hematologic disorders

Question 1

how does the hematologic system differ from the CV system?

Answer 1

it is composed of blood, blood vessels and organs producing blood (ex. bone marrow)

Question 2

“blood” contains what 4 components?

Answer 2

erythrocytes, leukocytes, platelets and plasma

Question 3

Hemotologic manifestations are more commonly secondary symptoms. They are often relate to what 4 factors?

Answer 3

NSAIDs
Neuro complications (pernicious anemia)
chemo or radiaiton

Question 4

In patients with hematologic disorders, what other symptoms might we expect to see in additon to changes in exertional effort, neurologic signs, and integ?

Answer 4

bloody stool, emesis and joint pain/swelling

Question 5

5 erythrocyte disorders mentioned in this class include anemia, polycythemia, poikilocytosis (abnormal shape), and __(2)

Answer 5

anisocytosis (abnormal size variation)
hypochromia (Hbg deficiency)

Question 6

what is anemia? what are it’s four subtypes?

Answer 6

insufficient amount/ quality of erythrocytes from bleeding, destruction or low production.
types:
* iron deficiency
* chronic/inflam disease
* neuro conditions
* infection

Question 7

what are some s/s that might increase the likelihood of anemia in your differential dx? (4)

Answer 7

skin changes, , slower processing/ depressed affect, decreased DBP, easily aggravated pain/ dyspnea with exertion

Question 8

T/F: anemia is a disease resulting in reduction of O2 carrying capacity.

Answer 8

false. this a symptom but not a disease

Question 9

what is polycythemia/erythrocytosis? What are 3 conditions might result in this secondary complication due to dec O2 supply to tissues?

Answer 9

an excessive amount of RBCs
smoking, high altitudes, and chronic heart/lung conditions

Question 10

what is the only known cause of primary erythroctytosis?

Answer 10

neoplastic dx of bone marrow

Question 10

Aside from HTN, what are some s/s that might increase the likelihood of polycythemia in your differential dx? (4)

Answer 10

hypoxemic s/s (ex cyanosis, AMS, dizziness), gout, malaise and SOB, weight loss

Question 11

In sicle cell anemia, a genetic abnormality results in the altered shape of RBCs that block blood supply. This produces recurrent and painful episodes of vasoocclusionand inflammation. Aside from MSK pain, including hand-foot syndrome, and and vascular complications, s/s can also present as (4)

Answer 11

pulmonary (ex. SOB, tachypnea)
neurologic manifestations (ex. paresthisia, CN palsy, nysagmus, drowsiness)
renal complicatons
splenic sequestration (pre-adolescent enlargement and tenderness)

Question 12

of the 3 types of leukocytes: lymphocytes, monocytes, and granulocytes, which contains the lysing agents? what do the others do?

Answer 12

1. granulocytes
2. monocytes: largest cells that travel to form macrophages and lymphocyes produce antibodies and react w/ antigens

Question 13

T/F leukocytosis (indicated by a count > 10,000/mm) is a normal immune respone to many infectious and inflammatory diseases.

Answer 13

true

s/s: fever and inflammation

Question 14

Conditions that may result in leukopenia (<5000/ml) include autoimmune diease, overwhelming infection, and (3)

Answer 14

dietary deficiency
some medications
many forms of bone marrow failure

Question 15

From neuro, we know nadir to be the end of a GBS progression. How does it’s defination explain this?

Answer 15

nadir is when the WBCs reach their lowest point. given GBS is an immune response gone wild, it maes sense for it to stop when WBCs bottom out.

for CA pts, this period is usually 7-14 days post chemo/radiation

Question 16

T/F: In a person who is already immunocompromised, the presence of fever, chills, and diaphoresis is an automatic medical referral.

mucual membrance ulcerations and UTI s/s also a concern

Answer 16

true

Question 17

Vitamin K is known to help ___ (dec/inc) coagulation

Answer 17

increase

Question 18

Thrombocytosis inc the bloods affinity for clotting, especially in the periphery. It can present as ___ (3) and be a primary result of abnormal mone marrow cells or secondary complication of iron deficit/polycythemia vera, occult neoplasm, or s/s compensation.

Answer 18

thrombosis
splenomegaly
easy bruising

Question 19

Thrombocytopenia can be caused by radiation &chemo, meds, metastatic cancers, and (3)

Answer 19

aplastic anemia (insufficient amount of blood cells)
leukemia
bone marrow failure

Question 20

Individuals with hemophilia often experience episodes of hemoarthrosis in their major joints along w/ bleeding in LE muscles and forearm flexors. What are the 3 more common MSK s/s?

Answer 20

progressive loss of motion
muscle atrophy
flexion contractures

Question 21

T/F:Hemophilia, caused by abnormally functioning plasma-clotting proteins, results in bleeding/ swelling episodes best treated by increased movement to promote blood circulaiton

Answer 21

false. it’s treated by factor replacement and joint immobilization.

Question 22

a hemophillic episode is more likely to present with which of the following:
* muscle bleeding
* hemarthrosis

Answer 22

muscle bleeding

also more insidious and massive than joint hemorrhages

Question 23

potential complications of hemophillia include localized ischemia/necrosis, replacement of muscle fibers w/ nonelastic tissue and __ (2)

Answer 23

peripheral N lesions via compression
pseudotumor formation w/ bone erosion

Question 24

acute hemoarthrosis might present with

Answer 24

tingling or prickling+ local inflammatory signs

Question 25

s/s of muscle hemorrhage might include

Answer 25

muscle position of comfort w/ protective spasms, limited movent, sensation loss, and gradually intensive pain

common in iliopsoas!!

Question 26

T/F: Hemophillia can also have GI and CN involvement.

Answer 26

true.

Question 27

Why would the inc in RBC /Hbg concentrations produced by polycythemia/Erythrocytosis ultimately diminished blood supply to organs?

Answer 27

inc viscosity and vol» inc clot risk

Question 28

total number of RBCs is affected by what 3 factors?

Answer 28

gender, altitude, conditioning levels

Question 29

s/s characteristic of leukopenia include: cold s/s, persistent infection, and what else? (2)

Answer 29

ulceration of mucous membranes and frequent or painful urination

Question 30

the main function of platelets are
1. blood clotting
2. ?
so what impacts them most often??

hint: drugs

Answer 30

maintaining capillary integrity; anticoagulants

Question 31

In individuals with hemophilia who are experiencing CNS involvement, we are ____(more/less) likely to see an intracranial hemorrhage than Intraspinal hemorrhage. What does this look like?

Answer 31

more; think hem stroke s/s

ex. seizure, apnea, lethargy, bulging, paralysis, death