Signs and Symptoms of Hematologic Disorders

General Signs and Symptoms

• Edema: Swelling due to excess fluid.

• Congestion: Excessive blood in vessels.

• Infarction: Localized necrosis from reduced arterial perfusion.

• Thrombosis: Formation of a blood clot within a vessel.

• Embolism: Obstruction of a blood vessel by an embolus.

• Lymphedema: Swelling due to lymphatic system blockage.

• Bleeding and Bruising: Increased tendency due to platelet disorders.

• Hypotension: Low blood pressure.

Shock

• Symptoms:

  • Rapid, weak pulse

  • SBP < 90 mmHg

  • Cool, moist skin

  • Pallor

  • Weak/absent peripheral pulses

Purpura

• Cause: Lack of normal platelets leading to easy bruising.

Physical Therapy (PT) Implications

• Monitor patient’s vitals closely.

• Avoid cuts and bruising in platelet disorders.

• Keep exercise at low intensity.

• Teach proper breathing techniques; avoid activities increasing intracranial, intrathoracic, or intraabdominal pressure.

Aging and the Hematopoietic System

Changes with Aging

• Decreased production of RBCs and lymphocytes.

• Increased myeloid cells.

• Hematopoietic stem cells (HSC) lose self-renewal and differentiation ability.

• Bone marrow contains mesenchymal-derived stem cells (MSCs) for structural support.

• Increased pro-inflammatory cytokines from platelets leading to chronic inflammation.

Peripheral Blood Changes

• Decreased hemoglobin and hematocrit, but within normal ranges.

• Iron deficiencies linked to rheumatologic conditions.

• Anemia associated with vitamin B12 deficiency.

Blood Transfusions

Types of Reactions

• Febrile, Nonhemolytic Reaction:

  • Symptoms: Temp increase during or within 4 hours.

  • Treatment: Stop transfusion, check blood, administer antipyretics.

• Transfusion-Associated Circulatory Overload (TACO):

  • Symptoms: SOB, elevated central venous pressure, pulmonary edema.

  • Treatment: Diuretics, respiratory support.

• **Transfusion-Related Acute Lung Injury (TR