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Anemia
Patho
| Question | Answer |
|---|---|
| RBC for men | 4.2-5.4 |
| RBC for women | 3.6-5.0 |
| hgb for men | 14-16.5 |
| hgb for women | 12-15 |
| hct for men | 40-50 |
| hct for women | 37-47 |
| What is the lab dx for anemia? | low hct, low hgb, low RBC |
| what are the 3 MCV (sizes) for RBC? | microcytic, normocytic, macrocytic |
| what are the 2 MCHC (color) for RBC? | hypochromic, normochromic |
| What does having a low MCV mean? | Fe def, hemoglobinpathy, chronic disease, and Pb poisoning |
| what does it mean to have a normal MCV? | acute bleeding, aplastic, hemolyic, low erythropoietin, and maligancy |
| what does it mean to have high MCV? | low vit B12, low folate |
| syncope | passing out |
| low hbg, # if circulating RBCs, or both...have a < O2 carrying capacity-tissue hypoxia | anemia |
| what are some causes of anemia? | Causes-excessive loss, destruction, or decreased production |
| what are the S/S of anemia? | S/S-rapid loss can lead to shock & circulatory collapse; fatigue, weakness, dyspnea, & sometimes angina, HA, syncope, dim vision, pallor of skin, mucous membranes, conjunctiva, & nail beds, tachycardia, palpitations, bone pain, & sternal tenderness |
| what are some complication of anemia? | Complications-ventricular hypertrophy, heart failure |
| When it comes to blood lose...is it easier to treat acute ot chronic anemia? | chronic |
| dyspnea | FEELING SOB not actually SOB |
| no cells at risk for infection | aplastic |
| What is the average size of RBC? | MCV: 85-100 lowers in microcytic and rises in macrocytic |
| What involves the premature destruction of RBC? | Hemolytic |
| What are the S/S of Hemolytic? | S/S-mild anemia, splenomegaly, jaundice, &bilirubin gallstones |
| What is are two different causes of Hemolytic anemia? | intrinsic and extrinsic |
| What is an inherited disorder of red cell membrane that is autosomal dominant? | Hereditary spherocytosis |
| Is Hereditary spherocytosis autosomal dominant or recessive? | dominant |
| life-threatening; sudden cessation of RBC production | aplastic crisis |
| what is the TX for a aplastic crisis? | splenectomy |
| results in a tight sphere instead of a disk | Hereditary spherocytosis |
| abnormality of the hgb structure and leads to accelerates RBC destruction | Hemoglobinopathies |
| What are 2 types of Hemoglobinopathies? | Sickle Cell and Thalassemias |
| abnormal substitution of amino acid in hgb | sickle cell |
| defective synthesis of one of the polypeptide chains tha form the globin portion of hgb | Thalassemias |
| Sickle cell is dominant or recessive? | recessive |
| a chronic disorder in which the RBS are sickled | sickle cell |
| what are some complications of sickle cell? | Complications-chronic hyperbilirubinemia, vaso-occlusion, acute chest syndrome, organ infarctions, stroke, splenic injury, growth retardation, osteomyelitis, sepeticemia, extreme jt pain, & death---organ failure & premature death |
| what is the difference between a sickle cell trait and a sickle cell disease? | Sickle cell trait-heterozygous; 40% of RBCs are sickled...Sickle cell disease-homozygous; almost all RBCs are sickled |
| sickled RBC are unable to transport ___ and they ____ | O2 and they clump together |
| what are big triggers for sickle cell? | dehydration, stress, cold, < O2, illness, physical exertion, etc |
| What is the TX for sickle cell? | TX-no cure, palliative; hydration & oxygenation help in acute situations to prevent complications; stem cell transplant slows promise |
| Absent or defective synthesis of the alpha of the beta chains (Mediterranean anemia) of hgb | Thalassemia |
| what are the 2 forms of Thalassemia and describe them | heterozygous: mild homozygous: severe |
| what are the contributing factors to thalassemia? | Contributing factors-reduced hgb synthesis & an imbalance in globin chain production |
| What are the S/S of Thalassemia? | S/S-based on severity; severe transfusion-dependant anemia, growth retardation, increased hematopoiesis (bone abnormalities), enlarge facial bones, increased Fe absorption, splenomegaly, hepatomegaly, cardiac disease |
| What are the TX options for Thalassemia? | TX-blood transfusion, & Fe chelation therapy |
| hepatomegaly | enlarged liver |
| Fe Chelation Therapy | when blodd is taken out of the body, and then the blood is filtered for minerals such as Fe and Pb |
| the most common an inherited enyzme defect | Def of G6PD |
| Gene defect of X chromosome-only expressed in males and homozygous females | Def of G6PD |
| RBCs more susceptible to oxidants & causes direct oxidation of hgb to methemoglobin & the denaturing of the hgb to form Heinz bodies | Def of G6PD |
| What are some triggers of Def of G6PD ? | Triggers-oxidant drugs (primaquine, sulfonamides, nitrofurantoin, ASA, phenacetin, & some chemos), acidosis, & infections |
| Exogenous factors such drugs, chemicals, toxins, venoms, infections, prosthetic heart valves, vasculitis, & severe burns cause | Acquired hemolytic anemia |
| Pressure changes caused by DIC, TTP, & renal disease can also trigger D/t membrane destruction | Acquired hemolytic anemia |
| May be immune mediated-autoantibodies (self) or alloantibodies (exogenous) | Acquired hemolytic anemia |
| What are the to autoantibodies of Acquired hemolytic anemia? Describe them. | Warm-reacting antibodies of IgG at 37 degrees C.......Cold-reacting antibodies of IgM at 4 degrees C |
| antibodies of _____ at ____degrees are warm reacting | IgG....37 |
| antibodies of _____at____degrees are cold reaction | IgM....4 |
| idenitfies RBC lysis by detecting antibody or complement on the surface of the RBC | Coomb's test (DX for Acquired hemolytic anemia) |
| very common; Causes-decreased dietary intake of iron, loss of iron through bleeding, or increased demands | Iron-def |
| What are the S/S of Iron-def? | S/S- fatigue, palpitations, dyspnea, angina, tachycardia, pallor, brittle nails and hair, smooth tongue, mouth sores, dysphagia, decreased acid secretion, pica |
| What is the DX for Iron-def? | DX- low hgb and hct, low serum iron, microcytic and hypochromic RBCs |
| What are the TX options for Iron-def? | TX-iron supplements; Ex ferrous sulfate (PO), iron dextran (IM) |
| pica | craving wierd non-food objects |
| what are the side-effects of taking Fe? | by mouth: constapation; weird poo color (dark green)....injective: stain skin.....liquid: stain teeth |
| parasthesias | numbness |
| spastic | tight muscles |
| ataxia | "drunk walk" |
| what vitamin is required for DNA synthesis? | Vit B 12 |
| Caused by abnormal nucleic acid synthesis that results in abnormally large RBCs & deficient nuclear maturation | Megaloblastic anemia |
| Cobalamin (Vit B 12) deficiency-AKA pernicious anemia is a ______ anemia | megaloblastic |
| what is the hallmark sign for Cobalamin def? | megaloblastic RBC |
| What is Cobalamin def? | lack of Vit B 12 |
| what does a lack of Vit B 12 lead to? | leads to a < nuclear maturation and cell division...may see myelin breakdown and neutrological complications |
| what are 2 megaloblastic anemias? | Cobalamin (vit B12) def and Folic Acid Def |
| What are the S/S of Cobalamin def? | S/S-parasthesias of the feet and fingers, loss of vibratory & position sense, spastic ataxia, & psychological changes |
| How do you DX Cobalamin def? | DX-Schilling’s test |
| What are the TX options for Cobalamin def? | TX-IM B12 usually once a month for replacement |
| _____ is required for DNA synthesis and RBC maturation | Folic Acid |
| > MCV and normal MCHC is seen in ____ | Folic Acid Def |
| What are the S/S of Folic Acid Def? | S/S similar to Vit B12 deficiency but w/o the neurological symptoms |
| most ___ is lost during cooking | Folic Acid |
| Who is Folic Acid def commonly seen in? | Common in the elderly, malabsorption syndromes, & in some cancers |
| What drugs can interfere with Folate? | Drugs (primidone, Dilantin, phenobarb, & methotrexate) can interfere w/ folate |
| PO means ____ | means by mouth |
| bone marrow depression of all blood cells | aplastic anemia |
| What are the S/S of aplastic anemia? | S/S-weakness, fatigue, pallor, petechia, eccymoses, epitaxis, bleeding of the gums or GI tract, & increased r/f infection |
| What are some causes of Aplastic Anemia? | Causes-high doses of radiation, chemicals, toxins, chemo, infections, AIDS |
| What are some TX options for aplastic anemia? | TX-stem cell or bone marrow transplants, immunosuppressive therapy, tx infections w/ ABT, blood transfusions (PRBCs & PLTs), & corticosteroids |
| complications of chronic infections, inflammation, and cancer...commonly seen in AIDS, osteomyelitis, rheumatiod arthritis, Hodgkin's disease, and renal failure | Chronic Disease anemia |
| what are the TX options for Chronic Disease anemia? | TX-erythropoeitin injections & POFe |
Created by:
TayBay15
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