Hematology and Coagulation Disorders Quiz

Hematology & Oncology Overview

• This subject covers the study of blood and blood-related cancers (oncology).
• Chapters 21-24 are specifically referenced.

Physiology Review

• This section, likely introductory, focuses on the fundamental processes connected to the subject.

Root Words

• Key terms like "hema-" (blood), "erythro-" (red), "leuko-" (white), "thrombo-" (clot), and "-emia" (in blood) are defined—along with a multitude of prefixes and suffixes—that relate to blood cells and processes.

Hematology Terms

• Core hematological terms such as hematopoiesis (blood formation), erythrocytes (red blood cells), leukocytes (white blood cells), thrombocytes (platelets), anemia (lack of blood), leukocytosis (increase in white blood cells), etc. are given definitions.
• Other related terms for cell numbers (cytosis, penia), tumors (oma), destruction (lytic), and creation (poiesis) are also introduced.

Stem Cell Differentiation

• A diagram depicts the complex pathways of stem cell differentiation into various blood cell types.
• Key cell types such as erythrocytes, mast cells, thrombocytes, basophils, neutrophils, eosinophils, monocytes, lymphocytes (T, B, and natural killer cells), and plasma cells are identified.

Hematologic Organs

• The bone marrow is highlighted as the primary site of blood cell production in adults.
• The Kidney's role in producing erythropoietin (a hormone that stimulates red blood cell production) when detects low oxygen levels is emphasized.
• The Liver produces clotting factors and stores iron, and the Spleen removes old or abnormal red blood cells.
• Reticulocytes function as indicators of bone marrow activity.

Laboratory Tests

• The Complete Blood Count (CBC) is a crucial lab test for analyzing blood.
• CBC analysis includes examining the blood smear to determine different cell types and count them.
• Key components of a CBC include RBC (Red Blood Cell) counts (normal ranges for men and women are provided).
• WBC (White Blood Cell) counts (normal range also noted).
• Platelet counts are additionally detailed with normal ranges.
• Hemoglobin and hematocrit are measured, and their normal values (for men and women) are specified.

Red Blood Cell Disorders/ Anemia

• Anemias are broadly categorized into decreased and increased red blood cell destruction types.

Iron Deficiency Anemia

• Iron is essential for hemoglobin production.
• Causes include decreased iron intake, absorption issues, and increased bleeding.
• Clinical symptoms include pale sclera, brittle nails, decreased appetite, headache, irritability, stomatitis, pica (eating nonfood items), and fatigue.
• Treatment approaches include identifying and fixing the cause of deficiency and increasing iron intake through diet (listed foods) and supplementation.

Vitamin B12 Deficiency Anemia

• Also known as pernicious anemia.
• Causes include B12 deficiency, likely due to a lack of intrinsic factor or reduced B12 intake.
• Macrocytic red blood cells are a characteristic feature.
• Symptoms include pallor, jaundice, smooth beefy red tongue, paresthesia (tingling), unsteady gait, loss of deep tendon reflexes, anorexia.
• Treatment focuses on diet (listed foods) and vitamin supplementation.

Aplastic Anemia

• A condition characterized by bone marrow depression affecting all blood cells (pancytopenia).
• Causes include autoimmune issues, medication side effects, medical treatments, viruses, and genetic factors.
• Clinical symptoms include anemia, leukopenia (low white blood cell count), and thrombocytopenia (low platelet count).
• Treatment involves blood transfusions and potentially bone marrow transplant.

Sickle Cell Disease

• Abnormal hemoglobin (HbS) causes red blood cells to sickle (become crescent-shaped) under stress.
• This can lead to a variety of complications.
• Etiology is a genetic disorder, more prevalent in people of African and Mediterranean descent.
• Clinical manifestations (crises) include pain, hypoxia, dehydration, infection, pregnancy, high/low altitudes, strenuous exercise, emotional stress, and anesthesia.
• Treatment focuses on managing pain and stress-reducing factors.

Thalassemia

• A genetic disorder characterized by an abnormality in hemoglobin.
• This can lead to delayed growth, bone deformities, fatigue, jaundice, hepatomegaly (liver enlargement), splenomegaly (spleen enlargement), and heart failure.

Disorder of Excess Red Blood Cells/Polycythemia Vera

• Too many red blood cells (erythrocytes) leading to thickening of the blood.
• Characterized by flushed, dark purple facial skin, intense itching, hypertension (high blood pressure), tachycardia (rapid heart rate), thrombosis (blood clots), hyperkalemia (high potassium levels), headaches, and vision changes.
• Treatment involves phlebotomy (blood removal) with apheresis, increasing hydration, anticoagulants, chemotherapy, and radiation therapy.

White Blood Cell Disorders

• Disorders include leukocytopenia (low white blood cell count) and neutropenia (low neutrophil count), both related to infections, complications of treatment or some underlying issue.
• Neutropenic precautions focus on reducing infection risks, including special care and restrictions to limit exposure to infections.
• Infectious mononucleosis is a disorder caused by the Epstein-Barr virus, spread through saliva.

Leukemia

• Cancer of the white blood cells (leukocytes), characterized by rapid cell reproduction.
• Four types (chronic myeloid leukemia [CML], acute myeloid leukemia [AML], chronic lymphocytic leukemia [CLL], and acute lymphoblastic leukemia [ALL]) have different population patterns and responses to treatment.
• Symptoms include weight loss, fever, frequent infections, shortness of breath, weakness, bone pain or tenderness, fatigue, loss of appetite, and swelling of lymph nodes.
• Treatment includes chemotherapy and, in some cases, bone marrow transplant.

Lymphoproliferative Disorders - Lymphomas

• The two most common types are Hodgkin lymphoma and Non-Hodgkin lymphoma (NHL).
• Hodgkin lymphoma involves specific cancer cells (Reed-Sternberg cells), different staging, manifestations, and treatment.
• NHL is a broader category of cancers involving various types of lymphoid cells.

Multiple Myeloma

• A type of cancer involving plasma cells that produce excessive amounts of abnormal proteins (Bence Jones proteins) in the bone marrow. The excessive production of these proteins can also be detected in the urine.
• Symptoms often include bone pain and a variety of other conditions depending on the severity and stage of the cancer.
• Interventions include watchful waiting, chemotherapy, and stem cell transplant.

Coagulation Disorders

• Hemostasis, the process of stopping bleeding, involves a complex series of steps in normal blood.
• Abnormal coagulation can lead to issues like excessive bleeding (hemorrhage), or inappropriate clotting, resulting in several diseases.
• Bleeding precautions and treatments depend on the nature of the disorder.

Platelet Disorders

• Idiopathic thrombocytopenia purpura (ITP) includes lower platelet counts with normal platelet production due to an autoimmune reaction or infection.
• Thrombotic thrombocytopenia purpura (TTP), involving hypercoagulation, is characterized by lower platelet counts due to excessive blood clotting, causing damage to blood vessels.

Clotting Factor Disorders

• Conditions affecting blood clotting factors, such as hemophilia, von Willebrand disease, and disseminated intravascular coagulation (DIC).
• Hemophilia is an X-linked recessive disease impacting clotting factors VIII or IX.
• von Willebrand disease affects the protein responsible for carrying factor VIII, leading to bleeding issues.
• DIC involves widespread coagulation and subsequent massive bleeding, needing immediate medical attention.