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Definition of Diagnosis Hemolytic Anemia, results from increased RBC destruction occurring in response to trauma, malarial infection, exposure

to certain chemical or drugs, and autoimmune reactions. All increase rate of RBC destruction by causing membrane lysis (breakage). In immunohemolytic anemia, immune system products attack a persons own RBCs for unknown reasons. (Ignatavicius, 2010) Hemolytic anemia, are characterized by the premature destruction of RBCs. RBCs may be destroyed because the cell itself is improperly formed (intrinsic) or because it has been damaged by an outside source (acquired). Intrinsic causes include defects in the cell membrane or hemoglobin structure and function, and inherited enzyme deficiencies. External causes of hemolytic anemia include drugs, bacterial and other toxins, and trauma. (Burke, 2007) Hemolytic anemia, premature destruction of erythrocytes results in liberation of hemoglobin from the erythrocytes into the plasma. The increase erythrocytes destruction leads to tissue hypoxia, which in turn stimulates erythropoietin production. This increased production is reflected in an increased reticulocyte count as the bone marrow responds to the loss of erythrocytes. The released hemoglobin is converted in large part to bilirubin; therefore, the bilirubin concentration rised. Hemolysis can result from an abnormality within the erythrocyte itself (e.g. sickle cell anemia, glucose-6-phosphate dehydrogenase [G-6-PD] deficiency) or within the plasma, or from direct injury to erythrocyte within the circulation. (Smeltzer, 2008) Hemolytic anemia, is anemia due to hemolysis, the abnormal breakdown of red blood cells (RBCs) either in the blood vessels (intravascular hemolysis) or

elsewhere in the body (extravascular). It has numerous possible causes, ranging from relatively harmless to life-threatening. The general classification of hemolytic anemia is either inherited or acquired. (http://en.wikipedia.org/wiki/Hemolytic_anemia) Hemolytic anemia is a rare form of anemia in which red blood cells (also called erythrocytes) do not live as long as healthy cells; they are destroyed and removed from the bloodstream prematurely. Healthy red blood cells usually live about 120 days in the bloodstream before the body removes them. In hemolytic anemia, the body breaks down and removes red blood cells faster than it can replace them. The breakdown of red blood cells is called hemolysis. The hemolysis can occur in the bloodstream or in an organ called the spleen. The bone marrow increases production of red blood cells to replace the hemolyzed blood cells, but it can't produce them fast enough to meet the body's needs. (http://wiki.medpedia.com/Hemolytic_Anemia) Hepatitis B, is transmitted primarily through blood (percutaneous and permucosal routes). HBV can be found in blood, saliva, semen, and vaginal secretions and can be transmitted through mucous membranes and breaks in the skin. HBV has a long incubation period. It replicates in the liver and remains in the serum for relatively long periods, allowing transmission of the virus. (Smeltzer, 2008) Hepatitis B, is usually transmitted by blood transfusion or contaminated needles, but also may be spread by sexual contact and from an infected mother to her fetus. Carriers cant transmit HBV while having no symptoms of the disease. The risk of liver cancer is signicant in clients infected with Hepatitis B. (Burke, 2007) Hepatitis B virus, is not transmitted like HAV. It is a double-shelled particle containing DNA composed of a core antigen (HBcAg), a surface antigen

(HBsAg), and another antigen found within the core (HBeAg) that circulates in the blood. HBV may be spread through these common modes of transmission: Unprotected sexual intercourse with an infected partner Sharing needles Accidental needle sticks or injuries from sharp instruments Blood transfusions Hemodialysis Maternal-fetal route

The clinical course of HBV may be varied. Symptoms usually occur within 25180 days of exposure and include: Anorexia, nausea and vomiting Fever Fatigue Right upper quadrant pain Dark urine with light stool Joint pain Jaundice

(Ignatavicius, 2010) The hepatitis B virus is a DNA virus, meaning that its genetic material is made up of deoxyribonucleic acids. It belongs to a family of viruses known as Hepadnaviridae. The virus is primarily found in the liver but is also present in the blood and certain body fluids. Hepatitis B virus consists of a core particle (central portion) and a surrounding envelope (outer coat). The core is made up of DNA and the core antigen (HBcAg). The envelope contains the surface antigen (HBsAg). These antigens are present in the blood and are markers that are used in the diagnosis and evaluation of patients with suspected viral hepatitis. (http://www.medicinenet.com/hepatitis_b/article.htm) Hepatitis B is caused by infection with the hepatitis B virus (HBV). This infection has 2 phases: acute and chronic.

Acute (new, short-term) hepatitis B occurs shortly after exposure to the virus. A small number of people develop a very severe, life-threatening form of acute hepatitis called fulminant hepatitis. Chronic (ongoing, long-term) hepatitis B is an infection with HBV that lasts longer than 6 months. Once the infection becomes chronic, it may never go away completely.

(http://www.emedicinehealth.com/hepatitis_b/article_em.htm)

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