Hematologic Disorders 5 Flashcards
Patient blood management develops an individualized plan for each person to minimize the need for transfusion
3 principles
- manage anemia
- minimize blood loss
- optimize hemostasis
Why does pt blood management need to be developed to minimize the need for transfusion?
- Techniques acceptable for religious groups (Jehovah’s Witnesses)
- New infectious agents possible
- Risks associated with transfusions
What needs to be done for pts who have had transfusions in the acute care, surgical, and post-op settings? (PT)
- Monitor lab values when treating patients
- Adjust treatment and intensity accordingly
disorders of iron absorption =
hemochromatosis
What type of disorder is hemochromatosis?
autosomal recessive hereditary disorder
What causes hemochromatosis?
mutations in genes of any of the proteins that regulate the entry of iron into th eblood
hemochromatosis severity depends upon:
variable, but thought to have an environmental component
- alcohol intake
- coexistence of Hep B/C
What does hemochromatosis result in (liver + iron)
Excessive absorption of iron from small intestine
hemochromatosis: sx onset
- present at birth
- onset of sx usually between 40-60 y.o.
hemochromatosis: prevalence
- Equal between men and women
- Men experience sx 5-10x more often than women
What are some of the sx associated with hemochromatosis?
- weakness
- chronic fatigue
- myalgia
- joint pain
- abnormal bronzing of the skin
What is used to diagnose hemochromatosis?
- blood tests
- liver biopsy
Medical tx for hemochromatosis (therapeutic phlebotomy)
Therapeutic phlebotomy until iron stores are at normal level
initial tx for hemochromatosis (amts)
- may be 1 pint
- 1-2x per week
maintenance therapy for hemochromatosis (amts)
- 1 pint
- every 2-4 months for life
What can hemochromatosis lead to if left untreated?
- hepatomegaly
- pancreatic damage
- DM
- destructive arthritis
- liver failure
- cardiac myopathy
- CHF
- arrhythmias
- impotence in men
- decreased libido and sterility in women
What is a major indicator with a pt who has hemochromatosis that distinguishes is from OA?
pt may report twinges of pain when flexing small joints of hands
ARTHROPATHY
Arthropathy is present in ______% of cases of hemochromatosis
40-60%
joint destruction with hemochromatosis
likely irreversible
For pts who have hemochromatosis, what do PT interventions seek to address?
- flexibility
- strength
- assistive devices
- orthoses
- fall prevention
