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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
Q

Labs and diagnostics of pernicious anemia

A

increased MCV
serum B12 decreased < 0.1 mcg/ml
anti-IF (intrinsic factor) and anti parietal cell antibody test affirms a deficiency

26
Q

Anemia of Chronic dz:

A

MCV normal
MCHC normal
Serum iron and TIBC low (binding capacity)
Serum Ferritin is high > 100 ng/ml (stores)

27
Q

Sickle cell anemia

A

Chronic hemolytic anemia that is genetically transmitted characterized by sickle cell shaped RBCs

28
Q

What factors precipitate sickling?

A

hypoxia, infections, high altitudes, dehydration, physical or emotional stress***, surgery, blood loss, acidosis

29
Q

what are common S & S of sickle cell dz

A

-delayed growth and development

increase susceptibility to infections

30
Q

what does peripheral smear show in sickle cell dz?

A

distorted sickle-shaped RBCs

31
Q

how to treat acute sickle cell

A

fluids (dehydration)
analgesia (morphine or dilaudid)
and oxygen (hypoxemia)

32
Q

What are leukemias?

A

neoplasms arising from hematopoietic cells in bone marrow

33
Q

what constitutes most leukemias in adults?

A

Acute-nonlymphocytic leukemia (ANL) and acute myelogenous leukemia (AML)

long term survival 40%

34
Q

what is the hallmark of ALL

A

pancytopenia with circulating blasts

all of the labs are down

35
Q

What is the hallmark of chronic lymphocytic leukemia?

A

lymphocytosis**
most common leukemia in adults
med survival is 10 years

36
Q

Chronic myelogenous leukemia

A

philadelphia chromosome seen in leukemic cells in hallmark of dz

37
Q

S & S of leukemias

A

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
Q

Management of leukemias

A
  • chemo
  • bone marrow transplant
  • control symptoms
39
Q

what is Stage 1 lymphoma

A

-dz localized to 1 lymph node or 1 spot

40
Q

stage 2 lymphoma

A

-more than 1 lymph node group involved; confined to one side of the diaphragm

41
Q

stage 3 lymphoma

A

-lymph nodes or the spleen involved; occurs on both sides of the diaphragm

42
Q

stage 4 lymphoma

A

liver or bone marrow involvement

43
Q

Non-hodgkin’s lymphoma

A

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
Q

Hodgkin’s Dz

A
  • more common in younger males

- cervical adenopathy*** and spreads in a predictable fashion along lymph node groups

45
Q

What differentiates Hodgkin’s dz from non-hodgkin’s?

A

reed-sternberg cells

46
Q

what is used to locate and stage hodgkin’s dz?

A

MRI
CT
biopsy and histopathologic exam confirms diagnosis

47
Q

management of Hodgkins

A
  • radiation
  • chemo
  • bone marrow transplantation
48
Q

S/S of pernicious anemia

A

what you would expect with anemia +

-glossitis, + neuro signs (romberg, babinski, loss fine motor control, paresthesias)

49
Q

of the 4 above anemias which is the most important one to ask about alcohol intake?

A

Folic acid deficiency anemia

50
Q

Normo-Normo anemia is?

A

anemia of chronic dz

51
Q

Macro-normo is

A

folic acid deficiency and pernicious anemia

52
Q

Sickle cell anemia, most common complaint

A

aching joint pain

53
Q

when do you biopsy a lymph node?

A

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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