Clinical Care of the Hematologic System

Question 1

anemia is defined by a value less than what in:

Males

Females

Answer 1

Less 41%, males

Less than 37% in females

Question 2

a ferritin lab value of what indicated anemia

Answer 2

less than 12 mcg/L ferritin

Question 3

most common cause of iron deficiency anemia

Answer 3

bleeding

Question 4

what is the most common type of anemia word wide

Answer 4

Iron deficiency

Question 5

what increases chances of iron anemia

Answer 5

menstruation

pregnancy

frequent blood donations

Question 6

• Fatigue
• Tachycardia
• palpitation
• tachypnea
• cheilosis
• Dysphasia (due to esophageal webs)
• Pica( ice chips)

What is the DX

Answer 6

Iron Anemia

Question 7

if a patient is given Ferrous Sulfate what else will be prescribed

Answer 7

stool softener or laxative

Question 8

Ferrous Sulfate turns the stool what color

Answer 8

black

Question 9

how much vitamin B12 does the liver contain

Answer 9

2000 - 5000 mcg

Question 10

B12 vitamin develops after how many years after abortion is ceased

Answer 10

3 years

Question 11

daily loss of vitamin B12 is

Answer 11

3-5 mcg/dL

Question 12

Vitamin B12 is rare and only seen in what population

Answer 12

Vegans

Question 13

What are physical findings for B12 deficiency

Answer 13

Glossitis

Anorexia

Late stage appears:

Pale

Paresthesia

difficulty w/ balance

Question 14

whats a hallmark CBC with Diff for B12 deficiency

Answer 14

Megaloblastic anemia

with characteristic find of macro-ovalocyte with hyperpigminted neutrophils

Question 15

what lab value is overly B12 deficiency

what lab value will show B12 deficient symptoms

Answer 15

170 pg/mL

100 pg/mL

Question 16

whats the treatment for B12 deficiency

Answer 16

IM injection of vitamin B12

• daily for 1st week
• weekly 1st month
• Monthly for life

Question 17

what are the intrinsic pathways

Answer 17

12

11

8

9

Question 18

what are the extrinsic pathways

Answer 18

7

Question 19

Hemophilia A is Congenital Deficiency of coagulation of factor

Answer 19

Congenital Deficiency of coagulation of factor 8

Question 20

Hemophilia B is Congenital Deficiency of coagulation of factor

Answer 20

Congenital Deficiency of coagulation of factor 9

Question 21

what a complications of both coagulopathies

Answer 21

recurrent hemarthroses or
arthropathy

inhibitory antibodies to factor 8 or 9

Question 22

complications of both coagulopathies is due to

Answer 22

infection with HIV or Hep C blood products

Question 23

what is disseminated intravascular coagulation

Answer 23

its a systematic process with the potential for causing thrombosis and hemorrhage

Question 24

what are common manifistation for disseminated intravascular coagulation

Answer 24

ecchymosoes

blood ozzing

venous thrombosis

arterial theombosis

Question 25

what are common causes of disseminated intravascular coagulation

Answer 25

Sepsis Malignancy trauma

Question 26

what is the go to medication to treat disseminated intravascular coagulation

Answer 26

Heparin

Question 27

what are complications of disseminated intravascular coagulation

Answer 27

Anemia Massive hemorrhage

Question 28

what is G6PD

Answer 28

hereditary enzyme defect that causes episodic anemia because of RBC to deal with oxidative stresses

Question 29

In G6PD oxidized hemoglobin dentures and forms precipitations called

Answer 29

Heinz bodies

Question 30

Heinz bodies cause membrane damage which leads to removal by what organ

Answer 30

Spleen

Question 31

G6PD is exacerbated by what drug

Answer 31

primaquine nitrofurantoin aspirin

Question 32

what is a consideration of military G6PD members

Answer 32

red dog tags ans warning on front of the health record

Question 33

what is Hemoglobinopathies / Sickle cell

Answer 33

a anemia austosomal recessive disorder in which an abnormal hemoglobin S

Question 34

hemoglobin S is carried in what percent of African Americans

Answer 34

8%

Question 35

what are S/S of Hemoglobinopathies / Sickle cell

Answer 35

jaundice Gallstones Hepatosplenmegly poor healing ulcers

Question 36

what are s/s of acute Hemoglobinopathies / Sickle cell

Answer 36

pain in bones (especially back, long bones chest)

Question 37

acute Hemoglobinopathies / Sickle cell last for how long

Answer 37

hours to days

Question 38

acute Hemoglobinopathies / Sickle cell labs have a hallmark of

Answer 38

hyposplenism such as Howell-Jolly bodies and target cells

Question 39

when acute painful episodes occur what should be the precipitating factors

Answer 39

keep hydrated and prevent hypoxemia search for underlying factors

Question 40

what are considerations sickle cell trait

Answer 40

painful episodes with vigorous exertion or high altitudes

Question 41

what is acute leukemia

Answer 41

malignancy of the hematopoietiuc progenitor cell

Question 42

acute leukemia is classified into what two subcategories

Answer 42

Acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL)

Question 43

what type of acute leukemia comprises 80% of childhood leukemias and 20% of adult leukemias

Answer 43

acute lymphoblastic leukemia (ALL)

Question 44

what type of acute leukemia is primarily an adult disease

Answer 44

Acute myeloid leukemia (AML)

Question 45

what are S/S of acute leukemia

Answer 45

fatigue bleeding in the skin and mucosal surfaces such as gingiva epitaxis menorrhagia enlagrment of the liver, spleen, lymph nodes bone tenderness (sternum, tibia, femur)

Question 46

whats a DXx for acute leukemia

Answer 46

Pertussis (whooping cough)

Question 47

what are lab hallmarks for acute leukemia

Answer 47

pancytopenia with circulating blast

Question 48

do you retain or medevac acute leukemia

Answer 48

medevac

Question 49

what is Leukocytosis / Leukopenia

Answer 49

Leukocytosis high white cell count Leukopenia low white cell count

Question 50

if a patient has determined to have Leukocytosis with a high lymphocytes what is the cause

Answer 50

viral infection Immune disease stress

Question 51

if a patient has determined to have Leukocytosis with a high Eosinophils what is the cause

Answer 51

Skin diseasse drug reaction parasite infection asthma

Question 52

if a patient has determined to have Leukocytosis with a high basophils what is the cause

Answer 52

chronic myeloid lukemia

Question 53

if a patient has determined to have Leukocytosis with a high monocytes what is the cause

Answer 53

infection autoimmune disease

Question 54

1 etiologies for leukopenia is ethnic neutropenia at what percent does it affect black and whites

Answer 54

4. 5% blacks | 0. 7% whites

Question 55

what are S/s of leukopenia

Answer 55

fever jaundice rash

Question 56

What is thromnoctopenia

Answer 56

low amount of circulating platlets

Question 57

the risk of spontaneous bleeding doe not typically increase until platelet count falls below what

Answer 57

10,000 to 20,000 mcL or unless pt has Dysfunctional platelets

Question 58

what are causes of thromnoctopenia

Answer 58

bone marrow failure medications bone marrow malignancy

Question 59

what helps determine weather a deficiency is platelets issue rather than a coagulopathy

Answer 59

petchia

Question 60

what is Thrombocytosis

Answer 60

abnormal high amount of thrombocytes 450,000

Question 61

what are the two different types of thrombocytosis

Answer 61

reactive tthrombocytosis Autonomus thrombocytosis

Question 62

what is a S/S of thrombocytosis

Answer 62

erthromelgia (see with painful burning of hands with erythemia)

Question 63

what is the treatment plan for thrombocytosis

Answer 63

refer to hemotology of there is no infectious cause or does not resolve in 2-4 weeks.