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99 Cards in this Set
- Front
- Back
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hemoglobin
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protein molecule in red blood cells that carries oxygen & CO2; iron in hemoglobin gives red color
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hematocrit definition
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the proportion, by volume, of blood that consists of red blood cells
expressed as a % |
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reticulocyte
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immature red blood cell
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mean corpuscular volume
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the average volume of RBC
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mean corpuscular hemoglobin
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the hemoglobin content of the average RBC
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mean corpuscular hemoglobin concentration
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measurement of the concentration of hemoglobin in a RBC
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erythrocyte sedimentation rate definition
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The rate at which red blood cells settle in blood with anticoagulant
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total iron binding capacity
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a test that measures the extent to which iron binding sites in the serum can be saturated
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serum ferritin
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iron-containing protein complex; primary form of iron storage in the body
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% transferrin saturation is ratio of
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serum iron to total iron binding capacity (x100)
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erythropoietin
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a glycoprotein that stimulates production of RBCs
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anemia (3 reasons)
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decrease in RBCs
-decr production -incr destruction -incr loss |
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polycythemia vera
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condition in which there is a net increase in the total circulating erythrocyte mass of the body, caused by a abnormality of the bone marrow
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hemoglobin measurement
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direct indicator of oxygen transport capacity of the blood
incr in polycythemia vera decr in anemia |
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hematocrit measurement (incr & decr)
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incr with neg fluid balance
decr with anemia or pos fluid balance |
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MCV distinguishes between:
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microcytic, macrocytic, and normocytic cells
incr in macrocytic patients decr in microcytic patients with IDA |
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MCH measurement (incr & decr)
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incr in patients with folate or B12 deficiency
decr in IDA |
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ferritin
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storage form of iron
low ferritin levels indicates IDA |
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sed rate measurement
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non-specific test for inflammation (usually incr in inflammatory diseases)
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morphology
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study of the form and structure or an organism or its parts
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hypochromic
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decr in ratio of weight of hemoglobin to volume of RBC
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iron deficiency anemia
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usually microcytic, hypochromic
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IDA etiology (4)
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inadequate dietary intake
inadequate absorption increased demand excessive blood loss or disease |
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diagnosis of IDA based on
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full blood count
peripheral blood smear bone marrow iron stain |
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s/s of anemia (14)
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fatigue
pallor icterus hepatosplenomegaly tachycardia wide pulse pressure pale mucosal membranes cardiac decompensation SOB edema dizziness light-headedness weakness cold extremities |
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icterus
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yellowing of the skin and whites of the eyes due to the accumulation of bile in the blood
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IDA patients: appearance
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tired
listlessness lifeless appearance |
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IDA patients: skin/hair
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pale
inelastic hair often dry and scanty |
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IDA patients: mouth (4)
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papillary atrophy
erythema of the tongue glossitis stomatitis |
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erythema
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Redness of the skin caused by dilatation and congestion of the capillaries
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stomatitis
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inflammation of the mouth
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IDA patients: nails
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flattened
longitudinally rigid concave (koilonychias) |
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koilonychia
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A nail deformity characterized by concavity of the outer surface of the nail
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IDA patients: eyes
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pearly white sclerae (white of the eye)
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IDA patients: CVS (4)
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slight cardiomegaly
tachycardia functional systolic murmur ankle edema |
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megaloblastic anemia definition
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red cell divisions arrested when B12 and folic acid are deficient; reduced cell divisions; RBC larger than normal
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B12 daily requirement
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1-5mcg
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B12 body stores
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2-5mg
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B12 in average diet
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over 20mcg (animal, dairy, meat, liver, fish, eggs)
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megaloblastic anemia - etiologies
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inadequate intake
malabsorption inadequate utilization or incr demand |
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pernicious anemia
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defects in or absense of intrinsic factor can lead to B12 deficiency
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possible causes of B12 malabsorption (5)
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blind loop syndrome/fish tapeworm infestation
gastrectomy inflammatory small bowel disease resection of small bowel pancreatic disorders |
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drugs that can cause B12 malabsorption (5)
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antibiotics
anticonvulsants cytotoxic agents oral contraceptives high dose vit C |
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folic acid daily requirement
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25-50ug/d
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mechanisms of folic acid deficiency (3)
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poor intake
increased requirement poor intestinal absorption |
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drugs that can cause folic acid deficiency (6)
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anticonvulsants,
ethyl alcohol, oral contraceptive, methotrexate, trimethoprim, triamterene |
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clinical presentation of B12 deficiency (12)
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dysphagia
anorexia / weight loss diarrhea beefy red tongue psychosis forgetfulness paresthesis ataxia + Romberg's sign + Babinski's sign impaired vibratory sense impaired position sense |
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dysphagia
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difficulty swallowing
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Romberg's sign
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A sign indicating loss of proprioceptive control in which increased unsteadiness occurs when standing with the eyes closed compared with standing with the eyes open
The patient can stand with the eyes open; and The patient falls when the eyes are closed. |
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Babinski's sign
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An extension of the great toe, sometimes with fanning of the other toes, in response to stroking of the sole of the foot
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clinical presentation of folic acid deficiency (8)
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dysphagia
anorexia / weight loss malnourished beefy red tongue personality changes pupura ecchymoses early graying of the hair |
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purpura
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condition characterized by hemorrhages in the skin and mucous membranes that result in the appearance of purplish spots or patches.
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ecchymoses
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The passage of blood from ruptured blood vessels into subcutaneous tissue, marked by a purple discoloration of the skin
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4 clinical presentation of megalobastic anemia (organs)
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atrophic glossitis
mild hepatosplenomegaly enlarged heart gastric cancer |
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normocytic anemia
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normocytic and normochromic hypoproliferative RBCs
adequate iron availability but ineffective utilization bone marrow less active |
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normocytic anemia usually seen in patients with:
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lupus
rheumatoid arthritis |
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normocytic anemia
RBC Hgb Hct concentrations |
decreased
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normocytic anemia
MCV MCH MCHC |
usually within normal limits
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normocytic anemia
ESR |
increased
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what is bleeding time
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a measure of platelet aggregation and capillary contraction; often taken prior to surgery
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relative thrombocytopenia
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150,000/mm^3
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absolute thrombocytopenia
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20,000/mm^3
at risk for spontaneous bleeding |
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prothrombin time reflects?
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alterations in the extrinsic system and in the common clotting pathway, but not in the intrinsic system
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protrombin time is prolonged by?
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deficiences in clotting factors II, V, VII, IX, X
low levels of fibrinogen very high levels of heparin |
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what drug can cause an increase in prothrombin time?
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heparin
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goal of oral anticoagulation therapy is to maintain the ratio of PT/control between
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1.3 to 1.5 times the control
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why was the international normalization ratio developed
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to standardize PT ratios generated by different laboratories
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an INR of ____ = PT of 1.3-1.5
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2 to 3
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activated partial thromboplastin time is used to monitor:
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heparin therapy
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aPTT measures activity of all factors except:
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VII
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during anticoagulation therapy, the goal is the maintain an aPTT of
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1.5 to 2.0
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fibrinogen is the circulating precursor of
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the clot material fibrin
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decr levels of fibrinogen suggests
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a state of active coagulation
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increase in FDP caused by
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excessive degradation of fibrin and fibrinogen
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when does elevated FDP occur
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in states of fibrinolytic activity (disseminated intravascular coagulation
or use of fibrinolytics) |
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disseminated intravascular coagulation
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a pathological process in the body where the blood starts to coagulate throughout the whole body. (This depletes the body of its platelets and coagulation factors, and there is a paradoxically increased risk of haemorrhage. It occurs in critically ill patients, especially those with Gram-negative sepsis (particularly meningococcal sepsis) and acute promyelocytic leukemia.)
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what are the 15 risk factors for developing thromboembolism?
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antithrombin II deficiency
dysfibrinogenemia heart disease immobility / paralysis obesity protein C or S deficiency lupus anticoagulant trauma estrogen use inflammatory bowel disease sickle cell anemia malignancy surgery peripartum period varicose veins |
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thromboembolism
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The blocking of a blood vessel by a blood clot dislodged from its site of origin.
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what is venous stasis?
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an alteration or decr in blood flow in the deep veins of the lower extremities that can lead to formation of thrombi
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what may cause venous stasis? (6)
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immobility
prolonged bed rest massive obesity late-stage pregnancy shock severe MI |
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mechanical causes of vascular wall injury
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venipuncture
indwelling cannulas or catheters factured bones surgery |
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chemical causes of vascular wall injury
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parental admin of potassium or hypertonic glucose
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hypercoagulability
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occurs when activation of the coagulation system exceeds the ability of the intrinsic fibrinolytic system to prevent thrombus formation
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physical findings associated with deep vein thrombosis (7)
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pain or tenderness
leg swelling discoloration incr skin temp palpable cord homan's sign leg ulcer/infection |
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commonly employed lab studies done for deep vein thrombosis (5)
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doppler ultrasonography
impedance plethysmography real time ultrasonograpy 125I-fibrinogen leg scan venography |
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doppler ultrasonography
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noninvasive
measures changes in sound waves to detect changes in venous flow |
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impedance plethysmography
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noninvasive
measures changes in electrical resistance which accompanies changes in blood volume |
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real time ultrasonography
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noninvasive
provides a 3D picture of the deep veins though the use of a transducer |
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125I-fibrinogen leg scan
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screening tool in high risk patients
adjunctive test to impedance plethsymography |
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125I-fibrinogen leg scan can detect __% of calf-vein thrombi & ___% of proximal vein thrombi
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over 90%
60 to 80% |
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venography
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most reliable, radio opaque contrast dye is injected into dorsal foot vein or femoral vein providing an outline of the deep venous system of lower limbs
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pulmonary embolism
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a condition in which a blood clot usually formed in of the leg veins becomes detached and lodges in the lung artery or one of its branches
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clinical presentation of pulmonary embolism (11)
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dyspnea
cough tachypnea tachycardia anxiety sense of impeding doom pleuritic chest pain hemoptysis acute right heart failure cardiovascular collapse fever |
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diagnostic findings of a pulmonary embolism CXR (4)
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atelectasis
infiltrates pleural effusions elevated diaphragm |
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diagnostic findings for a pulmonary embolism EKG
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tachycardia
right ventricular strain non specific ST wave changes |
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diagnostic findings for a pulmonary embolism ABGs
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decr pO2
decr pCO2 |
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diagnostic techniques for PE
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ventilation/perfusion (V/Q) scan
pulmonary angiography |
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V/Q scan
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noninvasive
based on anatomic patterns of injected and inhaled radioactive materials |
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pulmonary angiography
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gold standard!
detects filling defects used when v/q scan not conclusive |
