patho exam 1

petechiae

small, pinpoint red or purple spots, less than 3mm and dont fade when pressed

petechiae are caused by

tiny blood vessels brekaing under skin

purpura

large red or purple spots, several mm, may appear in clusters and look like bruises

purpura are caused by

blood vessel rupture

hypochromic cells

rbc that have a pale color due to lower amount of hemoglobin

hypochromic cells can be a sign of

anemia

microcytic cells

red blood cells that are smaller than normal

microcytic cells indicate

problem with hemoglobin production

oncotic pressure

pressure exerted by proteins that pulls water into bloodstream

oncotic pressure is also called

colloid osmotic pressure

oncotic pressure is dependent on the protein

albumin

the pressure at the arterial end of capillaries is

vascular pressure that is higher than oncotic pressure xausing fluid to move out of blood

the pressure at the venous end of capillaries is

decreased hydrostatic pressure to pull fluid back to blood

when pressures are off balance this can lead to

edema

anemia can lead to

microcytic hypochromic cells

microcytic hypochromic cells

small, pale rbc due to insufficient hemoglobin caused by low iron

iron is required for

hemoglobin synthesis

the most common anemia is

iron deficiency anemia

causes of iron deficiency anemia

dietary, blood loss, impaired absorption

telling symptom of iron deficicency anemia

spoon shaped nails

general symptoms of anemias

pallor, dry skin and membranes, SOB

chronic signs of iron deficiency anemia

spoon shaped nails, pica, malnurished

labs for iron deficiency anemia

hemoglobin, hematocrit, minerals (iron)

hemoglobin

protein within rbc that carries oxygen

hematocrit

measures rbcs in blood

those with iron deficiency anemia wants to include more

meats and leafy greens in their diet

pernicious anemia is due to

vitamin b12 deficit

cause of pernicious anemia

malabsorption, chronic gastritis, vegetarian diet

telling sign of pernicious anemia

pin and needles, tingling limbs

labs for pernicious anemia

B12, hemoglobin, hematocrit

intrinsic factor

protein produced in the stomach that allows B12 intestinal absorption

aplastic anemia

bone marrow fails to produce sufficient blood cells

a cause of aplastic anemia can be

pancytopenia

pancytopenia

small cells leading to low bone marrow function leading to low blood cells- anemia

symptoms of aplastic anemia

low blood cells, bleeding, infection, pancytopenia

autoimmune cause of aplastic anemia

75%- HIV, eptein barr, hepatitis

environmental cause of aplastic anemia

15%- chemicals, radiation

megaloblastic anemia

charcterized by large blood cells

causes of megaloblastic anemia

B12 deficiency, folic deficiency

symptoms of megaloblastic anemia

general anemia symptooms

sickle cell anemia

rbcs change shape and cannot carry oxygen- clog up

sickle cell pathophysiology

genetic both parents, african and medditerranean, male manifested

triggers of a sickle cell crisis

hypoxemia, dehydration, stress, high altittude, surgery

hypoxemia

low oxygen in blood

acute symptoms of sickle cell

pain from clots

chronic symptoms of sickle cell

delayed growth, priapism- sustained erection

managment of sickle cell

PAIN MANAGEMENT, hydration, immunizations, constricting clothing, oxygen

acute leukemia

bone marrow cancer

sumptoms of acute leukemia

bone pain, enlarged lymphnoids, anemia, purpura, wounds, weight loss

labs for acute leukemia

peripheral blood smear, bone marrow biopsy, cbc- wbc

acute lymphoblastic leukemia ALL is common in

children

acute myeloid leukemia AML is common in

adults

pathophysiology of acute leukemia

high immature wbc, low rbc and platelets

chronic leukemia is linked to

radiation and genetics

chronic leukemia has a slow progression which leads to

late discovery

with leukemia monitor for

infection and bleeding

with leukemia wash hands and use

electric razor to avoid bleeding

thrombocytopenia

low platelets in blood

casues of thrombocytopenia

chemotherapy, autoimmune, heparin, infection

symptoms of thrombocytopenia

petechiae, purpura, general bleeding

polycythemia vera

overproduction of rbc, blood gets thick- thrombus forms

thrombus

clot in blood vessel

primary cause of polycythemia vera

genetics

secondary cause of polycythemia vera

tumor

disseminated intravascular coagulation DIC

blood clotting is activated systemically, leading to excessive clotting and bleeding, MEDICAL EMERGENCY

leukopenia

low wbcs

leukopenia wbc count

less than <4,000

heparin is an

anticoagulant, prevent and treats clots

herparin is fast acting and administered

IV/SQ

heparin is monitored by

PTT

partial thromboplastin time PTT

measures how long it takes for blood to clot

heparin antidote

protamine sulfate

wafarin is an

anticoagulant

warfarin is oral and has

delayed onset

IV heparin is given as bridge until

warfarin is effective

warfarin is monitored by

PT and INR

prothrombin time PT

measures how quickly blood is clotting

international normalized ratio INR

measures how long for blood to clot

warfarin antidote

phytonadione- vitamin K

avoid while taking warfarin

alcohol, excess vitamin K

enoxaparin is an

anticoagulant- low molecular weight heparin

there is no routine coagulation monitoring for

enoxaparin

administer enoxaparin SQ with

air bubble

black box enoxaparin

spinal hematoma

thrombolytics

breakdown existing clots

alteplase is a

thrombolytic

alteplase is used for

stroke, pulmonary embolis, MI, occlusion of shunts and catheters

what does alteplase do

digests fibrin- stops all clotting and reestablishes blood flow

major risk with alteplase

internal bleeding

antithrombolytics

prevent clot formation

after administering antithrombolytics monitor for

unusual/excessive bleeding

clotting drugs are

systemic drugs, must educate and monitor bleeding

antifibrinolytics

prevent and treat excessive bleeding, promote clot formation

desmopressin is an

antifibrinolytic

hematopoiesis

production of blood cells

hematopoiesis fetal site

spleen/liver

hematopoiesis adult site

bone marrow

erythropoiesis

production of rbc

erythropoiesis is triggered by

hypoxia

hypoxia

low oxygen levels in tissues