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Pathophysiology Disease Project - Anemia

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Pathophysiology Disease Project - Anemia

  1. 1. Anemia Pathophysiology Disease Project Keiser University - Professor Martynyak Jasmine Diaz, Lizth Romero, Vaittiare Ramirez, Umbreen Bajwa, Gerrie Rosario
  2. 2. Sickle Cell anemia OVERVIEW, ETIOLOGY, PATHOPHYSIOLOGY ● An inherited disorder in which an abnormal hemoglobin [HbS] leads to chronic hemolytic anemia, pain and organ failure ● Demographics: sub-Saharan Africa, India, Saudi Arabia & Mediterranean ● Sickle cell-trait VS. Sickle cell disease ● Major consequences: Chronic hemolytic anemia (8g/dL) & Blood vessel occlusion SIGNS & SYMPTOMS ● Severe hemolytic anemia ● Chronic hyperbilirubinemia (jaundice) ● Vaso-occlusive crises ● Frequent infection ● Delayed growth and puberty ● Vision problem ●
  3. 3. (cont’d.) DIAGNOSTICS ● Hemoglobin electrophoresis - blood screening done to neonates; confirms the presence or absence of abnormal hemoglobin TREATMENTS ● Treatment strategies focus on prevention of sickling episode, symptom management, and treatment of complications ○ Pain management: NSAIDs, opiates ○ Hydroxyurea ○ Preventing infection: penicillin, erythromycin, immunizations ○ Drug to inhibit hemolysis: Oxbryta®; voxelotor ○ Drug to inhibit sickling: Adakveo®; crizanlizumab ○ Blood transfusion and RBC exchange (crisis situation) ○ Gene therapy ○ Bone marrow or stem cell transplantation*
  4. 4. (CONT’D.) PROGNOSIS ● No known cure; bone marrow or stem cell transplantation ● People with sickle cell anemia live long and productive lives ● Some can remain without symptoms for years ● Some have a reduced life expectancy PREVENTION & EDUCATION ● Educate couples who are at risk of having affected children (hemoglobin electrophoresis) ● Educate patient about preventing infections ● Prevent sickling and sickle cell crisis ● Get regular check-ups ● Seek emergency medical care
  5. 5. B12 (PERNICIOUS) Anemia ETIOLOGY ● B12 deficiency can be caused by a lack of B12 in the diet or malabsorption ○ Dietary deficiency of B12 develops slowly and is usually seen in strict vegetarians who avoid all dairy products as well as fish and meat. ○ Malabsorption of B12 can either be due to an antibody formation toward intrinsic factor or parietal cells both leading to the inability to absorb B12 Signs and symptoms ● Weak muscles. ● Numb or tingling feeling in hands and feet. ● Nausea. ● Decreased appetite. ● Weight loss ● Irritability.
  6. 6. B12 Diagnostic and treatments Diagnostics ● B12 levels in serum (normal 190-950 pg/mL) <100 pg/mL severely deficient ● Folate levels in serum (normal 2.7-17.0 ng/mL) >20 ng/mL ● Methylmalonic acid (normal 0.00-0.40 umol/mL) >0.40 umol/mL ● Homocysteine levels (normal 5-15 mmol/L) >50 mmol/L ● Detection of intrinsic factor and parietal cell antibodies Treatment ● Lifelong treatment is required ○ B12 intramuscular injections, intranasal sprays, or high oral doses of vitamin B12
  7. 7. B12 prognosis and education Prognosis ● Most people live without any complications by receiving regular treatment ● For those who don't receive treatment within 6 months of onset of symptoms, they can suffer permanent neurological complications Education ● Educate about foods that contain vitamin B12 ● Educate about regular blood work checkups to check for B12 deficiencies ● Educate about vitamins that contain vitamin B12
  8. 8. Aplastic Anemia Etiology & Pathogenesis - Exposure to high doses of radiation, chemicals, and toxins that suppress hematopoiesis directly or through immune system mechanisms. ● Examples: Chemotherapy and irradiation - It has been reported most often as a complication of viral hepatitis, mononucleosis, and other viral illnesses, including acquired immunodeficiency syndrome. Clinical Manifestations - Insidious or sudden. -can occur at any age -weakness, fatigue, pallor -petechiae (small skin hemorrhages) or ecchymosis (bruises) -bleeding from nose, gums, vagina, or GI tract -Susceptible to infection What is aplastic anemia? - Aplastic anemia describes a disorder of the bone marrow stem cells that results in a reduction of RBCs, WBCs, and platelets.
  9. 9. APLASTIC ANEMIA Diagnosis ● If the CBC test shows pancytopenia (low RBC, WBC, Platelet) ● Patient’s medical history (history of drugs or virus) Treatment ● Discontinuing any drugs or chemicals ● Hematopoietic stem cell replacement or immunosuppressive therapy Nursing Education ● Seek care immediately if you are short of breath, have trouble thinking clearly, have fever and a stiff neck. If you have sores or redness on your skin, blood in your urine, pain when you’re urinating. Medicines may be given to manage your anemia, however, do not take any medicine that contains ibuprofen or aspirin. Both of these are anticoagulants and can increase your risk of bleeding. Avoid people who are sick and wash your hands thoroughly & often.
  10. 10. IRON DEFICIENCY ANEMIA DEFINITION : Diminished red blood cell production due to low iron stores In the body. ETIOLOGY : ● Decrease dietary intake of iron ● Decrease iron absorption .e.g., celiac disease, intestinal Disorders, foods that decrease iron absorption ● Increase loss of iron (chronic blood loss .e.g., menstrual bleeding, peptic ulcer, excessive use of NSAIDs, Intestinal polyps, hemorrhoids, carcinomas ● Increase demand of iron .e.g., pregnancy, lactation, Infancy and adolescence
  11. 11. IRON DEFICIENCY ANEMIA SIGNS AND SYMPTOMS ● Fatigability, dyspnea ● Palpitations, tachycardia ● PICA - cravings for clay, ice ● Koilonychia - spoon-shaped nails ● Smooth tongue ● Angular cheilitis - cracks in the corners Of mouth
  12. 12. IRON DEFICIENCY ANEMIA DIAGNOSTICS ● CBC - Decrease Hb and hematocrit ● Red blood cell indices Decrease MCV, MCH and MCHC ● Decreased serum iron ● Decreased serum ferritin ● Increased TIBC ● Peripheral film - microcytic and hypochromic RBCs, poikilocytosis (irregular shape) and anisocytosis (irregular size)
  13. 13. IRON DEFICIENCY ANEMIA TREATMENT ● Identify the cause and increase dietary intake ● Oral iron supplements ● Blood transfusion if Hb is less than 6mg/dl PROGNOSIS - It is a treatment disorder with excellent outcome if underlying cause is identified EDUCATION - Explain patient about signs and symptoms, dietary sources of iron, foods that can decrease or increase the absorptions of iron, oral supplements in addition to modified diet, regular follow up visits.
  14. 14. REFERENCE Centers for Disease Control and Prevention. (2020, December 16). Living well with sickle cell disease. Centers for Disease Control and Prevention. Retrieved October 31, 2021, from https://www.cdc.gov/ncbddd/sicklecell/healthyliving-living-well.html. Fisher, K. A. (2019, October 2). Patient education. Johns Hopkins Medicine, based in Baltimore, Maryland. Retrieved October 31, 2021, from https://www.hopkinsmedicine.org/Medicine/sickle/patient/. Mayo Foundation for Medical Education and Research. (2021, July 17). Sickle cell anemia. Mayo Clinic. Retrieved October 31, 2021, from https://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/symptoms-causes/syc-20355876. Norris, T. L. (2020). Disorder of Red Blood Cells. In Porth's Essentials of Pathophysiology (5th ed., pp. 561–585). essay, Wolters Kluwer. Sickle cell disease. Cleveland Clinic. (2020, February 25). Retrieved October 31, 2021, from https://my.clevelandclinic.org/health/diseases/12100-sickle-cell-disease#outlook--prognosis. Winter, W. P. (n.d.). A brief history of sickle cell disease: Sickle cell center: Howard university. Howard University Health Care. Retrieved October 31, 2021, from http://huhealthcare.com/healthcare/hospital/specialty-services/sickle-cell-disease-center/disease-information/breif-history. Norris, T. E. (2020). Porth's Essentials of Pathophysiology (5th ed.). Wolters Kluwer.

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