HEMATOLOGY Flashcards
Transport of gases
and maintenance of acid-based balance
Erythrocytes
Promotes production of Mature RBC in the bone marrow
Erythropoietin
Necessary for RBC production
Iron
Lifespan of RBCs
120 days
An invasive procedure that helps in
evaluating the patient’s hematologic
status
Bone Marrow Biopsy
Most Common site for BMB
iliac crest or sternum
Advise client to avoid any activity that might result in trauma in the site
for ____
48H
A disorder in which there is a
deficiency in the number of
erythrocytes, the quantity of
hemoglobin and/or volume of
RBCs (hematocrit)
Anemia
Group of diseases involving inadequate production of normal Hgb which decreases RBC production
Thalassemia
Has Heterozygous form: 1 thalassemic gene and 1 normal
Thalassemia MINOR
It has a Homozygous form: 2 thalassemic genes; a life-threatening disease that slows the growth
physically and mentally
Thalassemia MAJOR
A rare disease caused by the
decrease in or damage to marrow stem cells
Aplastic Anemia
Group of disorders caused by impaired DNA synthesis and characterized by the presence of large RBCs
Megaloblastic Anemia
it is either caused by a deficiency in B12 or Folic Acid which is essential for normal DNA synthesis
Megaloblastic Anemia
A type of hemolytic anemia that causes destruction or hemolysis of RBCs at a rate that exceeds production
Sickle Cell Anemia
Tissue hypoxia and necrosis d/t inadequate blood flow to specific organ or tissue
Sickle crisis
results from infection with human
parvovirus; Hbg falls rapidly and the marrow cannot compensate
Aplastic Anemia
Other organs pool the sickled cells
causing infarction (most common splenic infarction in children; for adults, liver, and lungs)
Sequestration crisis
Refers to the primary polycythemia, an
increased volume of erythrocytes, which is a proliferative disorder of the myeloid stem cells
Polycythemia Vera
X-linked recessive genetic disorder caused by defective/ deficient coagulation factor
Hemophilia
Classic hemophilia with factor VIII
deficiency, 4x more common
Hemophilia A
Hemophilia with Christmas factor or
factor IX deficiency
Hemophilia B
slow, persistent, prolonged bleeding from minor trauma and small cuts
Hemophilia
Commonly seen in ethnics groups in the Mediterranean sea, Southeastern Asia, Middle East, India, Pakistan, China, Southern Russia and Africa
Thalassemia
Palpitations, Mild fatigue, Exertional
dyspnea, Hgb 10-12g/dL
Mild Anemia
Aside from S/Sx of anemia: infections d/t significant neutropenia, purpura (bruising) d/t significant
thrombocytopenia, cervical lymphadenopathy, splenomegaly, retinal hemorrhages
Aplastic Anemia
An autoimmune condition that prevents
formation of B12-intrinsic factor complex which decreases absorption of B12
Pernicious anemia
inability to release B12 from dietary proteins (may be secondary to H.Pylori infxn, gastric surgery, atrophic gastritis)
Food Cobalamin Malabsorption
absence of gastric acid and pepsin results in impaired liberation of B12 from food proteins and reduced intrinsic factors
Gastrectomy/ Bariatric Surgery
Cause:
1. Inadequate dietary intake
2. Increased requirements d/t rapid cell proliferation –
3. Intestinal malabsorption d/t surgery and inflammatory disorders like celiac disease
4. Medications such as methotrexate, antibiotics, antiseizure agents
5. Genetic disorders
B9 DEFICIENCY
Cause
1. Pernicious anemia
2. Inadequate dietary intake
3. Food Cobalamin Malabsorption
4. Gastrectomy/ Bariatric Surgery
5. Medications such as antacids, PPIs, H2 Blockers, Metformin
6. Small Intestine disorders
B12 DEFICIENCY
1) elevated reticulocyte count
2) fraction of unconjugated bilirubin is increased
3) supply of haptoglobin is depleted
Sickle Cell Anemia
Common triggers for the sickling crises
- Cold temperature
- Increased blood viscosity
Most common cause of death in sickle cell anemia
Pulmonary Hypertension
Fever, Cough, Tachycardia and infiltrates on CXR
Acute chest syndrome
Clinical Manifestation
- A rapidly hemolyzed and have very a short lifespan (10-12 days)
- Enlargement of the bones of the face and skull
- Anemia is present (Hgb 7-10g/dL) with jaundice (at sclera), for those w/ chronic anemia tachycardia, cardiac murmurs and cardiomegaly
- Any organ may be affected by the thrombosis but most common are in the lungs, spleen, and CNS
- Increased susceptibility to infection
Sickle Cell Anemia
o Typically with ruddy complexion, splenomegaly and generalized pruritus (d/t increased basophils releasing histamine)
o Increased blood volumes manifest as headaches, dizziness, tinnitus, fatigue, paresthesia, blurred vision
o Increased blood viscosity manifests as angina, claudication, dyspnea and thrombophlebitis
o Elevated Blood pressure and uric acid
o Erythromyalgia, a burning sensation in the fingers and toes and relieved by cooling
Polycythenia Vera
Complication for PV:
Increased risk of thromboses causes __
CVA & MI
Thrombotic complications as the most common causes of death
Complication for PV
Reduction of platelets below 150,000 mcL and occurs d/t impaired production, increased destruction or
abnormal distribution
Thrombocytopenia
A disease that affects people of all ages
but more common in children and young
women
Idiopathic Thrombocytopenic Purpura
occurs predominantly in children, appears 1-6 weeks after a viral illness, self-limited and may have a remission that occurs spontaneously within 6 months
ACUTE Idiopathic Thrombocytopenic Purpura
Diagnosed by exclusion of other causes of thrombocytopenia
CHRONIC Idiopathic Thrombocytopenic Purpura
An uncommon syndrome characterized by hemolytic anemia, thrombocytopenia and neurologic abnormalities, fever and renal abnormalities
Thrombotic Thrombocytopenic Purpura
Caused by deficiency of plasma enzyme (ADAMTS13) that breaks down von Willebrand clotting factor into normal size
Thrombotic Thrombocytopenic Purpura
Not a disease but a sign of an underlying condition. it may be triggered by sepsis, trauma, cancer, shock,
abruptio placentae, toxins, and allergic reactions
Disseminated Intravascular Coagulation
- slow, persistent, prolonged bleeding from minor trauma and small cuts
- delayed bleeding after minor injuries (several hours to days)
- uncontrollable hemorrhage after dental extraction/ irritation of the gingiva with a hard-bristle toothbrush
- nosebleeds, especially after a blow to the face
- hematuria and potential renal failure from GU trauma and splenic rupture
- bruising and subcutaneous hematomas
- neurologic signs, such as pain, anesthesia and paralysis
- hemarthrosis (bleeding in the joints)
Hemophilia
blood is taken from the patient and passed through a centrifuge where a specific component is separated and
removed. The remaining blood is then returned to the client
APHERESIS
Phases of Clotting Mechanism
- Vascular Phase
- Platelet Phase
- Coagulation Phase
- Clot Retraction
- Clot Destruction
largest lymphoid organ on the upper left quadrant; functions include: 1) hematopoietic, 2) filtration, 3)
immunologic and 4) storage
Spleen
A local anesthesia will be given and produce a _____
stinging/ burning sensation
Cover the site with dressing to control bleeding and MONITOR for
24 hours
Hgb 6-10g/dL, Bounding Pulse, Fatigue, dyspnea, Roaring in the ears
Moderate Anemia
Tachycardia, lethargy, Pallor, jaundice, pruritus, Tachypnea, Bone pain, Glossitis, smooth tongue, retinal hemorrhage, blurred vision, Headache, Hgb <6g/dL
Severe Anemia
Often asymptomatic, with mild-moderate anemia with microcytic and hypochromic cells, mild splenomegaly, bronze skin, and bone marrow hyperplasia
Thalassemia Minor
S/Sx develops by age 2 with general
symptoms of anemia, and jaundice is prominent
and pronounced splenomegaly
Thalassemia Major
Food High in B12 (Cobalamin)
o Beef liver
o Clams
o Tuna/ bluefin
o Nutritional yeast
o Salmon
Food High in Folate
o Beef liver
o Spinach
o Breakfast cereals
o Rice
o Asparagus
• Hematologic effects are accompanied by effects on other organ systems
• Extremely pale, confused and exhibits paresthesias in the extremities
• Difficulty maintaining balance d/t spinal cord damage and loss of position sense
• S/Sx are progressive and may have spontaneous remissions and exacerbations
B12 and B9 Deficiency
Apheresis procedure that remove platelets
Platelet pheresis
Apheresis procedure that remove WBCs
Leukapheresis
Apheresis procedure that remove RBCs
Erythrocytapheresis (RBC exchange)
Apheresis procedure that remove plasma proteins
Plasmapheresis (Plasma Exchange)
Apheresis procedure that remove circulating stem cells
Stem cell Harvest
1) compromised organ function
2) low platelet and fibrinogen levels,
3) prolonged PT, aPTT, and thrombin time elevated D-dimers (FDGs)
Disseminated Intravascular Coagulation
