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