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Hematologic And oncologoc Disorders > Anemias/Leukemias/Lymphomas > Flashcards

Anemias/Leukemias/Lymphomas Flashcards

1
Q

What is anemia?

A

reduction below normal of erythrocytes, hemoglobin, or volume of RBCs caused by variety of factors: blood loss, bone marrow failure/impaired production or hemolysis/destruction of RBCs

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2
Q

What is normal TIBC

A

250-450

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3
Q

What is normal serum iron?

A

50-150

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4
Q

What are erythrocytes?

A

most common type of blood cell. and the main means of delivering o2 to the body tissues via blood flow through the circulatory system.

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5
Q

What is MCH and what is norm value?

A
  • expression of the average amount and weight of Hgb contained in a single erythrocyte.
    norm: 26-34
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6
Q

what does low MCV mean?

A

iron deficiency anemia or thalassemia

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7
Q

what does high MCV mean?

A

B12 or folate deficiency**, alcoholism, liver failure, and drug effects

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8
Q

what does Normocyte mean?

A

anemia of chronic dz, sickle cell dz, renal failure, blood loss and hemolysis

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9
Q

what is MCHC and what is norm?

A

proportion of each RBC occupied by Hgb as a percentage (more accurate measure than MCH)

-norm is 32-36%

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10
Q

Iron deficiency anemia:

A

microcytic, hypo chromic ( <32% MCHC) anemia due to an overall iron deficiency.

iron loss exceeds intake so that storage is depleted and decrease in iron available for RBC formation

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11
Q

What causes iron deficiency anemia?

A

blood loss, inadequate iron intake, impaired absorption of iron

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12
Q

What are S & S of iron deficiency anemia?

A
  • slow in onset
  • pica*** (unusual food cravings such as ice, clay etc
  • dyspnea and mild fatigue
  • headache
  • palpitations
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13
Q

Laboratory and diagnostics of iron deficiency anemia

A 
low mcv
low mchc (hypo chromic)
low rbc
low serum iron
low serum ferritin (stores of iron)
high TIBC (the capacity for more iron is high)
high RDW
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14
Q

treatment for iron deficiency anemia

A

ferrous sulfate 300-325 mg 1-2 hours after meals

  • iron should not be taken with antacids as they interfere with absorption
  • taking iron with Vit C increases absorption
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15
Q

What is Thalassemia?

A

genetically inherited disorders resulting in abnormal Hgb production, microcytic and hypo chromic anemia
not common in western european descent**
middle eastern, african and asian = common

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16
Q

what is different lab values will you expect in Thalassemia vs. iron deficiency anemia?

A

same: low mcv, low mchc

different: normal TIBC, normal ferritin (capaccity and stores are normal)
decreased alpha or beta hgb chains

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17
Q

management of Thalassemia

A

no tx for mild forms

-RBC transfussion/splenectomy for more severe forms

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18
Q

what is contraindicated in Thalassemia?

A

Iron. can lead to iron overload

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19
Q

Folic acid deficiency

A

A macrocytic, normochromic anemia due to folic acid deficiency

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20
Q

Cause of Folic acid deficiency

A

inadequate intake/malabsorption of folic acid (needed for RBC production)

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21
Q

What is a unique finding of folic acid deficiency anemia and pernicious anemia?

A

glossitis (big beefy red tongue)

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22
Q

Labs and diagnostics of folic acid deficiency

A

mcv elevated
mchc normal
serum folate decreased
RBC folate < 100 ng/ml

23
Q

Management of folic acid deficiency

A

folate 1mg orally

foods high in folic acid

24
Q

pernicious anemia

A

a macrocytic, normochromic anemia d/t deficiency of intrinsic factor, which results in malabsorption of B12

25
Labs and diagnostics of pernicious anemia
increased MCV serum B12 decreased < 0.1 mcg/ml anti-IF (intrinsic factor) and anti parietal cell antibody test affirms a deficiency
26
Anemia of Chronic dz:
MCV normal MCHC normal Serum iron and TIBC low (binding capacity) Serum Ferritin is high > 100 ng/ml (stores)
27
Sickle cell anemia
Chronic hemolytic anemia that is genetically transmitted characterized by sickle cell shaped RBCs
28
What factors precipitate sickling?
hypoxia, infections, high altitudes, dehydration, physical or emotional stress***, surgery, blood loss, acidosis
29
what are common S & S of sickle cell dz
-delayed growth and development | increase susceptibility to infections
30
what does peripheral smear show in sickle cell dz?
distorted sickle-shaped RBCs
31
how to treat acute sickle cell
fluids (dehydration) analgesia (morphine or dilaudid) and oxygen (hypoxemia)
32
What are leukemias?
neoplasms arising from hematopoietic cells in bone marrow
33
what constitutes most leukemias in adults?
Acute-nonlymphocytic leukemia (ANL) and acute myelogenous leukemia (AML) long term survival 40%
34
what is the hallmark of ALL
pancytopenia with circulating blasts | all of the labs are down
35
What is the hallmark of chronic lymphocytic leukemia?
lymphocytosis** most common leukemia in adults med survival is 10 years
36
Chronic myelogenous leukemia
philadelphia chromosome seen in leukemic cells in hallmark of dz
37
S & S of leukemias
cbc with subnormal RBCs and neutrophils - elevated ESR - peripheral blood smear usually distinguishes acute and chronic leukemia but bone marrow aspiration is required to confirm diagnosis
38
Management of leukemias
- chemo - bone marrow transplant - control symptoms
39
what is Stage 1 lymphoma
-dz localized to 1 lymph node or 1 spot
40
stage 2 lymphoma
-more than 1 lymph node group involved; confined to one side of the diaphragm
41
stage 3 lymphoma
-lymph nodes or the spleen involved; occurs on both sides of the diaphragm
42
stage 4 lymphoma
liver or bone marrow involvement
43
Non-hodgkin's lymphoma
often presents with lymphandenopathy - most common neoplasm ages 20-40 - less predictable pattern of spread than hodgkin's - adv stage dz is usually apparent
44
Hodgkin's Dz
- more common in younger males | - cervical adenopathy*** and spreads in a predictable fashion along lymph node groups
45
What differentiates Hodgkin's dz from non-hodgkin's?
reed-sternberg cells
46
what is used to locate and stage hodgkin's dz?
MRI CT biopsy and histopathologic exam confirms diagnosis
47
management of Hodgkins
- radiation - chemo - bone marrow transplantation
48
S/S of pernicious anemia
what you would expect with anemia + | -glossitis, + neuro signs (romberg, babinski, loss fine motor control, paresthesias)
49
of the 4 above anemias which is the most important one to ask about alcohol intake?
Folic acid deficiency anemia
50
Normo-Normo anemia is?
anemia of chronic dz
51
Macro-normo is
folic acid deficiency and pernicious anemia
52
Sickle cell anemia, most common complaint
aching joint pain
53
when do you biopsy a lymph node?
any lymph node tht is > 1cm not a/w infection and lasting 4-6 weeks should be biopsied

Hematologic And oncologoc Disorders (2 decks)

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