hema/oncoc

Question 1

Low MCV anemia

Answer 1

iron deficiency
thalassemia

Question 2

high MCV anemia

Answer 2

b12 (pernicious)
folic acid

Question 3

normocytic anemia

Answer 3

anemia of chronic disease
sickle cell
renal failure

Question 4

normocytic

Answer 4

80-100

Question 5

normochromic

Answer 5

32-36%

Question 6

s/s of iron deficiency anemai

Answer 6

Pica
palpiation
pallor

low MCV, low MCHC, low serum ferritin, High TIBC

Question 7

thalassemia

Answer 7

microcytic hypocrhomic genetically inherited

seen in mediterranean, African, Middle eastern , Indian and asian population

Question 8

most familiar type of thalassemia

Answer 8

beta thalassemia

Question 9

forms of beta thalassemia

Answer 9

thalassemia minor (adults) one gene
thalassemia major children two genes

Question 10

elevated MCV, MCHC normal, decreased serum folate

Answer 10

folic acid deficiency

Question 11

s/s folic acid deficiency

Answer 11

glossitis
fatigue
anorexia
aphthous ulcers
*no neuro s/s

Question 12

mtg of folic acid deficiency

Answer 12

folate 1mg every day
folate foods

Question 13

pt presents with glossitis, paresthesia, loss of fine motor control and postive babinski what do you suspect and management

Answer 13

b12 anemia (pernicious)

b12(cyanocobalamin) 100mg IM daily x1 week then monthly lifelong (front loaded-once a dayqweek then monthly)

Question 14

most common anemia in elderly

Answer 14

anemia of chronic disease

Question 15

MCV normal, MCHC normal, serum ferritin high, TIBC low

Answer 15

anemia of chronic disease

Question 16

beta minor thalassemia is what gene wise

Answer 16

heterozygous - only one copy of gene

Question 17

which pt would have decreased a or b Hgb chains ?

Answer 17

thalassemia

Question 18

b1

Answer 18

thiamine

Question 19

reduced ability to create blood clots caused by mutation in clotting factor VIII

Answer 19

von willebrand disease

Question 20

mtg of von willebrand disease

Answer 20

desmopressin, recombinant von Hillebrand factors/factor VIII concentrate

Question 21

acute leukemia in adults

Answer 21

acute myeloggenous leukemia (AML)

Question 22

pancytopenia with blasts is hallmark of disease

Answer 22

acute lymphocytic leukemia (ALL)

Question 23

most common leukemia in adults with lymphocytosisi

Answer 23

chronic lymphocytic leukemia (CLL)

Question 24

what is hallmark of chronic myelogensous leukemia (CML)

Answer 24

philadelphia chromosome

Question 25

what is required to confirm dx of leukemia

Answer 25

bone marrow aspiration

Question 26

stage II lymphoma is what

Answer 26

more than one lymph node group involved; confined to one side of diaphragm

Question 27

stage III lymphoma is what

Answer 27

lymph nodes or the spleen involved; occurs on both sides of diaphragm

Question 28

which Hodgkins is usually advanced stage disease at dx

Answer 28

non-hodgkins lymphoma

Question 29

what characteristic differs Hodgkins from non-hodgkins lymphoma

Answer 29

reed-stern berg cells

Question 30

thrombocytopenia resulting from autoimmune destruction of plateltes

Answer 30

idiopathic thrombocytopenia purport (ITP)

Question 31

mtg of ITP

Answer 31

(idiopathic thrombocytopenia purpora)

high dose corticosteroids
IV gamma globulin
PLT Transfusion <20000

Question 32

Path of DIC

Answer 32

thrombin -> fibrinogen to fibrin -> fibrin clots in microcirculation
decrease fibrinogen,PT, PLT, factor V and VIII are reduced
activates fibrinolytic system which lyses fibrin clots into fibrin degradation products
hemorrhage results from anticoagulantnt activity of FDPs and depletion of coag factors

Question 33

labs r/t DIC

Answer 33

PLT <150,000
Fibrinogen < 170
Decreased RBCs
increased fibrin degradation products >45
PT >19 seconds
PTT >42 seconds
D-Dimer +