Week 6 - Hematology

Question 1

Signs of platelet diseases

Answer 1

• pallor
• bruises
• bleeding

Question 2

Signs of progressive tumor or complication of sickle cell

Answer 2

• tachypnea

Question 3

Disorders of blood cell amount/volume

Answer 3

• Iron-deficiency anemia

- Aplastic anemia

Question 4

Iron Deficiency Anemia definition

Answer 4

Bone marrow produces small RBCs that are LOW in Iron

Question 5

Iron Deficiency Anemia patho

Answer 5

• diet insufficient in iron
• vegetarian
• “white food”
• shift from formula to cow’s milk

Question 6

Is Iron Deficiency Anemia a disorder of malnutrition?

Answer 6

NO

Question 7

Is Iron Deficiency Anemia preventable and reversible?

Answer 7

Yes

Question 8

S/s Iron Deficiency Anemia

Answer 8

• Pallor (white sclera)

- Decreased CBC

Question 9

Iron Deficiency Anemia prevention and teaching

Answer 9

• breastfeed and formula until 6 months
• iron fortified food at 6 months
• limit cow’s milk
• vary diet
• supplementation with Vitamin C

Question 10

What can supplementation cause?

Answer 10

• constipation

- stained teeth

Question 11

Aplastic Anemia definition

Answer 11

Abnormality of bone marrow causes pancytopenia

• low RBC
• low WBC
• low platelets

Question 12

S/s of Aplastic Anemia

Answer 12

Depends on which type of blood is lowest:

• Anemia (weakness, fatigue, pallor)
• Leukopenia (fever, frequent infections)
• Thrombocytopenia (abnormal bleeding)

Question 13

Aplastic Anemia interventions (4)

Answer 13

• Prevent exposure to the cause
• Keep infections away (wash hands, immunization)
• Immunosupression meds
• Bone marrow transfusion (severe cases)

Question 14

Coagulation Abnormality Disorders (3)

Answer 14

• Immune thrombocytopenia
• Hemophilia
• Von Willebrand’s Disease

Question 15

Immune thrombocytopenia definition

Answer 15

Decreased platelets as a result of a immune-mediated response

Question 16

S/s Immune thrombocytopenia

Answer 16

• Petechiae (small bruises)

- Purpura (large bruises)

Question 17

Hemophilia definition

Answer 17

Issue of the clotting cascade

Question 18

Hemophilia types

Answer 18

• Hemophilia A: missing factor VIII

- Hemophilia B: missing factor IX

Question 19

S/s Hemophilia

Answer 19

• bleeding in the join that can occur without trauma

- might not be diagnosed until later in life

Question 20

Von Willebrand’s Disease definition

Answer 20

Genetic disorder missing or abnormal Von Willebrand factor (a clotting protein)

Question 21

Signs of decreased clotting

Answer 21

• heavy menses
• epitaxis (nose bleeds)
• increased abnormal bleeding
• gingival bleeding
• bruising from minor/spontaneous
• joint pain and damage from swelling

Question 22

Decreased clotting teaching

Answer 22

• prevent injury
• medical alert bracelet
• signs of decreased platelets
• sneezing with mouth open to decrease pressure

Question 23

Decreased clotting treatment

Answer 23

• administer factor VIII and factor IX

- desmopressin (stimulates release of Von Willebrand factor)

Question 24

Disorders of blood cell function and anatomy (3)

Answer 24

• Thelassemia
• Sickle Cell Disease
• Hereditary Spherocytosis

Question 25

Thelassemia definition

Answer 25

Anemia due to abnormally found hemoglobin (varying severity)

Question 26

Major Thelassemia s/s

Answer 26

- Pallor - Irritability - Growth retardation - Hepatospleenomegaly

Question 27

How can you prevent infection for blood cell function disorders?

Answer 27

- Hand washing - Penicillin - Vaccination

Question 28

Thelassemia treatment

Answer 28

- transfusion q 3-5 weeks with 1-3 units of blood - splenectomy - iron chelation r/t frequent transfusions - removes the high levels of iron

Question 29

Sickle Cell Disease definition

Answer 29

Change in genetic make up causes sickling of RBC

Question 30

Highest risk ethnicities of Sickle Cell

Answer 30

- African American | - Mediterranean

Question 31

Sickle Cell Disease genetics

Answer 31

- Autosomal recessive | - 6th amino acid is altered

Question 32

S/s of Sickle Cell Disease

Answer 32

- Acute Sequestration crisis (blood pooling in spleen, risk for hypovolemic shock) - Vaso-occlusive crisis (stressors that cause RBC to sickle) - Aplastic crisis (worsening anemia) - Spleenomegaly

Question 33

Vaso-occuluisve crisis (4)

Answer 33

- Clumping (altered peripheral perfusion and tissue hypoxia) - Severe pain - Swelling - Visual disturbance

Question 34

Sickle Cell teaching (5)

Answer 34

- hydration, keep out of high temps - know limitations - prevent infection (wash hands, penicillin, vaccinations) - folic acid daily supplementation - Hydroxyuria

Question 35

Hydroxyuria

Answer 35

- chemo drug that activates the fetal hemoglobin production | - helps replace sickled RBC

Question 36

Sickle Cell treatment

Answer 36

- Splenectomy - Transfusion - Treat the vaso-oclusive crisis (PCA, IV fluids, infection tx, O2)

Question 37

Hereditary Spherocytosis

Answer 37

Sphered shape RBC

Question 38

S/s Hereditary Spherocytosis

Answer 38

- anemia - jaundice (when RBC are broken apart bilirubin is released) - splenomegaly

Question 39

Hereditary Spherocytosis teaching

Answer 39

Prevent infection! - wash hands - penicillin - vaccinations

Question 40

Hereditary Spherocytosis treatment

Answer 40

- splenectomy | - transfusion in severe cases