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36 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Components of blood
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Erythrocyte-RBC's-transport gas to and from tissue cells and lungs
Thrombocytes-platelets-provide hemostasis following vascular injury;normal coagulation and clot formation/retraction Leukocytes-WBC-body defense mechanisms --Lymphocytes-Humoral and cell-mediated immunity --Monocytes-macrophage-phagocytosis --Eosinophils-phagocytosis;response to paracytes, control of allergic reactions --Neutrophils-phagocytosis-1st responders, bacteria killing. --Basophils-secretes inflammatory mediators---histamine. |
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What is in Plasma?
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Plasma
---Water ---Proteins ------Clotting factors, albumins, globulins. ---Fats ------Cholesterol ------HDL/LDL ------Triglycerides ----Electrolytes, Hormones, Gases, Nutrients. ---Wastes ------Bun, Creat, Uric Acid, Bili |
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Hemoglobin (Hgb)
Anemia |
< 13 Male
< 12 Female < 11 Pregnancy |
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Hematocrit (Hct)
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This is the percentage of RBC's by volume. Usually 3 times the amount that of Hgb.
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Causes of Anemia
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Loss of RBC's-due to either acute or chronic bleeding.
Decreased or abnormal production of RBC's. Increased destruction of RBC's (Hemolytic Anemia's--Sickle cell anemia, Thalessemias) |
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S/SX's of Anemia
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Fatigue/Weakness
Pallor SOB/Dyspnea Chest Pain/Arrythmias Othostatic hypotension or syncope Cold hands and feet Nail changes Decreased growth and development |
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RBC Size
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Normocytic-normal size
Microcytic-small Macrocytic-large |
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RBC hemoglobinization
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How much hemoglobin in cell
Normochromic Hypochromic Hyperchromic |
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RBC shape
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Anisocytosis-different sizes
Poichylocytosis-different shapes |
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Anemia of Acute Blood Loss
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Possibly due to trauma, alcoholic with rupture of esophageal varices, peptic ulcer, hemorrhoids, GI bleed
Considered normocytic, Normochromic Production of erythropoetin in kidneys |
In acute blood loss-overall loss, nothing wrong with production, volume down
MCV-mean corpuscular volume-size MCH-mean corpuscular hemaglobin Both normal |
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Anemia of Chronic Blood Loss
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Rate of loss exceeds our ability to regenerate. Iron reserves become depleted-iron deficiency occurs.
Microcytic, hypochromic anemia MCV and MCH LOW....... |
Also seen wth iron deficiency anemia, thalessemia, sideroblastic anemia
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Iron Deficiency Anemia
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Dietary lack, Impaired absorption, Increased requirements (growing infants, children, premenopausal, pregnant women), Chronic blood loss.
Microcytic, hypochromic ----Look at cause behind it---- |
Causes could include peptic ulcers, gastritis, gastric or colon carcinoma, hemorrhoids, menorrhagia, uterine CA, NSAIDS
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Iron Deficiency anemia
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Microcytic, Hypochromic
S/SX: fatigue, tachycardia, palpitations, tachypnea Koilonychia-spoon shaped nail beds Atrophic changes-Glossitis, Gastric Mucosa Pica-craving for non-food items |
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Diagnosis of Iron Deficiency Anemia
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Decreased-RBC's, Hgb, Hct, ferritin, FE, Reticulocytes
Increased-TIBC Important to diagnose cause of the anemia |
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Macrocytic/Megaloblastic Anemia
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B12/Folate deficiency
--Penicious anemia-autoimmune --Atrophic gastritis --Celiac Diseasse, Vegan --IBD --Gastrectomy or Gastric Bypass --Drugs interfere with B12/folate absorption: penytoin, methotrexate, bactrim, metformin, proton pump and H2 blockers |
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Pernicious Anemia
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autoimmune B12 deficiency
intrinsic factor secreted by parital cells in stomach-needs to bind with B12 to absorb in small intestines |
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Risks with megeloblastic anemias
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Functions of B12 and Folate
--formation of RBC's --DNA production --Maintenance of myelin (B12) --Catabolism of fatty acid --conversion of homocysteine (amino acid) to methionine (amino acid). Homocysteine-inflammatory to the cardiovascular system, so they can be at a higher risk for cardiac dx |
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Complications with B12 deficiency
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Neurological complications
--Damages myelin of nerves --Peripheral neuropathy and parathesias --Dementia Due to the myelin damage...some people may present like MS....check for underlying condition. |
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Diagnosis of Macrocytic Anemia
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MVC and MCH ?-could be low or high
Low serum B12 Elevated homocysteine Positive parietal cell antibodies serum |
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Aplastic Anemia
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Failure of multipotent myeloid stem cells in any age group
Due to: --Drugs and chemicals --Whole-body irradiation --Infections-HIV, viral hepatitis Pancytopenia --anemia, neutropenia, adn thrombocytopenia Hepatosplenomegaly and reticulocytosis are absent Malignancy-Leukemias Normochromic, Normocytic |
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Polycythemia Vera
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Increased blood cell production
--Primary-Unknown-Considered neoplastic growth --Secondary-High altitude, smokers S/SX's-HSM, thrombi, HA, tinnitus, visual disturbances, angina, **Red itchy skin after warm bath or shower due to massive histamine release Risk of stroke is high Testing: CBC-high RBC |
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Hemophilia
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X linked-female carriers-males get it
Hemophilia A-missing factor VIII Hemophilia B-missing factor IX-christmas dx Von Willibrands-missing von willebrands factor Test-Clotting factors Intrinsic use PTT-heparin Extrinsic use PT/INR-coumadin Platelets-clotting time |
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Leukemia
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Disorders of the blood or bone marrow.
Four types: ALL AML CLL CML Lymphocytic or Myelogenous |
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Symptoms of Acute Leukemia
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Anemia-fatigue, pallor
Neutropenia-fever, infections Thrombocytopenia-petechiae, ecchymoses, epitaxis Night Sweats Clotting Disorders-bleeding Bone pain Lymphadenopathy Papilledema and Nuchal Rigidity |
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Symptoms of Acute Leukemia
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Pancytopenia is common. People usually wake up with night sweats but are drenched
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Acute Leukemia's
ALL |
Most common type of childhood leukemia.
Causes: Genetic-familial, chromosomal disorders --Radiation, nuclear exposure, smoking, hair dye, poss viral Abnormal B and T cells |
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AML
Acute Myelogenous Leukemia |
Seen in adults-males greater than females
Causes: Idiopathic --Prior chemotheapy or radiation --Exposure to chemicals --Down's Symdrome **Auer Rods** |
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ALL and AML
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Both will see blasts(immature WBC's) on smear.
Massive overproduction of wbc. This causes lpain in the bones and lack of room for anything else to be created within the marrow. If level is > 50,000 can affect CNS and other organs. |
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Symptoms of Chronic Leukemia
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Often Asymtptomatic
Lymphadenopahty Signs and Symptoms of Anemia |
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Chronic Leukemia's
Chronic lymphacytic leukemia |
Most common leukemia in adults usully > 45yr
This is considered a B-cell origin, usually from radiation Poor prognosis, chronic phase |
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Chronic Leukemia
Chronic myelogenous leukemia |
Adults (25-60)
Philidelphia chromosome-there is a transposition of chromosomes 9 ad 22-a part of chr. 22 attaches to chr. 9. Poor prognosis, insidious onset, chronic phase |
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Both CLL and CML
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Can develop an acceleated phase-something triggers the leukemia to go into a acute phase---if the body fails to respond to any treatment then the blast phase occurs and these individuals will go into a blast crisis.
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Burkitt's Leukemia
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B cell lymphoma
Caused by epstein barr virus S/SX: tumors manifest at estranodal sites, usually of african american type approx 7 years of age. mass involves the maxilla or mandible involves cranial nerve 2, 5, 7 non-african involves the abdomen |
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Lymphomas
Hodgkin's |
B cell lymphoma
Cause: most common in young adults, fhx, epstein barr virus S/SX: painless lymphadenopathy, all other leukemia s/sx discussed, reed-sternberg cells (big b or t cells) |
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Non-Hodgkin's Lymphoma
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B cell
14 types-can be fast or slow growing. Worse prognosis than Hodgin's lymphoma Caused by epstein barr virus, hepatitis virus |
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Guillain-Barre Syndrome
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Ascending paralysis
Cause: post viral-infection, immunization S/SX: flaccid muscle weakness, loss of DTR's, respiratory paralysis Testing: clinical, EMG, CSF R/O myasthenia gravis, ms, or possible cva |
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