hematologic disorders Flashcards
how does the hematologic system differ from the CV system?
it is composed of blood, blood vessels and organs producing blood (ex. bone marrow)
“blood” contains what 4 components?
erythrocytes, leukocytes, platelets and plasma
Hemotologic manifestations are more commonly secondary symptoms. They are often relate to what 4 factors?
NSAIDs
Neuro complications (pernicious anemia)
chemo or radiaiton
In patients with hematologic disorders, what other symptoms might we expect to see in additon to changes in exertional effort, neurologic signs, and integ?
bloody stool, emesis and joint pain/swelling
5 erythrocyte disorders mentioned in this class include anemia, polycythemia, poikilocytosis (abnormal shape), and __(2)
anisocytosis (abnormal size variation)
hypochromia (Hbg deficiency)
what is anemia? what are it’s four subtypes?
insufficient amount/ quality of erythrocytes from bleeding, destruction or low production.
types:
* iron deficiency
* chronic/inflam disease
* neuro conditions
* infection
what are some s/s that might increase the likelihood of anemia in your differential dx? (4)
skin changes, , slower processing/ depressed affect, decreased DBP, easily aggravated pain/ dyspnea with exertion
T/F: anemia is a disease resulting in reduction of O2 carrying capacity.
false. this a symptom but not a disease
what is polycythemia/erythrocytosis? What are 3 conditions might result in this secondary complication due to dec O2 supply to tissues?
an excessive amount of RBCs
smoking, high altitudes, and chronic heart/lung conditions
what is the only known cause of primary erythroctytosis?
neoplastic dx of bone marrow
Aside from HTN, what are some s/s that might increase the likelihood of polycythemia in your differential dx? (4)
hypoxemic s/s (ex cyanosis, AMS, dizziness), gout, malaise and SOB, weight loss
In sicle cell anemia, a genetic abnormality results in the altered shape of RBCs that block blood supply. This produces recurrent and painful episodes of vasoocclusionand inflammation. Aside from MSK pain, including hand-foot syndrome, and and vascular complications, s/s can also present as (4)
pulmonary (ex. SOB, tachypnea)
neurologic manifestations (ex. paresthisia, CN palsy, nysagmus, drowsiness)
renal complicatons
splenic sequestration (pre-adolescent enlargement and tenderness)
of the 3 types of leukocytes: lymphocytes, monocytes, and granulocytes, which contains the lysing agents? what do the others do?
- granulocytes
- monocytes: largest cells that travel to form macrophages and lymphocyes produce antibodies and react w/ antigens
T/F leukocytosis (indicated by a count > 10,000/mm) is a normal immune respone to many infectious and inflammatory diseases.
true
s/s: fever and inflammation
Conditions that may result in leukopenia (<5000/ml) include autoimmune diease, overwhelming infection, and (3)
dietary deficiency
some medications
many forms of bone marrow failure
From neuro, we know nadir to be the end of a GBS progression. How does it’s defination explain this?
nadir is when the WBCs reach their lowest point. given GBS is an immune response gone wild, it maes sense for it to stop when WBCs bottom out.
for CA pts, this period is usually 7-14 days post chemo/radiation
T/F: In a person who is already immunocompromised, the presence of fever, chills, and diaphoresis is an automatic medical referral.
mucual membrance ulcerations and UTI s/s also a concern
true
Vitamin K is known to help ___ (dec/inc) coagulation
increase
Thrombocytosis inc the bloods affinity for clotting, especially in the periphery. It can present as ___ (3) and be a primary result of abnormal mone marrow cells or secondary complication of iron deficit/polycythemia vera, occult neoplasm, or s/s compensation.
thrombosis
splenomegaly
easy bruising
Thrombocytopenia can be caused by radiation &chemo, meds, metastatic cancers, and (3)
aplastic anemia (insufficient amount of blood cells)
leukemia
bone marrow failure
Individuals with hemophilia often experience episodes of hemoarthrosis in their major joints along w/ bleeding in LE muscles and forearm flexors. What are the 3 more common MSK s/s?
progressive loss of motion
muscle atrophy
flexion contractures
T/F:Hemophilia, caused by abnormally functioning plasma-clotting proteins, results in bleeding/ swelling episodes best treated by increased movement to promote blood circulaiton
false. it’s treated by factor replacement and joint immobilization.
a hemophillic episode is more likely to present with which of the following:
* muscle bleeding
* hemarthrosis
muscle bleeding
also more insidious and massive than joint hemorrhages
potential complications of hemophillia include localized ischemia/necrosis, replacement of muscle fibers w/ nonelastic tissue and __ (2)
peripheral N lesions via compression
pseudotumor formation w/ bone erosion
