Hema Flashcards
sicke cell anemia
african american descent
microcytic hypochromic anemia
-need oxygen & hydration
-may need blood transfusion
-do not elevate HOB above 30° & extremities extended
-antibiotics as prophylaxis
-analgesics for joint pain
-vaccinate: pneumococcal, meningococcal, flu
-splenectomy if recurring splenic sequestration
sickle turbidity test
fingerstick blood extraction
3min result
if +, further tested if only carrier or w/ the disease
thru Hgb Electrophoresis
hemophilia
-treatment of clotting factor deficiency
(VIII - A/Classic, IX - B/Christmas)
-female carriers, male w/ disease
-corticosteroid & vasopressin derivative
-bleeding tendencies
💀joint bleeding: apply ice, elevate, immobilize
💀intracranial hemorrhage: neurological status
💀internal bleeding: bruising
💀hematuria
*avoid contact sports
*wear helmet, knee & elbow pads
von Willebrands Disease
bleeding in mucous membrane
epistaxis, excessive menstrual bleeding, gum bleeding, easy bruising
-deficiency of the protein carrier of clot factor VIII
same treatment w/ hemophilia
types of thalassemia
- Thalassemia Minor: Asymptomatic silent carrier
*Thalassemia Trait: Produces mild microcytic anemia
*Thalassemia Intermedia: splenomegaly and moderate to severe anemia
*Thalassemia Major: severe anemia requiring transfusion support to sustain life (also known as Cooley’s anemia)
thalassemia major
*bone deformities
-Frontal bossing
-Maxillary prominence
-Wide-set eyes with a flattened nose
also
*Greenish yellow skin tone
*Hepatosplenomegaly
*severe anemia
*Microcytic, hypochromic red blood cells
both parents are carriers (genetic counseling)
-mediterranean descent
-supportive therapy thru blood transfusions
-bone marrow transplantation
-splenectomy for severe splenomegaly
-chelation for iron overload
liquid iron
taken with a straw or medicine dropper
at the back of the mouth
wipe or brush teeth
in between meals (not during or before: food decreases absorption)
Vaso-Occlusive Crisis
Caused by stasis of blood with clumping of cells in the microcirculation, ischemia, and infarction
Manifestations: Fever; painful swelling of hands, feet, and joints; and abdominal pain
Splenic Sequestration
Caused by pooling and clumping of blood in the spleen (hypersplenism)
Manifestations: Profound anemia, hypovolemia, and shock
Hyperhemolytic Crisis
An accelerated rate of red blood cell destruction
Manifestations: Anemia, jaundice, and reticulocytosis
Aplastic Crisis
Caused by diminished production and increased destruction of red blood cells, triggered by viral infection or depletion of folic acid
Manifestations: Profound anemia and pallor
chelation
derasirox or deferoxamine
Deferoxamine: antidote for acute iron toxicity
meperidine
may cause seizure in sickle cell anemia & should not be given
iron supplements
-Take between meals
-Take with a multivitamin or fruit juice: vitamin C increases absorption
-Do not take with milk or antacids -Side effects of iron supplements (black stools, constipation, and foul aftertaste).
severe iron deficiency anemia
microcytic hypochromic anemia
Intramuscular injections of iron (using Z-track method) or
IV administration of iron
iron rich foods
Breads and cereals
Dark green vegetables
Dried fruits
Egg yolk
Legumes
Liver
Meats
Vit B12 deficiency anemia
2 type:
macrocytic anemia - lack of vit b12 itself
pernicious anemia - lack of intrinsic factor, that absorbs vit b12
vit b12 rich foods
citrus fruits
dried beans
green leafy vegetables
liver
nuts
organ meats
brewer’s yeast
vitamin B12 injections
as prescribed, weekly initially and then monthly for maintenance (lifelong) if the anemia is the result of a deficiency of intrinsic factor
folate deficiency anemia
macrocytic anemia (RBCs are large & oval due to ⬇️ Vit B9).
💀smooth beefy red tongue
causes
-dietary deficiency
-malabsorption syndromes such as Celiac disease, Crohn’s disease, or small bowel resection
-medications: antiseizure
-pregnancy
-chronic alcoholism
-chronic hemodialysis.
folic acid rich foods
green leafy vegetables
meat
liver
fish
legumes
peanuts
orange juice
avocado
aplastic anemia
PANCYTOPENIA: all blood cells have arrested growth in the bone marrow
treatment: immunosuppressants & ultimately bone marrow transplantation
*immunosuppressive:
antilymphocyte globulin or antithymocyte globulin *Colony-stimulating factors to enhance bone marrow production *Corticosteroids and cyclosporine
*blood transfusions
possible causes: chronic exposure to myelotoxic agents, viruses and infections such as hepatitis, Epstein-Barr virus, autoimmune disorders such as human immunodeficiency virus, and allergic states
