Hematological & immunological

Question 1

causes of anemia

Answer 1

• blood loss
• immunosuppressant drugs: cyclosporine
• lack of Fe, B12

Question 2

s/s of anemia

Answer 2

• SOB, dizziness, pallor
• tiredness, fatigue

Question 3

normal hemoglobin range

Answer 3

• normal 12+
• bad: 8-9
• less than 7 = send to heaven

Question 4

causes of iron deficiency anemia in mothers

Answer 4

• diet low in: meat, fish, and poultry
• gastric bypass surgery
• pregnancy: fetus stores iron and depletes mom of Fe
• Pica: consume non-nutritious foods such as dirt, chalk

Question 5

iron deficiency anemia causes in infants and children

Answer 5

• premature birth
• insufficient oral intake
• excessive intake of cow’s milk >24oz
• vegan diet

Question 6

treatment for iron deficiency anemia

Answer 6

• diet in iron: meats, fish, poultry, dark leafy veg, whole grains
• high vit C help Fe absorption, but take at diff time
• ferrous sulfate (oral), iron dextran (IV/IM): dark stools expected
  take 1hr before other meds, if GI symptoms take with food

Question 7

what is sickle cell anemia

Answer 7

• genetic mutation causing moon-shaped RBCs
• fragile RBCs, shorter lifespan (10-20days vs. 120days)
• rigid -> hard to pass through small blood vessels
• can’t carry enough O2 -> ischemia

Question 8

vaso-occlusive crisis (sickle cell anemia)

Answer 8

ischemia -> extreme pain
- unilateral weakness -> suspect** stroke**
- swelling of feet and hands (dactylitis) 1st sign in infants
- new or sudden are key words

Question 9

sequestration crisis (sickle cell anemia)

Answer 9

sickle-cells pooling in spleen or liver
- life-threatening: decreased blood volume -> hypovolemic shock, hypotension

Question 10

aplastic crisis (sickle-cell anemia)

Answer 10

• lower RBC production
• typically triggered by viral infection
• results in anemia

Question 11

hyperhemolytic crisis (sickle-cell anemia)

Answer 11

• accelerated rate of RBC destruction
• anemia, jaundice, reticulocytosis (increased amount of immature RBCs)

Question 12

acute chest syndrome (sickle-cell anemia)

Answer 12

• similar to pneumonia
• new pulmonary infiltrate
• chest pain, fever, cough, tachypnea, wheezing, hypoxia

Question 13

diagnosis for sickle-cell disease

Answer 13

• Hgb electrophoresis
• DNA analysis

Question 14

treatment for sickle cell crisis

Answer 14

• IVF
• bedrest: lower energy expenditure
• pain control: PCA pump
• electrolyte replacement: hypoxia results in metabolic acidosis
• blood exchange transfusion (erythrocytapheresis)
• abx for infections