Anemias
Why is oral administration of vitamin B12 not effective as a treatment for pernicious anemia?
Vitamin B12 must be bound to INTRINSIC FACTOR before absorption (in pernicious anemia intrinsic factor is already lacking!)
Why can bone marrow damage result in multiple, recurring infections?
Bone marrow produces WBC's, if these are damaged the immune system becomes compromised
(Remember Male vs Female)
Male Children: 50% affected
Female Children: 0% affected (but 50% for being a carrier)
Which age group is CML most common in?
Adults age 30-50
Why is it best to defer any invasive procedures in leukemic patients including dental treatment, until the blood counts become normal?
1) severe infection risk
2) hemorrhage risk
How can chronic bleeding lead to iron deficiency anemia?
Iron loss exceeds iron intake
Why does excessive bleeding occur with aplastic anemia?
occurs because the damaged bone marrow cannot produce adequate platelets (throbocytes)
Difference between anemia and polycythemia. (H&H)
Anemia: low hemoglobin and hematocrit
Polycythemia: elevated hemoglobin and increased hematocrit
What is the malignant cell in AML & CML?
granulocytic stem cells
What is the cause of weak peripheral pulses when the iliac artery is blocked?
Reduced blood flow to the limb
How can the destruction of acid-producing cells in the stomach lead to iron-deficiency anemia?
Parietal cells in the gastric glands produce hydrochloric acid, if these cells are destroyed it is harder for the body to convert dietary (ferric) iron to the absorbable (ferrous) iron.
Why are vascular occlusions common in sickle cell patients?
The rigid cells obstruct small vessels
What is a risk of Thrombophilia?
abnormal clots in veins and arteries
What type of disorder is leukemia considered & involving what?
neoplastic disorder (involving WBCs)
Complications of loss of blood supply in a limb:
necrosis, ulcers, and gangrene (bacterial infection of necrotic tissue)
Signs of anemia that indicate compensation for hypoxia is occuring
(Think cardiac and respiratory) :)
Cardiac: increased HR & BP
Respiratory: increased RR & dyspnea
Why is it necessary to treat the bone marrow recipient with chemotherapy and radiation before transplant?
(Two purposes)
1) destroy diseased or dysfunctional marrow
-without this step, the recipients damages marrow would continue to occupy the space, preventing donor stem cells from establishing themselves
2) immunosuppression to prevent rejection
-prevent the host's immune system from rejecting the donor stem cells
How can a deep vein thrombosis in a large vein in the leg result in a life-threatening condition such as a stroke or MI?
The clot can dislodge and travel throughout the body!!
What is the malignant cell in ALL & CLL?
B lymphocytes
Compare the ideal position in a chair for a client with arterial obstruction with that for a client with varicose veins.
Arterial Obstruction: legs dependent-hanging down (gravity assist arterial blood flow to ischemic tissues)
Varicose Veins: legs elevated (reduces venous pooling and promotes venous return)
Thalassemia is a genetic defect resulting in...
the inability to effectively produce hemoglobin
Compare sickle cell trait vs sickle cell anemia.
(Homozygous/heterozygous) (Amount of HbS vs HbA)
Sickle cell trait: Heterozygous & less that 1/2 the hemoglobin is the abnormal HbS
Sickle cell anemia: Homozygous & most of the normal hemoglobin (HbA) is replaced by HbS
Three other causes of excessive bleeding other than hemophilia.
Von Willebrand, Thrombocytopenia, & Vitamin K deficiency
What age group is ALL most common in?
young children
How might leg ulcers develop in people with varicose veins?
Ischemia/poor circulation leads to skin breakdown and ulcerations