Download Blood Disorders 1 BLOOD DISORDERS – THREE CASE STUDIES

Blood Disorders
BLOOD DISORDERS – THREE CASE STUDIES
Blood Disorders, Resources: Ch. 8 of Human Diseases: Three Patient Case Studies
Author
Author Affiliation
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Blood Disorders
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Abstract
This paper examines the presenting histories and symptoms of 3 patients with potential blood
disorders. For each case the author identifies the blood disorder each of the 3 patients are at risk
for. The identification of blood disorders is based on upon symptoms, lifestyle, and/or family
history. Included is a description of the cause of the disorder, how it can be diagnosed, what can
be done to treat it, and how to prevent it in the future.
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Blood Disorders, Resources: Ch. 8 of Human Diseases: Three Patient Case Studies
Three patients have presented with varying histories and symptoms indicative of being at
risk for certain blood disorders. Although the symptoms of blood disorders can be vague and
nonspecific, when combined with a patient history and lifestyle, a working differential diagnosis
is possible.
Such groups of histories/symptoms sometimes relate to a decrease in blood cells, such as a
reduced number of red blood cells (anemia), a reduced number of white blood cells (leukopenia),
or a reduced number of platelets (thrombocytopenia).
This paper examines the presenting histories and symptoms of 3 such patients with
potential blood disorders. For each case the author identifies the blood disorder that each of the 3
patients are at risk for. The identification of the blood disorder is based on upon symptoms,
lifestyle, and/or family history. Included is a description of the cause of the disorder, how it can
be diagnosed, what can be done to treat it, and how to prevent it in the future. (The Merck
Manual of Medical Information, 2nd Home Edition)
Case Study Amy
Presenting History
Amy, a 4-year-old Caucasian female, has been complaining of being tired all the time. She
is pale and a picky eater. Her mother is a single mom with a small budget to feed a large family.
Amy only eats pasta, breads, and hot dogs, and drinks only artificial fruit punch.
Diagnosis (symptoms, lifestyle and/or family history)
Amy’s subjective symptom of “being tired all the time” and her pale skin tone suggest
that she may have anemia. This would be consistent with a lifestyle reported as “picky eater.” In
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addition, the lifestyle eating habits of eating food low in iron would point to an iron deficiency
resulting in anemia. On the other hand, depending upon the types of pasta, bread and hot dogs
eaten, Amy should be getting sufficient iron in her diet. However, the hot dogs could actually be
“veggie” dogs and the bread/pasta may not be whole grains. Blood work would be needed to
confirm the diagnosis. Again, the diagnosis of anemia is consistent with the family history of a
single mom, small budget and large family. This history is suggestive of a risk of nutritional
deficiency leading to anemia. With this presentation additional diagnostic work-up would be the
most prudent.
Causes
Anemia in children is usually caused by having an iron deficiency. The low iron in the
body causes blood counts to be low and can cause a child to feel tired, have pale skin, and be
irritable and weak. Left untreated it can lead to many problems, including learning disabilities
and behavior problems. The most common cause of iron deficiency is having a diet that doesn't
have enough iron in it. This can be caused by not eating foods that are rich in iron.
Treatment
Anemia should be treated with oral iron supplements in the form of ferrous sulfate.
Vitamin C can also increase absorption and is needed for the production of hemoglobin. Ironrich foods include raisins, meats (liver is the highest source), fish, poultry, egg yolks, legumes
(peas and beans), and whole-grain bread is the best natural treatment for anemia. Consideration
should be given to talking with the mother about nutrition classes and/or an introduction to
appropriate social services that might be available to the family.
Prevention
Diet is the most important way to prevent and treat iron deficiency.
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Case Study Marcus
Presenting History
Marcus is a 5-year-old African-American male who has just moved to New York City, and
is visiting his new pediatrician for a kindergarten physical. His mom tells the nurse that she
carries the “trait” and wants Marcus screened for it.
Diagnosis (symptoms, lifestyle and/or family history)
Marcus should be evaluated for Sickle trait and/or Sickle cell anemia. People who inherit
a sickle cell gene from one parent and a normal gene from the other parent have a condition
called sickle cell trait. The mother states that she does have the trait. Sickle cell trait is different
from sickle cell anemia. People who have sickle cell trait don’t have the disease, but they have
one of the genes that cause it. Sickle cell anemia is a serious disease in which the body makes
sickle-shaped red blood cells. Marcus is at risk for both and should fully evaluated.
Causes
Sickle cell anemia is an inherited, lifelong disease. People who have the disease are born
with it. They inherit two copies of the sickle cell gene—one from each parent. People who
inherit a sickle cell gene from one parent and a normal gene from the other parent have a
condition called sickle cell trait. Sickle cell trait is different from sickle cell anemia. People who
have sickle cell trait don’t have the disease, but they have one of the genes that cause it. Like
people who have sickle cell anemia, people who have sickle cell trait can pass the gene to their
children.
Treatment
People with sickle cell trait usually have no symptoms and need no treatment. (The
Sickle Cell Information Center)
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Prevention
Case Study Richard
Presenting History
Richard has noted over the past several weeks that he is having more bruises, or
ecchymosis, all over his body. After coughing this morning, he noticed tiny red marks all around
his eyes.
Diagnosis (symptoms, lifestyle and/or family history)
Thrombocytopenia An abnormally small number of platelets, or hrombocytopenia, result
from conditions that either impair production, increase destruction, or cause sequestration of
platelets. Regardless of cause, prolonged bleeding results from minor and major trauma.
Spontaneous hemorrhages are often-visible on the skin as small, flat, red spots called petechiae,
or as larger purplish patches called ecchymosis. Spontaneous hemorrhages may also occur in the
mucous membranes of the mouth and internal organs. Suppression of the bone marrow by certain
medications or cancer may diminish platelet production. Autoimmune disorders may increase
platelet destruction or impair platelet function. Massive blood transfusions dilute circulating
platelets and decrease platelet viability. Thrombocytopenia can usually be corrected by treating
the underlying cause. Preventative measures such as bedrest to avoid accidental trauma are highly
recommended until platelet counts increase to acceptable levels. Platelet transfusions are
reserved for severe thrombocytopenia or in cases of severe bleeding. Primary Thrombycythemia
Primary thrombocythemia is a marked increase in circulating platelets due to unknown causes.
Primary thrombocythemia occurs most frequently in adult men and women during the sixth or
seventh decade of life. Symptoms are related to abnormal platelet function and thrombosis.
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Thrombosis causes ischemia to the central nervous system, the peripheral extremities, and vital
organs of the body. Symptoms include dizziness, visual problems, headaches, difficulty
breathing, and extreme pain in the extremities. Bleeding may result in some cases due to
abnormal platelet function.
Causes
Treatment
Prevention
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders
(4th ed., text revision). Washington, DC: Author.
Degelman, D., & Harris, M. L. (2000). APA style essentials. Retrieved May 18, 2000 from
Vanguard University, Department of Psychology Web site:
http://www.vanguard.edu/faculty/ddegelman/index.cfm?doc_id=796
THE REFERENCES ABOVE ARE EXAMPLES OF THE CORRECT WAY TO SITE IN APA
FORMAT – BELOW ARE MY REFERENCES – NOT SURE HOW TO FORMAT –
REVIEW ASSIGNMENT
http://www.merck.com/mmhe/print/sec14/ch170/ch170b.html
(The Sickle Cell Information Center)
Blood Disorders Resources: Ch. 8 of Human Diseases, the WebMD® Web site at
http://www.webmd.com, and the drkoop® Web site at http://www.drkoop.com
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