ch 30 hematologic problems - book/2

Question 1

clinical manifestations of folic acid def

3

Answer 1

1. dyspepsia
2. smooth, beefy red tongue
3. absent of neuro problems

Question 2

folic acid def - serum folate is

Answer 2

low (normal is 3-16)

Question 3

folic acid def - cobalamin level

Answer 3

normal

Question 4

folic acid def is tx by

Answer 4

replacement therapy; 1 mg/day by mouth

Question 5

acute blood loss - IV fluids in emergencies include

4

Answer 5

1. dextran
2. hetastarch
3. albumin
4. LRs

Question 6

acute blood loss - once volume replacement is established, attention should be directed to

Answer 6

correcting the RBC loss

Question 7

body needs how long to make new RBCs in response to EPO

Answer 7

2-5 days

Question 8

the effects of chronic blood loss are usually r/t

Answer 8

depletion of iron stores and considered as iron-def anemia

Question 9

management of chronic blood loss anemia involves

Answer 9

identifying the source and stopping the bleeding; supplemental iron may be needed

Question 10

hemolytic anemia occurs because of

Answer 10

problems instrinsic or extrinsic to the RBCs

Question 11

intrinsic hemolytic anemias

Answer 11

usually hereditary, result from defects in the RBCs themselves

Question 12

hemolytic anemia - jaundice from

Answer 12

elevation in bilirubin

Question 13

hemolytic anemia - spleen and liver

Answer 13

enlarged bc of hyperactivity, r/t macrophage phagocytosis of the defective erthrocytes

Question 14

hemolytic anemia - renal

Answer 14

maintain renal function is important; when RBCs are hemolyzed, the hgb molecule is released and filtered by the kidneys. accumulation of hgb molecules can obstruct the renal tubules and lead to acute tubular necrosis

Question 15

SCD is usually fatal by middle age due to

4

Answer 15

1. renal failure
2. infection
3. pulmonary failure
4. stroke

Question 16

SCD abnormal hgb

Answer 16

hgb S

Question 17

sickling episodes are most commonly triggered by

Answer 17

low oxygen tension in the blood

Question 18

may reveal sickled cells and abnormal reticulocytes

Answer 18

peripheral blood smear

Question 19

teach pts with scd to

3

Answer 19

1. avoid high altitudes
2. maintain adequate fluid intake
3. treat infections promptly

Question 20

DIC

Answer 20

serious bleeding and thrombotic disorder that results from abnormally initiated and accelerated clotting

Question 21

DIC is characterized by

Answer 21

profuse bleeding that results from the depletion of plts and clotting factors

Question 22

DIC is always caused by

Answer 22

an underlying disease or condition

Question 23

is DIC a disease

Answer 23

no

Question 24

DIC lab results

2

Answer 24

1. clotting times are prolonged

2. fibrinogen and plts are reduced

Question 25

FFP is used in bleeding caused by

Answer 25

deficiency in clotting factors (DIC, hemorrhage)

Question 26

albumin transfusion is used for

2

Answer 26

hypovolemic shock, hypoalbuminemia

Question 27

most common cause of hemolytic transfusion reactions

Answer 27

improper product-to-patient identification

Question 28

who is responsible for typing and crossmatching the donor’s blood with the recipient’s blood

Answer 28

blood bank

Question 29

rate of blood transfusion during first 15 mins should be

Answer 29

no more than 2 ml/min