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D-Third semester > Exam 5- hematology-Cha 1 > Flashcards

Exam 5- hematology-Cha 1 Flashcards

1
Q

Blood Components
made up of x4

A

RBC

WBC

Platelets

Plasma

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2
Q

Rbc carry what x2 in body

A

carry hemoglobin and iron in the body

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3
Q

Hemolysis-

breakdown

recycling

converted

excreted

A

Breakdown of old and damaged RBC

Recycling of amino acids and iron

Converted into bilirubin

Excreted in bile

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4
Q

Diseases that increase hemolysis/ impair liver function

Leads to
Can lead to

A

Leads to increased bilirubin in the blood

Can lead to jaundice

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5
Q

White Blood Cells- Leukocytes

normal is
defesnes
originate where

A

Normal is 4,000-11,000

Defenses against microorganisms

Originate from stem cells in bone marrow

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6
Q

Leukocytosis=

Leuokpenia=

A

Leukocytosis= high wbc

Leuokpenia= low wbc

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7
Q

Neutrophils

what %

do what

A
  • 60-70% of wbc-

first to respond to injury/ inflammation

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8
Q

Eosinophil’s

respond to
increased

A
  • respond to parasites and allergies

increased numbers when those are involved

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9
Q

Basophils

respond to
contain

A
  • respond to allergies

contain histamines

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10
Q

Monocytes

immature

A
  • immature inflammatory immune response
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11
Q

Lymphocytes
immature

A
  • immature inflammatory immune response
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12
Q

Segs

A
  • mature neutrophiles
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13
Q

Bands

A
  • immature neutrophils
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14
Q

WBC are increased with

x3

A

infection/ inflammation

auto immune disordes

leukoemia

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15
Q

Decreased wbc x2

A

prolonged infection

bone marrow suppression

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16
Q

platlets

formed where
production controlled by
made where

A

formed in bone marrow

production is controlled by thrombopoietin

made in spleen and can circulate for 7-10 days in body

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17
Q

platlets

produces x2

aggregate why

requires what to clot

A

produce ATP and remediators for clotting

aggregate in resonse to trauma

requires calcium to clot- platelets alone will not clot

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18
Q

Thrombocytosis

Thrombocytopenia

A

Thrombocytosis- large amount of platlet cells

Thrombocytopenia- decreased amount of platelet cells

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19
Q

Platelets-Normal 150,000-450,000

What affects platelet levels?
x3

A

High altitude
Increased exercise
Chronic Cold weather

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20
Q

Hemostasis-

control

interaction

A

control of bleeding-

interaction between platelets and clotting mechanisms

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21
Q

goal of hemostasis

A

goal is to maintain a steady blood flow, blood volume , and blood pressure despite injury

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22
Q

first stage-Vessel spasm

does what

Five Stages of Hemostasis

A
  • contracts for 1 minute
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23
Q

second stage-Formation of platelet plug-

does what

Five Stages of Hemostasis

A

platelets attach to damaged vessels

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24
Q

third stage-Formation of insoluble fibrin clots

does what

Five Stages of Hemostasis

A
  • mesh of clots
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25
Q

fourth stage-Clot retraction

happens when
what happens

Five Stages of Hemostasis

A
  • happens in 30 minutes/

platelets pull the edge of damaged vessel together

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26
Q

fifth stage-Clot dissolution-
what happens

Five Stages of Hemostasis

A

after clot is formed, body starts to dissolve it to restore blood flow to area.

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27
Q

Amount of oxygen that gets to tissues depends on

availability
diffusing
number
amount
ability

A

Availability of oxygen in alveoli

Diffusing surface and capacity of lungs

Number of RBCs

Amount and type of (hemoglobin)Hbg

Ability of cardiovascular system to transport

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28
Q

Anemia

is what
every type of anemia decreases
leading to

A

abnormally low rbc count or reduced hemoglobin count

every type of anemia decreased-> oxygen carrying capacity,

leading to tissue hypoxia

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29
Q

S/S of anemia- If slowly- then body may be able to develop compensation mechanisms

what skin
what hr
a
f
h
d
what chages
what rr
what repository
what pain

A

Pale and cool skin
Tachycardia
Angina
Fatigue- due to ischemia/hypoxia

Headache
Dizziness
Vision changes
Tachypnea
Dyspnea
Bone pain- dt inc rbc production

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30
Q

S/S of long term anemia-

c
m
c f

A

Chf,

murmurs,

clubbed fingers

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31
Q

Chronic blood loss

happens from what

Anemia causes-

A

slow bleed from ulcers and cancer

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32
Q

Anemia- chronic blood loss
s/s are

A

minimal and during exercise or increased 02 consumption situations

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33
Q

Acute
caused by

Anemia causes-blood loss

A

caused by trauma-

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34
Q

Acute anemia s/s

what hr
what constricts
what contracts/releases

A

tachycardiac,

peripheral vessels will constrict,

liver will constrict and release a bolus of blood

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35
Q

Anemia can also be caused by

decreased
insufficient

A

decreased RBC production

insufficient or abnormal hemoglobin

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36
Q

Most common anemia is Iron deficiency anemia-

iron needed for what
body cant do what

A

iron is optimal for rbc formation

, body cannot synthesis hemolobin without iron

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37
Q

Hemolytic Anemia

characterized by

A

premature destruction/ hemolysis of blood cells

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38
Q

Hemolytic Anemia

s/s
f
j
i

A
  • fatigue,

jaundice,

irritability

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39
Q

Hemolytic Anemia
Intrinsic-

Two types of causes

A

disorder of blood cells- sickle cell

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40
Q

Hemolytic Anemia
Extrinsic

Two types of causes

A
  • outside of blood cells-

drugs, toxins, chemicals, trauma, and mechanical damage

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41
Q

heridtary->

usually//except

episodes happen where

Hemolytic Anemia- Sickle Cell

A

Hereditary- most common In black americans

Usually is asymptomatic unless stressed by hypoxia

Episodes happen where cells are crescent shaped- abnormal hemoglobin form in RBCs

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42
Q

Hemolytic Anemia- Sickle Cell

These patients are not always in a sickle cell crisis, but can be in one–s/s of sickling

p
f
j
i

A
  • pallor,

fatigue,

jaundice,

irritability

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43
Q

If person with trait for sickle cell had kid with Someone who doesn’t have trait,

A

then child may have trait but not the disease

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44
Q

If 2 people with the sickle cell trait have kids-

A

25% of disease in their children

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45
Q

Sickle Cell Anemia Signs and symptoms-

p
f
j
i

A

pallor,

fatigue,

jaundice

, irritbility

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46
Q

Sickle Cell Crisis

will experience x2 what hallmark signs

sickle cells do what
causing

A

Will experience Severe pain/ fever-

sickle cells clump together and obstruct capillary blood flow causing ischemia and possible infarction

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47
Q

sickle cell crisis

what gets back to normal shape

repeated acts

A

pts need to gain oxygen levels and rbc need to get back to normal shape/

repeated acts will weaken RBCs

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48
Q

Sickle Cell Crisis triggers

s
I
excessive
h
low
low
d

A

stress,

infection,

excessive exercise,

hypoxia,

low environmental 02,

low body temperature

dehydration

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49
Q

sickle cell crisis s/s-

f
h
what pain//how long
what resp

A

fever

headache,

abdominal /extremity pain for 4-6 days.

SOB

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50
Q

What is damaged by sickle cell crisis

what does that do

A

Spleen and kidney damage

kidney damage will decrease Erythpoetnan release- will decrease rbc production

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51
Q

Treatment for Sickle Cell Crisis

what control
large
prevention
education

A

pain control-pca pump- morphine

Large amounts of fluids

Prevention of stress and infection

Education on vaccines

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52
Q

Meds

h
f a
what transplant

Treatment for Sickle Cell Crisis

A
  • hydroxyurea decreased production of abnormal RBC

folic acid – assists with production of mature rbc

stem cell transplant- very expensive and could lead to death- only known cure for sickle cell crisis

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53
Q

Treatment for Sickle Cell Crisis

most infants

A

Most infants are tested for this so the parents know

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54
Q

Be aware of blood transfusions-

may have/causes

damages

what hmg for blood transfusion

Treatment for Sickle Cell Crisis

A

may have immune response that causes excess iron

which damages heart, liver and other organs

hmg under 7

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55
Q

what 2 labs in sickle cell

A

decreased HGB and rbc

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56
Q

pt may need what if they are getting blood transfusion

A

pt may need treatment for excess iron if they have transufion blood

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57
Q

Acquired Hemolytic Anemia
Caused by something outside of RBc-

mechanical
d
b
r
what disorders
I
what responses
what chemicals

A

mechanical trauma like heart valves,

dialysis,

burns,

radiation,

autoimmune disorders,

infections,

immune responses to blood transfusions

chemicals like drugs/ snake venom

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58
Q

Acquired Hemolytic Anemia-Signs and symptoms

enlarged
j
p
what hr
what else

A
  • enlarged spleen,

jaundice,

pallor,

tachycardia,

bone fractures leading to long term bone deformities

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59
Q

Aplastic Anemia-Rare-

bone marrow does what

leading to

normal/replaceed

A

bone marrow fails to produce all 3 types of blood cells,

leading to pancytopenia// normal marrow is replaced with fat

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60
Q

aplastic anemia

50% caused by

other causes are:
what damage
what infecetion
what chemicals

A

50% of cause is unknown

Other cause is
stem cell damage from chemo,
viral infections like hep c
, chemicals like arsenic/ benzine

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61
Q

Aplastic Anemia
S+Sx-

f
p
w
h
d
I
bleeding where
e

what labs

A

Fatigue
Pallor
Weakness
Headahce
Dyspnea
infections
bleeding gums
eccymoisis( bruising)

low rbc, wbc and platelets

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62
Q

decreased wbc do what

decreased platelets leads to

aplastic anemia

A

Decreased wbc are lead to infections

Decreased platelets can lead to bleeding gums and ecchymosis

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63
Q

tissue taken from where
may be
need to
painful->

Diagnostic Tests-Bone Marrow Biopsy

A

Tissue is taken out of posterior iliac crest or sternum,

May be sedated

Need to remain still

Painful but brief-like 20 mins

64
Q

Post procedue care-
pressure for how long
apply
may waht

Diagnostic Tests-Bone Marrow Biopsy

A

apply pressure for 5-10 minutes,

apply ice if bruising

may ache for 1-2 days

65
Q

Iron deficiency-

what supplements

Medications to Treat Anemias

A

iron supplements like oral supplements, parenteral, or im-very painful

Ferrous sulfate

66
Q

Sickle cell anemia

treat w->
what other
what subq

Medications to Treat Anemias

A
  • treat with hydroxyurea,

folic acid,

erythropoietin subq- can increase rbc production

67
Q

Aplastic anemia-

what med
what else

Medications to Treat Anemias

A

prednisone,

blood transfusions- packed rbc, whole blood, or platlets

68
Q

Iron foods

A
  • eggs , meat, green beans and dried fruit
69
Q

Folic acid foods

A

-green leafy vegetables, organ meats, eggs

70
Q

Vit b12- foods

A

eggs, milk, meat , cheese

71
Q

Leukemia

chronic
pt will
common in

A

Chronic malignant disorder of wbc

Pt will have reversed ratio of rbc to wbc

Common in children and men// causes unknown

72
Q

Leukemia-Risk factors-

c
what exposure
treatment from

A

cig smoke,

chemical exposure,

treatment from other cancers

73
Q

Leukemia s/s broad

a
I
b

A

anemia

infection

bleeding

74
Q

Leukemia- Signs and Symptoms

Anemia:
p
f
what hr
what resp

A

-pale,

fatigue

, tachycardia,

dyspnea,

75
Q

Leukemia- Signs and Symptoms
Infection

f
night
frequent

A
  • fever,

night sweats,

frequent infection

76
Q

Leukemia- Signs and Symptoms

Bleeding

77
Q

Leukemia

without treatment
with treatment

A

Without treatment- is fatal

With treatment- 5 year survival rate is just over 50%

78
Q

Acute
what

Leukemia classification

A

-rapid onset and progression

79
Q

Chronic
what

Leukemia classification

A
  • gradual onset
80
Q

Lymphocytic or lymphoblastic-

Leukemia classification

A

immature lymphocytes

81
Q

Myeloid

involves
interferes w

Leukemia classification

A
  • involves stem cells-

interferes with types of blood cell formation

82
Q

AML

Leukemia classification

A
  • worst of leukemias
83
Q

Acute Lymphocytic Leukemia- ALL

most common in

what onset

A

Most common type in children/ young adults

Rapid onset

84
Q

Acute Lymphocytic Leukemia- ALL S/S-

I
b
wt
what pain
h

A

infection,

bleeding,

wt loss,

bone pain,

headache

85
Q

Acute Lymphocytic Leukemia- ALL

Treatment-
c
what transplant
what transplant

A

chemo,

bone marrow transplant,

stem cell transplant,

remission rate is 90%

86
Q

Chronic Lymphocytic Leukemia- CLL

what progression
might require

A

Slower progression- older adults

might require no treatment at all or just monitoring

87
Q

Chronic Lymphocytic Leukemia- CLL
s/s
f
I
p

A

fatigue,

infection

pallor

88
Q

Acute Myeliod Leukemia- AML

strong association w

pts will have x2

A

strong association with exposure to toxins-like chemo and smoke and stuff

pts will have neutropenia and thrombocytopenia

89
Q

Acute Myeliod Leukemia- AML

S/S –
f
w
f
what pain
b
p
b

A

fatigue,

weakness,

fever,

bone pain,

bleeding,

petechia,

bruising

90
Q

Acute Myeliod Leukemia- AML

Treatment x2

A
  • chemo and stem cell transplants
91
Q

Chronic Myeliod Leukemia- CML

usually associated w

what onset
then becomes

A

Usually associated with chromosomal abnormality

Slow onset, and then becomes very aggressive

92
Q

Chronic Myeliod Leukemia- CML

S/S-
w
f
wt

A

weakness,

fatigue,

wt loss

93
Q

Chronic Myeliod Leukemia- CML
Treatment-

what med
what 2 others

A

interferon- modifies cells response to cancer

chemo and stem cell transplant

94
Q

Chemotherapy-

affects
kills
puts

Treatments For Leukemia

A

affects immature cells-

kills leukemic cells in bone marrow

puts cancer into remission

95
Q

Chemo- what to expect

n
I
loss of what
f

what else is affected

A

Nausea

immunosuppressed

hair loss

fatigue

all other organs are affected

96
Q

What meds help In chemo

anti-
f

A

antinausua- ondasatron

fluid

97
Q

Combination chemotherapy-

decrease

interrupts

Treatments For Leukemia

A

decrease drug resistance,

interrupts growth of cancer cells

98
Q

Colony stimulating factors-

helps

Treatments For Leukemia

A

helps bone marrow regain normal function after chemo

99
Q

Radiation therapy
damages

Treatments For Leukemia

A
  • damages cell of dna
100
Q

Bone marrow transplant

allogenic

Treatments For Leukemia

A

requires a donor- pt receives bone marrow cells from a donor

101
Q

Bone marrow transplant

uses what
harvested when

treatments for leukemia

A

uses the pts own bone marrow after chemo/radiation

pts bone marrow is harvested during remission

102
Q

Bone marrow transplant
Procedure for transplant-

what first – does what
risk for
then what

treatments for leukemia

A

need induction therapy (chemo/radiation) to kill cells in marrow-

huge risk for infection and bleeding

then marrow is infused

103
Q

Bone marrow transplant
Post transplant-

what means graft has taken hold
how long after

treatments for leukemia

A

if blood cell counts ( WBc, RBC, platelet ) increase then you will know the graft has taken hold-

usually 12-28 days later

104
Q

stem cell transplant
how does it work
risk for what

Treatments for Leukemia

A

same as bone marrow transplant

risk for graft vs host disease

105
Q

graft vs host disease

happens in what type
can be

A
  • happens in allognous stem cell

can be deadly

106
Q

Graft vs host disease s/s

rash where
what loss
d
what bleeding
what damage

A

rash in palms/ feet

skin loss

diarrhea

gi bleeding

liver damage

107
Q

treatment for graft vs host disease

a
s
i

A

antibiotics

steroids

immunosuppressants-

108
Q

biologic therapy like x2

does what

graft vs host disease

A

cytokines like interferon-

this will modify cells that attack cancer

109
Q

pts can also use complementary therapy

graft vs host disease

A

like relaxation, hypnosis, and nutrition

110
Q

risk for infection-> leukemia

what type of room
restrict whom
oral
avoid
neutrophils what level
no what food
no what

A

Protective isolation

Restrict sick visitors

Oral Hygiene

Avoid invasive procedures

Neutrophils <2,000

No raw fruits or veggies

No fresh flowers.

111
Q

Imbalanced Nutrition- leukemia

increased what
f
loss of
daily
/
give them what type of meals
and what illegal drug

A

increased metabolic needs

fatigue

loss of appetite

daily wts

I/o

give small frequent meals

marijuana- appetite stimulant

112
Q

leukemia

might see what in mouth

A

mouth sores

113
Q

Malignant Lymphoma

is what

what 2 types

A

Malignancies of lymphoid tissue

2 types- Hopkins or non Hodgkins

114
Q

Malignant Lymphoma

risks

g
h
c
u

A

genetic,

hiv,

chemicals,

unknown

115
Q

Hodgkin’s Disease

waht ages

what plays a role

what is prognosis

A

Ages 15-35 or over 50

epsteins barr virus and genetics play a role

very curable

116
Q

Hodgkin’s Disease S/S-

enlarger//where
f
s
f
wt

A

enlarged lymph nodes in subclavicular and cervical area,

fever,

sweats,

fatigue

weight loss

117
Q

Hodgkin’s Disease
Treatment

c
r
x2 transplants

A

-chemo,

radiation

, bone marrow transplants or stem cell transplants

118
Q

Hodgkin’s Disease

be cautious for radiation where

can cause

A

Radiation on lymph nodes on genitals

can cause sterility in patients

119
Q

Non-Hodgkin’s Lymphoma

More common- in who

what has affect

A

older adults

causes are unknown but environment/ genetics have an affect

120
Q

Non-Hodgkin’s Lymphoma

Starts where

A

peripheral lymph nodes and spread

121
Q

Non-Hodgkin’s Lymphoma S/S-

what lymph nodes
f
night
h
changes in

A

swollen lymph nodes,

fever,

night sweats,

headaches,

mental status changes

122
Q

Non-Hodgkin’s Lymphoma

Treatment-

c
r
x2 transplant

A

chemo,

radiation,

stem cell transplant, bone marrow transplant

123
Q

Staging of Cancer

stage 1-

stage iv-

A

Stage 1-single node, region or structure

Stage IV- involvement of a site not close to a node

124
Q

Staging of Cancer

A- what
B-x3

A

A-no systemic symptoms

B-systemic symptoms- night sweats, fever and wt loss

125
Q

Neutropenia

Count of WBC-

happens in:
prolonged
s
what disease

A

Count of less then 1500 WBC-

happens in
prolonged infection,

starvation

autoimmune disease

126
Q

NeutropeniaCauses

most common cause is

A

-most common cause is cancer w chemotherapy

127
Q

Neutropenia S/S-

I
c
f
f

A

infections,

chills,

fever,

fatigue

128
Q

Neutropenia Treatment-

I
what factor
what infusions
what colony

A

isolation,

growth factor to increase wbc production,

granulocyte infusions,

macrophage colony stimulating factor- stimulates production and function of monocytes

129
Q

Thrombocytopenia-

what platelet count
risk for

A

platelet count less then 100000-

risk for bleeding

130
Q

Thrombocytopenia

use what with blood draw

how long hold pressure or

A

use BP cuff to get iv

hold pressure for 5 minutes

131
Q

Idiopathic thrombocytopenia (purpura)

what disease

where what happens

A

-autoimmune disease

where platelets are destroyed too fast

132
Q

Idiopathic thrombocytopenia (purpura) s/s

p
e
b
what urine

id sytmoms persist- need what

A

petechia,

epistasis,

bruising-

blood urine

if symptoms persist they may need splenectomy

133
Q

Thrombotic Thrombocytopenia-

clots do what

can affect what

A

clots that occlude arterials and capillaries

can affect heart, kidneys and brain

134
Q

Thrombotic Thrombocytopenia- s/s

p
h
changes

A

petechia,

headache

loc changes

135
Q

Heparin induced Thrombocytopenia-

abnormal
what in blood
causes what

A

abnormal reaction to heparin,

partial platelets may be in blood and cause clotting cascade to develop a thrombus

136
Q

Heparin induced Thrombocytopenia- s/s

p
what extremities
e
e

A

pain,

pulseless extremities,

erythema

edema

137
Q

What med
does what
stop what

Care for Client With ALL 3 types of Thrombocytopenia

A

prednisone-

suppress immune system-

stop all heparin before giving

138
Q

Treatments

Care for Client With Thrombocytopenia

A
  • platelet transfusions
139
Q

Surgery-may need

Care for Client With Thrombocytopenia

A
  • may need splenectomy-
140
Q

spleen is where what occurs

where what’s produced

A

where platelet destruction is occurring

where antibodies are produced

141
Q

hemophilia a->
hemophilia b->

only seen in who
who is carrier

Hemophilia-Group of hereditary clotting factor disorders

A

Hemophilia A- destruction of clotting factor 8

Hemophilia B- christmas disease- clotting factor 9

A and b are only seen in men

females may be carriers

142
Q

Von Willebrands disease-
deficency of what

Hemophilia-Group of hereditary clotting factor disorders

A

deficiency of protein that mediates protein adhesions

143
Q

Factor XI deficiency-

when what is prolonged
form what
impairs formation of

Hemophilia-Group of hereditary clotting factor disorders

A

when postop bleeding is prolonged-

form platelet plugs but clotting factor is deficit

impairs formation of a stable fibrin clot

144
Q

Hemophilia s/s

h
b
bleeding of
what bleeding
spontaneous
h
p
what hemorrhage

A

hemarthrosis

, bruising

, bleeding of the gums,

gi bleeding,

spontaneous epistasis,

hematuria

, pain

intracranial hemorrhage

145
Q

Hemophilia Diagnosis

A
  • receive coagulation study
146
Q

Hemophilia meds

f
c
c

A

fresh frozen plasma,

Cryoprecipitate

concentrates

147
Q

Special Considerations For Children- iron deficiency anemia

why are kids more at risk
kids who ingest what
why are adolescents

A

because they need more for their body

kids that drink more milk then eat food are at risk for iron deficiency

adolescents with their menstrual cycle

148
Q

s/s of iron deficiency in kids

pale
poor
enlarged
enlarged

A

pale mucous membranes,

poor muscle tone,

enlarged spleen,

enlarged heart

149
Q

iron deficiency in kids

treatment

A

increasing iron rich food

150
Q

Pediatric Anemia Breastfed versus formula-

what happens

A

iron deficient moms will have iron deficient kids

151
Q

Pediatric Anemia

Screening at x3

A

9-12 months,

15-18 months

in adolescence

152
Q

Pediatric Anemia

Cows milk may cause what

may also cause

A

slight bleeding,

which may also cause iron deficney anemia

153
Q

bleeding precautions

what tooth
what sports
what razor

used when

A

soft bristled toothbrush

non contact sports

electric razor

used in thrombocytopenia or hep/anticoag use

154
Q

what blood product before surgery

155
Q

S/s of bleeding and coagulation

A

DIC

life threatening

D-Third semester (19 decks)

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