HEMATOLOGY PROBLEMS.docx - JORGE LOPEZ HEMATOLOGIC PROBLEMS...

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JORGE LOPEZ HEMATOLOGIC PROBLEMS ANEMIA Deficiency in the number of erythrocytes (RBC), the quantity or quality of hemoglobin and volume of hematocrit. Can be caused by three things Decreased RBC production Blood loss Increased RBC destruction Because they transport O2 if there is a disorder it can lead to HYPOXIA. This is what causes many of the signs and symptoms of ANEMIA Classified by reviewing CBC, reticulocyte counts, peripheral blood smears. Can be caused by PRIMARY hema problems or secondary from a disease They can also be classified by MORPHOLOGY or ETIOLOGY Morphologic  based on RBC color and size Etiologic  based on conditions causing ANEMIA. SIGNS AND SYMPTOMS Caused by the body’s response to tissue hypoxia Hemoglobin levels are the ones used to determine the severity of anemia o Mild state (10-12) can be w/o causing any symptoms if they develop it is because of something else like compensation for heavy exercise palpitations, dyspnea, mild fatigue o moderate state (6-10g/DL) cardio symptoms are increased and can have them while AT REST o severe anemia <6g/DL a number of symptoms occur INTEGUMENTARY CHANGES Pallor from reduced amount of hemoglobin and blood flow to skin
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JORGE LOPEZ Jaundice hemolysis of RBCs results in an increased concentration of BILIRUBIN Pruritis increased serum and skin bile salt CARDIOPULMONARY This happens because of the heart and lungs to provide enough amounts of o2 to the tissues Output is maintained by increasing heart rate and stroke volume Low viscosity leads to systolic murmurs and bruits so MI can happen if the heart is not getting enough oxygen. o Heart failure, cardiomegaly o Pulmonary and systemic congestion o Ascites o Peripheral edema can develop when the heart is overworked ASSESSEMENT GERONTOLOGIC CONSIDERATIONS IN ANEMIA older men have a decline in 70-88 because they have < testosterone But only a minimal decrease in seen in hemoglobin 1/3 have a diet anemia o Iron, folate, cobalamin 1/3 have renal insufficiency or inflammation
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JORGE LOPEZ Cobalamin B12 and folate deficiency can happen in 14% older because of pernicious, bad diet and malabsorption from low acidity. Symptoms in older adults o Pallor o Confusion o Ataxia, fatigue, worsening angina o Heart failure ANEMIA CAUSED BY DECREASED ERYTHROCYTE PRODUCTION Normally RBC production is in balance with RBC destruction and loss. Normal lifespan of one is 120 days 3 alterations can occur that decrease this o Decreased hemoglobin synthesis can lead to iron deficiency, anemia, thalassemia and sideroblastic anemia o Defective DNA synthesis in RBCs b12, folic deficiency can lead to megaloblastic anemias o Low availability of RBC precursors can lead to aplastic and chronic IRON DEFICIENCY ANEMIA 2-5% of men and POST MENOPAUSAL women Those at risk are very young Reproductive years Poor diets
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  • Spring '17
  • Acevedo
  • Folic acid, Platelet, Megaloblastic Anemia, Jorge Lopez

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