Common Blood Disorders (9/24a) [Biomedical Sciences 1] Flashcards
Hematologic System
Blood, capillaries, arteries
Organs involved with blood flow
Very diffuse and systemic
Composition of blood
8% of total body weight is blood
45% is blood cells (formed elements)
- Mostly red blood cells (erythrocytes) (>99%)
- Also white blood cells (leukocytes) (<1%), platelets (<1%)
55% is plasma
-Made of water (91%), proteins (7%), and other solutes (2%)
Functions of hematologic system
Delivery of substances (oxygen, iron, etc) for cellular function
Removal of wastes
Immune function
Injury repair
Maintain acid/base balance
Hematopoiesis
Creation of blood cells
Occurs primarily in the bone marrow in adults
Starts with hematopoietic stem cells
Pluripotent - differentiate into variety of cell types
Erythrocyte (Red Blood Cell, RBC)
Most common type of blood cell
Principal function - delivering oxygen via hemoglobin
Life span is about 90-120 days
Biconcave shape allows it to be flexible
Hemoglobin (HGB)
Protein within red blood cells
Required for formation:
Iron, Vitamin B12, Folic Acid
Binds and transports oxygen
Critical value: <8.0 g/dL
- <7.0 g/dL will receive transfusion
Hematocrit (HCT)
Percent of blood volume made up of red blood cells
Can be calculated → Hemoglobin x 3 = Hematocrit
Anemia - Overview
low levels of RBC, HGB, HCT
most common blood disorder - affects >3 mil
Due to deficiency of Iron/Vit B12/Folate, blood loss, hemolysis, bone marrow failure, etc.
Erythrocytosis/Polycythemia - Overview
high levels of RBC, HGB, HCT
Can occur in any hypoxic state
Due to lung disease, smoking, high altitudes, dehydration, polycythemia vera
Anemia
SIGNS: increased HR, lightheadedness, chest pain, SOB, tachycardia, tachypnea
PRECAUTIONS: frequent symptom check, Hb<7-8 slow movements
CONTRAINDICATIONS: rapid change in hemoglobin, Hb<7
Anemia - Types
Iron deficiency
Vit B12 and Folate deficiencies
Blood loss anemia
Anemia of chronic disease
Bone marrow failure
Sickle cell anemia
Sickle Cell Disease
SIGNS: musculoskeletal pain (esp. chest pain)
PRECAUTIONS: avoid dehydration, overexertion, hypoxia, cryotherapy
CONTRAINDICATIONS: acute sickle cell crisis
Leukopenia
SIGNS: fever
PRECAUTIONS: gloves, masks, hand washing, sterilize all equipment
Bleeding Disorders
SIGNS: joint pain, swelling, bruising, increased HR, decreased BP
PRECAUTIONS: no active grade V manipulations, fall precautions
CONTRAINDICATIONS: active bleedings, ADLs only when platelets <20k
Clotting Disorders
SIGNS: calf pain, swelling, redness, chest pain, SOB, hypoxia, increased HR
CONTRAINDICATIONS: suspected pulmonary emboli, not on anticoagulant, unstable vital signs
Leukocyte (White Blood Cell, WBC)
Principle function: immune and inflammatory responses
Normal Range: 5,000 – 10,000 cells/mcL
Differential – multiple types of white blood cells
WBC - Neutrophil
respond to bacterial infections
WBC - Lymphocyte
respond to viral infections
WBC - Monocyte
innate immune system
WBC - Eosinophil
parasitic infections and allergic reactions
WBC - Basophil
inflammatory mediator
Leukopenia - Overview
low levels of WBC
Due to aplastic anemia, sepsis, viral infection, malignancy, medications, genetic
Leukocytosis - Overview
high levels of WBC
Due to bacterial infection, inflammation, stress, trauma, medications, malignancy
Leukopenia/Neutropenia
Increased susceptibility to infections
Particularly notable when absolute neutrophil count (ANC) <1000
Precautions: hand hygiene, sterilize equipment, wear PPE
4 main types of leukemias
Acute Lymphocytic Leukemia (most common in kids, good prognosis)
Acute Myeloid Leukemia (poor prognosis)
Chronic Lymphocytic Leukemia (most common in adults, slow progression)
Chronic Myeloid Leukemia (“Philadelphia chromosome”
Lymphomas vs Leukemias
lymphomas are similar to lymphocytic leukemias, but involve lymphatic organs
(thymus, spleen, lymph node)
2 main types of lymphomas
Non-Hodgkin’s Lymphoma
Hodgkin’s disease (young adults, good prognosis w chemo)
Platelets
Principle function: hemostasis and inflammatory response
Not truly a blood cell → they are little pieces of cytoplasm (megakaryocytes)
Normal range: 140,000 – 400,000
Life span ~7 – 10 days
too few = easy bleed
too many = clots
Thrombocytopenia - Overview
low levels of platelets
Consumption, Sequestration, Dilution
risk of easy bleeding/bruising
<20k only ADLs
20-50k light exertion, aerobic, aquatic
<100k limit heavy resistance
Thrombocytosis - Overview
high levels of platelets
Essential, Reactive, Polycythemia vera
stroke, chest pain, weakness
Too many platelets → clots
Blood Disorders
Hemostasis
Von Willebrand disease
Hemophilia
Clotting Disorders
Virchow’s Triad
Venous Thromboembolism (DVT and PE)
Factor V Leiden
Protein C and/or S deficiency
