Hematologic Pathologies Flashcards
PART 1
PART 1
- One of the bigger issues as we age, is that there is a progressive decrease in the percentage of the _________ space occupied by hematopoietic (blood-forming) tissue.
- What are the implications of this?
- marrow
- As we age, we are at higher risk for anemia and reduced number of WBCs.
- As we age there is a decrease in _______ serum iron, total iron-_____ capacity, and intestinal iron ____________.
- What are the implications of this?
- total, binding, absorption
- As these abilities decline, the ability to synthesize RBCs declines. Anemia.
- As we age there is a rise in _______ and increased platelet adhesiveness, as well as an increase in red cell ___________.
- What are the implications of this?
- fibrinogen, rigidity
- Increased clot formation risk. Strokes.
Do hemoglobin and hematocrit levels decrease as we age?
Yes, however, the levels remain within the normal adult range.
Collectively, the changes caused by age contribute to _____perfusion and/or aggravation of various circulatory disorders including: ______tension, _________, diabetes and __________ changes.
- hypoperfusion
- hypertension, stroke, cognitive changes
Is blood transfusion an organ transplant?
-YES
Blood transfusion involves inserting _________ proteins into an individual (risk of eliciting an _________ reaction).
- foreign
- adverse
What is the most common blood transfusion related pathology?
Febrile, non-hemolytic transfusion reaction
Febrile, non-hemolytic transfusion reaction is an _______ reaction against the transfused RBCs and occurs in __% to __% of erythrocyte transfusions and __% of platelet transfusions.
- immune
- .5% to 1%
- 30%
- Febrile, non-hemolytic transfusion reaction is characterized by an increase in ____________ by more than 1°F during or soon after the transfusion.
- Is this reaction hemolytic? What does this mean?
- temperature
- No, this means the RBCs survive and are not ruptured.
What is the treatment for a febrile, non-hemolytic transfusion reaction?
- stopping the transfusion
- administering antipyretics or corticosteroids (reduce temp)
What are the S/S of febrile, non-hemolytic reactions?
- fever, chills
- headache
- nausea, vomiting
- hypertension
- tachycardia
What is an acute hemolytic transfusion reaction?
quick acting RBC rupturing
Acute hemolytic transfusion reaction is due to an ABO ______________ between donor and recipient. In this erythrocytes are destroyed intravascularly with resultant red plasma and red urine (___________).
- incompatibility
- hemituria
What is the mortality rate of an acute hemolytic transfusion reaction?
-17-60%
Why can an acute hemolytic transfusion reaction result in renal failure?
Antigen/antibody reaction forms clumps that can get caught at kidney.
What are the S/S of acute hemolytic transfusion reactions?
- fever, chills
- nausea, vomiting
- flank and abdominal pain
- headache
- dyspnea
- hypotension
- tachycardia
- red urine (hematuria)
PART 2
PART 2
- What is erythropoiesis?
- Where does erythropoiesis occur and how many are produced/sec?
- The production of RBCs
- Occurs in the marrow of long bones and produced at a rate of 2.4m/sec (200b/24hrs)
RBC destruction occurs in the ____________ and involves the recovery of _____ and production of ________.
- macrophages
- iron
- bilirubin
RBC production = RBC ________
destruction
What is the most common blood condition in the U.S. and what is it?
Anemia- A condition that develops when one’s blood lacks enough healthy functional RBCs or hemoglobin.
What populations are at increased risk for anemia?
- Women (blood (Fe++) loss during menstruation)
- People with chronic diseases
- Older adults (poor diet, comorbidities)
- The diagnostic criteria for anemia for males is a Hb of what?
- The diagnostic criteria for anemia for females is a Hb of what?
- 14g/100ml, 42%
- 12g/100ml, 35%
Is anemia a disease?
No, but rather a symptom of another disorder.
Causes of Anemia Include:
- Blood loss (acute or chronic)
- Decreased or faulty red blood cell ____________
- Excessive _________ of RBCs
- _______ deficiency (Vitamin B12)
- Congenital defects of hemoglobin (sickle cell disease)
- Exposure to industrial poisons (CCl4)
- Diseases of the bone _____________
- Chronic inflammation, infection or neoplastic disease
- production
- destruction
- dietary
- marrow
Causes of Anemia Resulting from Excessive Blood Loss:
- _________, _______
- Peptic and duodenal ulcers
- Gastritis
- ___ cancers
- Hemorrhoids
- Ulcerative colitis
- Colon polyps
- Parasitic worms (pediatric patients)
- NSAIDS, Aspirin
- GI
How do NSAIDS/Aspirin cause anemia?
Damage to the wall of the stomach, leading to blood loss.
Causes of Anemia Resulting from an Increased Destruction of RBCs:
- ___________ damage (damage by a mechanical heart valves)
- Autoimmune hemolytic anemia (AIHA)
- Parasites (e.g., malaria)
- ____________ (an overactive spleen, spleen degrades RBCs)
- _________________
- mechanical
- hyperspleenism
- thalassemias
Thalassemia is a _________ disorder in which the body makes an abnormal form of _________ resulting in abnormal RBCs. These RBCs are quickly removed, which results in excessive _________ of RBCs.
- genetic
- hemoglobin
- destruction
Causes of Anemia Resulting from a Decreased Production of RBCs:
- __________ deficiency (e.g., iron, vitamin B12, alcohol abuse, folic acid deficiency
- Cytotoxic or antineoplastic drugs
- Decreased _____ ________ stimulation (e.g., -hypothyroidism, decreased erythropoietin production)
- Bone marrow _________ (e.g., leukemia, aplasia)
- ____________ syndromes
- nutritional
- bone marrow
- failure
- myelodysplastic
- Anemias can result from a lack of __________ or loss of responsiveness to ______________.
- It may occur secondary to _________ diseases including RA, TB, cancer.
- erythropoietin (EPO), erythropoietin (EPO)
- chronic
Ways that Anemia is Diagnosed:
- _____
- Low ___ and ____
- Abnormal RBC ______ (mean volume & width) and RBC development
- _______ levels (intracellular protein that stores iron and releases it - low in anemia)
- Serum ____-________ protein levels (binds iron and transports it through the blood, elevated in periods of iron deficiency)
- CBC
- Hb and Hct
- geometry
- Ferritin
- iron-binding
What are the S/S of anemia?
- Pallor
- Fatigue
- Lightheadedness
- Weakness
- Dyspnea
- Angina
- Fainting
What does treatment of anemia look like?
- Understanding the causes and alleviating them
- Relieving the symptoms
- Preventing complications
Prognosis of patients with anemia depends on the ________ factors and potential treatment for the underlying disease.
-etiologic
__________ exercise tolerance and _______ fatigability may be expected in anyone with anemia.
- diminished
- easy
- Prevalence of iron-deficiency anemia is likely to be higher in _______ populations.
- Anticipate anemia in chronic ______ failure patients.
- Anemia may be accompanied by ___ pathology and/or disease.
- athletic
- renal
- CV
Anemia causes a decrease in ____ delivery which affects skin healing, exercise capacity, and functional capacity.
O2
PTs should also monitor for tachycardia, why?
Heart is compensating for low O2 by increasing the cardiac output.
PART 3
PART 3
Leukocytes is a comprehensive term for what?
All WBCs (agranular vs granular)
- What are the 2 agranular WBCs?
- What are the 3 granular WBCs?
- lymphocytes, monocytes
- basophils, neutrophils, eosinophils
Disorders of leukocyte or WBC concentration and in the relative proportions of the leukocyte types are recognized as measures of the reaction of the body to ________, ___________, _________ damage, or degeneration.
- infection
- inflammation
- tissue damage
What is leukocytosis?
An increase in the number of leukocytes in the blood (too many!).
Leukocytosis occurs with ___________ and chronic ____________.
- infections
- inflammation
Is an increase in leukocytes okay?
Yes, it is a normal response to things such as inflammation and infection.
Leukocytosis can also occur in response to physiological ________ and can result from an acute _________.
- stressors
- hemorrhage
Leukocytosis can cause both ______philia and ______philia.
- basophilia
- eosinophilia
Basophilia is involved in inflammatory and ________ reactions. Basophils degranulate when stimulated by an _________ and release _________ and other inflammatory cytokines.
- allergic
- allergen
- histamines
Eosinophils are recruited to areas of __________ and participate in the response. However, they play key roles almost exclusively in fighting ________ infections.
- inflammation
- parasitic