Which of the following factors are known to commonly trigger a crisis in patients with sickle cell disease? (Select all that apply)
Airplane flights
Dehydration
Cold weather
Illness
Flashing light patterns on television
Correct Answer : A,B,C,D
A. Airplane flights can trigger a crisis due to changes in altitude and decreased oxygen levels in the cabin. The lower atmospheric pressure and reduced oxygen can contribute to sickling of red blood cells, increasing the risk of a crisis.
B. Dehydration is a significant trigger for sickle cell crises. It can lead to hemoconcentration, making the blood more viscous and promoting sickling of the red blood cells. Maintaining hydration is crucial for preventing crises.
C. Exposure to cold weather can trigger vaso-occlusive crises in sickle cell patients. Cold temperatures can cause blood vessels to constrict, reducing blood flow and increasing the likelihood of sickling and pain episodes.
D. Any illness, particularly infections, can trigger a sickle cell crisis. Infections can lead to increased metabolic demand, dehydration, and inflammatory responses, all of which can contribute to vaso- occlusion and pain.
E. While certain sensory stimuli can affect individuals with various conditions (like migraines), flashing light patterns on television are not commonly recognized triggers for a sickle cell crisis. There is no substantial evidence linking this to vaso-occlusive events in sickle cell disease.
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Related Questions
Correct Answer is C
Explanation
A. In iron deficiency anemia, serum iron levels are typically low due to a deficiency in iron. Additionally, the Mean Corpuscular Volume (MCV) is often low because the red blood cells produced are smaller than normal (microcytic).
B. Similar to option A, serum iron levels in iron deficiency anemia would be low, not high. The MCV may be low or normal, but it would not be high due to the production of microcytic red blood cells.
C. In iron deficiency anemia, TIBC is usually high because the body is trying to maximize iron transport in response to low iron levels. Serum iron is low, and the MCV is low due to the production of smaller red blood cells.
D. This option is incorrect because option C accurately describes the expected lab results in iron deficiency anemia.
Correct Answer is C
Explanation
A. Epoetin Alfa is typically used to treat anemia, and it is often indicated when hemoglobin (Hgb) levels are below 11 g/dL. Therefore, if the Hgb is less than 11, it would be appropriate to administer the medication to help increase red blood cell production.
B. Do not hold. An activated partial thromboplastin time (aPTT) of 120 seconds indicates a prolonged coagulation time, which increases the risk of bleeding. However, Epoetin Alfa does not have a direct impact on coagulation, so this value alone would not warrant holding the medication.
C. Epoetin Alfa is generally not indicated if the Hgb level is already above 11 g/dL, particularly if there’s a risk of increasing the Hgb above the recommended therapeutic range (often above 12 g/dL). If the Hgb exceeds this level, the medication should be held to prevent complications such as thromboembolic events.
D. A PT/INR of 3.5 indicates a significantly prolonged prothrombin time, suggesting a high risk of bleeding. However, Epoetin Alfa does not directly cause bleeding.
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