hematological system

Question 1

acute hemorrhage

Answer 1

correct hemoglobin won’t show up unit 24 hours of hemorrhage.

Loss of 15% or higher = orthostatic hypotension

Question 2

neutropenia

Answer 2

frequent infections

ANC, absolute neutrophil count of

Question 3

b12 defeciency

Answer 3

gradual peripheral neuropathy, ataxia (postive romberg test), loss of vibration sense,.

Question 4

hodginks lymphoma

Answer 4

a cancer of B lymphocytes
pain with injection of alcoholic drinks, painless lymph nodes of the neck.

Common age 20-40yo or >60 yo, while male

Question 5

multiple myeloma

Answer 5

cancer of plasma cells.
The plasma cells are a type of WBC IN BONE MARROW . With this condition, a group of plasma cells becomes cancerous and multiplies.
The disease can damage the bones, immune system, kidneys, and red blood cell count.
Symptoms may not be present or may be non-specific, such as loss of appetite, bone pain, and fever.bone pain in the BACK PAIN or CHEST PAIN
proteinuria with Bence- jones protein

Question 6

bence jones protein suggested of what?

Answer 6

multiple myeloma

Question 7

thrombocytopenia

Answer 7

platelet count

Question 8

normal platelet count

Answer 8

150,000-450,000

Question 9

normal hemoglobin in males/females

Answer 9

males: 14-18 g/dl
females: 12-16g/dl

Question 10

normal hematocrit males/females

Answer 10

males: 42-52%
females: 37-47%

Question 11

MCV

Answer 11

80-100

Question 12

MCHC

Answer 12

color of the RBC

noral: 31-37g/dl

Question 13

MCH

Answer 13

indirect measure of the color of RBC

normal 25-35

Question 14

TIBC

Answer 14

total iron binding capacity
measure of available transferrin left unbent (transferrin transfers iron to the body)
ELEVATED if LOW iron
normal 250-410mcg

Question 15

Serum ferritin

Answer 15

storage form of iron produced in the intestines (spleen, over, marrow)

most SENSITIVE test for iron deficiency anemia

Iron def: decreased

thalassemia: normal to high ( high dt given iron supplements)
normal: 20-400 ng/dl

Question 16

RDW

Answer 16

red cell distribution width. ELEVATED in iron def and thalassemia (variability of RBC size)

Question 17

reticulocytes (aka stabs)

Answer 17

immature RBC that still have their nuclei. after 24 hours they mature into RBC. RBC survive 120 days before broken down by the liver.
normal value: .5% - 2.5% of total RBC count

> 2.5%= reticulocytosis. Plateletes make more RBC. elevated with iron supplementation or iron, folate, or b12, acute bleeding, leukemia. NOT WITH CHRONIC BLEED.

if NOT increased, check bone marrow failure ( aplastic amemai)

Question 18

poikilocytosis

Answer 18

SEVERE iron def anemia. may be also anisocytoiss (variable sizes)

Question 19

WBC

Answer 19

normal value 5,000-10,000/10mm3

Question 20

hemoglobin electrophoresis

Answer 20

“gold standard” tests for sickle cell and thalassemia

Question 21

secondary polycythemia

Answer 21

copd, chronic smoker, high altitudes

Question 22

anemia

Question 23

iron def. anemia

Answer 23

1 cause: BLOOD LOSS

microcytic
hypochromic

Question 24

classic case of iron def anemia

Answer 24

pallor of skin, nail beds, glossitis (sore and shiny red tongue), angular chelitis (skin fissure corner of mouth), cravings for ice and dirt (pica)

SEVERE: koilonychia (spoon shaped nails), systolic murmur, tachy, heart failure

Question 25

labs for iron def

Answer 25

dsg test:
TIBC (>410)
>RDW

microcytic

Question 26

thalassemia minor

Answer 26

microcytic, hypochromic

Ferritin increase or normal

Question 27

normacytic anemia

Answer 27

MCV 80-100, normochromic
hx of chronic disease
or inflammatory disease (RA)

Question 28

b12 /folate def/pernicious anemia (b12)

Answer 28

macrocytic, megaloblastic RBC

normochromic

Question 29

supplementation of iron

Answer 29

325mg ferrous sulfate. po TID, take with meals, with vitC
increase fiver and fluids
iron rich foods (beans, veges)
AVOID: ANTACIDS, daily, quiolones, tetracycline

Question 30

thalassemia minor or trait

Answer 30

if partner also has treat, 25% chance to children
beta thalassemia, abnormal hgb, a2, hgbF
NORMAL to HIGH ferritin level

Question 31

pernicious anemia cause

Answer 31

autoimmune, destruction of parietal cells in the funds resulting in cessation of intrinsic factor production, necessary to absorb b12 from the small intestine.

b12 sources; meal, poultry, eggs, milk, cheese

Neuropathic s/s (numbness, tingling,

Question 32

if MCV >100 what to order

Answer 32

b12 and folate

Question 33

b12 def s/s

Answer 33

ONLY one with neurologic s/s (tingling/numb)

Question 34

ferritin and serum iron level in thalassmia

Answer 34

norm to high