Hemo 4

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Disseminated intravascular coagulation
- Clotting and hemorrhage occur simultaneously bc All clotting factors used up
- Common after:
- ----Shock
- ----Sepsis
- ----Leukemia
- ----Massive trauma
- Less obvious signs
- ----Petechiae
- ----Cold, mottled digits
Intrinsic vs extrinsic DIC
- intrinsic
- ----endothelium
- extrinsic
- ----damage to the tissue around it
Management of DIC
- Dx by clinical presentation and lab work
- Treatment based on underlying cause
- Morbidity and mortality
- ----Independent predictor in pt with sepsis of severe trauma
- You don’t work with is pt until stabilized
Sickle Cell Disease
- Generic term for a group of inherited autosomal recessive disorders
- ---Needs to come from both parents
- Abnormal hemoglobin in the erythrocyte
Pathophysiologic features of sickle cell disease
- Chronic hemolytic anemia
- ----Becomes sickle opposed to biconcave after o2 leaves
- ----Only lasts 10-20 days now opposed to 120 days (destroyed before needs met)
- Vasoocclusion
- ----Can stick to other cells and become a clot preventing good cells from getting through
Risk Factors SCD
- SCD is characterized by “crises”
- ----Early destruction of the abnormal cells and obstruction of blood flow to the tissues
SCD Episodes precipitated by:
- Infection
- Dehydration
- Fatigue
- Acidosis
- Physical exertion
- High altitude
Clinical Signs and Symptoms SCD
- Sickled erythrocytes
- ----Hemolytic anemia
- ----Occlude microvasculature
- Crises or episodes
- ----Vasoocculsive or thrombotic
- ----Aplastic
- --------Bone marrow stops producing blood cells for a certain period of time
- ----Sequestration
- ----Hyperhemolytic
- ----Ultra destruction of RBC
- Pain
- ---Thrombosis
- Tissue damage
SCD Complications
- Neurologic: stroke
- Hand-foot syndrome: swollen
- End stage renal disease
- Bacterial infections
- Iron overload
- Chronic leg ulcers
- Retinopathy
SCD Management
- Universal screening every newborn
- Bone marrow transplant
- ----Tough to find match donors; High risks
- Supportive care
- ----Exercise btwn crises, ROM
- ----Stay hydrated
- ----Pain will limit exercise
SCD Prognosis
- No cure
- Treat the signs and symptoms
- Hydroxyuria (cancer med) decrease number of sickling cycles prolonging longevity
Sickle Cell Trait
- Heterozygous condition (from one partent)
- Rarely symptomatic
- Sudden death associated with exercise
Thalassemias
- Group of inherited chronic hemolytic anemia's
- ----Destroy RBC
- 1. Fragile erythrocytes – target cells (Destroyed more easily)
- 2. Alpha or Beta
- ----Depending on which chain on Hb is missing
- 3. Minor
- ----Mild to no symptoms/treatment
- 4. Major: Cooley’s anemia
- ----Large number of fragile RBC leading to lots of symptoms
- ----Need blood transfusions every few weeks
- ---Blood monitored
- ----May need elation (Remove Fe)

Author

jld15

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Card Set

Hemo 4

Description

Hemo 4

Updated

2015-06-14T18:07:02Z

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