Hematologic Disorders 5 Flashcards

1
Q

Patient blood management develops an individualized plan for each person to minimize the need for transfusion

3 principles

A
  • manage anemia
  • minimize blood loss
  • optimize hemostasis
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2
Q

Why does pt blood management need to be developed to minimize the need for transfusion?

A
  • Techniques acceptable for religious groups (Jehovah’s Witnesses)
  • New infectious agents possible
  • Risks associated with transfusions
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3
Q

What needs to be done for pts who have had transfusions in the acute care, surgical, and post-op settings? (PT)

A
  • Monitor lab values when treating patients

- Adjust treatment and intensity accordingly

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4
Q

disorders of iron absorption =

A

hemochromatosis

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5
Q

What type of disorder is hemochromatosis?

A

autosomal recessive hereditary disorder

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6
Q

What causes hemochromatosis?

A

mutations in genes of any of the proteins that regulate the entry of iron into th eblood

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7
Q

hemochromatosis severity depends upon:

A

variable, but thought to have an environmental component

  • alcohol intake
  • coexistence of Hep B/C
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8
Q

What does hemochromatosis result in (liver + iron)

A

Excessive absorption of iron from small intestine

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9
Q

hemochromatosis: sx onset

A
  • present at birth

- onset of sx usually between 40-60 y.o.

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10
Q

hemochromatosis: prevalence

A
  • Equal between men and women

- Men experience sx 5-10x more often than women

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11
Q

What are some of the sx associated with hemochromatosis?

A
  • weakness
  • chronic fatigue
  • myalgia
  • joint pain
  • abnormal bronzing of the skin
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12
Q

What is used to diagnose hemochromatosis?

A
  • blood tests

- liver biopsy

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13
Q

Medical tx for hemochromatosis (therapeutic phlebotomy)

A

Therapeutic phlebotomy until iron stores are at normal level

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14
Q

initial tx for hemochromatosis (amts)

A
  • may be 1 pint

- 1-2x per week

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15
Q

maintenance therapy for hemochromatosis (amts)

A
  • 1 pint

- every 2-4 months for life

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16
Q

What can hemochromatosis lead to if left untreated?

A
  • hepatomegaly
  • pancreatic damage
  • DM
  • destructive arthritis
  • liver failure
  • cardiac myopathy
  • CHF
  • arrhythmias
  • impotence in men
  • decreased libido and sterility in women
17
Q

What is a major indicator with a pt who has hemochromatosis that distinguishes is from OA?

A

pt may report twinges of pain when flexing small joints of hands

ARTHROPATHY

18
Q

Arthropathy is present in ______% of cases of hemochromatosis

A

40-60%

19
Q

joint destruction with hemochromatosis

A

likely irreversible

20
Q

For pts who have hemochromatosis, what do PT interventions seek to address?

A
  • flexibility
  • strength
  • assistive devices
  • orthoses
  • fall prevention