FNP-Hematology Flashcards
What is Reticulocytosis?
immature RBCs, slightly larger than a RBC
Lab value for neutropenia
ANC <1,500/mm^3
Vitamin B12 Deficiency
[know the lab results, s/sx, common causes)
Peripheral smear: shows macroovalocytes, some megaloblasts & multisegmented neutrophils (>5-6 lobes)
Neurological signs (numbness, ataxia with positive Romberg test, loss of vibration, possible sense, impaired memory, dementia in severe cases).
Common cases: malabsorption (d/t pernicicious anemia, gastric disease/infection or medications).
Multiple Myeloma
Definition & symptoms
Cancer of plasma cells
Symptoms-fatigue, weakness & bone pain
Causes proteinuria w/ Bence-Jones proteins, hypercalcemia, normocytic anemia
Normal MCV value
80-100 (Size of RBC’s)
<80: microcytic
>100: macrocytic
Normal value of Mean Corpuscular Hgb Concentration (MCHC)
31.0-37.0g/dL
Measure color of RBCs
Which anemia(s) has decrease MCHC?
iron-deficiency anemia & thalassemia (hypochromic)
Is total iron-binding capacity (TIBC) increased or decreased in iron-deficiency anemia?
TIBC is a measure of available transferrin that is left unbound (to iron) & it is ELEVATED when there is not enough iron to transport
What lab test is most sensitive for iron-deficiency anemia?
Serum ferritin (not serum iron b/c it is not as sensitive as ferritin & can be affected by recent blood transfusions)
What is poikilocytosis?
Abnormal RBCs w/ variable shapes seen on peripheral smear. Seen w/ severe deficiency anemia
What is Anisocytosis?
Variable sizes of RBCs
What is the gold-standard test to diagnose hemoglobinopathies such as sickle cell anemia & thalassemia?
Hemoglobin electrophoresis
Iron-deficiency Anemia (know symptoms & lab results)
Pallor of skin, conjunctiva & nail beds, daily fatigue, exertional dyspnea, may have glossitis (sore & shiny red tongue, angular cheilitis, pica, konilonychia (in severe cases), systolic murmurs, tachycardia, or heart failure.
Microcytic & hypochromic (small & pale RBCs)
Name some macrocytic anemias
Pernicious anemia, folate deficiency, Vitamin B12 deficiency
What are the RBC changes in thalassemia minor?
Abnormal in Beta-thalassemia (microcytic, hypochromic), Normal if alpha-thalassemia
What should you avoid taking iron pill with?
Antacid-wait about 4 hours (b/c it minimize binding)
Tetracycline antibiotics, levothyroxine & bisphosphonates (iron decreases its effectiveness)
What are food sources of Vitamin b12?
all foods of animal origin (meat, poultry, eggs, milk & cheese)
What do you always check both vitamin B12 & folate level together?
A pt can be deficient in both B12 & folate. H/H will go up with folate supplementation only (even if still deficient in B12).
What is the treatment for pernicious anemia?
B12 injections 1000mcg (1mg) per week x4 weeks, then monthly injections OR high oral doses (1,000-2,000mcg) daily
What lab results should cause you to suspect pernicious anemia?
ELEVATED Parietal antibody test (antiparietal antibody) and/ or intrinsic factor antibody tests (anti-IF)
