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NUR171-Hemato-3
Hematology - Ch 31 - File 3
| Question | Answer |
|---|---|
| 2 classifications of anemia | morphologic and etiologic (underlying cause) |
| What form of PO drug to use with iron supplementation? | non-enteric-coated capsules because hinders iron absorption in the right place. |
| Iron best absorbed as? | ferrous sulfate in acidic environment |
| Side effects of iron | heartburn, constipation, diarrhea |
| Thalassemia minor | 1 thalassemic gene |
| Thalassemia major | 2 thalassemic genes |
| Signs of Thalassemia minor | asymptomatic frequently – splenomegaly, mild jaundice |
| Signs of Thalassemia major | life-threatning, mental/physical retarda, pale, child onset, splenomegaly, hepatomegaly, chronic bone marrow hyperplasia (expansion) |
| How do you treat Thalassemia major? | blood transfusion with IV deferoxamine |
| What causes Megaloblastic Anemias? | impaired DNA synthesis, deficiency in Folic acid and Cobalamin (B12), lg RBCs – megaloblasts |
| Erythroleukemia can cause what kind of anemia? | megaloblastic anemias |
| What is required for cobalamin absorption in sm. Intestine? | IF – intrinsic factor – secreted by parietal cells of gastric mucosa |
| Neuromuscular manifestations of cobalamin deficiency | Weakness, Paresthesias of feet/hands, decreased position senses, ataxia, impaired thought process |
| Folic acid is required for? | DNA synthesis, RBC formation & maturation |
| Common causes of folic acid deficiency | anorexia, alcohol abuse, malabsorption syndrome |
| Neurologic problems occur with which nutritional deficiency? | cobalamin – folic acid doesn’t have that sign |
| Pancytopenia occurs with what anemia? | aplastic |
| Aplastic Anemia can be managed with? | EPO or blood transfusion |
| Clinical manifestations of aplastic anemia are caused by? | suppression of any or all bone marrow elements |
| What treatment options for aplastic anemia? | bone marrow transplant, immunosuppressive therapy |
| What are signs of retroperitoneal bleeding? | numbness, pain in the lower extremities, shock |
| Intrinsic Hemolytic anemia | hemolysis of RBCs due to abnormal hb, enzyme defic., or membrane abnormalities |
| What affect does hemolytic anemia have on spleen/liver? | enlarged due to hyperactive with macrophage phagocytosis of defective RBCs |
| Why can hemolytic anemia cause kidney tubular necrosis? | accumulation of hemoglobin molecules obstruct renal tubules |
| Homozygous for hemoglobin S (HbSS) would appear as? | Sickle cell anemia |
| Most common infection in Sickle cell disease | pnemonia |
| Acute chest syndrome can occur with which anemia? | Sickle Cell |
| Acquired Hemolytic anemia extrinsic factors are? | physical (like hemodialysis), Immune rxn (Autoimmune), Infection/toxins |
| Leukemia is basically | Accumulation of dysfunctional cells due to loss of regulation in cell division |
| Clonal proliferation of immature hematopoietic cells is what type of Leukemia? | Acute |
| Chronic Leukemia involves | Mature forms of WBC and onset is more gradual |
| Acute Myelogenous Leukemia (AML) | Adults mostly – serious infection or bleeding – uncontrolled proliferation of myleoblasts – hyperplasia of marrow & spleen |
| Acute Lymphocytic Leukemia (ALL) | Children mostly – immature lymphocytes proliferate in marrow, CNS manifestations, fever, bleeding |
| Chronic Myelogenous Leukemia (CML) | Excessive mature neoplastic granulocytes in marrow, massive |
| Chronic Lymphocytic Leukemia (CLL) | Enlarged lymph nodes, pain, paralysis from pressure |
| Hairy Cell Leukemia | Chronic lymphoproliferation of B lymph – infiltrate bone marrow/liver, have “hairy” appearance, vasculitis |
| Clinical manifestations of Leukemia | Overcrowding by abnormal cells, inadequate production of normal marrow elements |
| Inadequate marrow elements cause? | Anemia, thrombocytopenia, decrease in |
| Leukemic cells cause | Splenomegaly, hepatomegaly, lymphadenopathy |
| Chloromas | solid masses – tumor composed of leukemic cells that metastasize to brain, bone, skin, etc – green in appearance |
| Goal of collaborative care of leukemia | to attain remission |
| Induction therapy | attempt to induce remission by destroying leukemic cells |
| Consolidation therapy | After remission achieved, eliminate remaining leukemic cells not pathologically evident |
| Lymphomas are? | Malignant neoplasms originating in bone marrow and lymphatic structures – results in proliferation of lymphocytes |
| Hodgkins Lymphoma | Reed-Sternberg - in lymph nodes - giant, multinucleated cells, Epstein-Barr virus exp, lymph node destroyed by hyperplasia of monocytes & macrophages |
| Etiology and Pathophysiology of Hodgkin’s Lymphoma | arises in single location and spreads to adjacent lymphatics – infiltrates organs |
| Clinical manifestations of Hodgkin’s Lymphona | insidious onset, enlarged cervical, axillary, or inguinal lymph nodes - nodes nontender |
| Alcohol-induced pain occurs with which lymphoma? | Hodgkin’s |
| All Non-Hodgkin’s Lymphoma involve? | Lymphocytes arrested in various stages of development, can originate outside lymph node, painless lymph node enlargement |
| Prognosis for Non-Hodgkin’s Lymphoma | Not as good as that for Hodgkin’s |
| Treatment for Non-Hodgkin’s lymphoma | radiation and chemotherapy |
| Granulocytes originate where? | bone marrow |
| Agranular leukocytes originate where? | primarily in lymphatic tissue |
| Leukocytosis refers to? | overall increase in leukocytes |
| Why are elderly more prone to iron deficiency anemia? | poor dietary iron intake and decreased absorption in sm. Intestine |
| Supplemental iron intake is necessary for __ months to replenish body storage. | 6 |
| 2 causes of Pernicious anemia | loss of intrinsic factor (gastric resection), or autoimmune problem |
| Treatment of pernicious anemia | injection of B12, iron, vit C, folic acid |
| Pt taking Dilantin (anticonvulsant) may be at risk for? | aplastic anemia |
| Corticosteroids may be helpful __ anemia. | aplastic |
| Clinical manifestations of a pt w/Folic acid deficiency anemia. | Weight loss, emaciated, ill w/malnourishment |
| Goals for pt w/anemia | dianosis, decrease body oxygen needs, prevent infections, assess complications (cardio), educate pt regarding health maintenance |
| Conditions precipitating sickling effect. | acidosis, dehydration, hypoxia, temperature elevation |
| Hand-foot syndrome | occlusions in sm. Distal bones of hands & feet characterized by pain & swelling – sickle cell |
| Sequestration Crisis in sickle cell | pooling of blood in liver & spleen w/decreased blood volume |
Created by:
Ladystorm