Final exam new material Flashcards
What level of Hgb is considered anemia?
Men: 13.6
Women: 12
Iron deficiency anemia: Labs
Low Hgb
Low MCV, MCH
Low reticulocytes
High RDW
Thalassemia: Labs
High RBC
Low Hgb
Low MCV
Normal RDW
Vit B12 and folate labs
Low Hgb
Elevated MCV
Elevated RDW
Low reticulocyte
What type of anemia is methylmalonic acid elevated in?
B12
What type of anemia is homocysteine elevated in?
B12 & Folate
Anemia of chronic disease: Labs
Low Hgb Low reticulocytes Normal MCV Elevated RDW Elevated TIBC
What platelet level defines thrombocytopenia?
What level is there a risk of bleeding with surgery/trauma?
What level is there a risk for spontaneous bleeding?
Less than 150k
50k
10k
How do you manage lab levels with thrombocytopenia?
Recheck immediately if less than 50k
Recheck in 1-2 weeks if 50-100
Recheck in 1-2mo if 100-150
Name the condition:
Lack of iris color, hematuria, hypertension
unilateral abd mass that does not cross the midline (displaceable and painless)
Wilms Tumor
What type of WBC is most prevalent in leukemia?
Blasts (immature WBCs)
What are the B symptoms of lymphoma?
unexplained wt loss of 10% or greater of body weight in 6 months prior to dx
unexplained fever > 38
drenching night sweats
What type of lymphoma are B symptoms most common in?
Hodgkin lymphoma
What type of lymphoma are reed-sternberg cells most common in?
Hodgkin lymphoma
Where does Hodgkin vs. non-Hodgkin lymphoma begin and where do they metastasize to?
Hodgkin: starts in cervical lymph nodes; mets to liver, spleen
Non-Hodgkin: starts in intestinal lymph nodes; mets to CNS and bone marrow
When would the FNP perform a chest x-ray while working up acute bronchitis?
If respiratory distress s/s present - tachypnea, tachycardia; high fever
Definition of acute bronchitis
cough with or without sputum production persisting past 7 days
Atypical presentation of pneumonia
prodrome of headache and sore throat; dry cough
Typical presentation of pneumonia
fever, chills, malaise, productive cough
rales, consolidation
CURB 65 criteria
Confusion? BUN > 19 RR > 30 BP (SBP < 90, DBP < 60) 65 or older?
Management of pneumonia Previously healthy, no recent antibiotic use Atypical Significant comorbidities If suspect MRSA (recent abx use) Peds
Previously healthy, no recent antibiotic use: macrolide or doxycycline
Atypical: Macrolide
Significant comorbidities: Macrolide + Augmentin or respiratory fluoroquinolone (levofloxacin, moxifloxacin)
If suspect MRSA (recent abx use): vancomycin or linezolid
Peds: amoxicillin 1st line if presumed bacterial
Name the condition:
Sudden onset pleuritic chest pain, dyspnea
Tachycardia, tracheal deviation, hypotension
Pneumothorax
How does the FNP manage a pneumothorax?
Observation if asymptomatic/primary and < 2-3cm
Refer all patients to pulmonologist
Hospitalize if symptomatic or large pneumo
ALL tension and secondary pneumo need hospitalization
No air travel until after complete resolution
Name the condition:
Dyspnea, tachypnea, pleuritic chest pain
Pulmonary embolism
