Ch. 21 Hematologic function Flashcards by areanna burnett

Reduction in the total number of erythrocytes in the circulating blood or in the quality or quantity of hemoglobin

Anemia

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Anemia can be classified by size and identified by terms that end in….

-cytic (macrocytic, microcytic, and normocytic)

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Anemia can be classified by hemoglobin content. Identified by terms that end in…

-chromic (normochromic and hypochromic)

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Classic anemia symptoms

Fatigue, weakness, dyspnea, pallor

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Tx of anemia?

Correction of nutritional deficits, supplementation, and transfusion

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Megaloblastic anemias is also termed

Macrocytic-normochromic anemia

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Characterized by unusually large stem cells and result of defective DNA synthesis

Macrocytic normochromic anemias

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Macro/normo anemia results in defective DNA synthesis…this is caused by

deficiencies in B12 or folate

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Caused by a lack of intrinsic factor from the gastric parietal cells

Pernicious anemia

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Risk factors for pernicious anemia

Congenital, autoimmune gastritis, excessive alcohol and tea intake, and smoking

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Are the early symptoms of pernicious anemia specific?

no, they are nonspecific and vague

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With pernicious, what are the hemoglobin levels usually at?

7-8g/dl

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What is the normal range of hemoglobin for males and females?

M: 14-18
F: 12-16

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Symptoms of pernicious anemia

Weakness, fatigue
paresthesia, diff. walking
loss of appetite
Sore tongue (beefy and red)

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What are the neurologic manifestations of pernicious anemia? and why do they manifest?

Manifest due to nerve demyelination. Loss of position and vibration sense. Ataxia and spasticity

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Tx of pernicious anemia?

Parenteral or high doses of B12. Lifelong tx.

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Folate deficiency anemia is less common than pernicious

False

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Absorption of folate occurs where?

Upper small intestine

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___ ____ anemia is not dependent on any other factor. Similar to pernicious except there are not generally _______ manifestations

Folate deficiency; neurologic

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Tx of folate deficiency anemia?

Daily oral medication of folate

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At risk/causes of folate deficiency anemia?

Chronically malnourished, alcoholics, and stomatitis

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Characterized by red cells that are abnormally small and contain reduced amounts of hemoglobin

Microcytic-hypochromic anemias

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Most common type of anemia in the world?

Iron deficiency anemia

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_____ ___ anemia is a nutritional deficiency or blood loss

Iron deficiency

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Manifestations of iron deficiency occur when...

When serum Hgb decreases to 7 or 8gm/dl

Early symptoms of iron deficiency?

Fatigue, weakness, shortness of breath, pale earlobes and palms, and conjunctiva

Who is at risk for iron deficiency anemia?

Malnourished children, pregnant women, and women during menstruation

Progression of iron deficiency

Brittle, thin, coarsely ridged and spoon shaped nails (koilonychia) A red, sore, and painful tongue

Tx of iron deficiency anemia

Iron replacement therapy: IV or PO

Characterized by red cells that are relatively normal in size and hemoglobin content but insufficient in number

Normocytic Normochromic anemias

Damage to bone marrow, affecting erythropoiesis. (normo/normo)

Aplastic anemia

Acute blood loss is known as ______ (normo/norm)

Post-hemorrhagic

______: abnormal immune destruction of RBC's (acquired and hereditary)

hemolytic

Anemia of _____ _____: occurs in many chronic diseases

chronic inflammation

Splenomegaly

Enlargement of the spine

Splenomegaly is caused by ______: overactivity, leading to anemia, leukopenia, and/or thrombocytopenia

Hypersplenism

Thrombocytopenia is when your platelet count is

< 150,000/mm^3

<50,000 platelets

Hemorrhage from minor trauma

<15,000 platelets

Spontaneous bleeding

<10,000 platelets

Severe bleeding

Thrombocytopenia can be congenital or acquired. T or F

True

Thrombocytopenia can be acquired through autoimmune disorders such as ___ and ___

EBV or HIV

Thrombocytopenia can be acquired through ____ or ____ infections

viral or bacterial

Another way thrombocytopenia is acquired is if platelet consumption is increased. This can be _____-induced

heparin

What is DIC?

a condition in which blood clots form throughout the body, blocking small blood vessels.

What is typically seen in HIT?

50% drop in platelet count

What is the HIT paradox?

People with HIT can experience venous thrombosis

Chronic form of ITP

Platelet-specific IgG autoantibodies that target platelet glycoproteins. Progressively worsens, exacerbates, and then goes in remission.

Acute form of ITP

Develops after a viral infections. Platelets are damaged and destroyed in the spleen.

Which form of ITP is one of the most common childhood bleeding disorders

acute ITP

Acute ITP resolves in....

1-2 months

Manifestation of ITP

Petechiae and purpura. Progresses to major hemorrage

Dx of ITP?

H&P, blood counts

Tx of ITP (chronic)

Prednisone, IV immune globulin, or a splenectomy

Thrombotic thrombocytopenic purpura

blood clots in smaller vessels such as the arterioles and capillaries

TTP causes ____ with target organ damage

ischemia

Chronic relapsing TTP is common

false, very rare

Tx of TTP

Steroids, plasma, and plasmapheresis

Essential (primary) thrombocythemia (thrombocytosis) is characterized by

platelet counts >400,000

Megakaryocytes in the bone marrow are produced in excess with

Thrombocythemia

Clinical manifestations of thrombocythemia

Ischemia of fingers and toes

Tx of thrombocythemia

Hydroxyurea and Anegrelide

What is necessary for synthesis and regulation of prothrombin, the procoagulant factors, and proteins C and S (anticoagulants)

Vitamin K

What hemostasis disorders does liver disease cause

- Defects in coagulation - Fibrinolysis - Platelet number and function

Complex, acquired disorder in which clotting and hemorrhage simultaneously occur

Disseminated Intravascular coagulation (DIC)

Possible cause of DIC?

result of increased protease activity in the blood caused by unregulated release of thrombin.

Endothelial damage is the primary initiator of DIC. T or F

true

_____ is the most common condition associated with DIC

Sepsis

Sepsis is usually caused by ____ ___ organisms; endotoxins damage endothelium

gram negative

With DIC, coagulation results from abnormally widespread and ongoing activation of clotting. T or F

True

With DIC, the thrombosis activates plasmin and triggers _______

Fibrinolysis

With DIC, thrombosis triggers fibrinolysis. THe fibrin degradation products resulting from fibrinolysis actually have _______ properties

Anticoagulant

With DIC, clotting leads to deposition of _____ in the microcirculation that leads to _____, _____, and organ failure

Fibrin; obstruction, and organ failure

Patient presents with purpura, petechiae, and hematomas. Bleeding from venipuncture sites and arterial lines. Patient goes into shock and eventually has internal hemorrhaging. Patient has...

DIC

Tx of DIC

eliminate the cause so the liver can restore clotting factors. Infuse clotting factors. In some cases, heparin.