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68wm6 p2 Anemia
Anemia
Question | Answer |
---|---|
What is hypovolemic anemia? | Decreased RBC, hemoglobin, and hematocrit due to hemorrhaging |
Until how long can it take for lab results for hypovolemic anemia to be accurate? | Hours after injury |
What is the Tx for Hypovolemic anemia? | Same as for Hypovolemic Shock |
What is Pernicious Anemia? | Autoimmune disorder resulting from the destruction of parietal cells and eventual gastric mucosa atrophy |
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 |
Vitamin B12 is needed for what? | growth and maturation of all body cells |
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 |
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 |
What test shows malabsorption of B12? | Schillings test |
What test shows decreased serum levels of B12? | Megablastic anemia profile |
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. |
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 |
How often is the CBC monitored for a PT with pernicious anemia? | Every 3 - 6 months |
What is the name for vitamin B12? | Cyanocobalamin |
What is Aplastic Anemia (Aplasia)? | patients have lower counts of all blood cells due to a failure of the normal process of generation & growth |
What is Pancytopenia? | Low RBCs, Low WBCs, and Low Platelets |
In a PT with Aplastic Anemia (Aplasia), what is hematopoietic tissue replaced by? | Fatty tissue |
Oral leukoplakia manifests in which anemia? | Aplastic Anemia (Aplasia) |
Skin with lemon-yellow–tinged pallor and a "raw-beef" tongue manifests in which anemia? | Pernicious anemia |
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 |
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 |
What is medical therapy is used for PTs with Aplastic Anemia (Aplasia) who cannot recieve a bone marrow transplant? | Immunosuppressive therapy: antithymocyte globulin |
What is used to control the cause of aplastic anemia? | GM-CSF Granulocytic-macrophage colony-stimulating factor |
What is the most common cause of iron deficiency anemia in adults? | chronic intestinal or uterine bleeding |
What are the S/Sx of iron deficiency anemia? | *Glossitis *Pagophagia (desire to eat ice, clays, or starches... pica?) *Paresthesias *Pallor *Inflamed mucous membranes |
What is the medical management of iron deficiency anemia? | *Pallor *Inflamed mucous membranes *Iron rich diet |
Iron/Ferrous Sulfate should not be taken with what? | Antacids |
What foods are high in iron? | organ meats, white bean, leafy vegetables, raisins, molasses, dry fruits, and egg yolk |
What is the most common clinical manifestation of iron deficiency anemia? | Pallor |
What percentage of black americans has sickle cell trait? | 81% |
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) |
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. |
The venous distention and platelet dysfunction associated with secondary polycythemia causes what? | *Esophageal varices *Epistaxis *GI bleeding *Petechiae *Hepatomegaly and Splenomegaly from organ engorgement |
In a PT with Polycythemia, repeated phlebotomy is done to maintain a hematocrit of what Percentage? | 45% - 48% |
What is the purpose of drug therapy in polycythemia? | Decrease bone marrow response |
What is the major complication of polycythemia vera? | Thrombosis due to the abnormal increased number of circulating RBCs and platelets |
What is done to prevent thrombosis in a PT with polycythemia? | Encourage ambulation/ROM exercises |