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59 Cards in this Set
- Front
- Back
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Hemoglobin (Hgb) |
Main component of RBCs
Essential protein that combines and transports O2 to the body |
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Normal Hgb ranges |
Males 14-18/100
Females: 12-16/100 |
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Hematocrit (Hct) |
Measures the % of a given volume of whole blood that is occupied by erythrocytes
Amount of plasma to total RBC mass |
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Normal Hct values |
Males 40-54%
Females 37-47% |
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Total Iron binding capacity (TIBC) normal values |
250-450
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Serum iron normal values |
50-150 |
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Mean Corpuscular Volume (MCV) |
expression of the average amount and size of individual erythrocytes
cynic means size |
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Normal values of MCV |
80-100
Microcytic: <80 Normocytic: 80-100 Macrocytic: >100 |
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Mean Corpuscular Hemoglobin (MCH) |
expression of the average amount and weight of Hgb contained in a single erythrocyte |
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Normal MCH values |
26-34 |
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Mean Corpuscular Hemoglobin Concentration (MCHC) |
Expression of the average Hgb concentration or proportion of each RBC occupied by Hgb as a %
More accurate measure than MCH |
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MCHC normal values |
32-36%
Hypochromic: <32% Normochromic: 33-36% Hyperchromic: >36% |
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Low MCV anemias (microcytic) |
IDA thalassemia |
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High MCV anemias (macrocytic) |
B12 folate deficiency alcoholism liver failure drug effects |
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Normocytic anemias |
ACD Sickle cell renal failure blood loss hemolysis |
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Iron Deficiency Anemia (IDA) |
Microcytic/Hypocromic
due to overal deficiency of iron
MOST COMMON CAUSE OF ANEMIA
Caused by: blood loss, inadequate Fe intake, impaired absorption of Fe |
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IDA S/S |
Few symptoms with Hct >30
Pica: unusual food craving like ice and clay Dyspnea mild fatigue with exercise headache palpitations weakness tachy postural HTN pallor |
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Lab/Diagnostics for IDA |
Low Hgb Low Hct Low MCV (microcytic) Low MCHC (hypochromic) Low RBC Low serum Fe Low serum ferritin High TIBC High RDW (red cell distribution width) |
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Management of IDA |
Oral ferrous sulfate 2-3 hours p meals
Do not take iron with antacids due to interference with absorption
take with Vit. C to increase absorption
High Fe foods: green leafy veggies, red meats, citrus, raisins, Fe fortified cereals |
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Thalassemia |
Microcytic/Hypochromic
genetically inherited
Abnormal Hgb
Mainly in mediterranean, african, middle eastern, indian, and asian populations |
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Thalassemia S/S |
unremarkable unless severe |
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Lab/Diagnostics for Thalassemia |
Decreased Hgb Low MCV (microcytic) Low MCHC (hypochromic) Normal TIBC Normal ferritin Decreased alpha or beta Hgb chains |
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Management of Thalassemia |
no treatment for mild to moderate
RBC transfusion/splenectomy for more severe
Fe is contraindicated as Fe overload can happen |
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Folic Acid Deficiency |
macrocytic/normochromic
due to folic acid deficiency
inadequate intake/malabsorption of folic acid |
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S/S Folic Acid Deficiency |
fatigue dyspnea on exertion pallor headache tachy anorexia glossitis
NO NEURO SIGNS |
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Lab/Diagnostics for Folic Acid Deficiency |
Hct and RBC decreased MCV elevated (macrocytic) MCHC normal (normochromic) serum folate decreased RBC cell foalte <100 |
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Management of Folic Acid Deficiency |
Folate daily High folic acid foods: bananas, peanut butter, fish, green leafy veggies, iron fortified breads and cereal |
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Pernicious Anemia |
macrocytic/normochromic
deficiency of intrinsic factor resulting in malabsorption of B12 |
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S/S Pernicious Anemia |
weakness glossitits palpitations dizziness anorexia parasthesia loss of vibratory sense loss of fine motor control + romberg + babinski |
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Lab/Diagnostics for Pernicious Anemia |
Hgb, Hct, and RBCs low MCV icreased (macrocytic) Serum B12 decreased (<0.1) Anti IF (intrinsic factor) show deficiency Schilling test may help |
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Management of Pernicious Anemia |
B12 IM weekly maintenance monthly for life |
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Anemia of Chronic Disease (ACD) |
normocytic/normochromic
chronic
associated with chronic inflammation, infection, malignancy, and renal failure
second most common anemia |
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S/S ACD |
Fatigue Weakness Dyspnea on exertion Anorexia |
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Lab/Dignostics of ACD |
Hgb & Hct low MCV normal (normocytic) MCHC normal (normochromic) Fe low TIBC low Ferritin high >100 |
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Management of ACD |
treat associated disease
nutritional support |
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Sickle Cell Anemia |
chronic hemolytic anemia
genetic
sickle shaped RBCs
pain occurs form tissue ishcemia and blood hyperviscosity
factors that precipitate: hypoxia, infections, high altitude, dehydration, physical or emotional stress, surgery, blood loss, and acidosis |
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S/S Sickle Cell Anemia |
develop in infancy or childhood delayed growth and development increase susceptibility to infection
In crisis: sudden onset of severe pain in extremities, back, chest, and abdomen aching joint pain weakness dyspnea |
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Lab/Dignostics for Sickle Cell Anemia |
Hgb decreased Peripheral smear shows sickle-shaped RBCs
Cellulose acetate and citrate agar gel to confirm Hgb genotype |
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Management of Sickle Cell Anemia |
treat both chronic and acute complications
Acute: fluids analgesics O2 |
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Leukiemia |
hematopoietic cells in bone marrow |
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Acute Nonlymphocytic Leukemia (ANL)/Acute Myelogenous Leukemia (AML) |
80% of leukemias in adults
Remission rates from 50-85%
Long term survival ~40% |
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Acute Lymphocytic Leukemia (ALL) |
More difficult to cure in adults than kids
90% remission rate in kids
Pancytopenia with circulating blasts is hallmark of this |
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Chronic Lymphocytic Leukemia (CLL) |
Most common leukemia in adults
occurs in middle and old age
mean survive is 10 years
lymphocytosis is hallmark |
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Chronic Myelogenous (CML) |
most often over 40 years of age
median survival is 3-4 years
Philadelphia chromosome seen in leukemic cells is hallmark |
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S/S Leukemia |
may be asymptomatic fatigue weakness anorexia general lymphadenopathy weight loss |
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Lab/Diagnostics for Leukemia |
CBC will have subnormal RBCs and neutrophils Elevated ESR Peripheral smear will show acute and chronic leukemia
BONE MARROW IS REQUIRED TO CONFIRM |
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Management of Leukemia |
chemo bone marrow transplant control of symptoms |
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Stage I Lymphoma |
localized to single node or group
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Stage II Lymphoma |
more than one node group involved
confirmed to one side of diaphragm |
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Stage III Lymphoma |
nodes or spleen involved
both sides of diaphragm |
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Stage IV Lymphoma |
liver or bone marrow involvement |
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How to diagnose Lymphoma |
biopsy of enlarged nodes |
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Non- Hodgkin's Lymphoma |
Often presents with lymphadenopathy
20-40 years of age
less predictable pattern spread than Hodgkin's |
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Hodgkin's Lymphoma |
more common in males with 32 being avg age
cervical adenopathy and spreads in predictable fashion along lymph node groups
RED-STERNBERG CELLS differentiate from Non-Hodgkin's |
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Lab/Diagnostics for Lymphoma |
CT X-Rays Ultrasound MRI
biopsy and histopathologic to confirm |
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Management of Lymphoma |
Radiation Bone marrow transplant chemo |
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TNM Classification of Malignant Tumors |
T = size or direct extent of primary Tumor (0, 1-4)
N = spread to regional lymph Nodes (0-3)
M = distant Metastasis (0/1)
The use of an "X" rather than a number means the parameter was not assessed
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Common Gerontology Considerations with the immune system |
Immune system diminishes with age
Inate immunity funcitons
adaptive immune response diminishes
decreased thymic hormone production resulting in decrease # of T-cells
decreased antibody production and response
diminished response to antigens
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Possible immune findings in geriatrics |
overall increased susceptibility to infection
poor wound healing
exacerbation of chronic disease
waning vaccine-induced antibody response |
