hematological system Flashcards
acute hemorrhage
correct hemoglobin won’t show up unit 24 hours of hemorrhage.
Loss of 15% or higher = orthostatic hypotension
neutropenia
frequent infections
ANC, absolute neutrophil count of
b12 defeciency
gradual peripheral neuropathy, ataxia (postive romberg test), loss of vibration sense,.
hodginks lymphoma
a cancer of B lymphocytes
pain with injection of alcoholic drinks, painless lymph nodes of the neck.
Common age 20-40yo or >60 yo, while male
multiple myeloma
cancer of plasma cells.
The plasma cells are a type of WBC IN BONE MARROW . With this condition, a group of plasma cells becomes cancerous and multiplies.
The disease can damage the bones, immune system, kidneys, and red blood cell count.
Symptoms may not be present or may be non-specific, such as loss of appetite, bone pain, and fever.bone pain in the BACK PAIN or CHEST PAIN
proteinuria with Bence- jones protein
bence jones protein suggested of what?
multiple myeloma
thrombocytopenia
platelet count
normal platelet count
150,000-450,000
normal hemoglobin in males/females
males: 14-18 g/dl
females: 12-16g/dl
normal hematocrit males/females
males: 42-52%
females: 37-47%
MCV
80-100
MCHC
color of the RBC
noral: 31-37g/dl
MCH
indirect measure of the color of RBC
normal 25-35
TIBC
total iron binding capacity
measure of available transferrin left unbent (transferrin transfers iron to the body)
ELEVATED if LOW iron
normal 250-410mcg
Serum ferritin
storage form of iron produced in the intestines (spleen, over, marrow)
most SENSITIVE test for iron deficiency anemia
Iron def: decreased
thalassemia: normal to high ( high dt given iron supplements)
normal: 20-400 ng/dl
RDW
red cell distribution width. ELEVATED in iron def and thalassemia (variability of RBC size)
reticulocytes (aka stabs)
immature RBC that still have their nuclei. after 24 hours they mature into RBC. RBC survive 120 days before broken down by the liver.
normal value: .5% - 2.5% of total RBC count
> 2.5%= reticulocytosis. Plateletes make more RBC. elevated with iron supplementation or iron, folate, or b12, acute bleeding, leukemia. NOT WITH CHRONIC BLEED.
if NOT increased, check bone marrow failure ( aplastic amemai)
poikilocytosis
SEVERE iron def anemia. may be also anisocytoiss (variable sizes)
WBC
normal value 5,000-10,000/10mm3
hemoglobin electrophoresis
“gold standard” tests for sickle cell and thalassemia
secondary polycythemia
copd, chronic smoker, high altitudes
anemia
iron def. anemia
1 cause: BLOOD LOSS
microcytic
hypochromic
classic case of iron def anemia
pallor of skin, nail beds, glossitis (sore and shiny red tongue), angular chelitis (skin fissure corner of mouth), cravings for ice and dirt (pica)
SEVERE: koilonychia (spoon shaped nails), systolic murmur, tachy, heart failure
labs for iron def
dsg test:
TIBC (>410)
>RDW
microcytic
thalassemia minor
microcytic, hypochromic
Ferritin increase or normal
normacytic anemia
MCV 80-100, normochromic
hx of chronic disease
or inflammatory disease (RA)
b12 /folate def/pernicious anemia (b12)
macrocytic, megaloblastic RBC
normochromic
supplementation of iron
325mg ferrous sulfate. po TID, take with meals, with vitC
increase fiver and fluids
iron rich foods (beans, veges)
AVOID: ANTACIDS, daily, quiolones, tetracycline
thalassemia minor or trait
if partner also has treat, 25% chance to children
beta thalassemia, abnormal hgb, a2, hgbF
NORMAL to HIGH ferritin level
pernicious anemia cause
autoimmune, destruction of parietal cells in the funds resulting in cessation of intrinsic factor production, necessary to absorb b12 from the small intestine.
b12 sources; meal, poultry, eggs, milk, cheese
Neuropathic s/s (numbness, tingling,
if MCV >100 what to order
b12 and folate
b12 def s/s
ONLY one with neurologic s/s (tingling/numb)
ferritin and serum iron level in thalassmia
norm to high
