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Exam (elaborations)

MSN 277 Exam II (Scored A)

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Genetics - ANSWER - The study of genes and their role in inheritance Genomics - ANSWER - The study of all a person's genes Epigenetics - ANSWER - The study of chemical modification of specific genes Germline - ANSWER - Inherited from parent Somatic - ANSWER - Acquired Anemia - ANSWER...

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  • July 9, 2023
  • 19
  • 2022/2023
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MSN 277 Exam II (Scored A)

Genetics - ANSWER - The study of genes and their role in inheritance

Genomics - ANSWER - The study of all a person's genes

Epigenetics - ANSWER - The study of chemical modification of specific genes

Germline - ANSWER - Inherited from parent

Somatic - ANSWER - Acquired

Anemia - ANSWER - Deficiency in erythrocytes (RBCs)

Anemia is diagnosed by - ANSWER - CBC
Blood smear

Anemia clinical manifestations based on severity - ANSWER - Mild (Hgb 10-12) - no symptoms at rest,
mild fatigue with exertion
Moderate (Hgb 6-10) - cardiopulmonary symptoms that occur at rest
Severe (Hgb <6) - Multiple systems involved

Anemia general clinical manifestations (20) - ANSWER - Fatigue
Pallor
Jaundice
Pruritus
Palpitations
Tachycardia
Dyspnea
HF
Tachypnea
Angina/MI
Anorexia
Spleno/hepatomegaly
Headache
Vertigo
Depression
Irritability
Sensitivity to cold

,Weight loss
Orthopnea
Bone pain

Iron deficiency anemia - ANSWER - Most common type of anemia

Occurs from inadequate intake of iron, increased hemolysis, malabsorption (pts with their duodenum
removed), blood loss, and CKD

Can cause pallor, glossitis, cheiltis, headache, paresthesia, burning sensation of tongue

Diagnosed by Hgb, Hct, HGB, CBC, serum iron, TIBC elevated, ferritin low, stool for occult blood,
endoscopy, colonoscopy, bone marrow biopsy

Tx by increasing dietary source of iron (red meat, green leafy vegetables, whole grains, ferrous sulfate
with vitamin C

Anemia of chronic disease - ANSWER - Under production of anemia and/or decreased survival time

Can come from chronic diseases such as chronic inflammation, autoimmune disorders, HF, infectious
diseases, malignancies

Tx by correcting the underlying disorder, blood transfusion, and erythropoietin

Aplastic anemia - ANSWER - Can be chronic or acute (life-threatening); rare

Occurs from peripheral blood pancytopenia (decrease in all cells) and hypo cellular bone marrow

S/S include anemia (fatigue, dyspnea), neutropenia (infection, shock, death), thrombocytopenia
(bleeding, petechiae)

Dx by labs and biopsy

Tx by supportive care, HSCT, and immunosuppressive therapy in those >55

Anemia caused by acute blood loss - ANSWER - Occurs from hemorrhage

10% 500ml loss - no symptoms
20% 1000ml loss - no symptoms at rest, tachycardia with exercise, mild postural hypotension
30% 1500 ml loss - normal BP and pulse at rest, tachycardia and postural hypotension with exercise
40% 2000 ml loss - BP, CVP, and CO below normal, air hunger, rapid, thready pulse, cool, clammy skin
50% 2500ml loss - shock, lactic acidosis, possible death

, Tx by replacing fluid volume (lactated ringers, albumin), identify and correct source of blood loss, blood
transfusion, replace platelets, and supplement iron if needed

Thrombocytopenia - ANSWER - Low platelet count
Platelet count below 150,000
Results in abnormal hemostasis (prolonged bleeding from injury or spontaneous bleeding)
3 types: ITP, TTP, and HIT

S/S include mucosal/cutaneous bleeding (epistaxis, petechiae, purpura, abnormal bleeding, after
venipuncture/IM injections, internal bleeding

Major complication is hemorrhage

Platelet count
150,000 pt okay
<50,000 prolonged bleeding
<20,000 spontaneous life-threatening hemorrhages
<10,000 platelet transfusion

Dx by checking PT and aPTT

Tx by treating underlying condition, specific to each type, avoid anti-platelet drugs

Teach pt to shave with an electric razor, no gardening, good oral care, avoid tattoos, piercings, eyebrow
tweezing

ITP - ANSWER - Immune Thrombocytopenia Purpura

Most common

Abnormal destruction of platelets by the spleen

Tx by splenectomy, IVIG, corticosteroids, platelet transfusion

TTP - ANSWER - Thrombotic Thrombocytopenia Purpura

Rare

Results in the enhanced aggregation of platelets

Associated with hemolytic uremic syndrome

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