Hematology Flashcards
Polyheme
Does not have to be refrigerated and is universal
Types of infusion
Whole blood
Packed Red Cell’s
Fresh Frozen Plasma
Clotting Factors
What are the 5 areas that form blood
Red bone marrow (all types of erythrocytes formed here)
Yellow bone marrow (produces white cells)
Lymph nodes (produces lymphocytes and antibodies)
Spleen (Stores large quantities of blood & produces lymph, plasma cells and antibodies)
Liver (during intrauterine life)
What % of blood is RBC
95%
Plasma
fluid portion of blood (92% water)
RBC life span
120 days
RBC production cycle
Starts with one cell in the red marrow and divides into 16 then develop
WBC’s
5-10K cells/mm3
Platelets
Thrombocytes that travel to site of damage, swell and adhere to damaged vessel wall
Will start clotting cascade if damage too great.
Hematocrit
measures fraction of blood volume cantaining RBC’s
40-50% in males
35-45% in females
Hemoglobin
14-18% in males
12-16% in females
Anemia
poor O2- concentration of hemoglobin or RBC’s is below normal.
Precipitating causes of anemia
Chronic or acute blood loss
Decrease erythrocyte production
Increased destruction of erythrocyte
Common forms of anemia
Iron-deficiency anemia
Hemolytic anemia
Aplastic
Pernicious
Iron-deficiency anemia
Bone marrow roduces small and pale RBC’s with reduced O2 carrying capacity
Most common causes of iron deficiency anemia
Menstruation
GI Bleeds – stress, infection, alcoholics
Iron poor diet in kids
Hemolytic Anemia types
Inherited and aquired
Inherited
Often abnormal rigidity of cell membrane causing smaller cells
Cells trapped in the smaller blood vessels (often spleen) and destroyed by macrophages
Examples of Inherited hemolytic anemia
Sickle cell
Thalassemia
Glucose-6-phosphate dehydrogenase
3 conditions of aquired
Normal RBC’s disrupted due to mechanical forces (blood clots, atherosclerosis)
Autoimmune disorders which can destroy RBC’s with antibodies
RBC’s destroyed by microorganisms in the blood (ie malaria)
Other anemias
Aplastic
Failure to produce RBC’s
Pernicious (usually inherited)
Lack of vitamin B, needed for cell division
Anemia S/S
SOB Chest pain Fever Pale Fatigue, lethargy Headaches Sore mouth or tongue Brittle nails Cutaneous bleeding Bleeding from mucous membranes
Anemia Dx
History, blood tests, bone marrow biopsy
Leukemia
Cancer of Hematopoietic Cells – abnormal cells develop
Leukemia more common
Males and caucasians, children and young adults
Leukemia mortality in children
50%
Leukemia classified by type of WBC
Acute lymphoblastic leukemia (ALL)–Usually in kids
Acute myeloblastic leukemia (AML)–Usually middle age adults
Leukemia S/S
FREQUENT BRUISING Fatigue Infections secondary to low levels of Neutrophils (WBC) Bone pain Elevate temperature and diaphoresis Heat intolerance Abdominal fullness Bleeding Headache Weight loss Night sweats Enlarged lymph nodes, spleen, liver and testes
Dx Leukemia
Bone marrow biopsy Severity assessed by Degree of liver and spleen enlargement Anemia Lack of platelets in the blood
Rx of Leukemia
Transfusion of blood and platelets
Antibiotic therapy
Anticancer drugs - chemotherapy
Radiation
Lymphomas
Any neoplastic disorder of lymph tissue Two types Hodgkin's Non-Hodgkin’s Malignant
Hodgkin’s Lymphoma
Abnormal function of B cells
more common in males, in 20’s and then 55-70
Hodgkin’s S/S
Swollen lymph
Fatigue
Chills
Night sweats
Non-Hodgkin’s Lymphoma
Vary in malignancy according to nature and activity of normal cells
At least 10 types
Classified low to high grade
Cause unknown
Multiple Myeloma
Malignant neoplasm of the bone marrow
Composed of plasma cells
Production of large amounts of protein
Increases viscosity of blood
Multiple Myeloma S/S
Destroys bone tissue causing Pain – early Fractures - early Hypercalcemia Skeletal deformities
Multiple Myeloma
rare before 40
Polycythemia
Increase in total RBC mass
2 types of polycythemia
Secondary—due to hypoxia
Primary—due to unknown reasons
Secondary Polycythemia
Naturally present in people who live or visit high altitude areas
Primary Polycythemia
Polycythemia Vera
Condition occurs in those >50 years old
Increased blood production causes blood to thicken and cause hands and feet to have red-purple complexion
Hemophilia
Group of inherited bleeding disorders
Loss of 1 of 13 clotting factors
Type A and B hemophilia
A—loss of factor VIII – most common
B—loss of factor IX AKA Christmas disease
Sickle Cell Disease
Sickle Hemoglobin has a flawed chemical structure that results in erythrocyte deformity when oxygen levels are low.
Chronic Sickle Cell = Chronic Hemolytic Anemia
Sickle Cell S/S
PAIN DUE TO HYPOXIA EXCRUCIATING BONY DEFORMITIES Increased weakness Aching CP with SOB Sudden severe abdominal pain Icteric sclera Fever Arthralgia
Sickle Cell (vaso-occlusive) Crisis
DEHYDRATION INFECTION STRESS TRAUMA Exposure to temperature extremes Hypoxia Strenuous physical activity
Sickle Cell Rx
Treatment – Pain management, oxygen, fluids, rest and normothermic temperature
