MRIS 210 Chapter 17

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MRIS 210 Chapter 17
2012-06-18 18:41:45

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  1. Blood
    Blood provides the major transport system of the body for essentials such as oxygen, glucose and other nutrients, hormones, electrolytes, and cell wastes. 
  2. Hemostasis
    Blood maintain a stable pH of 7.35 to 7.45
  3. Hematocrit
    volume of red cell mass in 100 ml of plasma
  4. Plasma
    Is a clear yellowish fluid remaining after the cells have been removed
  5. Hematopoiesis
    The differentiation process forms committed stem cells for each type of blood cell.  These cells then proliferate and mature, providing the specialized functional cells needed by the body
  6. Erythrocytes
    Red blood cells (donut like centers but with thin centers rather than holes) 
  7. Hypoxia
    Insufficient oxygen
  8. Hemolysis
    destruction of RBC
  9. Leukopoiesis
    production of white blood cells
  10. Lymphocytes
    Make up 30% to 40% of WBCs 
  11. CBC
    Complete blood count
  12. HGB
    Hemoglobin content of blood
  13. WBC w/ Differential
    indicates the proportions of specific types of WBCs in the blood and frequently assists in the making a diagnosis
  14. Neutrophils
    Are the most common leukocyte, comprising 50% to 60% of WBCs, they only service only 4 days, they are the first to respond to tissue damage
  15. MCV
    Mean corpuscular volume= Size of RBC
  16. Basophils
    appear to migrate from the blood and enter tissue to become mast cells that can release histamine and heparin. 
  17. Eosinophils
    Tend to combat the effects of histamine. They are increased by allergic reactions and parasitic infections
  18. Monocytes
    Can enter the tissue to become macrophages which act as phagocytes when tissue damage occurs
  19. Thrombocytes
    Also called platelets, are an essential part of the blood-clotting process or hemostasis. Thrombocytes are not cells!
  20. Thrombocytopenia
    Refers to a decreased number of circulating platelets
  21. Thrombocytopenia
    Associated w/
    • ›Decreased bone marrow production
    • ›Increased pooling in the spleen
    • ›Decreased of blood vessel integrity result from structurally weak vessels or vessel damage due to inflammation and immune mechanisms.
  22. Manifestations of Thrombocytopenia
    • ›Rapid drop in platelet count several days after resuming drug
    • ›Hemorrhagic diathesis
    • ›Splenomegaly
  23. Treatment of Thrombocytopenia
    • ›Discontinue Drug
    • Splenectomy
  24. Idiopathic Thrombocytopenic Purpura
    an auto immune disorder, results in platelet antibody formation and excess destruction of platelets.
  25. Manifestations of Idiopathic Thrombocytopenic
    • ›Sudden onset of petechiae and purpura- acute condition
    • ›Bruising, bleeding from gums, epistaxis and abnormal menses
    • ›Splenomegaly
  26. Diagnosis Thrombocytopenia
    Platelet counts < 20,000/ml
  27. Treatment of Thrombocytopenia
    corticosteroid drugs, Splenectomy and immunosuppressive agents 
  28. Coagulation Defects
    • deficiencies of one or more of the known clotting factors
    • ›Defective synthesis
    • Inherited disease
    • ›Increased consumption of the clotting factors
  29. Blood Clotting Manifestations
    • ›Bleeding typically occurs after injury or trauma
    • ›Large bruises, hematomas, or prolonged bleeding into GI or urinary tract or joints
  30. Agglutination
    (clumping) antigen-antibody reaction would occur with, for example, an incompatible blood transfusion
  31. Primary coagulation defects
    • ›Hemophilias
    • ›Types:
    • ›Hemophilia A
    • ›Hemophilia B
    • Hemophilia C
  32. Blood Clotting
    • ›Diagnosis-
    • ›CBC, Clotting tests
    • ›PTT (partial thromboplastin time) measures the presence of plasma factors that act in a portion of the coagulation pathway
    • PT (prothrombin time) Test the ability of blood to clot (used to monitor patients take coumadin)
  33. Blood Therapies
    • Whole blood, packed red blood cells, or packed platelets 
    • ›Bone Marrow or stem cell transplants are used to treat some cancers severe immune deficiency or severe blood cell diseases
  34. Anemia
    not a disease but an indication of a disease process or alteration in body function. (Blood dyscrasia- disease)
  35. Categories of Anemias
    • ›1. Impaired oxygen transport
    • ›2. Changes in red cell structure
    • ›3. Signs and Symptoms of pathological process causing anemia
  36. Anemia S&S
    • ›1. pallor
    • ›2. Angina
    • ›3. Fatigue
    • ›4. dyspena
    • ›5. Tachycardia
    • ›6. Jaundice
    • ›7. Purpura, petechiae
  37. Sickle Cell Anemia
    • genetic defect in the hemoglobin causes shape of the cell to change
    • ›Cells cause obstruction in the vascular structures (spleen, bone) and causes small infarcts, cells rupture
    • ›Dx: CBC, blood smear, genetic studies
    • ›Trx: blood transfusions, palliative, pain meds, bone marrow transplant, counseling
  38. Thalassemia (Cooley’s Anemia)
    • ›absence of defective synthesis of hemoglobins, hereditary (found in the Mediterranean population)
    • ›S&S: splenomegaly, hepatomegaly
    • ›Dx: CBC, blood smear
    • ›Trx: Blood replacement
  39. Iron Deficiancy Anemia
    • Associated with inadequate dietary iron, chronic blood loss
    • ›More common in women
    • Leads to decreased hemoglobin synthesis, RBCs
    • ›S&S:
    • ›Fatigue
    • dysphagia
    • Brittle hair and nails
    • Angina
    • SOB
    • pallor
  40. Iron Deficiency Anemias
    • ›Cause: blood loss, decreased dietary intake of iron
    • ›Dx: CBC, blood smear
    • ›Trx: ferrous sulfate, Imferon
  41. Vitamin B-12 Deficiency Anemia (pernicious)
    • ›Lack of mature erythrocytes
    • ›Caused: lack of intestinal absorption of B-12.  B-12 cannot be absorbed into the bloodstream without the aid of a special substance intrinsic factor that normally found in gastric juice
    • ›Dx: CBC, blood smear, serum B12
    • ›Trx: Vitamin B-12 injections, treat underlying intestinal disorder if present
  42. Folic Acid Deficiency Anemia
    • Caused by malnutrition, found in alcoholics and debilitated patients
    • ›Dx: CBC
    • ›Trx: Folic Acid 1-5mg/day
  43. Aplastic Anemia
    • Failure of blood cell production due to aplasia (absence of development, formation) of bone marrow cells
    • ›Cause- unknown in 66% of cases, drugs, radiation, chemicals
    • ›Dx: CBC, blood smear, bone marrow aspiration
    • Trx: Blood Transfusions, bone marrow transplant
  44. Polycythemia Vera
    • ›An increase in RBCs from over production in the bone marrow
    • ›Dx: CBC, bone marrow, aspiration
    • ›S&S: headache, hypertension, weight loss,
    • Trx: phlebotomy, chemotherapy
  45. Thrombocytopenia
    • a decrease in platelets (thrombocytes) drug induced or idiopathic (unknown)
    • ›S&S- bruising, bleeding, splenomegaly
    • ›Dx: platelet count is below 10,000
    • Trx: Splenectomy, remove drug, replace the platelets
  46. Myelodysplastic Syndrome
    • ›MDS- involve inadequate production of cells by the bone marrow
    • ›Cause: idiopathic or following chemotherapy or radiation treatment 
    • ›Dx: Blood test, Bone Marrow Biopsy
    • ›Trx: transfusion replacements, bone marrow transplants
    • It can progress into chronic or acute leukemia
  47. Leukemia
    • ›A malignant neoplasm of hematopoietic stem cells causes
    • replacement of bone marrow with immature neoplastic cells in large numbers
  48. Myelocytic
    • ›Acute myelocytic leukemia (AML) ages 13-39
    • ›Chronic myelocytic leukemia (CML) ages 30-50
    • ›Dx: Blood smear and bone marrow aspiration(bx)
    • Trx: Chemotherapy and supportive trx, bone marrow transplant
  49. ›Lymphocytic
    • ›Acute lymphocytic leukemia (ALL) kids ages 2-4
    • Chronic lymphocytic leukemia (AML) adults over the age of 50
  50. ›Sample Chemo Protocol for ALL
    • ›Cytoxan›
    • Prednisone
    • ›Vincristine
    • Asparaginase
  51. Lymphoma
    Malignant neoplasm of cells native to lymphoid tissue, lymphocytes and histiocytes
  52. Hodgkin's
    • ›S&S: painless, progressive enlargement of a single lymph node or group of nodes usually above the diaphram (cervical or supraclavicular) fever, night sweats, fatigue, wt. loss
    • ›Dx: biopsy of lymph nodes with Reed-Sternberg cell (giant tumor cell), CT of abdomen, lymphangiography
    • ›Trx: radiation & chemotherapy
  53. ›Non-Hodgkin’s Lymphoma
    • ›Same as Hodgkin’s but does not have Reed-Sternberg cell
    • ›Trx and dx are the same as Hodgkin’s
  54. Multiple Myeloma
    • ›Malignant neoplasm of bone marrow
    • ›Plasma cell cancer that generally affects older people
    • ›S&S: pathologic fracture, bone pain in back, hypercalcemia from bone dissolution
    • ›Dx: Bence-Jones proteins in urine
    • Trx: palliative, chemotherapy, there is No cure