Hemotology Flashcards
normal HGB for male and female
male: 15 ish
female: 13 ish
normal HCT
multiply by 3
35-45
WBC count
4-10
platelets normal
150-400
what platelet count can lead to spontaneous bleeding
less than 20,000
causes of thrombocytopenia
-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)
what does the spleen do
filter and clean blood, serves as a reservoir for blood, part of the immune system
what is Immune thrombocytopenia purpura (ITP)
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)
what is TTP
(thromboti thrombocytopenic purpura)
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!!
what is the purpose of WBCs? what are the two types
defend body against infection, remove debris
agranular: T-cell, B-cell NK cell lymphocytes, monocytes
granular: basophils, neutrophils, eosinophils
what does a left shift mean?
that there are more young neutrophils
more bands (immature) than segs (matture)
it means that there is a bacterial infection
manifestations of neutropenia
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)
what does a reticulocyte count mean?
it means that your body is throwing out immature red blood cells because the mature ones are used up
examples of anemias of deficient RBC production
-iron deficiency
-b12 deficiency
-megaloblastic (folic acid deficiency and cobalamin)
-aplastic anemia
-anemia from medications, such as chemotherapy, thalassemia
examples of hemolytic anemias
- destruction of rbc’s
-sickle cell disease
-enzyme deficiency
s/s of iron deficiency anemia
pale skin, fatigued, tachypnea, tachycardi, inflamed tongue, inflamed lips
diagnosis of iron deficiency anemia and treatment
-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
oral iron supplements education
-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
megaloblastic anemias
‘Ba’Ba’
Big red blood cells
includes coBalamin (vit B12), folic acid anemia
Macrocytic, normochromic
pernicious anemia
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
thalassemias
autosomal recessive blood disorder common in ethnic grous near mediterranean
-reduction in production of normal hemoglobin
interprofessional care of thalassemia
-blood transfusions
-iron chelation (binds to iron and reduces iron overload)
-folic acid and zinc supplements
hemolytic anemias S/S
jaundice and dark urine
-increased schistocytes
-increased reticulocytes
-increase LDH
-decreased Haptoglobin
Treatment and Management of Acquired Hemolytic Anemia
-determine and treat causative agent
-supportive care
-emergency preparedness (hydration, electrolyte replacement, corticosteroids, blood products, splenectomy)
-medications such as rituximab and eculizumab
