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N398 Exam 1 > Hematology Patho > Flashcards

Hematology Patho Flashcards

1
Q

What is anemia?

A

Deficit of RBCs

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2
Q

Relative anemia?

A

Normal total RBC mass with increased plasma volume (happens in pregnancy)

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3
Q

Absolute anemia?

A

Decrease in # of RBCs

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4
Q

Major function of RBCs?

A

Carry O2

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5
Q

Tissue Hypoxia

A
  • Caused by decreased RBCs and hemoglobin which decreases O2-carrying capacity
  • Signs of tissue hypoxia: claudication (muscle), weakness/fatigue, pallor, increased resp rate and depth, dizziness/fainting/lethargy
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6
Q

What are compensatory mechanisms of tissue hypoxia?

A
  • CV: Increased SV, HR, capillary dilation
  • Renal: Increased renin-aldosterone response, Increased salt and water retention, Increased ECF
  • Increased DPG in cells: increased release of O2 from hemoglobin in tissues
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7
Q

Clinical Manifestations of Mild anemia

A
  • No symptoms
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8
Q

Clinical manifestations of mild to moderate anemia

A
  • Fatigue
  • Generalized weakness
  • Loss of stamina
  • Tachycardia
  • Exertional dyspnea
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9
Q

Clinical manifestations of moderate to severe anemia

A
  • Orthostatic and general hypotension
  • Vasoconstriction and pallor
  • Tachypnea/dyspnea
  • Tachycardia/transient murmur, angina pectoris
  • Intermittent claudication
  • Night cramps in muscles
  • Headache, lightheadedness, faintness
  • Tinnitus, roaring in ears
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10
Q

Evaluation and Treatment of Anemia

A
  • Evaluation: labs, bone marrow aspiration

- Treatment: erythropoietin, blood transfusions, supplements, rest/O2/fluids

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11
Q

Iron-Deficiency Anemia

A
  • Most common nutritional deficiency in the world and most common cause of anemia
  • Microcytic-hypochromic
  • Etiology: decreased capacity to absorb iron, increase in physiologic requirement (pregnancy), excessive iron loss (via blood loss), renal issues
  • Assessment findings: pica, fatigue, pallor, headaches and lightheadedness
  • Treatments: oral admin of iron
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12
Q

Bleeding Disorders

A
  • Vascular disorders: vascular purpura
  • Platelet disorders: abnormal quantity or quality of platelets (thrombocytopenia)
  • Coagulation disorders: deficiencies of one or more clotting factors (Vitamin K deficiency, inherited, disseminated intravascular coagulation)
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13
Q

Hemostasis?

A

physiologic process that stops bleeding at the site of injury while maintaining normal blood flow elsewhere

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14
Q

Primary hemostasis?

A

initial vasospasm at site of injury and formation of platelet flow

  • platelets adhere and clump
  • 3-7 minute process
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15
Q

Secondary hemostasis?

A

coagulation (clot formation from fibrin)

  • retraction: firming
  • 1 hour
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16
Q

Platelets

A
  • Role in primary and secondary hemostasis
  • Complex cell fragments with sticky surface receptors
  • Can degranulate and trigger clotting cascade
17
Q

Coagulation Factors

A
  • Plasma proteins produced by liver - cascade
  • Circulate in blood
  • Partially activated by platelets and by each other
18
Q

Pathways

A
  • Intrinsic: triggered when blood contacts altered endothelium and degranulation of platelets
  • Extrinsic: triggered by tissue damage (trauma)
  • Common pathways: Factor X
19
Q

Bleeding Disorder Assessment

A
  • Pallor
  • Jaundice
  • Petechia: flat pinpoint purple spots caused by capillary hemorrhage (no blanching)
  • Purpura: groups of petechia
  • Ecchymosis
  • Hemarthrosis: blood in joints
  • Hematoma: collection of blood
  • Hematuria
  • Hematochezia: blood in stool
  • Hematemesis
  • Epistaxis: blood in nose
  • Hemoptysis: blood in sputum
  • Menorrhagia: heavy menstrual bleeding
20
Q

Bleeding Disorders Lab Eval

A
  • CBC w smear: determine if anemia is present and morphology of platelets
  • Bleeding time: evaluate platelet and vascular response
  • Prothrombin and INR: evaluates extrinsic pathway of coagulation
  • Activated partial thromboplastin time: evaluates intrinsic pathway of coagulation
21
Q

Bleeding Disorders Treatment

A
  • Depends
  • Avoid cause
  • Steroids
  • IVIG
  • Factor replacement
  • Platelets
  • Fresh frozen plasma
22
Q

Thrombocytopenia

A
  • Common cause of generalized bleeding
  • Etiology: decreased production or increased consumption of platelets
  • Assessment: petechiae, purpura, decreased platelet counts, bleeding
  • Treatment: treat or remove the cause, block the immune response, blood and/or platelet transfusion
23
Q

Thrombus

A
  • Stationary blood clot formed within a vessel or chamber of the heart
  • Can be arterial or venous
  • Composed of aggregated platelets, clotting factors, and fibrin that adhere to vessel wall
  • Risks-Virchow’s triad: circulatory stasis (immobility), hypercoagulable conditions (pregnancy, cancer, obesity), endothelial/vessel wall injury (trauma, IV, catheter)
24
Q

DVT

A
  • Presence of thrombus in one of the deep veins (usually in lower extremities)
  • Assessment: edema, pain/tenderness, redness, warmth
  • Prediction rules, ultrasound, D-dimer
  • Treatment: thrombolytic to break down clot, anticoagulants to reduce further clot formation
  • Prevention: anticoagulants, SCD/compression stockings, movement, hydration

N398 Exam 1 (12 decks)

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