Hematologic Disorders

Question 1

Elevated RBC

Answer 1

Polycythemia

Question 2

Decreased RBC

Answer 2

Anemia

Question 3

Elevated WBC

Answer 3

Infection/Leukemia

Question 4

Decreased WBC

Answer 4

All 5 WBC low

Leukopenia

Question 5

How many WBC do we have

Answer 5

5

Question 6

PLT Elevated

Answer 6

Thrombocytosis

Question 7

PLT Low

Answer 7

Thrombocytopenia

Question 8

Sickle Cell Anemia

Answer 8

Usually round and spongey!

Hemoglobin S - Hard and Long

Question 9

Bad things for sickle cell anemia

Answer 9

Cold temperatures
High altitudes
Infection
Acidosis
Stress

Question 10

what do sickle cells do?!

Answer 10

Block capillary beds - PAIIIINNNNN!

Question 11

What can sickle cell do to men?

Answer 11

Priapism - blood stuck in penis

Question 12

Tx for Sickle Cell

Pain

Answer 12

NSAIDs/Opioids/Toradol

Heat for painful areas

Question 13

What drug for Sickle Cell Anemia

Answer 13

Hydroxyurea - prevents formation of sickle cell shape

Question 14

Other Tx for Sickle Cell

Answer 14

IV rehydration
O2
Transfusion
Abx for infection

Question 15

Dc Tx for Sickle Cell

Answer 15

Apply warm
Moist heat to affected areas to reduce pain and swelling
Well hydrated
Exercise
Avoid high altitudes (helicopters)
Limit exposure to cold

Question 16

Thrombocytosis can be due to

Answer 16

Chronic Hypoxia (overactive bone marrow)
Splenic Disorders
Bone Marrow Disorders

Question 17

What is erythromelalgia

Answer 17

Severe redness and burning in hands and feet (thrombocytosis)

Question 18

Tx for thrombocytosis

Answer 18

Low-dose ASA

Treat underlying condition

Question 19

Thrombyoctopenia usually related to

Answer 19

Immune conditions

After viral infection in a child

Question 20

Why do you bruise with low PLT?

Answer 20

Need PLT for clotting!

Question 21

PLT 30-50

Answer 21

Brusing

Question 22

PLT 10-30

Answer 22

Petechia/Gum bleeding

Question 23

PLT <10

Answer 23

Internal Bleeding

Question 24

Tx for thrombyoctopenia

Answer 24

Prednisone for immune causes

Possible PLT transfusion for <30

Question 25

DIC is

Answer 25

Disseminated intravascular coagulation

Question 26

DIC is a what type of syndrome?

Answer 26

paradoxical!! Two different things at the same time BLEEDING and CLOTTING

Question 27

First stage of DIC

Answer 27

Clotting stage!

Question 28

Factors that can cause PLT abnormal clotting? (4 eg)

Answer 28

1. Metabolic acidosis 2. Pregnancy - much higher clotting factors 3. Cold Body 4. Trauma

Question 29

DIC Abnormal Clotting problems

Answer 29

Metabolic acidosis Mottling Gangrene Organ Failure

Question 30

Second stage of DIC

Answer 30

Bleeding stage!

Question 31

How can you bleed with clotting? DIC?

Answer 31

Every clot produces fibrin degradation products - help to break down the clot - cause you don't want to keep the clot! Number of clots being formed + fibrin degradation (anticoagulant) = so many FDPs (only so many PLT - consuming all clotting factors and you run out - can't clot) BEGIN TO BLEED. OCCUR AT SAME TIME.

Question 32

Lab values of DIC

Answer 32

PLT = LOW PT/PTT = High (no clotting factors) Fibrinogen levels = Low (clotting factor being consumed) D-Dimer = High (FDP) H/H = Low (actively bleeding)

Question 33

Tx for DIC

Answer 33

Call the priest Chance of survival Low Control pokes! Handle gently Apply direct pressure to bleeding sites

Question 34

DIC in pregnancy can be caused by the

Answer 34

placenta

Question 35

DIC Pharmacological Interventions (Controversial)

Answer 35

Heparin TXA Amicar Due to paradox.

Question 36

DIC Blood Products

Answer 36

PRBC for bleeding PLT for thromcocytopenia Cryoprecipitate for low fibrinogen levels FFP for dec PT/PTT

Question 37

Hemophilia

Answer 37

Affects males Cannot form a clot One clotting factor that doesn't work decreases ability to form clot

Question 38

3 Forms of Hemophilia

Answer 38

Factor VIII (Hemophilia A) Factor IX (Hemophilia B - Christmas Disease) Factor XI (Hemophilia C - Rosenthal's syndrome) usually africa

Question 39

How do hemophilia tx at home?

Answer 39

Clotting factors at home

Question 40

Tx for Hemophilia

Answer 40

Give the factor DDAVP - stimulates release of Factor VIII

Question 41

Treat Hemophilia Hematoma

Answer 41

Ice Compression Dressing Immobilization Elevation

Question 42

Treat Hemophilia lac

Answer 42

Administer replacement factor before suturing or cast to avoid compartment syndrome

Question 43

Treat Hemophilia nosebleed

Answer 43

Topical Thrombin

Question 44

Treat Hemophilia venipuncture

Answer 44

Hold pressure minimum 5 minutes NEVER GIVE IM INJECTION

Question 45

Why do immunocompromised not have symptoms?

Answer 45

Already lack the WBC that show the redness/swelling/puss

Question 46

Immunocompromised BAD BAD SIGN

Answer 46

FEVER

Question 47

Fever in child under 28 days?

Answer 47

Poor immune system | Sign of life threatening bacterial infection

Question 48

28 - 6 month child w/ fever

Answer 48

Risk of bacterial infection decreases

Question 49

after 6 months w/ fever

Answer 49

Most common cause is viral

Question 50

Three most common life-threatening causes of fever in young adult

Answer 50

1. Sepsis 2. Pneumonia 3. Peritonitis

Question 51

Fever in the elderly (or chronically ill)

Answer 51

Immune system weans Older we get the less immune system response we have May lack a fever - hypothermia

Question 52

Febrile seizures are most common between

Answer 52

6 months and 5 years of age

Question 53

After one febrile seizure

Answer 53

risk of recurrent febrile seizures are high

Question 54

HR increases how with fever?

Answer 54

0.5 C elevation HR increases 10 BPM

Question 55

RR increase how with fever?

Answer 55

1 C elevation RR | 5 BPM