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23 Cards in this Set
- Front
- Back
Myeloid disorders are what type of disorders
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Neoplastic disorders of stem cells
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What are the classifications of Neoplastic Myeloid disoders
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1. Chronic Myeloproliferative diorders
2. Myelodisplastic Syndrome 3. Acute Myloblastic Syndrome |
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Classification of Chronic Myleoproliferative Disorders
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1.Polycythemia Vera
2. Chronic Myelogenous leukemia 3. Myeloid Metaplasia with myelofibrosis 4. Essential Thrombocythemia |
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Polycythemia is defined as
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increase in hemoglobin, hematocrit, and RBC
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Polycythemia: plasma volume
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changes based on the type
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RBC Count vs RBC MASS
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RBC = # of RBC's/uL
RBC Mass= total # of RBC in Body RBC count is the ratio of RBC mass to Plasma volume |
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If you have polycythemia what question should you ask first?
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Is it relative or absolute
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What is relative polycythemia?
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Increased RBC count due to a decrease in PV Plasma Volume
--Ex: Volume depletion from sweating |
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What is absolute polycythemia?
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Increase in bone marrow production of RBC
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What would the clinical findings of relative polycythemia look like?
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Increase in RBC count, Decrease in PV, Normal O2 sat, and EPO
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After you have determined that it is absolute polycythemia, what should ask yourself next?
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Is it appropriate or inappropriate
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What is appropriate polycythemia?
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Appropriate absolute poly= occurs when there is tissue hypoxia
---EX. primary lung disease, cyanotic heart disease, high altitude living, |
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What does appropriate polycythemia look like? RBC mass, EPO, O2 sat, Plasma volume
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Increase RBC mass
Increase EPO Normal PV Decrease Sao2 |
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What does inappropriate polycythemia look like? RBC mass, EPO, O2 sat, Plasma volume
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Increase RBC mass
Increase EPO Increase PV Normal Sa02 |
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What is the definition of inappropriate polycythemia?
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No hypoxic stimulus for EPO release
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What are the causes of inappropriate polycythemia?
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1. Polycythemia Vera
2. Ectopic Secretion of EPO ( Renal cell damage, cyst or cancer) |
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Pathogenesis of Polycythemia Vera
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1. Clonal expansion of multipotent myeloid stem cell
2. Increase in RBC's, granulocytes, mast cells, and platelets |
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What are the clinical findings of Polycythemia Vera?
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1.Splenomegaly
2.Thrombotic Events due to hyperviscosity 3. Signs of histamine release 4. Gout |
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What are the signs of histamine release in Polycythemia Vera
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1. Ruddy Race - Red Face
2. Pruritus when bathing ***** 3. PUD- histamine stimulates production of acid release |
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Why do you have gout in polycythemia vera?
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Due to increased breakdown of nucleated cells with release of purines
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What is do you give patients on chemotherapy and why?
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Allopurinol
B/c of huge cell death from chemo releases purines which are broken down to hypoxathine |
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What would expect the Lab Findings of Poly to look like?
RBC WBC Platelets EPO Bone Marrow |
1.Increase RBC mass and PV
***Only polycythemia with increase in PV 2. Absolute leukocytosis >12,000 3.Thrombocytosis > 400,000 4. Decreased EPO 5. Normal Sa02 6. Hypercellular bone marrow with fibrosis in later stages |
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Why is EPO decreased in Polycythemia Vera?
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1. Increased O2 content inhibits EPO release
2. Only poly with decreased EPO |