Hematology

Question 1

Polyheme

Answer 1

Does not have to be refrigerated and is universal

Question 2

Types of infusion

Answer 2

Whole blood
Packed Red Cell’s
Fresh Frozen Plasma
Clotting Factors

Question 3

What are the 5 areas that form blood

Answer 3

Red bone marrow (all types of erythrocytes formed here)

Yellow bone marrow (produces white cells)

Lymph nodes (produces lymphocytes and antibodies)

Spleen (Stores large quantities of blood & produces lymph, plasma cells and antibodies)

Liver (during intrauterine life)

Question 4

What % of blood is RBC

Answer 4

95%

Question 5

Plasma

Answer 5

fluid portion of blood (92% water)

Question 6

RBC life span

Answer 6

120 days

Question 7

RBC production cycle

Answer 7

Starts with one cell in the red marrow and divides into 16 then develop

Question 8

WBC’s

Answer 8

5-10K cells/mm3

Question 9

Platelets

Answer 9

Thrombocytes that travel to site of damage, swell and adhere to damaged vessel wall

Will start clotting cascade if damage too great.

Question 10

Hematocrit

Answer 10

measures fraction of blood volume cantaining RBC’s
40-50% in males
35-45% in females

Question 11

Hemoglobin

Answer 11

14-18% in males

12-16% in females

Question 12

Anemia

Answer 12

poor O2- concentration of hemoglobin or RBC’s is below normal.

Question 13

Precipitating causes of anemia

Answer 13

Chronic or acute blood loss
Decrease erythrocyte production
Increased destruction of erythrocyte

Question 14

Common forms of anemia

Answer 14

Iron-deficiency anemia
Hemolytic anemia
Aplastic
Pernicious

Question 15

Iron-deficiency anemia

Answer 15

Bone marrow roduces small and pale RBC’s with reduced O2 carrying capacity

Question 16

Most common causes of iron deficiency anemia

Answer 16

Menstruation
GI Bleeds – stress, infection, alcoholics
Iron poor diet in kids

Question 17

Hemolytic Anemia types

Answer 17

Inherited and aquired

Question 18

Inherited

Answer 18

Often abnormal rigidity of cell membrane causing smaller cells
Cells trapped in the smaller blood vessels (often spleen) and destroyed by macrophages

Question 19

Examples of Inherited hemolytic anemia

Answer 19

Sickle cell
Thalassemia
Glucose-6-phosphate dehydrogenase

Question 20

3 conditions of aquired

Answer 20

Normal RBC’s disrupted due to mechanical forces (blood clots, atherosclerosis)
Autoimmune disorders which can destroy RBC’s with antibodies
RBC’s destroyed by microorganisms in the blood (ie malaria)

Question 21

Other anemias

Answer 21

Aplastic
Failure to produce RBC’s
Pernicious (usually inherited)
Lack of vitamin B, needed for cell division

Question 22

Anemia S/S

Answer 22

SOB
Chest pain
Fever
Pale
Fatigue, lethargy
Headaches
Sore mouth or tongue
Brittle nails
Cutaneous bleeding
Bleeding from mucous membranes

Question 23

Anemia Dx

Answer 23

History, blood tests, bone marrow biopsy

Question 24

Leukemia

Answer 24

Cancer of Hematopoietic Cells – abnormal cells develop

Question 25

Leukemia more common

Answer 25

Males and caucasians, children and young adults

Question 26

Leukemia mortality in children

Answer 26

50%

Question 27

Leukemia classified by type of WBC

Answer 27

Acute lymphoblastic leukemia (ALL)--Usually in kids | Acute myeloblastic leukemia (AML)--Usually middle age adults

Question 28

Leukemia S/S

Answer 28

``` FREQUENT BRUISING Fatigue Infections secondary to low levels of Neutrophils (WBC) Bone pain Elevate temperature and diaphoresis Heat intolerance Abdominal fullness Bleeding Headache Weight loss Night sweats Enlarged lymph nodes, spleen, liver and testes ```

Question 29

Dx Leukemia

Answer 29

``` Bone marrow biopsy Severity assessed by Degree of liver and spleen enlargement Anemia Lack of platelets in the blood ```

Question 30

Rx of Leukemia

Answer 30

Transfusion of blood and platelets Antibiotic therapy Anticancer drugs - chemotherapy Radiation

Question 31

Lymphomas

Answer 31

``` Any neoplastic disorder of lymph tissue Two types Hodgkin's Non-Hodgkin’s Malignant ```

Question 32

Hodgkin's Lymphoma

Answer 32

Abnormal function of B cells | more common in males, in 20's and then 55-70

Question 33

Hodgkin's S/S

Answer 33

Swollen lymph Fatigue Chills Night sweats

Question 34

Non-Hodgkin's Lymphoma

Answer 34

Vary in malignancy according to nature and activity of normal cells At least 10 types Classified low to high grade Cause unknown

Question 35

Multiple Myeloma

Answer 35

Malignant neoplasm of the bone marrow Composed of plasma cells Production of large amounts of protein Increases viscosity of blood

Question 36

Multiple Myeloma S/S

Answer 36

``` Destroys bone tissue causing Pain – early Fractures - early Hypercalcemia Skeletal deformities ```

Question 37

Multiple Myeloma

Answer 37

rare before 40

Question 38

Polycythemia

Answer 38

Increase in total RBC mass

Question 39

2 types of polycythemia

Answer 39

Secondary—due to hypoxia | Primary—due to unknown reasons

Question 40

Secondary Polycythemia

Answer 40

Naturally present in people who live or visit high altitude areas

Question 41

Primary Polycythemia

Answer 41

Polycythemia Vera Condition occurs in those >50 years old Increased blood production causes blood to thicken and cause hands and feet to have red-purple complexion

Question 42

Hemophilia

Answer 42

Group of inherited bleeding disorders | Loss of 1 of 13 clotting factors

Question 43

Type A and B hemophilia

Answer 43

A—loss of factor VIII – most common | B—loss of factor IX AKA Christmas disease

Question 44

Sickle Cell Disease

Answer 44

Sickle Hemoglobin has a flawed chemical structure that results in erythrocyte deformity when oxygen levels are low. Chronic Sickle Cell = Chronic Hemolytic Anemia

Question 45

Sickle Cell S/S

Answer 45

``` PAIN DUE TO HYPOXIA EXCRUCIATING BONY DEFORMITIES Increased weakness Aching CP with SOB Sudden severe abdominal pain Icteric sclera Fever Arthralgia ```

Question 46

Sickle Cell (vaso-occlusive) Crisis

Answer 46

``` DEHYDRATION INFECTION STRESS TRAUMA Exposure to temperature extremes Hypoxia Strenuous physical activity ```

Question 47

Sickle Cell Rx

Answer 47

Treatment – Pain management, oxygen, fluids, rest and normothermic temperature