Chp 34 hematology key points

Question 1

What is anemia?

Answer 1

A deficiency in the number of erythrocytes, the quantity of hemoglobin, and/or the volume of packed RBCs.

Anemia is a manifestation of several pathologic processes and not a specific disease.

Question 2

How are the types of anemia grouped?

Answer 2

According to either morphology or etiology.

Morphology refers to cellular characteristics, while etiology refers to underlying causes.

Question 3

What causes the clinical manifestations of anemia?

Answer 3

The body’s response to tissue hypoxia.

Question 4

What is the primary goal of therapy for anemia?

Answer 4

Correcting the cause of the anemia.

Question 5

What are the main causes of iron-deficiency anemia?

Answer 5

• Inadequate dietary intake
• Malabsorption
• Blood loss
• Hemolysis

Question 6

What is thalassemia?

Answer 6

A group of diseases with an autosomal recessive genetic basis involving inadequate production of normal hemoglobin.

Question 7

What are the two forms of thalassemia?

Answer 7

• Heterozygous
• Homozygous

Question 8

What is megaloblastic anemia characterized by?

Answer 8

Impaired DNA synthesis and the presence of large RBCs.

Question 9

What are two common forms of megaloblastic anemia?

Answer 9

• Cobalamin deficiency
• Folic acid deficiency

Question 10

What is the primary treatment for cobalamin deficiency?

Answer 10

Parenteral or intranasal administration of cobalamin.

Question 11

What is anemia of chronic disease caused by?

Answer 11

Chronic inflammatory, autoimmune, infectious, or cancerous diseases.

Question 12

What is aplastic anemia?

Answer 12

A disease with peripheral blood pancytopenia and hypocellular bone marrow.

Question 13

What are the sources of acute blood loss?

Answer 13

• Trauma
• Complications of surgery
• Conditions that disrupt vascular integrity

Question 14

What is sickle cell disease characterized by?

Answer 14

The presence of an abnormal form of hemoglobin in the erythrocyte.

Question 15

What are the three categories of extrinsic causes of hemolysis?

Answer 15

• Physical trauma
• Antibodies
• Infectious agents and toxins

Question 16

What is hemochromatosis?

Answer 16

An autosomal recessive disease characterized by increased intestinal iron absorption.

Question 17

What is polycythemia?

Answer 17

The production and presence of increased numbers of RBCs.

Question 18

What is thrombocytopenia?

Answer 18

A reduction of platelets below 150,000/μL.

Question 19

What is the most common acquired thrombocytopenia?

Answer 19

Immune thrombocytopenic purpura (ITP).

Question 20

What is the primary treatment for hemophilia?

Answer 20

Replacement of deficient clotting factors.

Question 21

What is disseminated intravascular coagulation (DIC)?

Answer 21

A serious bleeding and thrombotic disorder resulting from abnormally initiated and accelerated clotting.

Question 22

What is neutropenia?

Answer 22

A reduction in neutrophils, a type of granulocyte.

Question 23

What is myelodysplastic syndrome (MDS)?

Answer 23

A group of related hematologic disorders characterized by changes in the quantity and quality of bone marrow elements.

Question 24

How is leukemia classified?

Answer 24

Based on acute versus chronic disease and the type of WBC involved.

Question 25

What is the most common type of leukemia in children?

Answer 25

Acute lymphocytic leukemia (ALL).

Question 26

What are the two major types of lymphoma?

Answer 26

* Hodgkin’s lymphoma * Non-Hodgkin’s lymphoma (NHL)

Question 27

What characterizes Hodgkin’s lymphoma?

Answer 27

Proliferation of abnormal giant, multinucleated cells called Reed-Sternberg cells.

Question 28

What is multiple myeloma?

Answer 28

A condition in which cancerous plasma cells infiltrate the bone marrow and destroy bone.

Question 29

What is splenomegaly?

Answer 29

Enlargement of the spleen.

Question 30

What is splenomegaly?

Answer 30

Enlargement of the spleen ## Footnote It is associated with increased filtering and sequestering capacity, lowering the number of circulating blood cells.

Question 31

What are common symptoms of splenomegaly?

Answer 31

Abdominal pain and early satiety ## Footnote An enlarged spleen is easily palpable on physical examination.

Question 32

When might a splenectomy be necessary?

Answer 32

To evaluate or treat splenomegaly or if the spleen ruptures from trauma

Question 33

What is blood component therapy?

Answer 33

A treatment used in managing hematologic diseases that temporarily supports the patient ## Footnote It is not a permanent solution and should be followed by resolving the underlying problem.

Question 34

What must be done when blood or blood components are obtained from the blood bank?

Answer 34

Positive identification of the donor blood and recipient must be made ## Footnote Improper product-to-patient identification causes most hemolytic transfusion reactions.

Question 35

How should blood be handled once brought to the patient?

Answer 35

It should be started as soon as it is brought and not refrigerated on the nursing unit.

Question 36

What is autotransfusion?

Answer 36

Removing whole blood from a person and transfusing that blood back into the same person ## Footnote This avoids problems of incompatibility, allergic reactions, and disease transmission.

Question 37

What are the types of blood transfusion reactions?

Answer 37

Acute and delayed transfusion reactions

Question 38

What is the most common cause of hemolytic reactions?

Answer 38

Transfusion of ABO-incompatible blood

Question 39

What causes most febrile reactions during transfusion?

Answer 39

Leukocyte incompatibility ## Footnote Many people receiving 5 or more transfusions develop circulating antibodies to WBCs in the blood product.

Question 40

In which patients are allergic reactions to blood transfusion more common?

Answer 40

In persons with a history of allergies

Question 41

What condition puts a person at risk for circulatory overload during transfusion?

Answer 41

Cardiac or renal insufficiency ## Footnote This risk increases if a large quantity of blood is infused in a short period, especially in older patients.

Question 42

What is transfusion-related acute lung injury (TRALI)?

Answer 42

A sudden development of noncardiogenic pulmonary edema (acute lung injury)

Question 43

What is a massive blood transfusion reaction?

Answer 43

A reaction that can occur when 10 or more units of RBCs are transfused within 24 hours

Question 44

What are the components of delayed transfusion reactions?

Answer 44

Delayed hemolytic reactions, infections, and iron overload

Question 45

Name some infectious agents that can be transmitted by blood transfusion.

Answer 45

* Hepatitis B virus * Hepatitis C virus * Human immunodeficiency virus * Human herpesvirus type 6 * Epstein-Barr virus * Human T-cell leukemia virus, type 1 (HTLV-1) * Cytomegalovirus * Malaria