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HEALTH SCIENCES PRESENTATION

Sarah Johnson-Cotes

Created on November 6, 2024

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Transcript

Sickle Cell Disease Complications

ACUTE CHEST SYNDROME

DVT/PE

RENAL DISEASE

New infiltrate on CXR + fever/respiratory symptomsLabs: CBCD + Rtc Management: - Optimize ventilation - Hydration and pain control - Antibiotics: 3rd generation cephalosporin + macrolide - Blood transfusion as needed

SOB, tachypnea, chest pain, leg pain swelling Imaging: US, CXR, CTPA Management: - Anticoagulation (heparin, warfarin) - D-dimer not accurate due to over-activation of coagulation cascade at baseline.

Hypertension secondary to reduced flow/micro-infarctsRenal papillary necrosis Labs: Renal Function Panel Imaging: RBUS w/doppler Management: - Anti-hypertensives (valsartan shown to decrease stickiness of RBCs)

LONG-TERM MANAGEMENT

Acute Complications

  • Vaso-occlusive Crisis
  • Acute Chest Syndrome
  • Splenic Sequestration
  • DVT/PE
  • Stroke
  • Sepsis
  • Dactylitis
  • Priapism

Chronic Complications

  • Poor growth
  • Renal Disease
  • Osteonecrosis
  • Functional Asplenia
  • Cholelithiasis

Hydroxyurea

  • Increases fetal Hgb
Prophylactic Penicillin
  • Protects against encapsulated organisms up to age 5
Immunizations
  • Pneumococcal, meningococcal, HiB and routine vaccinations
RBC Transfusion
  • Indicated when hemoglobin below baseline with clinical decline
Hematopoitic Stem Cell Transplant
  • Curative measure