Anemia - Pathophysiology I - Lecture 2 (1)

Acute chest syndrome acs leading cause of death

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Acute chest syndrome (ACS) – Leading cause of death Pulmonary infiltrates (Unclear response to antibiotic therapy) Shortness of breath Cough Fever Chest pain Pulmonary infarction → lung damage → pulmonary arterial hypertension (PAH)
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SICKLE CELL ANEMIA Complications Splenic injury Neurologic abnormalities Cerebral vascular occlusion (i.e. stroke) → paralysis Retina damage → blindness Infections Encapsulated organisms Streptococcus pneumoniae Haemophilus influenzae type b Klebsiella
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SICKLE CELL ANEMIA – Laboratory Findings Blood work Decreased Hgb, Hct Normal MCV MCH MCHC Increased Liver function tests -bilirubin (Hyperbilirubinemia) Peripheral blood smear Normocytic Normochromic Sickled cells
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TREATMENT GOALS – SICKLE CELL ANEMIA Goals of therapy Prevention of complications Avoid areas with high altitudes or low oxygen Adequate fluid intake Yearly eye exam Vaccinations Pneumococcal Influenza Meningococcal
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CLINICAL SCENARIO #2 MM is a 21 yo AAM who presents to the ED complaining of severe left hip pain. MM describes sudden acute chest pain, shortness of breath and unproductive cough for the last 2 hours and denies trauma. PMH : Sickle cell anemia Current meds : none Medication allergies : none Immunizations : Up to date
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CLINICAL SCENARIO #2 FH : Father - sickle cell disease, mother - sickle cell trait SH : Non-significant Vitals : BP 105/70 mmHg, HR 120 bpm, RR 22 bpm, Temp 98.9ºF, Ht 6’2”, wt 165 lbs ROS : pt crying, in pain, unable to stand up Labs : Hgb 9.1, Hct 27%, Normal MCV and MCHC
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CLINICAL SCENARIO #2 What is the likely cause of MM’s abnormal laboratory findings? What signs and symptoms is MM presenting with? If a peripheral smear was performed, what would be the likely morphology of BD’s RBCs?
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Anemia – Part II Pathophysiology I Ginah Nightingale, Pharm.D., BCOP Assistant Professor Jefferson School of Pharmacy October 12, 2012
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