Hematology Physical Assessment

Integrated Pharmacy Practice Lab #2

4TH Pharm D
Pharmacy Practice Dep.,
Unizah College Of Pharmacy
2015-2016

Coagulation
Bleeding
DISEASE
Diseases
Diseases
INDUCED

History & Physical Clues

Ask your patient about the ease in which they perform activities
of daily living, to determine if hypoxia is present.
Inquire about fatigue, shortness of breath, or episodes of
breathlessness. These assessment findings may clue patient in to
a potential hematological deficiency.
Common bloodrelated causes of hypoxia (low oxygen
carrying capacity of the blood) include:
Low number of circulating red blood cells
Poor supply of hemoglobin within these red blood cells
Carbon monoxide poisoning
Physical clues that will aid in assessing oxygen carrying
capacity include:
Skin coloration
Respiratory rate
Pattern of respiratio
Capillary refill
Heart rate
Skin temperature

Physical examination
Inspection

Skin
Paleness: anaemia
Iron deficiency: dry skin, koilonychia,
brittle hair and nail, hair loss, itching
haemolytic anaemia, pernicous anaemia :
Jaundice
thrombocytopenia :Thrombocytopenic purpura
(petechia, ecchymosis, suffusion)
Skin infections: neutropenia (lack of pus!)

Physical examination
(cont.)
Inspection
Oral cavity, mucous membranes
Plummer & mucous membrane atrophy in
iron deficient anaemia
Hunters glossitis: vitamin B12 deficiency
Petechia: thrombocytopenia

Physical examination
(cont.)
Splenomegaly
Haemolysis (RES hyperplasia):
thalassaemia, sickle cell anaemia, any type
of haemolytic anaemia

Useful laboratory tests General

Peripheral blood smear

CBC, reticulocyte ESR, CRP
EPO, Ferritin, B12
Direct Coombs, irregular antibodies
Haptoglobin, plasma free haemoglobin
Stool benzidin test
urine sediment

Imaging techniques
Xray (bone laesions of MM)
CT
MRI
Gallium scan
PET/CT

Physical assessment of
anemia

Assessment of vital signs of

anemic patient
Temperature
Pulse
Respiratory rate
Blood pressure

Laboratory interpretation

Coagulation Diseases
Coagulation
Bleeding
Disease
Diseases
Diseases
Induced

Plasma
Plasma is a strawcolored, clear liquid that
is ninety percent water. It is essential for the
transport of blood components.
Plasma water, electrolytes and plasma
proteins that maintain the osmotic
distribution of fluid and substances capable
of buffering pH changes.

The Clotting componrnts

Bl. Platelets
Clotting factors
Fibrin
Thrombin

HAEMOPHILIA
Factor VIII (Haemophilia A)
Factor IX (Haemophilia B)
Inhibitors

Deep venous thrombosis

Review of Clotting Factors