Ch. 21 Hematologic function Flashcards Preview

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Flashcards in Ch. 21 Hematologic function Deck (75)
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1
Q

Reduction in the total number of erythrocytes in the circulating blood or in the quality or quantity of hemoglobin

A

Anemia

2
Q

Anemia can be classified by size and identified by terms that end in….

A

-cytic (macrocytic, microcytic, and normocytic)

3
Q

Anemia can be classified by hemoglobin content. Identified by terms that end in…

A

-chromic (normochromic and hypochromic)

4
Q

Classic anemia symptoms

A

Fatigue, weakness, dyspnea, pallor

5
Q

Tx of anemia?

A

Correction of nutritional deficits, supplementation, and transfusion

6
Q

Megaloblastic anemias is also termed

A

Macrocytic-normochromic anemia

7
Q

Characterized by unusually large stem cells and result of defective DNA synthesis

A

Macrocytic normochromic anemias

8
Q

Macro/normo anemia results in defective DNA synthesis…this is caused by

A

deficiencies in B12 or folate

9
Q

Caused by a lack of intrinsic factor from the gastric parietal cells

A

Pernicious anemia

10
Q

Risk factors for pernicious anemia

A

Congenital, autoimmune gastritis, excessive alcohol and tea intake, and smoking

11
Q

Are the early symptoms of pernicious anemia specific?

A

no, they are nonspecific and vague

12
Q

With pernicious, what are the hemoglobin levels usually at?

A

7-8g/dl

13
Q

What is the normal range of hemoglobin for males and females?

A

M: 14-18
F: 12-16

14
Q

Symptoms of pernicious anemia

A
  • Weakness, fatigue
  • paresthesia, diff. walking
  • loss of appetite
  • Sore tongue (beefy and red)
15
Q

What are the neurologic manifestations of pernicious anemia? and why do they manifest?

A

Manifest due to nerve demyelination. Loss of position and vibration sense. Ataxia and spasticity

16
Q

Tx of pernicious anemia?

A

Parenteral or high doses of B12. Lifelong tx.

17
Q

Folate deficiency anemia is less common than pernicious

A

False

18
Q

Absorption of folate occurs where?

A

Upper small intestine

19
Q

___ ____ anemia is not dependent on any other factor. Similar to pernicious except there are not generally _______ manifestations

A

Folate deficiency; neurologic

20
Q

Tx of folate deficiency anemia?

A

Daily oral medication of folate

21
Q

At risk/causes of folate deficiency anemia?

A

Chronically malnourished, alcoholics, and stomatitis

22
Q

Characterized by red cells that are abnormally small and contain reduced amounts of hemoglobin

A

Microcytic-hypochromic anemias

23
Q

Most common type of anemia in the world?

A

Iron deficiency anemia

24
Q

_____ ___ anemia is a nutritional deficiency or blood loss

A

Iron deficiency

25
Q

Manifestations of iron deficiency occur when…

A

When serum Hgb decreases to 7 or 8gm/dl

26
Q

Early symptoms of iron deficiency?

A

Fatigue, weakness, shortness of breath, pale earlobes and palms, and conjunctiva

27
Q

Who is at risk for iron deficiency anemia?

A

Malnourished children, pregnant women, and women during menstruation

28
Q

Progression of iron deficiency

A

Brittle, thin, coarsely ridged and spoon shaped nails (koilonychia)
A red, sore, and painful tongue

29
Q

Tx of iron deficiency anemia

A

Iron replacement therapy: IV or PO

30
Q

Characterized by red cells that are relatively normal in size and hemoglobin content but insufficient in number

A

Normocytic Normochromic anemias

31
Q

Damage to bone marrow, affecting erythropoiesis. (normo/normo)

A

Aplastic anemia

32
Q

Acute blood loss is known as ______ (normo/norm)

A

Post-hemorrhagic

33
Q

______: abnormal immune destruction of RBC’s (acquired and hereditary)

A

hemolytic

34
Q

Anemia of _____ _____: occurs in many chronic diseases

A

chronic inflammation

35
Q

Splenomegaly

A

Enlargement of the spine

36
Q

Splenomegaly is caused by ______: overactivity, leading to anemia, leukopenia, and/or thrombocytopenia

A

Hypersplenism

37
Q

Thrombocytopenia is when your platelet count is

A

< 150,000/mm^3

38
Q

<50,000 platelets

A

Hemorrhage from minor trauma

39
Q

<15,000 platelets

A

Spontaneous bleeding

40
Q

<10,000 platelets

A

Severe bleeding

41
Q

Thrombocytopenia can be congenital or acquired. T or F

A

True

42
Q

Thrombocytopenia can be acquired through autoimmune disorders such as ___ and ___

A

EBV or HIV

43
Q

Thrombocytopenia can be acquired through ____ or ____ infections

A

viral or bacterial

44
Q

Another way thrombocytopenia is acquired is if platelet consumption is increased. This can be _____-induced

A

heparin

45
Q

What is DIC?

A

a condition in which blood clots form throughout the body, blocking small blood vessels.

46
Q

What is typically seen in HIT?

A

50% drop in platelet count

47
Q

What is the HIT paradox?

A

People with HIT can experience venous thrombosis

48
Q

Chronic form of ITP

A

Platelet-specific IgG autoantibodies that target platelet glycoproteins. Progressively worsens, exacerbates, and then goes in remission.

49
Q

Acute form of ITP

A

Develops after a viral infections. Platelets are damaged and destroyed in the spleen.

50
Q

Which form of ITP is one of the most common childhood bleeding disorders

A

acute ITP

51
Q

Acute ITP resolves in….

A

1-2 months

52
Q

Manifestation of ITP

A

Petechiae and purpura. Progresses to major hemorrage

53
Q

Dx of ITP?

A

H&P, blood counts

54
Q

Tx of ITP (chronic)

A

Prednisone, IV immune globulin, or a splenectomy

55
Q

Thrombotic thrombocytopenic purpura

A

blood clots in smaller vessels such as the arterioles and capillaries

56
Q

TTP causes ____ with target organ damage

A

ischemia

57
Q

Chronic relapsing TTP is common

A

false, very rare

58
Q

Tx of TTP

A

Steroids, plasma, and plasmapheresis

59
Q

Essential (primary) thrombocythemia (thrombocytosis) is characterized by

A

platelet counts >400,000

60
Q

Megakaryocytes in the bone marrow are produced in excess with

A

Thrombocythemia

61
Q

Clinical manifestations of thrombocythemia

A

Ischemia of fingers and toes

62
Q

Tx of thrombocythemia

A

Hydroxyurea and Anegrelide

63
Q

What is necessary for synthesis and regulation of prothrombin, the procoagulant factors, and proteins C and S (anticoagulants)

A

Vitamin K

64
Q

What hemostasis disorders does liver disease cause

A
  • Defects in coagulation
  • Fibrinolysis
  • Platelet number and function
65
Q

Complex, acquired disorder in which clotting and hemorrhage simultaneously occur

A

Disseminated Intravascular coagulation (DIC)

66
Q

Possible cause of DIC?

A

result of increased protease activity in the blood caused by unregulated release of thrombin.

67
Q

Endothelial damage is the primary initiator of DIC. T or F

A

true

68
Q

_____ is the most common condition associated with DIC

A

Sepsis

69
Q

Sepsis is usually caused by ____ ___ organisms; endotoxins damage endothelium

A

gram negative

70
Q

With DIC, coagulation results from abnormally widespread and ongoing activation of clotting. T or F

A

True

71
Q

With DIC, the thrombosis activates plasmin and triggers _______

A

Fibrinolysis

72
Q

With DIC, thrombosis triggers fibrinolysis. THe fibrin degradation products resulting from fibrinolysis actually have _______ properties

A

Anticoagulant

73
Q

With DIC, clotting leads to deposition of _____ in the microcirculation that leads to _____, _____, and organ failure

A

Fibrin; obstruction, and organ failure

74
Q

Patient presents with purpura, petechiae, and hematomas. Bleeding from venipuncture sites and arterial lines. Patient goes into shock and eventually has internal hemorrhaging. Patient has…

A

DIC

75
Q

Tx of DIC

A

eliminate the cause so the liver can restore clotting factors. Infuse clotting factors. In some cases, heparin.