Hematology

Question 1

Manifestations of anemia

Answer 1

Jaundice, red sore tongue, pica, pallor, hypotension and all signs of hypoxia (weakness, fatigue, tachycardia-one of the first signs, SOB, dizziness)

Question 2

Iron deficiency anemia interventions

Answer 2

>Oral iron (ferrous sulfate) -take with OJ
Liquid – dilute
SE: heartburn, constipation
>Epoetin alfa IV or SC
>IM or IV iron

Question 3

Folic acid deficiency anemia causes and intervention

Answer 3

> Diet: Alcoholism, Eating Disorders, Diets
Malabsorption: Crohn’s disease
Pharmaceuticals: Oral contraceptives, AED, Antibiotics, Methotrexate (interferes with folic acid metabolism)

Iron rich foods- leafy greens, red meats, beans, enriched cereals and breads, cream of wheat, iron supplement

Question 4

Vitamin B12 deficiency anemia

Answer 4

B12 is required for DNA synthesis and normal nerve function
>Diet: vegetarian, reduced dairy
>Bowel resection

> Foods with B12- leafy greens, avocados, egg yolks, raisins

Question 5

Pernicious anemia

Answer 5

Can be pretty serious bc it can cause neural probs
Inadequate secretion of IF
IF secreted by gastric mucosa
IF required for B12 absorption

> Diagnostics: Serum levels, Schilling test

> Treatment: B12 injections, IV or PO Folate, Intranasal gel (Nascobal), Intranasal spray

Question 6

Aplastic anemia

Answer 6

Pancytopenia: reduced RBCs, WBC, Platelets
Bleeding time prolonged
Confirmation requires bone marrow aspiration

Temporary Treatment: Blood transfusions, Platelet transfusions, Antibiotics

Bone marrow transplantation or immunosuppressive therapy