part 6 Flashcards
What are the causes of anemia caused acute blood loss?
trauma
surgery complications
diseases that disrupt vascular integrity
hypovolemic shock
What are the clinical manifestations of acute blood loss anemia (more important that lab values)
- pain: internal hemorrhage
- retropertoneal bleeding: numbness, pain in lower extremities
- shock
What can happen with the labs for acute blood loss?
- values may be high or normal for 2-3 days
- once plasma is replaced low RBCs will become evident
What are some sources of chronic blood loss?
What is the management?
bleeding ulcer
hemorrhoids
menstrual and postmenopausal blood loss
ID the source
stop the bleeding
provide supplemental iron
- destruction/hemolysis of RBCs at a rate that exceeds production
- caused by problems intrinsic (heredity: defects in RBCs themselves) or extrinsic to the RBCs
- specific manifestations: jaundice (elevated bilirubin), enlarged spleen and liver
- maintenance of renal function is major focus of treatment
- results from: physical destruction, antibody reactions, and infectious agents and toxins
hemolytic anemia
What are the 3 types of acquired hemolytic anemia?
physical destruction
antibody reactions
infectious agents and toxins
- physical destruction of RBCs from extreme force
causes: hemodialysis, cardiopulmonary bypass, prosthetic heart valves, abnormal vessels - fragmentation/destruction as the RBCs pass through abnormal artery or vein microcirculation
- excess platelet aggregation and/or fibrin polymer formation (seen in thrombotic thrombocytopenia purport and disseminated intravascular coagulation)
acquired hemolytic anemia physical destruction
antibodies may destroy RBCs by mechanisms involved in antigen-antibody reactions
acquired hemolytic anemia antibodies
- causes hemolysis in 3 ways:
- invade RBC and destroy (parasite like malaria)
- release hemolytic substances (clostridium)
- generate an antigen-antibody reaction (mycoplasm pneumonia)
acquired hemolytic anemia infectious agents
What is the treatment for acquired hemolytic anemia?
- supporitive care
- alternate rest and activity
- hydration, electrolyte replacement, corticosteroids, blood products, splenectomy
- folic acid and immunosuppressive agents for chronic conditions