Common indicators of hematologic disorders
Exertional problems are common - dyspnea, chest pain, palpitations, severe weakness, and fatigue. May also have headaches, drowsiness, dizziness, syncope, polyneuropathy. May also have pallor of the face, hands, nail beds, cyanosis, clubbing, blood in stool
Anemia Causes
- Iron Deficiency
- Chronic diseases (cancer, kidney, liver) or inflammatory diseases (RA, lupus)
- Pernicious anemia
- infectious disease (TB or AIDS)
Anemia Signs and Symptoms
- skin pallor
- fatigue
- dyspnea on exertion w/ palpitations
- chest pain w/ minimal exertion
- decreased diastolic BP
- CNS issues (headache, drowsy, dizzy, syncope, apathy, depression, polyneuropathy)
Polycythemia Causes
Is an increase of RBC and concentration of Hg
- Primary - neoplastic of bone marrow
- Secondary - decreased O2 to the tissue
Polycythemia S/S
-most common first symptoms are shortness of breath and fatigue
-increased skin coloration
-increased BP
-Gout
-cyanoiss
-clubbing
weight loss
Sickle Cell Anemia Cause
Autosomal recessive disorders characterized by presence of abnormal form of Hg
Sickle Cell Anemia S/S
- Progressive damage to most organs
- chest pain, dyspnea
- avascular necrosis, CVA, chronic ulcers
- low-grade fever, back pain, joint pain, periosteal pain, headaches
- seizures, dizzy, drowsy, paresthesias, CN palsies, coma
- head-foot syndrome
Leukocytosis Cause
characterizes many infectious diseases - a count of more than 10,000 leukocytes/mm3
Leukocytosis S/S
- fever
- symptoms of systemic infection
- symptoms of inflammation or trauma to tissue
Leukopenia S/S
- sore throat, cough
- high fever, sweats
- ulceration
- frequent/painful urination
- persistent infection
Thrombocytosis S/S
- thrombosis
- splenomegaly
- easy bruising
Thrombocytopenia S/S
- bleeding w/ minor trauma
- spontaneous bleeding
- Petechiae
- Ecchymosis
- Purpura Spots (bleeding under the skin)
- Epistaxis
- Menorrhagia
- Gingival bleeding
- Melena (black, tarry stools)
Acute Hemarthrosis S/S
- Aura, tingling, prickling sensation
- Stiffen into position of comfort
- Decreased ROM
- Pain
- Swelling
- Tenderness
- Heat
Muscle Hemorrhage S/S
- gradually increasing pain
- Protective muscle spasm
- limit movement at surrounding joint
- loss of sensation
Vascular and CNS involved S/S
- Intraspinal hemorrhage
- Intracranial hemorrhage
- irritability, seizures, unequal pupils, apnea, vomiting, paralysis, death
Vascular and GI S/S
- abdominal pain and distention
- Melena (blood in stool)
- Hematemesis (vomiting blood)
- fever
Tests
- flex trunk and severe pain = iliopsoas bleeding
- hip rotated and severe pain = hip hemorrhage
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Red Flags18
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Interview Do's and Don't's15
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Pain Types and Viscerogenic Pain Patterns34
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Hematologic Screening16
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Cardiovascular Screening61
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Pulmonary Screening53
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GI Screening57
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Hepatic and Biliary Screening40
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Urogenital Screening45
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Endocrine and Metabolic Screening43
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Immunolgoic Screening49
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Cancer Screening50
