Chapter 41 and 42 Hematology

Question 1

Fibrinolytics

Answer 1

Selectively degrade fibrin threads in the formed blood clot

Question 2

Platelet Inhibitors

Answer 2

prevent platelets from becoming active or activated platelets from clumping together

Question 3

Anemia

Answer 3

Reduction in RBC’s, hemoglobin, or hematocrit

Question 4

Sickle cell disease

Answer 4

Genetic

chronic anemia, pain, disability, organ damage, increased risk for infection, and early death

Question 5

Sickle Cell Disease: Pathophysiology

Answer 5

Formation of abnormal hemoglobin chains

Question 6

Iron Deficiency Anemia cause

Answer 6

blood loss, poor intestinal absorption, or inadequate diet

Question 7

Iron Deficiency Anemia sx

Answer 7

weakness and pallor

abnormal bleeding, especially from the GI tract

Question 8

Causes of Vitamin B12 Deficiency Anemia

Answer 8

small bowel resection, tapeworm, overgrowth of intestinal bacteria

Question 9

Result of Vitamin B12 Deficiency Anemia

Answer 9

improper DNA synthesis of RBCs.

Question 10

Pernicious Anemia

Answer 10

failure to absorb vitamin B12

Caused by a deficiency of intrinsic factor

Question 11

Aplastic Anemia

Answer 11

Deficiency of circulating RBCs

failure of the bone marrow to produce RBC’s

Question 12

Aplastic Anemia tx

Answer 12

Blood transfusions
Immunosuppressive therapy
Splenectomy

Question 13

Polycythemia Vera

Answer 13

Cancer of the RBCs
Increase in blood hemoglobin or hematocrit
Over production of red blood cells, leukocytes and platelets

Question 14

Polycythemia Vera tx

Answer 14

Phlebotomy
Hydration
Anticoagulants

Question 15

Myelodysplastic Syndromes

Answer 15

caused by the formation of abnormal cells in the bone marrow

Question 16

Drugs for iron overload

Answer 16

deferasirox and deferoxamine mesylate

Question 17

Leukemia

Answer 17

of cancer with uncontrolled production of immature white blood cells in the bone marrow

Question 18

Laboratory assessment of leukemia

Answer 18

Decreased H&H
Low platelets
Abnormal WBC (high)

Question 19

Hodgkin’s Lymphoma: Interventions

Answer 19

One of the most treatable types of cancer
External radiation
Chemotherapy

Question 20

Hodgkin’s Lymphoma marker

Answer 20

Reed-Sternberg cell

Spreads to different lymph nodes in an orderly fashion

Question 21

Hodgkin’s Lymphoma sx

Answer 21

Large, painless lymph node, usually in the neck, becomes painful when alcohol ingested; fever, drenching night sweats, and unexplained weight loss

Question 22

Non-Hodgkin’s Lymphoma

Answer 22

more than 12 types
do not have Reed-Sternberg cell
Not orderly

Question 23

Multiple Myeloma

Answer 23

White blood cell cancer that involves a more mature lymphocyte called a plasma cell

Question 24

Multiple Myeloma interventions

Answer 24

Chemotherapy
Autologous stem cell transplant
Analgesics
Bisphosphonates

Question 25

Autoimmune Thrombocytopenic Purpura

Answer 25

Total number of circulating platelets is greatly reduced even though production in the bone marrow is normal. Patients make an antibody directed against the surface of their own platelets.

Question 26

Autoimmune Thrombocytopenic Purpura drug therapy

Answer 26

corticosteroids, azathioprine, IV immunoglobulin, IV anti-Rho, or low doses of chemotherapy Platelet transfusions`

Question 27

Thrombotic Thrombocytopenic Purpura (TTP)

Answer 27

Rare | platelets clump together abnormally in the capillaries, and too few platelets remain in circulation

Question 28

Thrombotic Thrombocytopenic Purpura (TTP) tx

Answer 28

plasmapheresis, aspirin, alprostadil, plicamycin, and immunosuppressive therapy

Question 29

Types of Transfusions

Answer 29

``` Red blood cell Platelet Plasma—fresh frozen plasma Cryoprecipitate Granulocyte (white cell) ```

Question 30

Function of albumin in the blood

Answer 30

increases osmotic pressure of the blood, preventing the plasma from leaking into the tissues

Question 31

Functions of globulins in the blood

Answer 31

transport substances, protect the body from infections, and are the main protein of antibodies

Question 32

Components of plasma

Answer 32

albumin, globulins, and fibrinogen

Question 33

RBC's

Answer 33

Majority of blood cells 4.2-6.1 million Live 120 days produce hemoglobin

Question 34

Function of hemoglobin

Answer 34

carries O2 | Needs iron to function

Question 35

Function of the spleen in blood

Answer 35

balances blood cell production with blood cell destruction and assists with immunity. It destroys old or imperfect RBC’s, breaks down the hemoglobin , stores platelets, and filters antigens

Question 36

Trigger of blood clotting

Answer 36

formation of a platelet plug

Question 37

Most common sx of anemia

Answer 37

fatigue

Question 38

Most common cause of anemia

Answer 38

GI bleed

Question 39

Sickle cell anemia sx

Answer 39

``` pain #1 may be asymptomatic Jaundice SOB, fatigue Murmur, poor tissue perfusion tachycardia, priaprism pallor ```

Question 40

Labs seen in sickle cell anemia

Answer 40

low hematocrit high reticulate count (due to release of immature blood cells) high bilirubin increased WBC

Question 41

Sickle cell anemia interventions

Answer 41

pain related to hypoxia to tissues: tx w/ O2 and opioids hydrate promote venus return RBC transfusion

Question 42

Polycythemia Vera sx

Answer 42

``` dark flushed skin itching caused by dilated blood vessels and poor tissue perfusion HTN Distended veins sluggish blood flow ```

Question 43

Chelation

Answer 43

chemical binding of iron and its removal from the body

Question 44

Leukemia without tx

Answer 44

PT will die of infection of hemorrhage

Question 45

Acute leukemia sx

Answer 45

echymosis, petechiae, open infected lesions, pallor, bleding gums, anorexia, weiht loss, enlarged liver and spleen, hematuria, tachycardia, orthostatic hypotension, palpitations, dyspnea on exertion, fatigue, h/a, fever, bone pain, joint swelling and pain

Question 46

Chronic leukemia sx

Answer 46

murmurs, bruits, slow cap refill, respiratory changes, chronic repeated infections, pallor, coolness of extremities, petechia, easy bleeding, weight loss, nausea, anorexia

Question 47

Bone marrow transplant

Answer 47

typical tx for luekemia

Question 48

Graft vs host disease (GVHD)

Answer 48

cells of the donated marrow recognize the patients cells as foreign and start an attack Drugs are given to suppress the immune function

Question 49

Oprevlakin (Neumega)

Answer 49

given to leukemia PT's to induce platelet growth after chemo

Question 50

Autoimmune Thrombocytopenic Purpura sx

Answer 50

o Ecchymosis, petechial rash on the arms, legs, upper chest, and neck, musosal bleeding, anemia and low H&H if bleeding episodes have happened

Question 51

Autoimmune Thrombocytopenic Purpura complication

Answer 51

Rare: intracranial bleed-induced stroke

Question 52

Hemophilia transmission

Answer 52

• X linked recessive trait passed from women to their daughters who will be carriers and to their sons who will have the disease

Question 53

Hemophilia A

Answer 53

deficiency of factor VIII and accounts for 80% of cases

Question 54

Hemophilia B

Answer 54

deficiency of factor IX- accounts for 20% of cases

Question 55

Platelet count to qualify for transfusion

Answer 55

<10,000