Anemia
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| What is hypovolemic anemia? | Decreased RBC, hemoglobin, and hematocrit due to hemorrhaging
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| Until how long can it take for lab results for hypovolemic anemia to be accurate? | Hours after injury
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| What is the Tx for Hypovolemic anemia? | Same as for Hypovolemic Shock
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| What is Pernicious Anemia? | Autoimmune disorder resulting from the destruction of parietal cells and eventual gastric mucosa atrophy
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| What vitamin is a PT with Pernicious Anemia potentially lacking in, and why? | Parietal cell damage ---> Decreased intrinsic factor production ---> Intrinsic factor not available to combine with Vitamin B12
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| Vitamin B12 is needed for what? | growth and maturation of all body cells
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| Vitamin B12 deficiency leads to what in RBCs and nerve cells? | *Leaves erythrocyte membranes fragile and easy to rupture *Leads to large, immature RBCs *Progressive demyelination and degeneration of nerves and white matter
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| List 5 S/Sx of pernicious anemia: | *Jaundice *Dyspnea *Hypoxia *Edema of legs *Constipation or diarrhea *Dysphagia *Parasthesia *Smooth and erythematous tongue *Partial or total paralysis due to destruction of the nerve fibers of the spinal cord
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| What test shows malabsorption of B12? | Schillings test
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| What test shows decreased serum levels of B12? | Megablastic anemia profile
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| How is a schillings test performed? | PT is given radioactive B12 PO and a parenteral flushing of nonradioactive B12. Urine is monitored for percentage of radioactive B12 for 24 hrs. Low % in urine indicates deficient intrinsic factor.
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| What is the B12 therapy for pernicious anemia? | *IM injections given daily for 2 weeks *Then Weekly for one month *Then Monthly for the rest of the patient’s life
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| How often is the CBC monitored for a PT with pernicious anemia? | Every 3 - 6 months
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| What is the name for vitamin B12? | Cyanocobalamin
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| What is Aplastic Anemia (Aplasia)? | patients have lower counts of all blood cells due to a failure of the normal process of generation & growth
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| What is Pancytopenia? | Low RBCs, Low WBCs, and Low Platelets
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| In a PT with Aplastic Anemia (Aplasia), what is hematopoietic tissue replaced by? | Fatty tissue
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| Oral leukoplakia manifests in which anemia? | Aplastic Anemia (Aplasia)
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| Skin with lemon-yellow–tinged pallor and a "raw-beef" tongue manifests in which anemia? | Pernicious anemia
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| What will be found in a bone biopsy of an Aplastic Anemia (Aplasia) PT? | *Hypoplastic or aplastic fatty deposits *Decreased cellular elements *Decreased hematopoietic activity
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| Why are blood transfusions avoided when possible in PTs with Aplastic Anemia (Aplasia)? | to prevent iron overloading and the development of antibodies to tissue antigens, and to minimize the risk of rejection for a bone marrow transplant candidate
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| What is medical therapy is used for PTs with Aplastic Anemia (Aplasia) who cannot recieve a bone marrow transplant? | Immunosuppressive therapy: antithymocyte globulin
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| What is used to control the cause of aplastic anemia? | GM-CSF Granulocytic-macrophage colony-stimulating factor
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| What is the most common cause of iron deficiency anemia in adults? | chronic intestinal or uterine bleeding
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| What are the S/Sx of iron deficiency anemia? | *Glossitis *Pagophagia (desire to eat ice, clays, or starches... pica?) *Paresthesias *Pallor *Inflamed mucous membranes
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| What is the medical management of iron deficiency anemia? | *Pallor *Inflamed mucous membranes *Iron rich diet
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| Iron/Ferrous Sulfate should not be taken with what? | Antacids
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| What foods are high in iron? | organ meats, white bean, leafy vegetables, raisins, molasses, dry fruits, and egg yolk
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| What is the most common clinical manifestation of iron deficiency anemia? | Pallor
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| What percentage of black americans has sickle cell trait? | 81%
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| What is Polycythemia Vera (primary polycythemia)? | Excessive bone marrow production (hyperplasia of bone marrow) causing increased circulating erythrocytes, granulocytes and platelets (inc RBCs/Granulocytes/Platelets/basophils)
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| What is secondary polycythemia caused by? | Caused by hypoxia rather than a defect in the evolution of the RBC. Hypoxia stimulates erythropoietein in the kidneys which stimulates erythrocyte production.
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| The venous distention and platelet dysfunction associated with secondary polycythemia causes what? | *Esophageal varices *Epistaxis *GI bleeding *Petechiae *Hepatomegaly and Splenomegaly from organ engorgement
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| In a PT with Polycythemia, repeated phlebotomy is done to maintain a hematocrit of what Percentage? | 45% - 48%
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| What is the purpose of drug therapy in polycythemia? | Decrease bone marrow response
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| What is the major complication of polycythemia vera? | Thrombosis due to the abnormal increased number of circulating RBCs and platelets
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| What is done to prevent thrombosis in a PT with polycythemia? | Encourage ambulation/ROM exercises
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