41 Differential Diagnosis for PT: Hematological, Cardiovascular, Immune, and Digestive System Disorders: Summary
○ Basophils: Become mast cells (histamine); synthesize and store histamine Hematopoiesis (Platelets) • Thrombocytes: Form in blood marrow ○ Function in hemostasis (coagulation) and maintaining capillary integrity ○ Platelet count affected by: ■ Anticoagulant drugs: Aspirin/heparin ■ Diet: Lecithin/vitamin K ■ Exercise: Boosts production of activators that destroy clots ■ Liver disease ■ Radiation/chemotherapy BLOOD DISORDERS Erythrocyte Disorders Anemia Reduction in O2-carrying capacity of blood due to reduced RBC count • Symptoms: Pallor, fatigue, shortness of breath (SOB), delayed healing, irritability Sickle cell anemia Hereditary, chronic disease where a defect occurs in hemoglobin amino acid chain • More common in African American population • Signs do not appear until about age 1 year • Symptoms: Pallor, fatigue, tachycardia, splenomegaly, infarctions, delayed growth, chronic heart failure (CHF) , infection • Treated with hydroxy-urea to reduce sickling and prolong life Polycythemia Increase in total RBCs; increased hematocrit • Neoplastic disorder of unknown origin • Can be primary or secondary • Symptoms: Cyanotic skin, increased blood pressure (BP) , splenomegaly, thrombosis, CHF • Clients with polycythemia have increased whole blood volume/viscosity ○ Increased tendency toward clotting ○ Diminished blood to brain and other tissues due to high viscosity
INTRODUCTION Differential diagnosis is defined as the process of examination, evaluation, and medical screening to determine appropriateness of intervention within scope of practice—or need for referral to another practitioner. Provider responsibility is to determine what biomechanical or neuromusculoskeletal problem is present and then provide treatment. Clinicians must be able to identify signs and symptoms of systemic disease. Use of evidence-based practice will enable a provider to build their own screening tools. This course will review differential diagnosis screening for hematological, cardiovascular, immune and digestive disorders. HEMATOLOGICAL PATHOPHYSIOLOGY Formed Blood Elements • Erythrocytes: Carry oxygen (O2) to tissues and remove carbon dioxide; red blood cells (RBC) • Leukocytes: Act in inflammatory/immune responses; white blood cells (WBC) Hematopoiesis (RBCs) • Erythropoiesis is regulated by cellular O2 requirements and metabolic needs; if hemoglobin levels are below normal, tissues do not receive an adequate supply of O2 and hypoxia occurs • Decreased O2 in blood → stimulates production of hormone erythropoietin from kidneys → stimulates bone marrow stem cells to produce more RBCs • Production of RBCs can be limited by lack of essential nutrients ○ Iron folate, protein, vitamins B12 and B6: Form hem Hematopoiesis (WBCs) • Lymphocytes: Produce antibodies/react with antigens • Monocytes: Form macrophages (active phagocytes) • Granulocytes: All work in digesting foreign material ○ Neutrophils: Common phagocytic cell ○ Eosinophils: Allergic conditions and parasites
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