursing unit.
What is autotransfusion?
Removing whole blood from a person and transfusing that blood back into the same person
This avoids problems of incompatibility, allergic reactions, and disease transmission.
What are the types of blood transfusion reactions?
Acute and delayed transfusion reactions
What is the most common cause of hemolytic reactions?
Transfusion of ABO-incompatible blood
What causes most febrile reactions during transfusion?
Leukocyte incompatibility
Many people receiving 5 or more transfusions develop circulating antibodies to WBCs in the blood product.
In which patients are allergic reactions to blood transfusion more common?
In persons with a history of allergies
What condition puts a person at risk for circulatory overload during transfusion?
Cardiac or renal insufficiency
This risk increases if a large quantity of blood is infused in a short period, especially in older patients.
What is transfusion-related acute lung injury (TRALI)?
A sudden development of noncardiogenic pulmonary edema (acute lung injury)
What is a massive blood transfusion reaction?
A reaction that can occur when 10 or more units of RBCs are transfused within 24 hours
What are the components of delayed transfusion reactions?
Delayed hemolytic reactions, infections, and iron overload
Name some infectious agents that can be transmitted by blood transfusion.
- Hepatitis B virus
- Hepatitis C virus
- Human immunodeficiency virus
- Human herpesvirus type 6
- Epstein-Barr virus
- Human T-cell leukemia virus, type 1 (HTLV-1)
- Cytomegalovirus
- Malaria
