International Classification of Diseases Coding Ii

The physical Assessment Findings: The patient’s head, eyes, ears and nose are normal, however there is white patches on the buccal mucosa. The lymph nodes and carotid bruits are absent. Her heart beat at a regular rate and rhythm without murmur. Her lungs sound is diminished to auscultation with end expiratory wheezes, and dull percussion to the right lower lobe. Her anterior-posterior diameter of the chest wall is also increased. Her abdomen is benign. She has strong pedal pulses to all extremities without edema.

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

As a provider, one will care for many patients that have different types of anemia. Anemia is not so much as a disease as a symptom of an underlying issue. Although there can be particular signs and symptoms associated with anemia, the basis of a diagnosis is from laboratory data. For the purpose of this discussion, I will evaluate a case study and give a differential diagnosis. I will also assess how patient history, physical exam, and lab reports support my diagnosis. I will explain the pathophysiology of the type of anemia and give causes and treatment options available.

The anemia of acute blood loss could be described as which one of the following?

“The patient is Adam Rudd, a 78 y/o white male with a history of hypertension. He has been diagnosed with hypertension past 15 years and is on anti-hypertensive medications and aspirin. He is very weak and short of breath. He is accompanied with his longtime friend Jennifer, who reports that Rudd was looking very weak and was complaining of severe headache and blurred vision before coming to the hospital. He is 5’9” and weighs 270 lb. Vital signs recorded were: oral temperature 98.20 F, BP 224/120 mm Hg with a heart rate of 102 beats/minute and respiration of 24 breaths per minute. The pulse oximetry reading was 94% on room air. He is complaining of severe headache and blurred vision. Rudd said that he did not take his antihypertensive medication or aspirin since he ran out of pills. He has not been taking his medication for past 15 days. He reports no known allergies to any medications or other substances.”

J.) As Cari’s Pco2 and alkaline blood pH rose, how was the oxygen-carrying capacity of hemoglobin affected?

2. All of the following EXCEPT ___ lead to a decrease in hematocrit. A dehydration

Also known as normocytic anemia. This is the most frequent type of anemia most often happening to males over 85 years old. It is a common problem that occurs to men and women over 85 years old. Symptoms include and are caused by: a reduced production of normal-sized red blood cells even though presence of hemoglobin in the red blood cells is within the standard range; an increased production of HbS as is seen in sickle cell diseases; greater destruction and loss of red blood cells; an increase in plasma volume that is not compensated by anything else; a B2 (riboflavin) deficiency; and a B6 (pyridoxine) deficiency. (Brill & Baumgardner 2000).

1. Anemia, pp. 989. Anemia is a areduction in the total number of erythrocytes in the circulating blood or a decrease in the quality or quantity of hemoglobin. Anemias commonly result from (1) impaired erythrocyte production, (2) blood loss (acute or chronic), (3)increase erythrocyte destruction, or (4) a combination of these three. sThe fundamental physiologic manifestation of anemia is a reduced oxygen-carrying capacity of the blood resulting in tissue hypoxia.

Vital signs are BP 113/82, pulse 83, respirations 18, O2 saturation is 99. Alert, in no acute distress. HEENT: Atraumatic. Examination of his mouth revealed a 1 cm erythroplastic lesion to the left side mid tongue, which he reports some tenderness to it during palpation. Lesion has well defined borders and its unique color it is all red.

Yearly, around six hundred to nine hundred people are diagnosed with Aplastic Anemia within the United States. Aplastic Anemia is a autoimmune hematological disorder that causes pancytopenia which is a reduction in major blood components, namely, erythrocytes, leukocytes and platelets. This disease has been labelled as a type of bone marrow failure, that is often due to not one but a variety of disorders that occur simultaneously. Aplastic Anemia can therefore be defined as a bone marrow disorder that is often rare, non contagious, and can often be life threatening.

Drueke TB, Locatelli F, Clyne N, Eckardt KU, Macdougall IC, Tsakiris D, et al. Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med. 2006 Nov 16;355(20):2071-84.

These tests also help nurses and physicians to see the fluctuations that take place from time of admission. The patient came in with low RBC’s which may be caused by her chronic kidney failure. Erythropoietin is excreted by the kidneys to gather more red blood cells. When the kidneys are not functioning, this may inhibit the excretion of erythropoietin, causing a low red blood cell count. She also came in with low hemoglobin levels which indicates anemia which also goes hand in hand with her low red blood cell count because hemoglobin is a protein located within red blood cells that carries oxygen from the lungs to the body and tissues. E.M. lastly appeared to have low hematocrit levels this again, is associated with the patient's anemia this is the proportion of blood that contains red blood cells, and in this patient's case is very

Due to these findings patient was directly admitted to the hospital and placed on a heparin drip. On physical exam patient had absent pulses below the right femoral artery. However, there was no discoloration, change of temperature, or sensory as well as motor deficits of the right lower extremity. Patient was taking a low-dose aspirin and red yeast rice for cholesterol management at that time.

Thalassemia is an inheritable blood disorder wherein the body synthesizes an abnormal form of hemoglobin, the protein in red blood cells that carries oxygen. According to Giardina & Rivella (2013), the thalassemias are inherited as pathologic alleles of one or more of the globin genes located on chromosomes 11 and 16. These lesions range from the total deletion or rearrangement of the loci to point mutations that impair transcription, processing, or translation of globin mRNA (p. 505). This disorder may further lead to the excessive destruction of red blood cells, commonly known as anemia.