Hematological Disorders Flashcards
bone marrow
bld forming tissue, produces cell components of bld, all develop from common stem cell.
types of bld cells
RBC WBC platelets
function of RBC
oxygenation
hemoglobin
transports O2
erythropoiesis
production of RBC, regulated by cellular O2 requirements and general metabolic activity, influenced by nutrition
reticulocyte
immature erythrocyte
how long for reticulocyte to mature
when released, 48 hours
RBC life span
120 days
anemia
dec in RBC, hemoglobin, & hematocrit
CM for mild anemia
Hb 10-14, palpitations, exertional dyspnea, may not have symptoms
CM for moderate anemia
Hb 6-10, inc palpitations, dyspnea
CM for severe anemia
Hb <6, affects all body systems
cytic
cell size
chromic
hemoglobin content
types of “cytic”
micro, macro, normo
types of “chromic”
hypo, normo
types of macrocytic normochromic
pernicious anemia, folic acid anemia
types of microcytic hypochromic
iron deficiency anemia
pernicious anemia
impaired vit B12 absorption
what is vit B12 used for?
DNA synthesis
patho of p.a
defective gastric secretion of intrinsic factor
what is intrinsic factor needed for
absorption of extrinsic factor (Vit B12)
etiology of p.a
gastric atrophy, surgery
what does gastric bypass do?
can reduce amt. of intrinsic factor
CM for p.a
weakness, fatigue,
general symptoms
GI problems- in gastic mucosa (sore mouth, anorexia, nausea, abd pain)
Neurological problems- need vit B12 for normal nerve “f”, neuropathy, balance, muscles, concentration — can be irreversible
how long b4 damage is permanent
3-6 months
diagnosis for p.a
serum B12, RBS, H&H, Schillings test
schillings test
pt. drinks vit B12 substance, measure amt. of substance excreted in urine.
if absorbs, they don’t have p.a
treatment for p.a
Vit B12 injections
Folic acid anemia
lack of vit folate.
what is folate needed for?
DNA synthesis, which leads to RBC formation
etiology of f.a.a
poor nutrition
poor absorption
alcohol abuse
most common cause of f.a.a
alcohol abuse
CM for f.a.a
same as p.a EXCEPT NO NEURO PROBLEMS
diagnostic tests for f.a.a
serum folate, RBC, H&H
treatment for f.a.a
folic acid
iron deficiency anemia
depletion of iron in body
result of i.d.a
dec supply of iron for hemoglobin
patho of i.d.a
iron stores for RBS production depleted
not enough iron transported to bone marrow
altered rbc production starts
hemoglobin deficient RBCs enter circulation and replace normal ones
etiology of i.d.a
inadequate intake (diet)
malabsorption
blood loss
pregnancy
most common cause of i.d.a
diet, inadequate intake
CM for i.d.a
tongue and lips inflamed
H/A
numbness, tingling
confusion
diagnostic tests for i.d.a
serum iron, RBC, H&H
treatment for i.d.a
treat cause
iron supplements
polycythemia
inc RBC
causes thick bld, excess volume
polycythemia vera
primary
caused by excessive proliferation of erythrocyte precursors in marrow
myeloproliferative disorder
what does P.vera cause
inc in granulocytes/platelets
secondary polycythemia
caused by hypoxia
inc erythropoetin due to underlying systemic disorder
who has higher risk for hypoxia
people with history of COPD, resp. conditions, CHF, people who smokes, live in higher altitudes
effects of polycythemia
dec bld. flow, inc bp, risk of bld. clot, injury to tissues, tissue infarction
CM for polycythemia
PELSHCVP plethora enlarged retinal/cerebral veins liver enlargement spleen enlargement H/A confusion visual changes painful itching
diagnostic tests for polycythemia
blood tests (CBC), bone marrow biopsy
treatment for polycythemia
reduce BV- phlebotomy
fluids
meds to dec bone marrow activity
leukocytes
responsible for phagocytosis of bacteria and foreign particles.
types of leukocytes
granulocytes, lymphocytes, monocytes
types of granulocytes
neutrophils, eosinophils, basophils
neutrophils
primary phagocytic cell involved in inflam. process
eosinophils
engulf antigen-antibody complexes formed during allergic response, active in parasitic infections
basophils
granules contain heparin, serotonin, histamine
lymphocytes
cellular and humoral responses
types of lymphocytes
T cells and B cells
B cells
stimulated by antigens to produce antibodies
T cells
involved in cellular immune response against viruses
monocytes
potent phagocytosis. macrophages. interact with lymphocytes.
function of thromocytes
bld coag. and control of bleeding
normal platelet count
140-340 k
thromboctyopenia
dec platelet count. <100 k
etiology of thrombocytopenia
VNDIT viral infection nutritional deficits drugs ITP TTP
ITP
immune thrombocytopenia purpura
autoimmune destruction of platelets- antibodies destroy antigens
TTP
thrombotic thrombocytopenia purpura- platelets aggregate and cause occlusions
CM of thrombocytopenia
PPPE petechiae purpura prolonged bleeding ecchymosis
diagnostic tests for thrombocytopenia
platelet count
bleeding time
treatment for thrombocytopenia
platelets
if ITP- steriods
if TTP- plasma
thrombocythemia
elevated platelet count >400 k
etiology of thrombocythemia
accelerated production
splenectomy
why does splenectomy cause thrombocythemia
bc the spleen stores platelets. taking out spleen will release platelets.
CM of thrombocythemia
THTH thrombosis formation H/A TIA- transient ischemia attacks hemorrhage
treatment for thrombocythemia
meds to suppress bone marrow
pheresis- remove platelets
clotting mechanisms
PVC
vascular response, platelets, clotting factors
clotting
hemostasis
etiology of impaired hemostasis
vit k deficiency
liver disease
vit K is needed for?
clotting factors
why is liver disease such a big problem for hemostasis?
the liver produces clotting factors
DIC
thrombohemmorhagic disorder.
Disseminated Intravascular Coag.
thrombosis (clotting) and hemmorhage
depletion of platelets and clotting factors
etiology for DIC
see related to injury
shock. infection, obstetric accidents, burns, trauma, liver disease
patho for DIC
normal coag mechs enhanced.
excess clotting activates fibrinolytic system
lyses newly formed clots
creates fibrin split products- anticoag properties
loses ability to clot
CM for DIC: bleeding
pallor petechiae/bruising inc RR, HR hemoptysis dec BP GI bleeding HA, intracranial bleeding change in MS
CM for DIC: thrombosis
dyspnea PE tissue necrosis ARDS kidney damage
diagnostic test for DIC
platelet count- low
fibrin split products- high
bleeding time- high
treatment for DIC
treat cause
bld products- for hemorrhage
anticoags- to prevent random bld clots
function of spleen
FISH filter- out defective RBC immune storage- lymphocytes/platelets hematopoietic- RBC production
overactive spleen
hypersplenism
reduction of all circulating bld cells
caused by liver disease, CHF
underactive spleen
splenectomy
dec immune response
inc leukocytes
more defective bld cells
function of lymphatic capillaries/ducts
carries bld from interstitial spaces to bld
returns excess fluid back to i.s to PREVENT EDEMA
TRANSPORTS PROTEIN/FAT from gi tract to blood/certain hormones
function of lymph nodes
contain lymphocytes/monocyte and macrophages
which clean lymph of foreign part. and microorg.
why do lymph nodes enlarge during inf
bc inc macrophage activity
lymphadenopathy
enlargement of lymph nodes
types of lymphadenopathy
localized
generalized
localized lymphadenopathy
indicates drainage in area where theres infection
generalized lymphadenopathy
associated with infection
