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Pharmacology > Hematology > Flashcards

Hematology Flashcards

1
Q

What is anemia

A

Deficiency in RBC

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2
Q

What are the two types of anemia

A

Relative

Absolute

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3
Q

What is absolute anemia

A

the decrease in number of RBC

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4
Q

What is relative anemia

A

The normal total RBC mass with increased plasma volume

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5
Q

What population is prone to relative anemia?

A

Pregnant mothers because the percentage of RBC decreases as plasma volume increases

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6
Q

What is the job of RBC

A

to deliver oxygen. If you don’t have enough, organs, cells can get oxygenated

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7
Q

What is the mechanism for pernicious anemia

A

lack of vitamin B leads to altered DNA synthesis

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8
Q

What is the mechanism for folate deficiency

A

Lack of folate leads to premature cell death

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9
Q

What is the mechanism for iron deficiency

A

lack of iron leads to lack of hemoglobin

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10
Q

What is the mechanism for Thalassemia

A

Congenital impaired synthesis of hemoglobin chain

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11
Q

What is the mechanism for aplastic anemia

A

Bone marrow suppression leads to decreased production

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12
Q

What is the mechanism for sickle cell anemia

A

congenital abnormal hemoglobin molecule

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13
Q

What is the mechanism for post hemorrhage

A

blood loss leads to insufficient RBC

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14
Q

What is the mechanism for anemia of chronic Dz

A

chronic infection
inflammation
malignancy leads to increased demand or suppression

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15
Q

What is the mechanism for hemolytic disease of newborn

A

Maternal antibodies case destruction of fetal cells

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16
Q

What is the mechanism for Acute blood loss

A

blood loss to insufficient RBC

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17
Q

Why does anemia result in tissue hypoxia

A

failure of the delivery of oxygen to cells

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18
Q

What are signs and symptoms of tissue hypoxia that results from anemia that you would see on physical assessment?

A 
Pallor skin or mucous membrane
Increase RR
Muscle pain (claudication) 
CNS  (dizziness, fainting, lethargy)
Fatigue
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19
Q

What systems are involved in compensatory mechanisms

A

Cardiovascular
Renal
DPG
Erythropoietin

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20
Q

What compensatory mechanisms occur in the cardiovascular system

A

Increase HR
Vasodilation
Increase stroke volume

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21
Q

What compensatory mechanisms occur in the renal

A

Increases renin-aldosterone response

Increases extracellular fluid

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22
Q

What compensatory mechanisms occur in the DPG

A

Increase in DPG cells to release oxygen from hemoglobin tissues

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23
Q

What compensatory mechanisms occur in the Erythropoietin

A

Increases erythropoietin to stimulate bone marrow to produce more RBC

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24
Q

What are mild clinical manifestations of anemia?

A

no symptoms

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25
Q

What are mild to moderate clinical manifestations of anemia?

A 
Loss of stamina
Exertional dyspnea
Generalized weakness 
Tachycardia
Fatigue
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26
Q

What are moderate to severe clinical manifestations of anemia?

A

Tinnitus in the ear
Angina pectoris (chest pain)
Muscle cramps
Orthostatic hypotension

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27
Q

What are test that you can anticipate that could be ordered for your patient to evaluate for anemia.

A

hemoglobin
hematocrit
peripheral smear

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28
Q

What does hemoglobin measure and what is the lab value?

A

12-16 g/dl

Measures of the protein that is in RBC responsible carrying and delivering the oxygen

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29
Q

What does hematocrit measure and what is the lab value

A

37-47%

Volumes of RBC compared to total blood volume

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30
Q

What does the peripheral smear measure?

A

It will tell you the color and shape of RBC

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31
Q

What are general treatments for anemia?

A

Treatment is based on cause of anemia

Blood transfusion
Supplements
Rest, oxygen, fluids

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32
Q

What is the most common nutritional deficiency and cause of anemia?

A

Iron deficiency

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33
Q

What are the causes/etiology of iron deficiency anemia?

A

Low intake of iron

Anytime you have an physiologic increase in requirement

Excessive iron loss due to blood loss (heavy periods, post-partum hemorrhaging)

Renal issues

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34
Q

What is an assessment finding of iron deficiency?

A

Pica

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35
Q

What is pica?

A

When they crave non nutrition food substances

Strong indicator they have iron deficiency anemia

36
Q

What is the treatment for iron deficiency anemia?

A

oral administration like ferrous sulfate

37
Q

What is the definition of hemostasis?

A

It is a physiologic process that stops bleeding at the site of injury while maintaining normal blood flow elsewhere

38
Q

What occurs in primary hemostasis?

A

formation of the primary platelet plug

Vasoconstriction

It takes 3-7 minutes

39
Q

What occurs in secondary hemostasis

A

Formation of fibrin

Clotting factors are activated

Form 3-10 minutes

It takes 1 hour

40
Q

Name the different types of bleeding disorders

A

Vascular Disorders

Platelet Disorder

Coagulation Disorders

41
Q

What are platelets and how do they play a role in hemostasis?

A

Platelets are responsible for adhesion
Occur in both primary and secondary hemostasis
They contribute to the intrinsic pathway

42
Q

What are coagulation factors?

A

Proteins in the blood to form clots

If any of your factors are missing or defective, it can lead to heavy, uncontrolled bleeding after an injury.

43
Q

How do coagulation factors play a role in hemostasis?

A

They occur in intrinsic pathway and extrinsic pathway

They activate factor 10

If a problem is found, you likely have a condition known as a bleeding disorder.

44
Q

Name the three bleeding disorders?

A

Vascular disorder
Platelet disorder
Coagulation disorder

45
Q

What are coagulation disorders

A

They are deficiencies of clotting factors

46
Q

What are the cause factors of coagulation disorders

A

Vitamin K deficiency

Inherited (von Willebrand, Hemophilia)

Disseminated intravascular coagulation

47
Q

What are platelet disorder

A

abnormal quantity or quality of platelets

48
Q

What is an example of a platelet disorder?

A

Thrombocytompenia

49
Q

What is a vascular disorder

A

Vascular defect

50
Q

What is an example of a vascular disorder

A

Vascular Purpura

51
Q

What are the assessment findings that may indicate bleeding disorder

A 
Epistaxis
Ecchymosis
Hemarthrosis
Hematoma
Hematuria
Hematochezia
Hematemesis
Hemoptysis
Jaundice
Menorrhagia
Petechia
Purpura
Pallor
52
Q

Define epitaxis

A

nose bleeds

53
Q

Define ecchymosis

A

bruising of skin

54
Q

Define hemarthrosis

A

bleeding at joint spaces

55
Q

Define hematoma

A

blood in tissue

56
Q

Define hematuria

A

blood in urine

57
Q

Define hematemesis

A

blood in vomit

58
Q

Define Hemoptysis

A

coughing of blood

59
Q

Define Jaundice

A

yellow discoloration

Liver/gallbladder/coagulation disorders

60
Q

Define Menorrhagia

A

heaving menstruation

61
Q

Define Petechia

A

small red spots

62
Q

Define Purpura

A

Bumpy red spots

63
Q

Define Pallor

A

pale skin

64
Q

What are the test that you can anticipate that could be ordered for your patient to evaluate for bleeding disorders?

A

CBC
Bleeding time
Prothrombin and INR
aPTT

65
Q

What is the purpose of CBC

A

Determine if anemia is present,
number of platelets present,
morphology of platelets

66
Q

What is the purpose of bleeding time

A

Evaluate platelet and vascular response

67
Q

What is the purpose of Prothrombin and INR

A

Evaluates extrinsic pathway of

coagulation

68
Q

What is the purpose of partial thromboplastin time

A

Evaluates intrinsic pathway of

coagulation

69
Q

What are potential treatments for bleeding disorders

A

Avoid the cause

Steroids

IVIG

Factor replacement

Platelets

Fresh frozen plasma

70
Q

What is thrombocytompenia?

A

platelet count less than 150,000 platelets/ul of blood

71
Q

What is the cause of thrombocytompenia

A

Decreased production or

Increased consumption of platelets.

72
Q

What is an assessment finding of thrombocytompenia

A

Petechiae
Purpura
Decreased platelet counts
Bleeding

73
Q

What are potential treatments for thrombocytompenia

A

Treat or remove the cause
Block the immune response
Blood and/or platelet transfusion

74
Q

Name two thromboembolic disorders

A

Thrombus

Deep vein thrombosis

75
Q

What is thrombus

A

Stationary blood clot formed within a vessel or chamber of the heart

76
Q

Thrombus can either be?

A

Arterial or venous

Composed of aggregated platelets, fibrin, clotting factors

77
Q

What is deep vein thrombosis

A

Presence of thrombus in one of of the deep veins (usually of the lower extremities)

78
Q

The risk for developing spontaneous thrombi is related to several factors referred to as the?

A

Virchow Triad

79
Q

What is Virchow’s Triad

A

Endothelial vessel wall injury
Circulatory stasis
Hypercoagulable conditions

80
Q

What are the patient examples the endothelial vessel wall injury

A

Injury to the blood vessel endothelium

Trauma, smoking, HTN, catheter, surgery

81
Q

What are the patient examples the circulatory stasis

A

abnormalities of blood flow

immobile, Atrial Fib, venous insufficiency

82
Q

What are the patient examples the hypercoagulable conditions

A 
Pregnant women
Obese patients
Oral contraception
Postpartum patients
Cancer
83
Q

What are assessment findings that may indicate a deep vein thrombosis is present?

A 
Prediction rules
Ultrasound
Redness or discoloration
Pain/Tenderness (general or elicited)
Labs- D-dimer
Edema
Warmth
84
Q

What are the test that you can anticipate that could be ordered for your patients to evaluate for deep vein thrombosis?

A

IDK

85
Q

What are common treatments for DVT

A

Thrombolytic to break down the clot (tPA)

Anticoagulant to reduce further clot formation

86
Q

What types of prevention measures patients can take to prevent the formation of DVT

A

Anticoagulants
SCD or compression stockings
MOVE
Good hydration

Pharmacology (7 decks)

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