Relating the Pathophysiology of Pernicious Anemia to the Manifestations Listed in the Case Study.

Relating the Pathophysiology of Pernicious Anemia to the Manifestations Listed in the Case Study.

Relating the Pathophysiology of Pernicious Anemia to the Manifestations Listed in the Case Study.

The manifestation of pernicious anemia is evidenced by the unavailability of B12 because of a lack of intrinsic factors. These substances are responsible for the absorption of the vitamin in the intestine. In a healthy person, the intrinsic factor is produced by parietal cells in the stomach. These cells also produce hydrochloric acid. The absence of Vitamin B12 reduces the ability of the body to synthesize DNA properly (McCance & Huether 2019). As a result, the production of red blood cells is affected. The cells become megaloblasts and are destroyed in the bone marrow, not further released for circulation. Some megaloblasts mature to become large RBCs called macrocytes which reach circulation and function abnormally. This affects the blood flow in the body, further resulting in a deficiency of white blood cells (leukopenia) and platelets (thrombocytopenia). These signs are evident in the case study, proving pernicious anemia.

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How the Gastric Abnormalities Contribute to Vitamin B12 and Iron Deficiency and How Vitamin B12 Deficiency Causes Complications Associated with Pernicious Anemia

A special protein called intrinsic factor (IF) always bind vitamin B12 so that it can be absorbed in the stomach. However, when the stomach cannot make enough intrinsic factors, the intestine cannot absorb vitamin B12. The weakened stomach lining (atrophic gastritis) limits the stomach from making enough intrinsic factors leading to abnormalities in the absorption of vitamin B12 (Mohamed et al., 2020). These complications affect red blood cell production and further result in the rise of many abnormal cells that affect blood flow in the body.

Other Tests that the Nurse Practitioner May Order to Diagnosis this Type of Anemia, Treatment Available and the Limitations.

Other tests, such as blood screening and DNA tests, are significant in determining the extent of abnormal cells in circulation. Such cases require a treatment that involves the intramuscular injection of vitamin B12, which may be a continuous process for life (Tavares et al., 2019). Most patients respond positively to the treatment, but the damage cannot be reversed fully.

References

McCance, K.L and Huether S.E. (2019).Pathophysiology Online for Pathophysiology (8^th ed.).Mos by: Elsevier. ISBN:9780323654388

Mohamed, M., Thio, J., Thomas, R. S., & Phillips, J. (2020). Pernicious anaemia. Bmj, 369. https://doi.org/10.1136/bmj.m1319

Tavares, J. G., Baptista, B., Gonçalves, B., & Horta, A. B. (2019). Pernicious anaemia with normal vitamin B12. European Journal of Case Reports in Internal Medicine. http://orcid.org/0000-0002-5395-5236

 

Week 10 Case Study Chapter 30

Explaining ITP and Who Can Get It.

Immune thrombocytopenic purpura (ITP) is a blood disorder defined by a decrease in the number of platelets in the blood. The decrease in the number of platelets can easily cause bruising, internal bleeding, and bleeding gums (Onisâi et al.,2019). The order is fairly common among children and adults. It can occur in two forms. One is acute thrombocytopenic purpura or chronic thrombocytopenic purpura.

Four Mechanisms of Thrombocytopenia.

The four primary causes of thrombocytopenia are hypoproliferation, sequestration, consumption, and destruction. Hypoproliferation is the lack of production, while sequestration is the separation of cells from others (McCance & Huether 2019). Different cells perform different functions in the body of a person, and so they have to be separated to perform their designed duties (Wang et al.,2020). Consumption is the utilization of the cells, and the final stage is destruction, where the sued cells are destroyed and removed from the body.

Symptoms and Tests that Confirm its Diagnosis

A nurse professional would expect to see various symptoms in a patient with ITP. One of the most compelling symptoms is the number of platelets in the body of a patient. The normal platelet count in a person should be between 150,000 to 450,000. However, a patient with ITP will have a platelets count below 100,000. The platelet count would be 10,000 or less when a patient starts bleeding. The reduced platelets count increases the risk of bleeding. ITP patients will also have a purple color on the skin, tiny red dots under the skin, frequent nosebleeds, and bleeding gums and mouth (Wang et al.,2020). The females might experience heavy menstrual periods. Other symptoms include blood in the vomit, urine, or stool and bleeding in the head, one of the most severe symptoms of ITP. Tests such as complete blood count (CBC) are important in measuring different blood cells’ size, number, and maturity in a specific blood volume.

References

McCance, K.L and Huether S.E. (2019).Pathophysiology Online for Pathophysiology (8^th ed.).Mos by: Elsevier. ISBN:9780323654388

Onisâi, M., Vlădăreanu, A. M., Spînu, A., Găman, M., & Bumbea, H. (2019). Idiopathic thrombocytopenic purpura (ITP)–new era for an old disease. Romanian Journal of Internal Medicine, 57(4), 273-283. https://doi.org/10.2478/rjim-2019-0014

Wang, Z., Chen, L., Zhang, F., Lu, H., Chen, X., Wen, A., … & Zheng, L. (2020). First‐in‐patient study of hetrombopag in patients with chronic idiopathic thrombocytopenic purpura. Journal of Thrombosis and Haemostasis, 18(11), 3053-3060. https://doi.org/10.1111/jth.15078

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minimum of 2 sources for each case study. One source must be from the textbook assigned chapters. Reputable sources may not be older than 5 years. APA format. Type only questions and answers. Include reference page for each case study.

CASE STUDY ASSIGNMENT CHAPTER 29

The patient is 59 years old and came to the physician’s office with complaints of marked fatigue, nausea with occasional diarrhea, and a sore, swollen tongue. He tells the nurse practitioner that he has been experiencing a tingling feeling in his toes and a feeling of clumsiness. Microscopic examination of a blood sample indicated a reduced number of erythrocytes, many of which are megaloblasts, and reduced number of leukocytes, including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin B12 were below normal. Additional tests confirm pernicious anemia.
Relate the pathophysiology of pernicious anemia to the manifestations listed in the case study.
Discuss how the gastric abnormalities contribute to vitamin B12 and iron deficiency and how vitamin B12 deficiency causes complications associated with pernicious anemia.
Discuss other tests that the nurse practitioner may order to diagnosis this type of anemia. Discuss the treatment available and the limitations. Be specific.

CASE STUDY ASSIGNMENT CHAPTER 30

The patient is a 32-year-old female who had been sick with a cold virus for 10 days. She states that she had flu symptoms of cough, sore throat, and fatigue. It has been 3 weeks since the cold, and she continues to be fatigued and finds it hard to get enough energy to do things. The patient says she has noted that she has been bruising easily. She hit her arm accidentally on the edge of a counter, and now she has a large bruise. She has also noted little purple spots all over her hands and chest. On exam it is noted that she does have a large bruise on her right arm and petechiae and purpura over her chest and hands. Lab work comes back with a platelet count of 40,000mm3.

1. The patient has been diagnosed with idiopathic thrombocytopenic purpura (ITP). Explain what it is and who can get it.

2. Discuss the four mechanisms of thrombocytopenia.

3. What symptoms would the nurse practitioner expect to see in a patient with ITP, and which tests would be used to confirm the diagnosis?