Icm Fall Sickle Cell

Front 1

what is the incidence of sickle cell

Back 1

4,000-5,000 births/year are at risk for sickle

Front 2

what is the physiology of sickle cell

Back 2

1. sickling of RBC
2. increased viscocity of blood
3. Deoxygenation indiced polymerization of Hb S (deoxygenation occurs very often)

Front 3

whats the clinical course of sickle cell

Back 3

1 typically ID early in life
2. anemia in btwn painful episodes
3. all organ systems are affected by vasoocclusions and so can have acute organ damage
4. intravascular and extravascular hemolysis
5. increased infections bc of poor splenic fx
5. live to 42 (M) 48 (F)
6. tx to help sx, no therapy to get cells normal

Front 4

what things predispose someone to vaso-occlusive crisis

Back 4

*this is the REALLY really painful episode. can be NO PE findings (others will have fever, tenderness, swelling, tachypenia, HTN, nausea, vomit)

**pain is all over but LE/back, abdomen is common. more severe later in life (3/4 decade)

Many things:
1. dehydration
2. Cold
3. infection
4. stress
5. menses
6. EtOH
7. UNKNOWN

Front 5

what organism is most likely to cause ______ in sickle cell

1. Osteomylitis
2. Meningitis
3. Sepsis
4. Pneumonia

Back 5

1. osteomylitis- salmonella. eats away at the bone so you make new bone

2. Meningitis: strep pneumonia

3. Sepsis: strep pneumonia (leukocytosis, L shift)

4. Pneumonia: mycoplasm, or viral

Front 6

what is the standard of care for a febrile pt with sickle cell

Back 6

WORK THEM UP! infection is common

Front 7

in our sickle kid with the swollen knee what do we need to RO

Back 7

1. septic arthritis- joint locked, ppl wont move them and its hard for you to. need to wash out in OR, can cause perm damage

2. Osteomylitis: caused by salmonella, eats away at the bone and new bone is made. Xray!

Front 8

what happens to the spleen in sickle cell

Back 8

first gets big then autosplenectomy

**no longer can fight off infection

Front 9

Define factors, both psychological and physiological, which may place sickle patients in the category of “drug seekers”

Back 9

they get hooked! the incomplete therapy for acute attacks. prolonged duration of pain promotes drug seeking

They metablize drugs FAST, they need mre drug

**treatment by PCP is good bc they know the pt and condition/course of disease

**


**give pain meds aggressively, O2, hydration

Front 10

strep pneumonia commonly causes what in sickle cell pts

Back 10

sepsis
meningitis

**can also be HIB, E coli, Salmonella

Front 11

salmonella causes what in sickle cell pts

Back 11

osteomylitis

**infarcted bone.

strep pneumonia, E coli, proteus, and s aureus also can cause it

Front 12

what does Mycoplasm and virus lead to in sickle cell pts

Back 12

pneumonia


**it is NOT strep pneunomia and H influenze are NOT the most common

**important to know bc AB choice will differ

Front 13

why do we care so much about the infectinos sickle cell sdisease ppl get

Back 13

we can treat them, we cant do a whole lot else for sickle cell

Front 14

what are the neuro complicaiotsions assicuated with sickle cell

Back 14

25% get some neuro

Most Common: TIA, transient ischemic attack
2. Cerebral infarct
3. cerebral hemmorage
4. seizuire
5. unexplained coma

Front 15

what are hte cardiac complicaitons associated with sickle cell

Back 15

well pts are anemic and have highly viscous blood. CO increased --> chamber enlargement

**cardiomegaly

Front 16

what is the pain mgmt for sickle cell

Back 16

aggressive! also give hydration, O2

**not drug seekers!!!!
**family doc is GREAT bc they know the pt and the course of disease
**they metabolize faster so need more drug!

Front 17

how many ppl get sicke in the us

Back 17

5000 a year

Front 18

what will a reticulocyte count tell us about a person with sickle cell

Back 18

if their body is trying to make new blood cells, high is good :)