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Hemaglobin

Hematologic Problems

QuestionAnswer
Anemia Decreased Hgb. S/S: tired, pale, tachycardia, murmurs/chest pain
Iron Deficiency Anemia Type of anemia common in very young people, people w/ poor diets, and pregnancy
S/S of Iron Deficiency Anemia Glossitis (inflammation of tongue)
Thalassemia Autosomal Recessive disease common in Mediterranean people, dx by 2 yrs old (physical/mental retardation common)
S/S of Thalassemia Spleen & liver enlargement, jaundice
Iron Toxicity Tx: Desferal, common in patients with Thalassemia. Will need Zinc & Ascorbic acid replacements
What is Thalassemia heme part of Hgb molecule is okay, but unable to produce globulin
Megaloblastic Anemia Anemia caused by Vit B12 deficiency causing large immature RBC's
S/S of Megaloblastic Anemia Neurologic problems, parathesia of hands, and impaired thought processes
Folic Acid Deficiency hemodialysis, poor nutrition, GI issues, poor nutrition, methotrexate, and alcoholism. S/S: smooth, beefy red tongue
Aplastic Anemia Anemia caused by pancytopenia. It's a chromosomal abnormality from radiation, infection & chemo meds
S/S of Acute blood loss Decreased BP, tachycardia, decreased urine output, bleeding. Cold/Clammy skin - indicates shock d/t decreased perfusion (not enough blood volume to organs causing them to go hypoxic)
Sickle Cell Disease Increased oxygen demand b/c cells change shape so they do not hold O2.
Sickle Cell These cells occlude arteries and cause pain; the spleen is constantly removing these mishapen cells leading to anemia -- Complications: chronically anemic, artery occlusion & eventual organ failure
Teach Sickle Cell patients Avoid high altitudes and dehydration, get vaccines
Polycthemia Increased RBC, WBC, platelets. S/S: HTN, viscous blood, chest pain, thrombosis, stroke, excessive Hgb
Hydrea Sickle Cell Anemia, polycthemia
Thrombocytopenia Platelet count <150,000
Immune Thrombocytopenia Purpura (ITP) autoimmune
Thrombotic Thrombocytopenia Purpura (TTP) drug toxicity or infection
Heparin Induced Thrombocytopenia (HIT) due to heparin
S/S Thrombocytopenia bleeding, bruising, petechia, decreased platelets
Treatment for ITP Corticosteroids (watch for hyperglycemia), spleenectomy, IgG antibody, Rituxan (pre-medicate w/ Benadryl do NOT use w/ Orencia)
Treatment for TTP Corticosteroids or plasmaphoresis (plasma exchange)
Treatment for HIT Angiomax, Refludan, Agatroban (Direct Thrombin Inhibitors given IV drip) monitor PTT
Hemophilia Sex linked recessive disorder. Deficient/Defective clotting disorder
S/S Hemophilia Slow persistant bleeding (nose, GI & joints) or delayed bleeding
Treatment for Hemophilia DDAVP - for vW & VIII Amicar - inhibits breakdown of clots Surgery in 2 weeks to get blood off joints. Rest/Ice Pain relief. Avoid Aspirin
Disseminated Intravascular Coagulation (DIC) Bleeding and clotting cycle disorder, only seen in very sick patients -- supportive care
S/S DIC Decreased Hgb, platelets, fibrinogen (necessary for clotting). D dimer increases
Neutropenia Neutrophil count <1000 (increased risk for infection). May not have normal inflammation response (fever)
Treatment for Neutropenia Neupogen - stimulates WBC production
Leukemia cancer of bone marrow that can affect lymph system & spleen. Dx by bone marrow biopsy
Acute Myelogenous Occurs in adults 60-70. 1st phase. Majority of acute cases. Abrupt & dramatic onset. Decreased Hgb, Hct, platelets
Acute Lymphocytic Occurs in children ages 2-9. Fevers that will not go away despite antibiotic therapy
Chronic Myelogenous 2nd phase in adults where abnormal chromosomes (Philadelphia chromosomes). Cancer cells infiltrate liver & spleen
Chronic Lymphocytic Most common leukemia in adults. Enlarged lymph nodes without any other symptoms. WBC >100,000
Hodgkin's Lymphoma Malignant cancer in lymph nodes. Giant cells (Reed Sternberg) in lymph, possibly linked to mono
S/S Hodgkin's Lymphoma enlarged lymph nodes, moveable, non-tender, weight loss, fatigue
Non-Hodgkin's Lymphoma Malignancy of B or T cells related to immune suppression. S/S: painless lymph node enlargement
Multiple Myeloma Plasma cells infiltrate bone marrow & destroy the bone (advanced when diagnosed. DX: bone pain & pathological fractures lead to diagnosis) -- RARELY CURED
Diagnostics of Multiple Myeloma M proteins in the blood, Bence Jones Proteins in urine, bone marrow biopsy
Multiple Myeloma Risks bone breakdown leads to increased calcium leading to kidney stones (increase fluids to flush stones out)
Created by: kristyd02