Hematology PowerPoint Flashcards
red blood cells also known as
erythrocytes
primary function of red blood cells/erythrocytes
transport oxygen
other function of RBC/erythrocyte
carry carbon dioxide back to lungs
platelets also known as
thrombocytes
primary function of platelets/thrombocytes
coagulation and capillary hemostasis
WBC also known as
leukocytes
WBC/luekocytes are the bodies
protective system
5 types of WBC/leukocytes
neutrophils
eosinophils
basophils
monocytes (macrophages)
lymphocytes
neutrophil function
phagocytosis
eosinophil function
allergic reactions
basophils function
inflammatory reactions
monocytes (macrophages) function
phagocytosis, antigen processing
lymphocyte function
humoral immunity (B cell)
cellular immunity (T cell)
what cells are primary fighter cells
monocytes
lymphocytes
hemoglobin
oxygen carrying protein in RBC
hematocrit
proportion of RBC to plasma in blood
MCV
average size of RBC
MCH
average mass or volume of HBG per RBC
RBC distribution width RDW
measure of the variation of RBC
WBC standard value
4.5-11
RBC standard value
3.5-5.5
hemoglobin standard value
12-15
hematocrit standard value
36-48
MCV standard value
79-101
MCH standard value
25-35
MCHC standard value
31-37
RDW-CV standard value
11-16
platelet count standard value
150-420
MPV standard value
7-10
anemia defintion
a reduction in the number of RBC’s, the quantity of hemoglobin and the volume of packed red cells to below normal levels
some reasons to develop anemia
decreased production
blood loss
increase use ~ child growing rapidly
examples of decreased production of anemia
marrow infiltration/injury
nutritional deficiency
erythropoietin deficiency
ineffective erythropoiesis
examples of blood loss of anemia
hemolysis
- acquired
- inherited
acquired hemolysis
hemolytic jaundice
Rh/ABO incompatible
what will the reticulocyte count be with decreased proaction anemia
inappropriately low
what will the reticulocyte count be with blood loss anemia
inappropriately high
what is reituclocyte count
how much RBC you are producing
can a low reticulocyte count be normal
yes, especially if the H and H is normal because there is no need to make more RBC
most common type of anemia
iron def
microcytic anemia
small
hypochromic
low MCV
normocytic anemia
decreased red blood cell production
or
increased red blood cell loss
macrocytic anemia
large red blood cells
- vit b12 and folate def
iron def is what type of anemia
microcytic
is iron def hypo chromic
yes due to lack of iron
in iron def what happens
ineffective for carrying o2
who is more likely to have iron def
toddlers drinking lots of milk
- more than 16-24 oz/day
menorrhagia
GI bleeding
physiologic ANEMIA
fetal hemoglobin breaks down faster and adult hemoglobin isn’t developed
when does physiologic anemia occur
6mo
- which is why iron fortified foods exist
s/s of iron def
tachycardia
- due to O2 carrying capacity being reduced
tachypnea
- due to decreased O2 carrying capacity
cardiomegaly
- hearts working harder and due to tachycardia
glossitis (tongue swelling)
angular stomatitis
decreased attention span
decreased alertness
decreased leraning
koilonychia (spoon nails)
iron def manifestations are based on
severity
tx of iron def
2-5mg/kg/day of elemental iron
iron should be taken with
ascorbic acid or Vit C to improve absorption
side effects of iron pills
GI
- N/V/C
- dark stools
sickle cell what type of disease
autosomal recessive
- both parents have to have it and it is 25% chance with each pregnancy
abnormal hemoglobin name
Hemoglobin S
in sickle is the cells normally shaped
yes but when low O2 they sickle
s/s of sickle cell depends on
crisis location
where is the pain common in for SC
joints
kidney
spleen
Hbg S replaces
normal hemoglobin
vasooclusive crisis
sickle cells can then block blood flow in the vessels of limbs and organs
what is the life span of SC cells
10-20 days
how do SC become anemic
bone marrow cannot keep up with the high turnover from the short half life
Hb SS sickle cell
most common
Crest shaped
homozygous condition (child has two sickle hemoglobin genes)
subject to crisis
45 years
Hb SC sickle cell
one Hb S and one Hb C
RBC are C shaped
anemia is milder
painful crisis occur in about 50% as often
65 years
how do we diagnosis sickle cell
newborns are screened in all 50 states
if the test is positive than HBG electrophoresis is then performed to verify
when do children start to show symptoms of sickle cell
4-6 mo due to the fetal hembolgin breaks down
what is the most common crisis for sickle cell
vaso occulsive
what is vaso occulsive crisis
stasis of blood with clumping of cells in the microcirculation, ischemia, and infarction
what is vaso occulsive precipitated by
dehydration
temp extremes (fever or environmental)
infection
localized hypoxemia
physical or emotional stress
vaso occulsive symptoms
fever
tissue engorgment
painful swelling of joints, hands, and feel
priapism
severe abdominal pain
complications of vaso occulsive
thrombosis and infarction
stroke
what is splenic sequestration
pooling of blood in spleen
splenic sequestration s/s
profound anemia (spleen helps produce RBC)
hypovolemia
shock
splenic sequestration treatment
removal of spleen
aplastic crisis triggered by
infection of parvovirus b19
or
depletion of folic acid
aplastic crisis defintion
diminished production and increased destruction of red blood cells
aplastic crisis s/s
profound anemia and pallor
acute chest syndrome
acute lower respiratory tract illness
acute chest syndrome s/s
pulmonary infiltrate/consilidation of defined edges on CXR
fever
chest pain
tachypnea
wheezing
difficulty breathing
low O2 saturation
children with sickle cell disease have laboratory evidence of abnormal spleen function as early as
4-6 mo
fever of 38.5 in children with sickle disease is treated as an
emergencyd
do we delay antibiotics for these patietns
no
sickle cell treatment
- what helps with cell turnover and everyone with sickle cell should be on it
folic acid
- helps with proteins synthesis which in turns helps to replicate DNA and RBC
sickle cell treatment
- what medication from when they are a newborn until 5 years
penicillin
- spleen doesn’t work until age 5
sickle cell treatment
- what med increases fetal hemoglobin
hydroxyurea
- increase hbg f
- decreased hbg s
sickle cell treatment
- supportive care
pain
O2
cold
hot
how does a hematopoietic stem cell transplant work
replaces the HBG s
sickle cell treatment
IV hydration
pain management
- Tylenol
- NSAIDS
- opioids
PCA age
6 years
PCA reporting
self reporting pain scale
PCA risk
resp depression
tolerance
thalassemia beta 3 types
minor or trait: mild anemia
intermedia: moderate, may require transfusions
major Cooley: requires transfusion
cause of beta thalassemia
defective synthesis of hemoglobin, structurally impaired RBC’s and shortened life span
alpha thalassemia
one gene defect: asymptomatic
two gene: mild anemia
major: transfusion dependent
- hydrops fetalis
alpha thalassemia cure
hematopoetic stem cell transplant
hemophilia A
VIII
hemophilia B
IX
hemophila disease
A and B X linked recessive disorders
- affected males, female carriers
what is the most common inherited bleeding disorder
von willebrand
von willebrand types are classified on presence and function of
von willebrand factor
von willebrand disease type
autosomal dominant
