Hemotology

Question 1

normal HGB for male and female

Answer 1

male: 15 ish
female: 13 ish

Question 2

normal HCT

Answer 2

multiply by 3
35-45

Question 3

WBC count

Answer 3

4-10

Question 4

platelets normal

Answer 4

150-400

Question 5

what platelet count can lead to spontaneous bleeding

Answer 5

less than 20,000

Question 6

causes of thrombocytopenia

Answer 6

-decreased platelet production (decreased bone marrow function)
-acute viral infections (EBV, rubella, CMV, HIV)
-autoimmune disease
-nutritional deficiencies
-radiation therapy/chemotherapy
-disseminated intravascular coagulation
-hyperslenism
(1/3 of platelets are stored in the spleen)

Question 7

what does the spleen do

Answer 7

filter and clean blood, serves as a reservoir for blood, part of the immune system

Question 8

what is Immune thrombocytopenia purpura (ITP)

Answer 8

immune disorder, common in children, platelets accumulate and are destroyed by phagocytes in the spleen and other lymphoid tissues
treatment: childrens rarely need treatment
adults: steroids, blood transfusions, splenectomy (rarely)

Question 9

what is TTP
(thromboti thrombocytopenic purpura)

Answer 9

this is worse than ITP
-less common
-enhanced aggregation of platelets. with form clots!
-characterized by: hemolytic anemia, thrombocytopenia, fever not associated with infection, neuro and renal abnormalities
-caused by a deficiency in enzyme ADATS13
-medical emergency!!

Question 10

what is the purpose of WBCs? what are the two types

Answer 10

defend body against infection, remove debris
agranular: T-cell, B-cell NK cell lymphocytes, monocytes
granular: basophils, neutrophils, eosinophils

Question 11

what does a left shift mean?

Answer 11

that there are more young neutrophils
more bands (immature) than segs (matture)
it means that there is a bacterial infection

Question 12

manifestations of neutropenia

Answer 12

frequent infection, purulent drainage might not occur,
-they might not get a fever in the same way (a low grade fever could be very significant)

Question 13

what does a reticulocyte count mean?

Answer 13

it means that your body is throwing out immature red blood cells because the mature ones are used up

Question 14

examples of anemias of deficient RBC production

Answer 14

-iron deficiency
-b12 deficiency
-megaloblastic (folic acid deficiency and cobalamin)
-aplastic anemia
-anemia from medications, such as chemotherapy, thalassemia

Question 15

examples of hemolytic anemias

Answer 15

• destruction of rbc’s
  -sickle cell disease
  -enzyme deficiency

Question 16

s/s of iron deficiency anemia

Answer 16

pale skin, fatigued, tachypnea, tachycardi, inflamed tongue, inflamed lips

Question 17

diagnosis of iron deficiency anemia and treatment

Answer 17

-CBC will be low
-iron studies will be low
-total iron binding capacity will be HIGH
**Microcytic, hypo-chromic **
to treat, we replace iron by giving supplements, or for severe a transfusion of packed RBCs

Question 18

oral iron supplements education

Answer 18

-to enhance absorption, take one hour before meals, take with vitamin C or orange juice
-undiluted iron may stain teeth
-GI side effects are common
-stools will be black

Question 19

megaloblastic anemias

Answer 19

‘Ba’Ba’
Big red blood cells
includes coBalamin (vit B12), folic acid anemia
Macrocytic, normochromic

Question 20

pernicious anemia

Answer 20

autoimmune disorder that leads to destruction of the gastric mucosa and loss of parietal cells
-leads to lack of intrinsic factor necessary for absorption of vitamin b12

people at risk: chronic gastritis, chronic alcoholism, gastrectomy, ilium resection, illium inflammation or neoplasm

Question 21

thalassemias

Answer 21

autosomal recessive blood disorder common in ethnic grous near mediterranean
-reduction in production of normal hemoglobin

Question 22

interprofessional care of thalassemia

Answer 22

-blood transfusions
-iron chelation (binds to iron and reduces iron overload)
-folic acid and zinc supplements

Question 23

hemolytic anemias S/S

Answer 23

jaundice and dark urine

-increased schistocytes
-increased reticulocytes
-increase LDH
-decreased Haptoglobin

Question 24

Treatment and Management of Acquired Hemolytic Anemia

Answer 24

-determine and treat causative agent
-supportive care
-emergency preparedness (hydration, electrolyte replacement, corticosteroids, blood products, splenectomy)
-medications such as rituximab and eculizumab

Question 25

what is acute chest syndrome

Answer 25

a complication of sickle cell disease
-acute pulmonary complications like pneumonia, tissue infarction, fat embolism
characterized by fever, chest pain, cough, dyspnea
can lead to pulmonary hypertension, heart failure, miocardial infarction AND MORE

Question 26

aplastic anemia

Answer 26

bone marrow & blood stem cells are damaged
pancytopenia
-congenital or acquired