Hemotology Flashcards
What is anemia
reduced red blood count/production of erythrocytes
<12 g/100ml in women
Is anemia a symptom or a disease
symptom
What can cause anemia
iron deficiencies due to GI blood loss inflammatory d/o; SLE, RA nutritional problems infectious diseases, HIV Neoplastic diseases or from their treatments blood loss (trauma, birth)
What can cause a deceased production of erythrocytes
nutritional deficiencies of Iron and B12 Folic Acid (poor dietary intake, alcoholism, anorexia) Bone marrow pathology (leukemia, chemotherapy, radation to long bones, pelvis, and skull)
What can anemia cause
blood loss, destruction of erythrocytes or hemolysis (autoimmune anemia, lupus), decreased production of erythrocytes (kidney disease, chronic disease RA, SLE)
What do kidneys secrete and what does it do
erythropoietin, stimulates bone marrow to make erythrocytes
What are signs and symptoms of anemia
Weakness, DOE, exercise intolerance, yellowing of skin/fingernails, tachycardia, angina
How is anemia diagnosed
complete blood count (RBC number, RBC pathology)
Explain RBC pathology
macrocytic: B12, folate
Microcytic: iron deficiency
How is anemia treated
treat the underlying cause (cancer, chronic disease, diet, blood transfusion)
What is Hemophilia A
lack of clotting factor VIII which is found on the X chromosome and produced by the liver
What is the clotting factor important in
the production of thrombin which helps create a stable clot and stop bleeding
How is hemophilia classified and what do the ranges mean
% of clotting factor present Normal: 50-100% Mild: 6-30% Moderate: 1-5% Severe: <1%
Describe mild hemophilia
spontaneous bleeding is rare
Describe moderate hemophilia
major bleeding with mild trauma
Describe severe hemphilia
spontaneous bleeding is common or with slight trauma
What are the signs and symptoms of hemphilia
bleeding after immunizations
hematoma where parents hold/grab their children
hemarthroses during ambulation
intracranial bleeding
What joints are most likely to see hemarthoses due to hemaphilia
Synovial joints (knee most common)
What happens after hemarthoses has occured
- bleeding is an irritant and the synovium becomes hypertrophied and villi which extend into the articular surfaces get damaged
- Iron is deposited in synovium which decreases the production of synovial fluid –> cartilage damage, joint collapse, pain, loss of ROM, muscle atrophy
Where do muscle hemorrhages due to hemophilia normally occur
flexor muscle groups
What do muscle hemorrhages cause
warmth, swelling, loss of ROM, numbness
How is hemophilia diagnosed
CBC, Assessment of clotting factors**, PTT, DNA testing, in utero chorionic villus sampling
How is hemophilia treated
no known cure at this time
IV factor replacement therapy before procedures or when actively bleeding
Factor replacement chronically
PT: strengthening to protect joints, bracing, pain control
What is sickle cell disease
autosomal recessive disorder of hemoglobin molecule
What does hemoglobin do
delivers oxygen to tissues
What happens to hemoglobin shape in someone with SCD
the biconcave shape changes to a sickle cell when it releases oxygen
What can sickle cell disease cause
anemia, ishchemia
What is the normal lifespan of hemoglobin? What is the lifespan of a sickle cell
120 days
8-10 days
When are sickle cell episodes likely to happen
physiologic stress high altitude anesthesia pregnancy fever trauma
What are the signs and symptoms of sick cell disease
pain from sickled cells blocking blood flow
acute chest syndrome
CVA
Thrombotic events in lungs
hand-foot syndrome (microvasculature is blocked in hands and feet)
How is sickle cell disease diagnosed
pre-natal genetic testing
newborn screens
How is sickle cell disease treated
bone marrow transplant
supportive care with rest, pain medications, oxygen, antibiotics
blood transfusions
hydroxyurea (stimulates body to make fetal hemoglobin)
