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19 Cards in this Set

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Microcytic anemia-history
asymptomatic
dyspnea on exertion
fatigue, dizziness, HA, palpitations, sleep disturbances, nausea, irritability
angina and CHF
tachycardia, wide pulse pressure,
pale conjuctiva if Hct around 20, pallor at Hct 15
Microcytic lab workup
Hemoblogin elec.
Serum ferritin (r/o iron def.)
ZPP (<70 nl)
Retic count (nl<2%)
serum iron
serum transferrin
TIBC
Normocytic anemia -history
same as microcytic
Normocytic anemia lab work up
SErum ferritin (most sensitive for iron def.)
ZPP-high means heme percursors not being linked to iron
serum transferrin
TIBC (high=iron def.)
Macrocytic folate defiency
history
dietary-overcooking
alchoholism, malabsorption, drugs
symptoms same as anemia
Macrocytic Vitamin B12 defiency-history
*very rare
servere gastric depletion
vegan
Macrocytic Vitamin B12 defiency
s/s
fatigue, weaknes, burning tongue, anorexia, diarrhea, wt loss, ataxia, peripheral neurpathy, dementia
Foods that increase iron aborption
meat, vit C, empty stomaach
Iron rich foods
red meat, poultry, fish
dark green veges, almonds, dried apricots, beans, fortified grains, broccoli, molasses, prune juice, raisins, egg yolks
nettles,
Alpha thalasemia minor trait
no iron absorption
test FOB
refer to genetic counseling
prenatal diagnosis not recommended unless parents are Asians and then bb at risk for 4 gene deletions and stillbirth
Beta thalasemia
Screen FOB with CBC and Hgb electrop
monitor IUGR if both parents carriers
Sickle cell anemia
q trimester urine c&s
if FOB carrier, offer prenatal diagnosis
Alpha thal minor trait
diagnosis
dianosis of exclusion
Beta thalessia diagnosis
Hgb A2>3.5%
MCV<80
MCH<26
Hgb>2% (only in 50% of cases)
maybe mild anemia
Sickle cell diagnosis
SA>50% Hgb A the rest S
SS>80% HGB S, the rest Hgb F
Du antigen
weak Du positive,
not at risk for alloimmunization therefore no anti-D imunoprophylaxix
Management for Rh neg client
antibody sreceen,
Rh cord blood at delivery
If + , give Rhogam
300 for regular
mini Rhogam (50) for aborption, ectopic
Management for thrombocytopenia
avoid aspirin, NSAIDS
significant risk of bleeding if platelets<50,000
Work-up for thrombocytopenia
hx of bleeding?
don't order anti-platlet antibody test