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67 Cards in this Set
- Front
- Back
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1.what is happening in DIC?
2. what does it lead to? (2) 3. what does it do to clotting factors and platelets 4. what does it eventually cause? |
-There is a persistent clotting in small vessels
-Clotting leads to blood vessel occlusion and tissues ischemia - consumption of clotting factors and platelets which may lead to hemorrhage |
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In laymens term, what is happening in DIC?
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bleeding and clotting occuring stimultaneously
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what can initiate DIC acutely? (6 vague)
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think SSHOCC as in shock
1. shock 2. Septicemia 3. Hemolysis 4. Obstetric 5. cancers 6. Crush injury |
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what kind of shocks might initiate DIC? (3)
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hemorrhagic, cardiogenic, anaphylactic
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Hemolysis that can initiate DIC can occur because of (2)?
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1. mismatched blood transfusions
2. infections |
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what kind of obstretic procedures may initiate DIC? (3)
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1.abruptio placentae
2.amniotic fluid embolism 3.septic abortion |
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what kind of crush tissue injury may initiate DIC? (4)
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THINK TB-HS
1. Burns 2. trauma 3. heatstroke 4. snakebites |
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what is happening pathologically in DIC during the clotting portion? (5steps)
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1. THe stimulus activates clotting cascade
2.clotting cascade produces Intravascular thrombin 3. Thrombin catalyzes fibrinogen to fibrin and causes fibrin and plt aggregation 4. fibrin & plt aggregation forms clots in capillaries and arterioles |
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what is happening pathologically in DIC during the fibrolytic stage? (5)
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1. excessive clotting activates fibrinolytic system
2. Fibrinolytic system breaks down clot to form fibrin degredation products (FDP) 3. FDP is anticoagulant and will stop any additional clotting. 4. Too much breaking down clots from FDP and consumption of clotting factors will reduce body's ability to form clots anymore 5. Inability to form clots will cause hemorrhaging |
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what are the s/s of DIC? (3 major)
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1.petechiae, purpura or hemorrhage
2.Bleeding from any orifice and any puncture 3. ischemia and necrosis from thrombosis to organs like kidneys, heart, lungs and brain |
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what might DIC lead to which you should worry about?
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cardivascular shock
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Define anemia (3) all of this will result in?
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1.Deficiency in number of erythrocytes
2. reduced amount of hemoglobin 3. low volume of packed RBCs -all will result in reduced oxygen-carrying capacity of blood |
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what may anemia be due to/causes?(3)
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may be due to
1.Decreased Erythrocyte Production 2. Blood Loss 3. Increased Erythrocyte Destruction |
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what might cause decreased RBC production which may then lead to anemia? (8)"what is wrong that causes anemia"
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1. Decreased Hemoglobin synthesis
2. iron deficiency 3. Defective DNA synthesis: 4. Folic acid deficiency 5. vit B12 6. Decreased number of erythrocyte precursors as in 7.aplastic anemia 8 chronic disease 7&8 r/t 6 |
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what might cause blood loss which may then lead to anemia?
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acute: trauma
chronic: gastritis |
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what may cause an increased Erythrocyte Destruction which may then cause anemia?
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Abnormal hemoglobin seen in sickle cell anemia
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what does MCV mean?
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MCV: mean or average size of RBC
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what does it mean by macrocytic? what does that mean?
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size of RBCs is bigger than normal thus MCV is higher than normal in macrocytic
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what does it mean by microcytic?
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size of RBCs is smaller than normal thus MCV is lower than normal
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what is MCHC?
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Proportion of each cell that is occupied by Hemoglobin
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what is hyperchromic mean?
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thus it means that hemoglobin occupies the cell more (there is a high % of hemoglobin in the cell)
-higher MCHC |
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what is hypochromic?
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lower MCHC (less % of hemoglobin occupies the cell)
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Describe Macrocytic – normochromic anemia
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– Large abnormally shaped erythrocytes with a normal hemoglobin content
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what is 2 causes of macrocytic normochromic anemia?
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1. deficiency in intrinsic factor
2. DNA synthesis defect |
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a person with macrocytic normochronic anemia (might have what 3 problems
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1.Pernicious anemia
2. abnormal Dna and RNA , 3. Folate deficiency |
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Describe Microcytic-hypochromic anemia
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Small abnormally shaped erythrocytes with decreased hemoglobin conentration
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a pt with Microcytic-hypochromic anemia might have what 2 problems?
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1.Iron deficiency
2. thalassemia (genetic anemia) |
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what might cause microcytic hypochromic anemia (2)?
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1.chronic blood loss
2.iron deficiency in diet |
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Normocytic-normochromic anemia
is due to? |
Destruction or depletion of normal erythroblasts
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what are the s/s of mild anemia? what is it due to?
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Often no symptoms
If any symptoms occur it would be from hypoxia 2nd to exertion: palpitations, dyspnea and diaphoresis |
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what are the s/s of moderate anemia?
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1.palpitations
2.dyspnea 3.diaphoresis all during exertion and rest |
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what are the s/s of severe anemia? (10)
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THINK bald-pgst-tv
1.bone pain 2.angina 3.lethargy 4.depression 5.pallor 6.glossitis 7.smooth tongue 8.tachycardia, 9.tachypnea 10.vertigo, |
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s/s of anemia are dependent on? (7)
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THINK SAD-CRUS
1.rate of hgb drops 2.compensatory mechanisms, 3.activity level of individual 4 duration of anemia 5. severity of the anemia 6. underlying diseases 7. severity of co-existing diseases |
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If there is a sudden blood loss (>30%), there is hypovolemia and hypoxemia with symptoms of: (5)
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THINK RTSCD (really think someone could die)
1.restlessness 2. diaphoresis 3. tachycardia 4. SOB 5. circulatory collapse/shock |
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for hemoglobin, If slow drop, (up to a 50%) decrease, what compensatory mechanisms would occur (11)
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1. increased heart rate, 2.palpitations
3. systolic murmur. 4.increased respiratory rate 5.increased oxygen supply 6.shift of the oxy hemoglobin disassociation curve to right 7.increase blood pressure 8.pale skin, mucous membranes, conjunctiva and nailbeds 9.fatigue, weakness 10.diffuse bone pain 11. sternal tenderness |
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what kind of anemia is pernicous anemia and what is it due to?
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Macrocytic-normochromic anemia: d/t malablsorption of Vitamin B12.
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what is absent in pernicious anemia and why is it needed?
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intrinsic factor is absent which is needed for absorption of vit b12
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in pernicious anemia, what s/s would you see initially? (2)
what about later on when hgb gets be 7-8g/dl? (4) |
infections, mood swings,
later: weakness fatigue difficulty walking beefy red tongue |
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what kind of anemia is microcytic-hypochromic anemia?
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Iron Deficiency
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why is iron important for hgb?
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Iron is present in all RBCs as the heme in hemoglobin
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what are some causes of iron deficiency anemia? (4)
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1.Inadequate dietary intake
2.blood loss 3. malabsorption 4. GI srugery |
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what are the general s/s of people with all types of anemia? (4)
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1.Pallor (first noted in earlobes, conjunctivia)
2.Glossitis 3.atrophy of papillae 4.Cheilitis (inflammation of the lips) |
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what are the subcategories of Normocytic-normochromic anemia? (3)
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1.blood loss (hemorrhagic anemia)
2. hemolytic anemia 3. sickle cell anemia |
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Acute blood loss will result in ___ and ___. the RBC will be what size and color?
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– RBCs are normal size and normal color
– Results in hypovolemia and shock |
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Chronic blood loss leads to what kind of anemia? How will the RBC look like (size/color)
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Leads to iron deficiency anemia because iron stores will be depleted
RBCs will have too little hemoglobin so smaller in size, lighter in color |
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what is hemolytic anemia?
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A normocytic-normochromic anemia that is caused by premature destruction of RBCs
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what will happen physiologically in hemolytic anemia? (iron, bone marrow, rbc)
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1. retain iron in the body
2. Bone marrow is overactive so will produce increased reticulocytes in blood 3. RBC will be destructed but the remaining ones will be normocytic-normochromic |
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what is an example of a hemolytic anemia?
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sickle cell anemia
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what is sickle cell anemia?
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it is a genetically determined defect of hemoglobin synthesis (hemoglobinopathy)
• Presence of abnormal hemoglobin S within RBCs • Increased hemolysis so jaundice may be present |
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____ is replaced with ___ to form ____ for sickle cell anemia?
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VALINE replaces GLUTAMIC ACID to form HBG S ( a sickle cell mutation)
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what kind of disorder is sickle cell anemia and what race does it usually affect?
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it is an autosomal recessive disorder that occurs with Black Americans
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How long does sickle cell RBC live compared to the norm?
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Sickle cell lives 10-20 days versus normal 120 days
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when does sickle cell s/s appear?
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after 6 months of age
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For sickle cell anemia affecting a child, what is happening and what could it cause?
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Sudden massive pooling of blood in liver and spleen which can cause Cardiovascular collapse
seen only in young children, may result in death |
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what is the most probable cause of death with pt who have sickle cell anemia? What 2 things are required to help prevent this from occuring?
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Infection is the most probable cause of death
vaccinations and prophylactic antibiotics are necessary |
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what are the s/s of severe sickle cell anemia? (6)
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think PTS JG
1.Chronic hyperbilirubinemia (5.jaundice 6. gall stones) 2.-pain in abdomen, chest, bone or joints 3.-Tissue damage to liver, spleen, heart, kidneys, retina, etc. 4.-Splenic injury |
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what is happening to the spleen in severe sickle cell anemia and what might it cause (what should you worry about)?
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spleen has sluggish blood flow and low oxygen tension
-may result in a non-functional spleen |
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what is happening with the cells in Primary Polycythemia Vera? (3)
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1. high levels of RBC
2. Increased levels of leukocytes 3. increased levels of platelets |
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what is the most probable cause of primary polycythemia vera?
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Likely problem with pluripotential cell
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when do s/s occur and who do they usually occur with?
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40-60 year old Black male
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what will be increased in primary polycythemia? (8)
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1.-Increased RBC
2.-increased hemoglobin 3.-increased hematocrit 4.-Increased blood volume 5.-Increased viscosity 6.-Increased clotting 7-Increased acidosis 8-increased uric acid |
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Increased clotting in primary polycythemia may lead to?
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leading to possible ischemia and infarction
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Increased viscosity in primary polycythemia may lead to?
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– clotting and possible bleeding
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Increased uric acid in primary polycythemia may lead to?
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increased risk for
1.gout 2.kidney stones |
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in general, what are the s/s of primary polycythemia? (7)
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THINK HID-BIG-KCC "think of primary school"
1. headache 2 inability to concentrate 3.may decrease vision and hearing 4. cyanosis of lips, nails and mucous membranes 5.itching and pain in finger and toes 6.clotting and possible bleeding 7.increased risk of gout and kidney stones |
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what is happening to cerebral blood flow in primary polycythemia?
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it will be decreased
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what is happening to the blood flow in general with primary polycythemia? what is it attributed to?
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it is sluggish and may have stasis
due to the increased wbc, hgb, rbc, hct, platelet=sluggish |
