Hematologic diseases

Question 1

iron deficiency anemia

Answer 1

poor absorption or excessive loss of iron

Question 2

pernicious anemia

Answer 2

poor absorption of B12 due to absence of intrinsic factor

leads to low H&H, GI problems, neuro symptoms

Question 3

Aplastic anemia

Answer 3

bone marrow without erythroid, myeloid, megakariocytic cell lines
Requires transfusions until bone marrow again produces cells
S/S: weakness, dyspnea, headaches

Question 4

hemolytic anemia

Answer 4

RBC are destroyed, bone marrow cannot keep up with RBC loss

Question 5

Thalassemia

Answer 5

genetic disorder leading to inadequate hemoglobin production

Question 6

Polycythemia Vera

Answer 6

Over production of RBC, WBC, and platelets
Thick blood, large blood volume, organ congestion
S/S: Red complexion, dizziness, headache, visual disturbances, painful joints
Treatment: myelosuppresive drugs, radiation

Question 7

Immune thrombocytopenia purpura

Answer 7

abnormal destruction and reduced production of circulating platelets, primarily an autoimmune disease

Question 8

Hemophilia

Answer 8

X-linked recessive genetic disorder caused by a defective of deficient coagulation factor

Question 9

Disseminated intravascular coagulation

Answer 9

widespread clotting
Causes: shock, sepsis, cirrhosis, severe trauma
usually a secondary event from activation of one of the coagulation pathways

Question 10

Acute Leukemia

Answer 10

clonal proliferation of immature hematopoietic cells

Question 11

Chronic Leukemia

Answer 11

Mature forms of WBC and onset is more gradual

Question 12

Leukemia-ALL

Answer 12

childhood 80% of time, diagnosis by lymphoblasts in bone marrow, bleeding, anemia symptoms, joint pain

Question 13

Leukemia- AML

Answer 13

advanced aging- 60 years, auer rod structure in cytoplasm of myeloblasts confirms diagnosis

Question 14

Leukemia- CLL

Answer 14

age 55 or older, frequently detected incidentally, diagnosis by lymphocytosis, lymphadenopathy present 80%

Question 15

Leukemia- CML

Answer 15

middle age 55 years, Philadelphia chromosome confirms diagnosis, main symptoms of fatigue and spleenomegaly

Question 16

Peripheral Arterial Disease-PAD

Answer 16

progressive narrowing and degeneration of arteries of upper and lower extremities
Leading cause: atherosclerosis
Symptoms: intermittent claudication ( muscle pain that is caused by exercising) resolves within 10 min or less with rest, numbness or tingling, loss of hair on legs, absent or diminished lower extremity pulses, pain at rest from insufficient blood flow

Question 17

PAD treatment

Answer 17

ace inhibitor (Ramipril), antiplatelet agents (aspirin, plavix) drugs for intermittent claudication: cilostazol (increases vasodilation), pentoxifylline ( increase RBC flexibility, decreases blood viscosity) 
Exercise, diet high in fruits, veggies, and whole grains

Question 18

Raynaud’s Phenomenon

Answer 18

vasospastic disorder of small cutaneous arteries (fingers and toes usually) imbalance between vasodilation and vasoconstriction
primarily young women 15-40
Causes color changes of fingers, toes; decreased perfusion=white then cyantotic then red once blood returns back
coldness and numbness then throbbing pain and tingling swelling.

Question 19

Thromboangiitis Obliterans (Buerger’s Disease)

Answer 19

occlusive disease of the median and small arteries and veins, distal upper and lower limbs are most commonly affected
Intermittent claudication, aching pain more severe at night, cool numb or tingling sensation, diminished pulses, ulceration development

Question 20

Aortic aneurysms

Answer 20

dilated aortic wall becomes lined with thrombi that can embolize. Wall of artery forms the aneurysm, at least one vessel still intact.
Pre-op: monitor VS and assess risk factors for arterial disease process, assess for abdominal and back pain
Avoid straining