Study Guide for Final Exam
Chapter 42 Care of Patients with Hematologic Problems
1. Identify the etiologies and clinical manifestations common to all types of anemia. (See Table 42-1 p 870 and Chart 42-1 p 871) Common Cause Sickle cell disease: autosomal recessive inheritance of two defective gene alleles for hemoglobin synthesis Glucose-6-phosphate dehydrogenase (G6PD) deficiency anemia: X-linked recessive deficiency of enzyme G6PD Autoimmune hemolytic anemia: abnormal immune function in which a person’s immune reactive cells fail to recognize his or her own red blood cells as self cells Iron deficiency anemia: Inadequate iron intake caused by: iron deficient diet, chronic alcoholism, malabsorption syndromes and partial gastrecromy. Rapid metabolic (anabolic) activity caused by: pregnancy, adolescence and infection Vitamine B12 deficiency anemia: dietary deficiency, failure to absorb vitamin b12 from intestinal tract as a result of: partial gastrectomy, pernicious anemia, malabsorption syndromes Folic acide deficiency anemia: dietary deficiency, malabsorption sndromes Drugs: oral contraceptives, anticonvulsants, methotrexate Aplastic anemia: exposure to myelotoxic agents: radiation, benzene, chloramphenicol, alkylating agents, antimetabolites, sulfonamides and insecticides. Viral infection (unproven): Epstein-Barr virus, hepatitis B and cytomegalovirus. Manifestations: Integumentary manifestation: -pallor, especially of the ears, the nail beds, the palmar creases, the conjunctivae, and around the Mouth - Cool to the touch - Intolerance of cold temperatures - Nails become brittle and may lose the normal convex shape; over time, mails become concave and figures assume clublike appearance. Cardivascular manifestations: - Tachycardia at basal activity levels, increasing with activity and during and immediately after meals - Murmurs and gallops heard on auscultation when