Problems Flashcards
S/Sx of iron deficiency anemia
- Pallor
- Glossitis (inflamed tongue)
Cheilitis (inflamed lips)
Parasthesias
Headache
Fatigue
Palpitations
Sensitivity to cold
What is thalassemia? What are 2 types?
Do not make enough Hemoglobin, which leads to RBC deficit
Genetic disorder
Two types: Minor (one parent)
Major (two parents)
Happens to people of certain ethnicities that live around the equator.
S/Sx of thalassemia
Minor type: Same as anemia
Major type: Life threatening anemia
Symptoms develop by age 2. If untreated leads to growth and developmental deficits.
Jaundice
Splenomegaly (from high RBC death)
Cardiomegaly (from iron deposits)
Hepatomegaly (from iron)
Tx for severe thalassemia
Blood exchanges regularly
Chelating meds that bind iron and remove it
What is pernicious anemia?
Risk factors?
No intrinsic factor (made in stomach)
So cannot absorb B12
Risk factors: GI problems, like surgery. Malabsorption (like Crohns or celiac), Alcoholism, smokers, long term proton pump inhibitors, vegetarians
S/sx of pernicious anemia
Tx?
Typical anemia s/sx with:
Beefy, red, shiny tongue
Anorexia, N/V
Tx: IM Vitamin B12
What is aplastic anemia?
Decrease of all blood cell types (pancytopenia) AND hypo cellular bone marrow.
This is autoimmune (70% of time)
What is meant by hemolytic anemia?
RBCs are being destroyed faster than can produce
This is a broad term that can involve many subtypes of anemia.
Sickle cell in most common
What is sickle cell anemia?
Most severe type of SSD
Inherits gene from both parents
What is sickle cell cycle?
Hypoxia (many causes but usually infection)
leads to
RBCs become rigid, sickle shaped
leads to
Vascular occlusion
leads to
More Hypoxia
Cycle starts again
What happens to the spleen in SSD?
Sickle cells have high turn over rate
Spleen become overworked and can’t handle infections (infection is common cause of death in SSD)
Anemia worsens
Spleen atrophies
S/sx of SSD
Pallor (look at mucous membranes)
Gray coloring
Jaundice
Pain (this is main symptom)
Fever
HTN
Tachypnea
N/V
Complications of SSD
Vaso-occlusive crisis
Kidney damage
Infection (pneumonia common)
Immunocompromised
HF
PE
CVA
Leg ulcerations
Priapism
Gallstones/Hepatomegaly
Spleen atrophy
Eye vascular problems
What is hemochromatosis?
Tx?
Too much iron
Iron overload leads to liver enlargement
Iron deposits in different organs
Skin bronzing
Tx: removing blood
Chelating meds
What is polycythemia?
Two types?
Too much blood cells (RBCs, WBCs, platelets)
Two types: Primary: Polycythemia vera (JAK2 gene mutation)
Secondary polycythemia (driven by hypoxia) (think resp. or CV chronic illness)
S/Sx of polycythemia
This patient will be clogged up and overloaded:
Headache, vertigo, dizziness, tinnitus, visual changes
Itching (caused by increased basophils)
paresthesias
erythromelalgia (painful burning/redness of hands/feet)
Thrombosis
Tissue hypoxia
Hypertension
Engorgement may cause bleed out
Hepatomegaly-feel full and bloated
Splenomegaly-feel full and bloated
Plethora (ruddy complexion)
Tx for polycythemia
Phlebotomy q 2-3 months
Hydration
Baby aspirin
Myelosuppressive agents
Nutrition
What is thrombocytopenia?
What are some potential causes?
Lack of platelets
1. Acquired Immune disorder (ITP)
2. Heparin induced (HIT)
What is pathos in immune thrombocytopenia?
Autoimmune attack on platelets
Acute condition in kids
Chronic in adults
What is pathos of HIT (heparin induced thrombocytopenia?
Body’s immune system responds to heparin by binding platelets to heparin then forming an antibody to it and destroying it. This removes the platelets from your blood.
What is a surprising complication of HIT?
Thrombi can form as all the platelets are used up and then are in hypercoag state. Have an increased D-dimer and low platelet count
What is the common complication of HIT?
Uncontrolled bleeding
Tx for HIT
Stop heparin
Warfarin
Plasmapheresis (if clotting severe)
Treatment for immune thrombocytopenia
Corticosteroids
