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Erythrocyte sedimentation rate (ESR) - Male/female
-
Erythrocyte sedimentation rate (ESR) - rate INC w/what? - 2
- Infection
- Inflammation (RA) or pelvic
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What is target INR for pts w/genetic clotting disorders?
3.5
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INC in bleeding time w/what? - 2
- Platelet disorders
- Thrombocytopenia
-
S/S of hematological disorders - 2
- Easy bruising w/spontaneous petechiae
- External hematoma
-
S/S of anemia - 5
- Fatigue/weakness w/minimal exertion
- Dyspnea on exertion
- Pallor or yellow skin of face/hands/nails/lips
- Tachycardia
- Bleeding of gums, mucous membranes or skin in absence of trauma
-
Anemia - PT - 3
- Pts exhibit DEC exercise tolerance
- Exercise should be instituted gradually w/Physician approval
- RPE should be used
-
RBC normal - female/male
- Female - 4.2-5.9
- Male - 4.6-6.2
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Sickle Cell Disorders - Define
Group of inherited RBC disorders
-
Sickle cell crisis - define + S/S - 8
- Acute episodic condition occurring in children w/sickle cell anemia
- Pain - Acute & severe from clots in any organ, bone or joint
- Acute abdominal pain
- Painful swelling of soft tissue of hands & feet (hand-foot syndrome)
- Persistant HA
- Dizziness
- Convulsions
- Nystagmus
- Acute chest syndrome - chest pain, coughing, dyspnea, tachypnea
-
Sickle cell anemia - PT during sickle event - 3
- Pain control
- Application of warmth is soothing
- Relaxation techniques
-
Sickle cell anemia - PT + Contraindication - 3
- Low-mod exercise
- Ensure adequate fluid intake
- Exercise intolerance - exaggerated HR; limited peak performance
- Contraindication - Cold - INC vasoconstriction & sickling
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Hemophilia
Hereditary bleeding disorders
-
Hemophilia - bleeding - 4
- Spontaneous or d/t trauma
- Can result in internal hemorrhage or hematuria
- Hemarthrothis (bleeding into joint spaces)
- Hemorrhage into mms
-
Hemophilia - hemarthrosis - most common areas - 4
-
Acute S/S of hemarthrosis - 4
- Swelling
- Warmth
- Pain
- DEC ROM
-
Hemophilia - hemorrhage - what mms are most affected? - 3
- Forearm flexors
- Gastroc/soleus
- Iliopsoas
-
Hemophilia - what meds for pain management are allowed? what meds aren’t?
- Allowed - Acetaminophen (Tylenol)
- Not allowed - aspirin
-
Hemophilia - gait - 2
- Equines gait
- Lack of knee extensor torque
-
Hemophilia - early PT - subacute stage after hemostasis (stopping of flow of blood) - 4
- Isometrics
- Aquatic therapy
- Pain management - TENS, massage, biofeedback, ice
- AAROM —> AROM
-
Hemophilia - later PT - subacute stage - strengthen what mms? - 4
- Hip, knee, elbow extensors
- Ankle PF
-
Hemophilia - PT - NEVER do what? - 2
- PROM
- Passive stretching - d/t risk of myositis ossificans
- Closed chain exercises
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