Red Blood Cell Disorders: Clinical Flashcards
Clinical symptoms of anemia
Weakness, fatigue, palpitations, increased heart rate, dyspnea, positional dizziness, syncope, bleeding from any site, or increased / new-onset angina.
Also may be suspected with tachycardia, tachypnea, orthostasis, pallor, or jaundice.
When might an RBC transfusion be indicated with anemia?
Pt has tachycardia, dyspnea, altered mental status, orthostatic hypotension, syncope, and shock
Pt has history of melena, abd pain, ASA or NSAID use, anticoag use, and past peptic ulcer disease. What do you suspect?
GI bleed or platelet dysfunction
If pt. presents with a history of pica (abnormal craving of ice, clay, starch), or complaints of dysphagia, what should you suspect?
Iron deficiency
If pt reports poor diet, what should you suspect?
iron, vit b12, or folate deficiency
If pt has history of gastric bypass surgery, distal paresthesias, gait problems, memory issues, and is taking metformin for DM, what should you consider?
Vit b12 deficiency
If pt has history of alcohol abuse, what should you consider?
folate deficiency or liver disease
If pt drinks moonshine or has exposure to lead paint/pipes, what should you suspect?
Lead toxicity
If pt has family history of blood disorder, what should you consider?
sickle cell disease
G6PD deficiency
thalassemia
if pt has hx of jaundice, transfusion, new med, and injection, what should you consider?
hemolytic process
Pt has hx of weight loss, lower back or bone pain, what should you consider?
cancer
multiple myeloma
Pt has hx of prolonged bleeding, epistaxis, gum bleeding, heavy menses, and easy bruising. Consider?
thrombocytopenia
von Willebrand disease (vWD)
Pt has hx of headaches, vertigo, pruritus, nosebleeds, DVTs, COPD, and exposure to high altitude. Consider?
polycythemia
On general PE, pt has pallor of skin or conjunctiva, spoon nails, or palmar creases. Suspect?
iron deficiency
On general PE, pt has weight loss. Consider?
cancer, HIV, chronic disease
On skin PE, pt has petechiae or purpura. Suspect?
low platelets or vWD
Pt has tachycardia. Suspect?
anemia (increased cardiac output)
Pt. has tachypnea. Suspect?
anemia (decreased hemoglobin-oxygen transport)
Pt. has orthostatic changes. Suspect?
volume depletion or acute bleeding
Pt. has fever. Suspect?
Infection or drug/transfusion reaction (hemolysis)
on eye PE, pt has jaundice. suspect?
hemolysis
What might you also see in an anemic patient’s eye?
pallor of palpebral conjunctivae
on mouth PE, patient has glossitis and angular stomatits. suspect?
iron, folate, or vit b12 deficiency
on heart PE, what might you find?
increased output/murmur
S3 gallop
displaced PMI in high output heart failure
What might you find on abdomen PE?
liver/spleen enlargement
masses
tenderness
surgical scars (i.e. gastric bypass/ileal resection as cause of vit b12 deficiency)
If pt has a + Guaiac test, what do you suspect?
GI bleed
If pt. has decreased vibratory and positional sense, what should you suspect?
Vit B12 deficiency
