Path - Chapter 10: Blood Disorders

Process of blood cell development

hematopoiesis stem cells differentiate to RBC, WBCS, and platelets based on need

Erythropoietin

Made in the kidneys stimulates production of RBCs in response to oxygen deficiency

Hemoglobin

An iron-containing protein on red blood cells that transport oxygen

Thrombus

blood clot

Embolus

moving blood clot

Anticoagulants

prevent blood clot formation

Type A blood

A antigens, B antibodies

Type B blood

B antigens, A antibodies

AB blood

A and B antigens, no antibodies

O blood

no antigens, A and B antibodies

A blood can receive

A, O

B blood can receive

B and O

AB blood can receive

A, B, AB, O (universal recipient)

O blood can receive

only O (universal donor)

Incompatable transfusion reactions

Flank pain, fever, headache, chest pain, abdominal pain, low bp, increase hr

complete blood count (CBC)

Screens for WBCs (immunity), RBCs, platelets (clotting)

Leukocytosis

Increased WBC. Associated with infection and inflammation

Leukopenia

Decreased WBC. Associated with chemotherapy, viral infections

Increased eosinophils

Common in allergic responses

Thrombocytosis

increased platelet count

Thrombocytopenia

low platelet count

Prothrombin Time (PT) or International Normalized Ratio (INR)

Measure intrinsic pathways, and the ability of blood to clot, ƒ vitamin K is needed

Partial Thromboplastin Time (PTT)

Measure externsic pathways, and the ability for blood to clot

Anemia

Hemoglobin deficit causing a reduction in oxygen transport

iron deficiency anemia

anemia caused by inadequate iron intake. This impedes synthesis of hemoglobin and decreased oxygen distribution. Most common

iron deficiency anemia presentation

Pallor, fatigue, irritability, degeneration of hair and nails, tachycardia, dyspenia (shortness of breath), and delayed healing

iron deficiency anemia treatment

iron supplements and dietary changes

Pernicious anemia

- Caused by decreased production of intrinsic factor by the parietal cells in the stomach. Intrinic factor is needed to absorb B12.

- common in vegans

Pernicious anemia presentation

Enlarged or sore tongue, GI distress, tingling or burning in netves

Pernicious anemia treatment

Vitamin B12 injections (cannot be given oral)

Aplastic anemia

Failure of bone marrow causing loss of stem cells, decreased RBC, WBC, and platelets

Aplastic anemia presentation

- low RBC: Pallor, dyspenia (shortness of breath), tachycardia

- low WBC: Recurrent or multiple infections

- low platelets: petechiae

Aplastic anemia treatment

bone marrow transplant

Aplastic anemia complications

- decreased cellular and tissue perfusion

- hemorrhage

- severe infection

- fatal

Sickle cell anemia

Inherited characteristics lead to formation of abnormal hemoglobin causing RBC to sickle due to deoxygenation

Sickle cell anemia presentation

extreme pain

Sickle cell anemia complications

tissue death, obstruction, Destruction of organs,

Warning signs of excessive bleeding

-persistent bleeding from gums,

-repeated nosebleeds (epitaxis)

-petechiae (pinpoint flat red spots)

-purpura and eccymoses (bruises)

-more persistent bleeding than warranted by trauma

-hemarthroses (bleeding into joint)

-coughing up blood (hemoptysis)

-vomiting blood (hematemesis)

-blood in feces

-anemia

-feeling faint and anxious, low BP, rapid pulse

Hemophilia A (excessive bleeding)

factor VIII deficiency (most common), x-linked

Hemophilia B (excessive bleeding)

Factor IX deficiency "Christmas disease"

Von Willebrand Disease (excessive bleeding)

bleeding disorder caused by a deficiency of von Willebrand factor

Disseminated Intravascular Coagulation (DIC)

Excessive clotting and excessive blood loss

treat underlying cause

Often life threatening

leukemia

A group of neoplastic disorders (cancer) involving an increase in WBCs

Leukemia Pathophysiology

Undifferentiated, Immature, nonfunctional Leukocytes present and multiply uncontrollably in the bone marrow. Large amounts are released into the general circulation

These cells then infiltrate the lymph nodes, spleen, liver, brain, and other organs, causing lymphadenopathy.

Leukemia presentation

Signs of anemia, bone pain, enlarged organs, headache

Leukemia complications

Infection, bleeding, anemia, cardiotoxicity, delayed growth and development

Atherosclerosis

hardening of the arteries due to overabundance of lipids in the blood forming plaque

Atherosclerosis prevention

-minimize risk factor

-low dose aspirin

-statins(eg simvastatin and lovastatin): lower LDLs and anti-inflammatory, stabilizes plaque

Atherosclerosis complications

Obstructions

What complication would you assess for in a client with an elevated PT/INR or PT

excessive bleeding (low clotting)

non-Hodgkins lymphoma

a malignant neoplasm that starts in the lymphocytes distinguished by multiple node involvement

Hodgkin's lymphoma

distinguished from other lymphomas by the presence of Reed-Sternberg cells

lymphedema

lymphatic obstruction

lymphedema symptoms

persistent tissue swelling in extremities

lymphadenopathy

Inflammation or infection of lymph nodes due to another disease

lymphadenopathy symptoms

swollen lymph nodes

plasma

clear yellowish fluid that remains after cells have been removed. it is indicated for treatment of patients with elevated pt/INR, and abdominal clotting

varicose veins

abnormally swollen, twisted veins from defective valves of weakness in vein walls

vasodilation

decrease ph, increase CO2, decrease O2, releases histamine, and increase temp

vasoconstriction

increase ph, decrease CO2, increase O2, decrease temp

hemolysis

destruction of RBC resulting in elevated levels of bilirubin

does Hodgkins or non Hodgkins lymphoma have a better prognosis

Hodgkins

Non-Hodgkin's and Hodgkin Lymphoma symptoms

- begins painless

- swollen lymph nodes (unilateral, firm)

lymphomas (non Hodgekins and Hodgekins) treatment

radiation, chemotherapy, surgery

acute leukemia

rapid onset

chronic leukemia

slower progression

in middle-aged and older individuals

how to differentiate between concerning lymph nodes and non concerning lymph nodes

non concerning: bilateral, pain, moveable (infection)

concerning: unilateral, painless, firm, stays in one place (cancer)