BlLymDis2

• injury
• vasoconstriction
• platelets
• prothrombin to thrombin
• fibrinogen to fibrin
• fibrinolysis

• -baso, eosin, neutr
• supp of bone marrow/chemo, radiation, bact, -
• -antibiotics,
• -viral inf, genetics (possibility)
• -WBC/neutrophils
• -deadly infection
• - inflammatory stuff, ulcers in mucous membranes, later- pneumonia, UTI

• find/x cause of marrow suppression
• treat/prevent infections
• xfusion of PRBC
• figrastim (Neupogen) SC
• handwashing

• lots of WBCs, no infection,
• immature,
• anemia
• splenomegaly, lymphadenopathy, mepatomegaly, bone pain, meningeal irritation, oral lesions, bleeding, petechiae

• 5 year remission- only 25%
• can survive longer

• 4.500-10,500 cells/mm3
• epinephrine, aspirin, allopurinol, steroids, heparin
• bacterial infections, bone marrow dep, pernicious anemia
• antibiotics, anithyroid, antiepiletic, ntihistamines, chemo, diuretics

• erythropoietin rel by kidneys
• epo

• 150-400 X10^3
• aspirin, heparin

(thrombocythemia, thrombocytosis) renal failure, malignancies, chronic pancreatitis

(thrombocytopenia) include disseminated intravascular goag, hemolytic anemia, bone marrow malignancies.

Less than 20,000 cells/mm3 associated with a tendency for spontaneous bleeding and prolonged bleeding time.

malignant neoplastic immunodeficiency disease of bone marrow.

neoplastic cells infiltrate bone marrow- bone probs like pain, fractures, deformities, back pain

• older 40, peak at 65, gradual, insidious, , suscpt to infection follows disturbances of antibody form by abnormal plasma cells.
• bone destruction w dissemination into lymph nodes, liver, spleen, kidneys, patho fractures.
• Prod of all blood cells crowded out, so infection, anemia, inc pot for bleeding. Ca and Ph drain from bones, leading to hyper calc and renal problems, cell dest contrib to dev of hyperuicemia, wcan cause renal failure alon w myeloma protein.

dx- radiographic sk studies, bone marr biopsy, lab exam bl and urine, monoclonal ab may be present, aeb serum or urine electrophoresis. no cure. radiation, chemo for tumor size. intineoplastic drugs. Analgesic and ortho supports. Fluid, corticosteroids

• Heparin induced thrombocytopenia
• platelets coated in antibodies
• Protamine

Vitamin K

adequate nerve func, protein and carb metab, normal growth, RBC dev, cell repro

Flushing diarrhea, itching, rash, hypoK

GI functions, K levs at beg of treatment. Need to return for shot 1X/mo if pernicious anemia

Erythropoieses, inc RBC, WBC, plt fomr in megaloblastic anemias,

rash, pruritis, gen malaise, bronchospas, slight flushing

IM, SC, IV

Rep iron stores needed for RBC development

• NVD const epigastric pain, black and red tarry stools, discolored urine, staining of teeth
• between meals, OJ, straw to avoid staining teeth

Given for Mild Von Willebrand's, not for Hemophilia

Prom reabsorp of water by kidneys and inc plasma factor 8 lev, inc platelet agg, resulting in vasopressor effect, nasal irr, cong, drowsiness, h ache, flushing, nausea, ab cramps, heartburn, vulval pain, HTN, avoid overhydration

Can cause hyper or hyponatremia, cures D insipidous

Stim prolif and diff of neutrophils

fever, alopecia, sk pain , NVD, mucositis, anorexia

Adverse affects- thrombocytopenia

(arryth, chest pain mi- very rare)

clot and bleed, clot and bleed, clot and bleed

Heparin, easier to get a head of, even tho can be a cause

Elevated D-dimer (clotting)

• Elevated coag (bleeding)
• intubated

thrombin activity

thrombocytopenia

• aPTT q 6 h until therapeutic
• 1.5-2 X normal PTT

• 2
• protamine sulfate

• DVT and prev, usually SC
• DIV-IV
• Maintain patency of indwelling IV cath- IV in catheter only, during/post MI, thrombotic stroke-IV, A fib

• Ibuprophen, ASA, Warfarin, other anticoags
• bleeding, excessive bruising,
• monitor stools,
• heparin stopped 30-60 prior to procedures
• aPTT, platelets (same, just aPTT more sensitive) for thrombocytopenia, liver enzymes- if liver damaged, making clotting factors longer, caution w heparin, HCT only if bleeding

• formation of clots dt heparin (related to DIC)
• heparinPTTprotaminesulfate

given for potential bleeding dt heparin overdose, dilute and give IV slowly over 30 minutes, severe hypotension, circ collapse, brady, pulm edema

causes severe hypotension and bradycardia

• angiomax or bivalirudin
• DON"T MONITOR aPTT

• may increase
• 1.2 life 25 min
• Given in PCI procedures instead of Heparin

• DVT prophy
• dec dose in renal stop 12-24 h prior to procedures
• platelets, hgb, HCT, ALT, AST, don't monitor coag.. CNS,-fever, confusion, edema, anemia, thrombocytopenia, bleeding, angioedema, anaphylaxis