PATHO-- RBC's, anemias, alterations in homeostasis

Question 1

aplastic anemia

Answer 1

stem cell disorder characterized by reduction of hematopoietic tissue in bone marrow and pancytopenia (reduction in WBC, RBC, platelets)

Question 2

aplastic anemia etiologies

Answer 2

toxic, radiant, or immunologic injury to bone marrow stem cells

Question 3

aplastic anemia clinical manifestations

Answer 3

late symptoms–fatigue, tachycardia, weakness, lethargy. Pancytopenia

Question 4

labs of aplastic anemia findings

Answer 4

RBC’s are normocytic and normochromic

Question 5

aplastic anemia treatment

Answer 5

bone marrow transplant

Question 6

anemia of chronic renal failure

Answer 6

failure of renal function impairs erythropoietin production and bone marrow compensation

Question 7

anemia of chronic renal failure labs

Answer 7

decreased RBC count with low HCT and HGB level

Question 8

anemia of chronic renal failure treatment

Answer 8

dialysis and administration of erythropoietin

Question 9

RBC appearance in labs anemia of chronic renal failure

Answer 9

normocytic, normochromic

Question 10

pernicious anemia etiology

Answer 10

lack of intrinsic factor causes vitamin B-12 deficiency due to malabsorption of vitamin b-12

Question 11

pernicious anemia lab findings

Answer 11

low RBC, WBC, and platelets, increased MCV

Question 12

RBC appearance in labs pernicious anemia

Answer 12

microcytic

Question 13

pernicious anemia clinical manifestations

Answer 13

pallor, fatigue, sore tongue, anaorexia, nausea and vomiting, abdominal pain

Question 14

pernicious anemia neurological manifestations

Answer 14

Paresthesias of hands and feet, reduced vibratory position and sense, muscle weakness, impaired thought process

Question 15

folate deficiency anemia etiologies

Answer 15

poor dietary intake,

Question 16

folate deficiency anemia cells

Answer 16

macrocytic, normochromic

Question 17

iron deficiency anemia etiologies

Answer 17

inadequate diet, malabsorption of iron, blood loss

Question 18

iron deficiency anemia pathogenesis

Answer 18

body’s Fe+ stores depleted, lack of Fe+ for bone marrow which leads to iron deficient RBC production

Question 19

iron deficiency anemia clinical manifestations

Answer 19

pallor, fatigue, hypoactivity, pica, glossitis

Question 20

iron deficiency anemia lab findings

Answer 20

hypochromic and microcytic RBC’s, low MCV, MCH, and MCHC, TIBC increased

Question 21

iron deficiency anemia treatment

Answer 21

PO ferrous sulfate or IV ferrous gluconate

Question 22

thalassemia etiology

Answer 22

is a GENETIC DISORDER group associated with presence of mutant genes

Question 23

thalassemia pathogenesis

Answer 23

increased RBC destruction (hemolysis) results in decreased RBC survival rate

Question 24

thalassemia lab findings

Answer 24

hypochromic and microcytic RBC’s, MCV, MCH, and MCHC are low, erythroblastic hypoplasia

Question 25

thalassemia treatment

Answer 25

blood transfusions, splenectomy, bone marrow transplantation, genetic counseling

Question 26

sickle cell anemia etiology

Answer 26

genetic defect of hemoglobin synthesis, results in hemoglobin instability, autosomal recessive disorder

Question 27

sickle cell anemia pathogenesis

Answer 27

predisposes RBC's to early destruction due to abnormalities in structure, sickled cells cause vascular occlusion

Question 28

lab findings sickle cell anemia

Answer 28

severe anemia, RBC’s of different shapes and sizes

Question 29

sickle cell anemia treatment

Answer 29

O2, pain management, fluids, stem cell transplant

Question 30

hemolytic disease of the newborn

Answer 30

fetal RBC's cross the placenta, stimulate production of maternal antibodies against antigen on fetal RBC's not inherited by mother, maternal antibodies cross into fetal circulation and destroy fetal cells

Question 31

complications of hemolytic disease of the newborn for the newborn

Answer 31

anemia, reticulocytosis, nucleated RBC's in blood of infant

Question 32

how to prevent hemolytic disease of the newborn

Answer 32

Standard dose of anti-Rh immune globulin (RhoGAM) is given to mother before or after delivery, in some cases in eutero transfusion or early delivery

Question 33

acute blood loss

Answer 33

may be from trauma or secondary to a disease process, Symptoms develop with activity at 20% loss of blood volume (tachycardia & postural drop in BP), and increase in severity with continued blood loss

Question 34

acute blood loss treatment

Answer 34

blood volume replacement therapy

Question 35

thrombocytopenia

Answer 35

common cause of general bleeding: has 2 types-- ITP and acquired thrombocytopenia

Question 36

ITP--idiopathic thrombocytopenia purpura

Answer 36

autoimmune, platelets function normally but live only 1-3 days. acute= after viral illness. chronic= women aged 20-40

Question 37

acquired thrombocytopenia

Answer 37

diminished or defective platelet production, splenic sequestration, medications, platelet dilution

Question 38

thrombocytopenia pathogenesis

Answer 38

general mechanisms: decreased platelet production, decreased platelet survival, intravascular dilution of circulating platelets

Question 39

thrombocytopenia lab findings

Answer 39

low platelet count, prolonged bleeding time, abnormal peripheral smear

Question 40

thrombocytopenia clinical manifestations

Answer 40

platelet count is less than 150,000 (50,000 for spontaneous bleeding from slight trauma, below 20,000 life threatening), bruising (purpura, petechae), internal bleeding.

Question 41

treatment for thrombocytopenia

Answer 41

based on identified cause

Question 42

hemophilia

Answer 42

most common inherited genetic disorder; excessive bleeding

Question 43

hemophilia etiology

Answer 43

x linked recessive disorder (mother to son), 25% due to genetic mutation (not family history)

Question 44

types of hemophilia

Answer 44

hemophilia A--classic hemophilia, factor VIII deficiency hemophilia B-- Christmas disease, factor 9 deficiency

Question 45

treatment for hemophilia

Answer 45

patient/family education, hemophilia A= cryoprecipitate or factor VIII concentrate hemophilia B= fresh frozen plasma or cryoprecipitate

Question 46

hemophilia clinical manifestations

Answer 46

hemarthrosis (oozing of blood into soft tissue, muscle, joint capsule). Knee is most common site. Begins with a slight tear and joint expands with blood, leads to degenerative arthritis.

Question 47

Von willebrand disease

Answer 47

disorder of factor VIII and platelet function, excessive bleeding

Question 48

etiology of vwd

Answer 48

autosomal dominant inheritance

Question 49

pathogenesis of vwd

Answer 49

VW factor is needed to stabilize factor VIII and for platelet adherence. Bleeding occurs when VWF is decreased or absent

Question 50

vwd clinical manifestations

Answer 50

nose bleed, mucosal bleed, bruising, GI hemorrhage, menorrhagia, hemarthrosis (rare)

Question 51

vwd lab tests

Answer 51

prolonged bleeding time, normal platelet count

Question 52

vwd treatment

Answer 52

replace VWF

Question 53

disseminated intravascular coagulation

Answer 53

acquired bleeding syndrome, clotting and bleeding occur simultaneously. NOT a disease itself, develops second to other conditions

Question 54

etiology of DIC

Answer 54

trauma, burns, shock

Question 55

pathogenesis of DIC

Answer 55

continued release of thromboplastic material causes abnormal levels of thrombin in plasma--> essential to clot breakdown---> leads to emboli

Question 56

clinical manifestations of DIC

Answer 56

Bleeding; often from 3 or more sites, Weakness, malaise, fever, CNS bleeding, altered LOC