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88 Cards in this Set
- Front
- Back
chronic blood loss |
does not effect blood volume but instead leads to iron deficiency anemia when iron stores are depleted |
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acute blood loss |
rbc normal size and color. hypoxia from blood loss stimulates rbc from bone marrow. |
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acute blood loss if bleeding controlled and sufficient iron stores are available |
rbc concentration returns to normal within 3-4 weeks |
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what is most common cause of acute blood loss anemia |
GI bleed |
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why blood loss anemia (2) |
rbc & hgb & hct low, mcv & mch & mchc normal |
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aplastic anemia is what kind of disorder |
life threatening |
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aplastic anemia is from |
stem cell in bone marrow |
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cause of aplastic anemia |
poorly understood |
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mcv and H&H of aplastic anemia |
high mcv, low H&H |
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what may induce aplastic anemia |
drugs (chemo) |
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iron deficient anemia classified as |
microcytic hypochromic |
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4 values seen in iron deficient anemia |
low H&H, low MCV, low MCH, low serum iron level |
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3 causes of iron anemia |
increased iron demand while pregnant, inadequate iron intake, chronic blood loss |
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inadequate iron intake difficult to achieve because |
need very little |
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inadequate iron intake seen in |
infants who get formula only first year of life, breastfeeding is good cause get iron from mom |
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4 sns of iron anemia |
tongue, cheilosis, hair and nails, pica |
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iron anemia tongue |
shiny smooth beefy-red inflamed sore |
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cheilosis |
cracks in corners of mouth |
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iron anemia hair and nails |
fine brittle hair, thin nails |
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pica |
craving to eat unusual substances such as starch and ice chips |
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TIBC |
total serum iron binding capacity |
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iron anemia TIBC |
is increased |
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serum IBC measures |
iron binding by transferrin |
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an increase in TIBC indicates |
transferrin is not carrying any iron which signals reduced iron availability |
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iron anemia develops slowly through 3 phases |
1) body's stores of iron used erythropoesis are depleted 2) insufficient iron is transported to the bone marrow and iron deficient erythropoesis begins 3) large amount of hgb deficient cells enter circulation |
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iron supplements SE |
nausea, bloating, constipation or diarrhea, aggravate peptic ulcers, black or dark green stool |
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liquid iron supps do what |
stain teeth |
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liquid iron supps need to do what |
dilute with juice or water, admin with straw, good oral hygiene |
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iron supps NI (7) |
assess lab values, drug better absorbed on empty stomach, give periodically to give bone continuous supply, not with dairy/antacids/tetracyclines, takes few months, IV iron fatal anaphylactic, IM iron causes skin discoloration (Z track) |
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B12 anemia classified as |
macrocytic normochromic anemia |
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B12 anemia impairs |
cellular division and maturation |
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B12 anemia labs show |
increase in MCV and MCHC |
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pernicious anemia is body's inability to |
absorb vit B12 due to lack of intrinsic factor |
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most common reason fro B12 anemia |
lack of intrinsic factor |
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3 other reasons for B12 anemia |
total gastrectomy or intestinal surgery, tape worm, intestinal disease (chrons) |
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how to determine if lack intrinsic factor |
antibodies test - antibodies to intrinsic factor means pernicious anemia |
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B12 anemia sns |
demyelination of neurons, prioception |
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demyelination of neurons causes |
paresthesias and decreased DTR |
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prioception is |
difficulty identifying one's position in space which may progress to difficulty with balance and spinal cord damage |
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B12 anemia MCV value |
greater than 100 |
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B12 for anemia given |
SC or IM |
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B12 for anemia given oral |
not effective because lack of intrinsic factor and cannot be absorbed |
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B12 injections |
q 2 days then q 3 days then q month and is life long |
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B12 anemia foods |
eggs, meats, dairy |
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Rx routes of B12 anemia |
oral, SL, nasal spray |
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oral B12 for |
milder deficiency |
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folic acid anemia classified as |
macrocytic anemia |
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macrocytic mcv and hgb values |
mcb high, hgb low |
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main cause of folic acid anemia |
poor nutrition |
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folic acid sns different from B12 by |
lack of neuro symptoms |
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folic acid diet |
one veggie or fruit juice q day, good foods inculde - veggies, organ meats, eggs, milk |
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folic acid admin |
oral |
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folic acid used preventatively in |
pregnancy |
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sickle cell anemia |
severe sometimes fatal hereditary disease caused by an abnormal type of hgb ( Hgb S) |
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hgb S is result of |
minor changes in the molecular structure |
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hgbS causes what |
profound changes in stability and solubility of RBC |
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inheriting one defective gene is called |
sickle cell trait |
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sickled red cells have a decreased |
survival time - causing anemia |
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hgbS causes RBc to |
elongate, become rigid, assume cresent sickled shape |
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hgbS causes cells to |
clump together, obstruct capillary blood flow causing ischemia and possible tissue infarction |
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with normal oxygenation |
the sickled RBCs resume their normal shape |
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repeated episodes of sickling and unsickling |
weaken the cell membrane causing them to hemolyze and be removed |
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sickle cell crisis triggers (8) |
hypoxia, low environmental and/or body temp, excessive exercise, high altitudes, inadequate O2 during anesthesia, infection, dehydration, acidosis |
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main trigger for sickle cell crisis |
hypoxia |
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problem with patients with sickle cell |
noncompliant with O2 use, would rather pain med |
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patho sickle cell crisis - what creats logjam effect |
vasospasm |
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logjam effect causes what |
blood flow through vessel to stop |
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patho of sickle cell crisis - stopped blood flow leads to |
thrombosis and infarction of local tissue |
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sickle cell leads to crisis state which is |
extremely painful, lasting 4-6 days |
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manage sickle cell crisis how |
pain control |
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sickle cell crisis sns (3) |
anemia, large joints and swollen surrounding tissue, pripism if penile veins obstructed |
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sickle cell crisis sns - anemia |
sickled cells on smear, pallor, jaundice, fatigue, irritability |
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pripism |
abnormal painful continuous erection of penis |
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thalassemia |
a hemolytic anemia characterized by microcytic hypochromic and short lived RBC |
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thalassemia caused by |
deficient synthesis of hgb polypeptide chains |
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thalassemia transmitted by |
autosomal recessive genes |
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two types of thalassemia |
major and minor |
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thalassemia major evident in |
infancy |
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4 thalassemia major sns |
anemia, fever, failure to thrive, splenomegaly |
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thalassemia major require frequent cause why |
frequent transfusions because RBCs are rapidly destroyed |
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thalassemia major leaves what where from rapid RBC destruction |
leaves large amounts of iron deposited in skin becoming bronze and freckled |
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cure for thalassemia major |
none |
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tx for thalassemia major |
treat symptoms |
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thalassemia minor |
mild anemia and minimal red blood cell changes |
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thalassemia minor lacks what |
clinical symptoms although pt show hematological evidence of the disease |
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acquired hemolytic anemia characterized by |
chronic premature destruction of red blood cells |
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acquired hemolytic anemia associated with |
blood transfusion reactions |
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hemolytic reaction (7) |
flushed, HA, urticaria, lumbar pain, chills or fever, dyspnea, hypotension |