Term
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Definition
| It is a deficiency in the number of erythrocytes, the quantity of hemoglobin, or volume of packed RBC's (hematocrit). Anemia is not a disease it is a symptom of an underlying cause (of which there are many). The specific type of anemia can be ID'd an dclassified by laboratory diagnosis. |
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Term
| What are the normal hemoglobin levels for males and females? |
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Definition
Male: 13.5-18
Female: 12-16 |
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Term
| What are the normal values for hematocrit in males and females? |
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Definition
Males:
40-54
Females:
38-47 |
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Term
| What are the possible causes of anemia? |
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Definition
Decreased production of erythrocytes:
Inadequate EPO production (renal impairment)
Iron, Vitamin B12, or Folic acid deficiency
Decreased iron availability (Intrinsic factor or incr Ca2+)
Blood Loss:
Chronic Hemmorhage due to bleeding ulcers or colon cancer
Acute trauma
Increased Destruction of erythrocytes:
Hemolosysis due to sickle cell anemia, certain medications, incompatible blood, or surgical trauma (eg. bypass)
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Term
| Why are erythrocytes so key in body functioning? |
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Definition
They are responsible for both the transport of both O2 and CO2 to body tissues.
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Term
| Define mild, moderate, and severe anemia in terms of presence of symptoms and laboratory values. |
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Definition
Mild Anemia:
- Hemoglobin levels of 10-14g/dl
- May not have symptoms
- If present, symptoms include: palpiations, dyspnea (shortness of breath), and diaphoresis (sweating).
Moderate Anemia:
- Hemoglobin levels of 6-10 g/dl
- Increased cardiopulmonary symptoms that will be experienced at rest or during activity
- Symptoms include fatigue, dyspnea, chest pain, etc.
Severe Anemia:
- Hemoglobin levels less than 6 g/dl
- Pale, jaundice, smooth tongue, increased stroke volume, dyspnea, anorexia, difficulty swallowing, bone pain, vertigo, headache, irritability, etc.
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Term
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Definition
| It is a glycoprotein thats primarily produced in the kidneys. 10% of it is produced in the liver. It increases the number of stem cells committed to erythrocyte production. It also shortens the time to mature erythrocytes. |
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Term
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Definition
It is the production of erythrocytes. The average erythrocyte lfe span is 120 days. There are three alterations to erythropoiesis that decrease RBC production: decreased hemoglobin synthesis, defective DNA synthesis in RBC's (weak membranes subject to lysis), or diminished availability of EPO precursors.
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Term
| What is iron-deficiency anemia? |
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Definition
It is anemia due to inadequate dietary intake, malabsorption, blood loss, or hemolysis.
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Term
| What are the risk factors for iron deficiency anemia? |
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Definition
Premenopausal
Preggo
Poor
Prolonged Bleeding
Old |
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Term
| How is iron defiency anemia diagnosed? |
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Definition
CBC w diff revealing: microcytic and hypochromic RBCs, incr platelet count, decr MCV and MCHC
Decr serum iron and ferritin
Incr TIBC
History/Workup also relevant |
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Term
| What is the treatment for iron deficiency anemia? |
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Definition
Increased iron uptake, nutritional therapy, oral or parenteral iron supplements.
Transfusion of packed RBC's is a last resort. |
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Term
| What is the cause of thalassemia? |
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Definition
| It is a genetic disease that is autosomal recessive. It results in inadequate hemoglobin production and hemolysis due to abnormal globin. |
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Term
| What populations are at risk for thalassemia? |
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Definition
| It is more common in mediterranean climates and in equatorial asia and africa. |
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Term
| What are the subtypes of thalassemia? |
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Definition
Thalassemia major and thalassemia minor.
Major- both copies of the gene
Minor- one copy of the gene |
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Term
| What are the symptoms of thalassemia minor? |
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Definition
Generally asymptomatic
Patients may experience mild jaundice, mild anemia, and splenomegaly |
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Term
| What are the symptoms of thalassemia major? |
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Definition
Physical and mental retardation
Pale
splenomegaly
hepatomegaly
jaundice
chronic bone marrow hyperplasia
devastating diagnosis |
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Term
| How is thalassemia diagnosed? |
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Definition
Hemoglobin tests to test for abnormal globin
Family hx
Prenatal testing
Microcytic RBC's
Reduced RBC ct |
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Term
| What is megaloblastic anemia? |
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Definition
It is impaired DNA synthesis resulting in comrpomised membrane integrity due to B12 or Folic Acid Deficiency.
**THINK ETOH!!** |
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Term
| What is B-12 Deficiency Megaloblastic Anemia caused by? |
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Definition
| It is a pernicious anemia with an insidious onset that is caused by nutritional deficiencies, hereditary enzyme defects(problem with IF), IF absence,incr stomach pH, GI surgery, long term H2 blocker use, and alcoholism. |
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Term
| What are the s/s of B12 Deficiency Megaloblastic Anemia? |
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Definition
THey are the normal symptoms of anemia (shortness of breath, etc.) + a sore tongue, n&v, abdominal pain, and neurological symptoms like weakness, paresthesias, ataxias, muscle weakness, and impaired thought.
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Term
| How is B-12 Deficiency Megaloblastic Anemia diagnosed? |
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Definition
Serum B12 and homocysteine levels (low)
Large abnormal RBCs
Schilling Test
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Term
| How is B-12 Deficiency Megaloblastic Anemia treated? |
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Definition
1. Dietary Modification- often seen in vegans/veggies; need to supplement or change diet; reduce alcohol consumption
2. B-12 Shots 1x wkly or monthly |
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Term
| What are the causes of Folic Acid Deficiency Megaloblastic Anemia? |
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Definition
| Poor nutrition, malabsorption syndrome, drugs, etoh abuse, anorexia, hemodialysis |
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Term
| What are the s/s of Folic Acid Deficiency Megaloblastic Anemia? |
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Definition
| normal anemia symptoms + sore tongue, n&v and abdominal pain |
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Term
| How is Folic Acid Deficiency Megaloblastic Anemia Diagnosed? |
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Definition
CBC: low hematocrit and hemoglobinHigh ferritin, slightly high transferrin
RBC folate level low |
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Term
| How is Folic Acid Deficiency Megaloblastic Anmeia treated? |
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Definition
Replacement Therapy
Nutrition |
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Term
| What kind of diseases cause chronic disease associated anemia? |
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Definition
| ESRD, chronic liver disease, chronic inflammation, malignant tumors, chronic endocrine disease |
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Term
| How are chronic disease associated anemias treated? |
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Definition
| The underlying cause is treated. Patients may also be given EPO therapy (epogen). Transfusions are rarely used. If they are they will be given simultaneously with dialysis. |
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Term
| What are the causes of aplastic anemia? |
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Definition
| It can be congenital or acquired. Viruses, chemical exposure, cancer treatments, preggo, drugs and autoimmune diseases can cause it. It has a poor prognosis if untreated. Untreated, 75% of cases are fatal. |
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Term
| What are the s/s of aplastic anemia? |
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Definition
| Has a gradual development and the normal symptoms of anemia. Pancytopenia |
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Term
| How is aplastic anemia diagnosed? |
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Definition
| Normocytic normochromic but low quantity pancytopenia due to suppression of bone marrow. |
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Term
| How is aplastic anemia treated? |
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Definition
Prevention of complications due to infection or hemorrhage
Bone marrow transplantation
Immunosuppressive therapy |
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Term
| What is the cause of acute blood loss anemia? |
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Definition
....Acute blood loss!!!
Sudden hemorrhage duet o trauma, surgery complication (eg md nicks an organ), disruption of vascular integrity |
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Term
| What are the s/s of acute blood loss anemia? |
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Definition
| Same symtpoms + pain due to internal hemorrhage and tissue distention and organ displacement. Ther ewill be nerve compression, numbless, and pain in the lower extremeties. Hyovolemic shock and reduced plasma volume are the biggest concerns. |
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Term
| Why are labs insufficient for diagnosing acut eblood loss anemai? |
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Definition
| RBC problems won't show up on labs for 2-3 days |
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Term
| How is acute blood loss anemia treated? |
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Definition
Replace blood volume to prevent shock
ID source of the hemorrhage
Stop blood loss
Correct RBC loss
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Term
| How does chronic blood loss effect the body and how can the symptoms be managed? |
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Definition
| Chornic blood loss results in reduced iron stores (due to bleeding ulcers, hemorrhoids, menstrual and postmenopausal blood loss). It should be managed by identifying the source, stopping the bleeding and using iron supplements in necessary. |
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Term
| Describe hemolytic anemia. |
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Definition
| It is the third major cause of anemia. It is due to intrinsic factors such as abnormal hemoglobin, enzyme deficiencies, and rbc membrane abnormalities. It can also be due to extrinsic factors. The sites of hemolysis can be intravascular or extravascular. |
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Term
| What are the s/s of hemolytic anemia? |
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Definition
| Jaundice due to increased destroyed RBCs and bilirubin (often seen in eyes). Splenomegaly, livermegaly. Hyperactive liver due to macrophage phagocytosis of the defective RBCs. |
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Term
| What is sickle cell anemia? |
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Definition
| It is a group of inherited, autosomal recessive disorders. There is an abnormal form of hemoglobin (hbs) in the erythrocyte. It causes the RBC to stiffen and elongate, creating a sickle shape in response to decreased oxygen levels. It is a genetic disorder and is incurable. It is often fatal and few sickle cellers make it past 50. The sickle cells clog capillaries causing little blood clots all over the body. This is immensely painful and the pain is often poorly managed. |
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Term
| What are the possible complications of sickle cell disease? |
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Definition
Gradual involvement of all body systems, fatal by middle age due to renal and pulmonary failure. They are prone to infection (pneumonia is the most common infection).
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Term
| What diagnostic studies are used for sickle cell disease? |
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Definition
| Peripheral blood smears, sickling tests, electrophoresis of hemoglobin, DNA testing, skeletal x-rays, and MRI. |
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Term
| How is sickle cell disease treated? |
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Definition
Management of pain
and management of complications
Give patients oxygen
For acute chest syndrome: provide antibiotics, oxygen and fluid therapy
Give folic acid supplements daily (decreases hemolysis and amout of sickled cells)
Blood transfusion may be necessary in crisis
Hydroxyurea(hydrea) to increase amt of hbf
Bone marrow transplants
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Term
| What 3 factors can cause acquired hemolytic anemia? |
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Definition
Physical factors like dialysis and prosthetic heart valves
Immune reactions (like spleen problems)
Infections agents and toxins |
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Term
| What causes Polycythemia? |
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Definition
| The over production of RBCs generally due tot an abnormality in the stem cells of the bone marrow (called polycythemia vera). Can also be due to an increase in EPO (normal response to chronic hypoxia or inappropriate response to eposecreting tumors). |
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Term
| How is polycythemia treated? |
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Definition
| It is treated by reducing the blood volume and viscosity and bone marrow activity. The goal is to keep hematocrit less than 45%. This can be done via taking blood or using myelosuppressive agents such as Hydrea (this is an off label use since you are using hydrea for its adverse effects). |
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Term
| What are the two main types of lymphoid and leukocyte disorders? |
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Definition
| Qualitative and quantitative. Quantitative disorders increase or decrease cell numbers. They include bone marrow disorders, premature destruction of cells, or infectious microorganism invasion. Qualitative disorders result from a disruption of cellular function. |
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Term
| Name the quantitative alterations of leukocytes |
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Definition
Leukocytosis: normal protective response to physiologic stressors
Leukopenia: not normal and not beneficial; predisposes one to infection
Neutrophilia: first stages of infection or inflammation
Neutropenia: prolonged severe infection; decreased production and reduced survival; often seen in chemo patients
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Term
| What are the quantitative alterations of leukocytes? |
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Definition
Agranulocytosis: interference with heamtopoises, immune mechanisms, chemotherapy destruction, and radiation.
Lymphocytosis: acute viral infection; increase in lympthocytes
Lymphocytopenia: immune deficiency, drug destruction and viral destruction. |
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Term
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Definition
A group of malignant disorders affecting the blood and blood-forming tissues of bone marrow, lymph system, and spleen
Occurs in al ages and all groups
Accumulation of dysfunctional cells due to loss of reuglation in cell division
It is fatal if untreated
The number of adults affected is ten times greater than the number of children affected. |
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Term
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Definition
| There is no single causative agent. It is due to a combination of genetic and environmental influences. There are several factors that are associated with development: chemical agents, chemotherapeutic agents, viruses, radiation, and immunologic deficiencies. |
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Term
| What is the difference between acute and chronic leukemia? |
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Definition
Acute: clonal proliferation of immature hematopoietic cells
Chronic: mature forms of wbc and onset more gradual |
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Term
| How are leukemias classified? |
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Definition
Acute lymphocytic leukemia
Acute myelogenous leukemia
Chronic myleogenous leukemia
Chronic lymphocytic leukemia |
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Term
| Describe acute myelogenous leukemia. |
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Definition
25% of all leukemias
85% of acute leukemias in adults
Aprupt and dramatic onset: serious ifnection or abnromal bleeding
Uncontrolled proliferation of myeloblasts; hyperplasia of bone marrow and spleen |
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Term
| Describe acute lymphocytic leukemia. |
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Definition
| Most common type of leukemia in chidlren. Accounts for 15% of leukemia in adults. Immature lympthocytes proliferate in the bone marrow. The signs and symptoms (mainfestations) are fever and bruising. |
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