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Lab > 16-3 > Flashcards

16-3 Flashcards

1
Q

Anemia
males HCT less than %?
females HCT less than %?

A

41%
37%

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2
Q

What is the #1 cause for Anemia in adults?

A

bleeding

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3
Q

Most important treatment is what?

A

identification of the cause of blood loss, especially a source of occult blood loss.

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4
Q

Menstruation, pregnancy, and frequent blood donors increase chances of what?

A

Anemia

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5
Q

What considerations should be taken for males with Anemia?

A

may be due to a disease process and require a further evaluation and a higher level of care.

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6
Q

Severe iron deficiency causes what?

A

skin and mucosal changes,

smooth tongue,
brittle nails,
cheilosis.

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7
Q

Many iron-deficient patients develop pica, craving what?

A

ice chips

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8
Q

What lab do you order for someone with suspected iron deficiency?

A

CBC with differential

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9
Q

Most important treatment for Anemia is?

A

identification of the cause of blood loss, especially a source of occult blood loss.

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10
Q

What is the tx for Anemia?

A

oral iron supplement

Ferrous sulfate 325mg TID x 3-6 months

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11
Q

What Ferritin value is considered Anemic?

A

<12 mcg/L

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12
Q

Vitamin B12 Deficiency is less than

A

<100 pg/mL

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13
Q

Physical Findings for vitamin B12 deficiency:

A
  • Glossitis
  • Anorexia
  • Diarrhea
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14
Q

What is the CBC with diff hallmark for vitamin B12 deficiency?

A

megaloblastic anemia (large RBC’s)

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15
Q

What late stage & and early stage considerations should be taken for vitamin B12 deficiency?

A
  • MEDEVAC for late stage
  • Referral to Hematologist for early stage
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16
Q

What is a sequence of responses that stops bleeding when blood vessels are injured?

A

Hemostasis

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17
Q

Intrinsic pathway, key factors include:

A

8, 9, 11, 12

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18
Q

Extrinsic pathway key factor:

A

7

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19
Q

Intrinsic pathway is measured by

A

PTT

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20
Q

Extrinsic pathway is measured by

A

PT

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21
Q

What is a systemic process with the potential for causing thrombosis and hemorrhage. It can present as an acute, life threatening emergency?

A

Disseminated intravascular coagulation (DIC)

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22
Q

What does G6PD stand for?

A

Glucose-6-phosphate dehydrogenase

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23
Q

What is a hereditary enzyme defect that causes episodic hemolytic anemia because of the decreased ability of red
blood cells to deal with oxidative stresses?

A

G6PD

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24
Q

What drug can cause hemolysis for a G6PD patient?

A

Primaquine

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25
Q

What might a red blood cell smear reveal for a G6PD pt?

A

“bite cells” or Heinz bodies

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26
Q

What condition might have abnormal RBC take the shape of a sickle rather than a biconcave disc?

A

Sickle Cell Trait

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27
Q

What is a condition that causes acute painful episodes of back and long bones last hours to days and may produce low-grade fever. And Non-healing ulcers of the lower leg and retinopathy may be present.

A

Sickle Cell Trait

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28
Q

What lab should be done for someone with suspected SCT?

A

CBC w/ diff

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29
Q

average life expectancy for Sickle cell anemia is?

A

40 - 50 y/o

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30
Q

SCT can cause acute pain under extreme conditions such as…?

A

vigorous exertion at high altitudes or unpressurized aircraft

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31
Q

What is a malignancy of the hematopoietic progenitor cell. These cells proliferate in an uncontrolled fashion and replace normal bone marrow elements?

A

Leukemia

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32
Q

More than what % of blasts in the bone marrow is considered Leukemia?

A

20%

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33
Q

Acute lymphoblastic leukemia (ALL) comprises % of the acute leukemias of childhood. It is also seen in adults, causing approximately __% of adult acute leukemias.

A

80%

20%

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34
Q

Which Leukemia is primarily an adult disease with a median age at
presentation of 60 years and an increasing incidence with advanced age?

A

Acute myeloid leukemia (AML)

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35
Q

What S&S are present with Leukemia?

A

pale, purpura, petechiae

Bone tenderness in the sternum, tibia, and femur.

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36
Q

Differential Diagnosis for Leukemia could be what?

A

Viral infection such as Mononucleosis

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37
Q

Patients with ALL may have what visible on a chest radiograph?

A

mediastinal mass

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38
Q

What is the treatment for Leukemia?

A

MEDEVAC

Referral to hematologist.

39
Q

Approximately what % of adults with AML under age 60 years achieve complete remission?

A

70-80%

40
Q

Bone marrow transplantation is curative in what % of cases?

A

50-60%

41
Q

What is a high white cell count relative to normal physiologic numbers?

A

Leukocytosis

42
Q

What is a low total white cell count?

A

Leukopenia

<4400 cells/microL

43
Q

What is an abnormally low amount of circulating platelets?

A

Thrombocytopenia

44
Q

The risk of clinically relevant spontaneous bleeding does not typically increase until the platelet count falls below what?

A

10,000 - 20,000/mcL

45
Q

What helps you determine that the deficiency is platelets rather then a coagulopathy?

A

Petechia

46
Q

Should you MEDEVAC someone with Thrombocytopenia

A

Yes if actively bleeding

47
Q
A
48
Q

What causes skin and mucosal changes, including a smooth
tongue, brittle nails, and cheilosis?

A

Iron Deficiency Anemia

49
Q

What are contraindications for Ferrous sulfate?

A
50
Q

What should the pt be counseled on about ferrous sulfate?

A

very constipating and turns stool black

51
Q

Vit B12 deficiency is seen mostly in?

A

Vegans

52
Q

What is considered a Vit B12 deficiency?

A

<100/pg/mL

53
Q

How much stored Vit B12 does the liver contain?

A

2000-5000 mcg

54
Q

How long does Vit B12 deficiency take to develop?

A

3 years

55
Q

Physical findings of:

Glossitis, Anorexia, Diarrhea, pale, paresthesia

indicate what?

A

Vitamin B12 dificiency

56
Q

What Dx has a hallmark of megaloblastic anemia on a CBC w/ diff?

A

Vit B12 deficiency

57
Q

What is the Tx for Vit B12 deficiency?

A

Vit B12 inj IM daily for a week, weekly for a month, and monthly for a year

58
Q

For late stage Vit B12 deficiency what should you do?

A

MEDEVAC

59
Q

For early stage Vit B12 deficiency what should you do?

A

Referral to Hematologist

60
Q

3 stages of blood clotting?

A
  1. Formation of prothrombinase
  2. Prothrombinase converts prothrombin to thrombin
  3. Thrombin converts fibrinogen into insoluble fibrin
61
Q

Intrinsic pathway key factors?

A

8,9,11,12

62
Q

Extrinsinc pathway key factor?

A

7

63
Q

Intrinsic pathway lab

A

PTT

64
Q

Extrinsic pathway lab

A

PT

65
Q

Hemophilia A

A

Deficiency of factor 8

66
Q

Hemophilia B

A

Deficiency of factor 9

67
Q

What is a systemic process with the potential
for causing thrombosis and hemorrhage. It can present as an acute, life-threatening
emergency.

A

Disseminated intravascular coagulation (DIC)

68
Q

Common bleeding manifestations include

A

petechiae; ecchymoses;
and blood oozing from wound sites

69
Q

Common causes of DIC

A
  • Sepsis
  • Malignancy
  • Trauma
  • Obstetrical complications
  • Heat stroke, crush injuries and Rattlesnake or
    another viper bite.
70
Q

What medication should you avoid giving someone with DIC?

A

Heparin

71
Q

Sx: Bruising, bleeding, epistaxis, bleeding from eyes, heavy vaginal bleeding

Dx?

A

DIC

72
Q

What labs would you do for DIC?

A

PT, PTT, INR, CBC

73
Q

What does G6PD stand for?

A

glucose 6 phosphate dehydrogenase

74
Q

What may reveal bite cells or Heinz bodies?

A

G6PD

75
Q

What is a autosomal recessive disorder with hemoglobin S

A

Sickle cell anemia

76
Q

Acute back and bone pain, low grade fever, non-healing ulcers in the legs, lasting hours to days

A

SCT

77
Q

What lab is done for SCT?

A

CBC w/ diff

78
Q

How is Sickle cell hemoglobin confirmed?

A

Hemoglobin Electrophoresis

79
Q

What is the tx for SCT

A

keep hydrated and oxygenated

80
Q

Average life expectancy of sickle cell anemia?

A

40-50 y/o

81
Q

What conditions can exacerbate SCT?

A

vigourous exertion, high altitude, unpressurized aircraft

82
Q

A malignancy were cells proliferate and replace normal bone marrow

A

Leukemia

83
Q

What % of blasts in the bone marrow indicates Leukemia?

A

20%

84
Q

What are the 2 classifications of Leukemia?

A

AML and ALL

85
Q

What % of ALL is children?

What % of ALL is adults?

A

80%

20%

86
Q

AML is common in what age group?

A

adults over 60y/o

87
Q

Sx: Fatigue, gingival bleeding, epistaxis, menorrhagia,

pale, purapura, and petechiae

Bone tenderness in the sternum, tibia, and femur

A

Acute Leukemia

88
Q

What viral infection presents similar to Leukemia?

A

Mononucleosis

89
Q

If lab reveals combo of pancytopenia w/ circulating blasts

what Dx?

A

Leukemia

90
Q

Mediastinal mass visible on CXR may be what Dx?

A

ALL

91
Q

What is the tx for Leukemia?

A

MEDEVAC

Referral to hematologist

chemo and radiation therapy

92
Q

What % of adults with AML achieve remission?

A

70-80%

93
Q

Bone marrow transplant for Leukemia is curative in what % of cases?

A

50-60%

94
Q

High WBC Dx?

A

Leukocytosis

Lab (12 decks)

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