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Treatment of Hematological Problems
Diagnosis and Treatment of Hematological Problems
10
Nursing
Not Applicable
09/18/2010

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Cards

Term
Leukemia
Definition

Diagnosis: Decreased HCT, Hb, RBC & platelets; increased ESR, immature WBC and bleeding time. Bone marrow biopsy show large number of immature leukocytes

 

Treatment: Radiation therapy, antineoplastics, antibiotics, and transfusion therapy.

Term
Lymphoma
Definition

Diagnosis: Bone marrow aspiration and biopsies show small diffuse lymphocytic or large, follicular-type cells (N). Lymph node biopsy + for Reed-Sternberg (H).

 

Treatment: Radiation therapy, packed RBCs, combined chemotherapy.

Term
Iron Deficiency Anemia
Definition

Diagnosis: Decreased Hb, HCT, Iron, Ferritin, Reticulocytes, transferrin saturation and increased TIBC.

 

Treatment: High iron, roughage, protein, ascorbic acid, vitamin diet w/ increased fluids and avoidance of teas. Transfusion therapy. Mineral supplementation.

Term
Pernicious Anemia
Definition

Diagnosis:  Peripheral blood smear- oval,macrocytic hyperchromic erythrocytes. Bone marrow- increased megaloblasts, few maturing erythrocytes and defective leukocyte maturation.

 

Treatment: Balanced diet w/ increase in B-12 rich foods. Packed RBCs (rare). Cyanocobalmin and multivitamins.

Term
Aplastic Anemia
Definition

Diagnosis:  Decreased granulocytes, RBCs and thrombocytes. Bone marrow biopsy shows fatty marrow w/ reduction of stem cells.

 

Treatment: Platelets and packed RBCs. Immunosuppressants, granulocyte colony-stimulating factor.

Term
Idiopathic Thrombocytopenic Purpura
Definition

Diagnosis: Decreased Hb, HCT and platelets. Normal PT and PTT. Prolonged Bleeding Time.  Bone Marrow Biopsy shows increased and abnormal megakarocytes.

 

Treatment: Corticosteroids and Immune globulin IV.

Term
Polycythemia Vera
Definition

Diagnosis: Alkaline phosphatase >100 units/L, Serum B12 >900 pg/ml, RBC mass > or = 36 ml/kg (males) or 32 ml/kg (females), WBC >12,000/mcl,platelets >400,000 and increased HCT and Hb. Bone marrow biopsy shows increased number of immature cell forms and decreased iron in marrow. 

 

 Treatment: Phlebotomy, Antimetabolites, Imidazole quinazoline, interferon, and myelosuppresants.

Term
Multiple Myeloma
Definition

Diagnosis: xrays show diffuse, round, punched out bone lesions; OP, Osteolytic lesions of the skull and widespread demineralization. +Bence-Jones Assay. 

 

 Treatment: Antineoplastics, glucocorticoids, immunosuppresants, biphosphonates and radiation therapy.

Term
Hemophilia
Definition

Diagnosis: Factor VIII or Factor IX deficiency. PTT- prolonged. PT, bleeding time and platelet count and function- normal.

 

Treatment: Factor VIII or Factor IX concentrates. Aminocaproic acid (antifibrinolytic), Desmopressin (DDAVP- a vasopressor).

Term
Sickle Cell
Definition

Diagnosis: Hb electrophoresis shows Hb S.  Low RBCs, elevated WBCs and platelets, decreased ESR, increased serum iron, decreased RBC survival and reticulocytosis. Hb levels low or normal.

 

 Treatment: Analgesics, antimetabolite and folate. O2 therapy.

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