Boards me > Hematology > Flashcards
Hematology Flashcards
The most common type of hemophilia in the United States is
hemophilia A
Thrombocytopenia is defined as a platelet count of
<150,000
If the TIBC and ferritin levels are normal, the patient has
thalassemia
Best absorbed form of iron supplementation (and cheapest) is
ferrous sulfate
If patients took an antacid, ask them to wait about — hours before taking an iron pill (minimizes binding).
4 hours
Untreated vitamin B12 deficiency can result in
irreversible neurolgoic damage
Any patient complaining of neuropathy or who has altered mental status should have —– levels checked
b12
In a person with normal bone marrow, supplementing the deficient substance (iron, B12, folate) will increase the hemoglobin/hematocrit in about 1 to 2 weeks and will normalize within
4 to 8 weeks
The screening test for all anemias is the
CBC
normal MCV is
80-100
2 main macrocytic anemias are
vitamin b12 and Folic
most microcytic anemia is
IDA
what anemia has neurologic changes
b12
HBsAg is the indicates
AG - always growing + this means acute or chronic infection
IgM
now
Igg
Old
+HbsAg and a +igG
chronic infection
- HbsAg and +Igg
indicates infection is gone
can pt get Hep B vaccine
yes in pregancy
First hep b
first 24 hours after birth
CML see
spleen enlargement
anemia
liver enlargement
A patient diagnosed with systemic lupus erythematosus is at an increased risk for an autoimmune
hemolytic anemia
The mean corpuscular hemoglobin (MCH) is:
A.A measure of the average size of the red blood cells in a sample of blood
B.The average hemoglobin content in a red blood cell
C.A measure of the average hemoglobin concentration per red blood cell
D.The average volume (size) of the red blood cells
Answer: B. The average hemoglobin content in a red blood cell
The MCH is the average hemoglobin content in a red blood cell. The mean corpuscular volume (MCV) is the average volume (size) of the red blood cells. Mean corpuscular hemoglobin concentration (MCHC) is the average hemoglobin concentration per red blood cell. Red cell distribution width (RDW) is a measure of the variation in red blood cell size.
The inheritance pattern for sickle cell anemia is described as:
A.Autosomal recessive
B.X-linked dominant
C.Autosomal dominant
D.X-linked recessive
Answer: A. Autosomal recessive
The five patterns of Mendelian inheritance are autosomal dominant, autosomal recessive, X-linked dominant, X-linked recessive, and Y-linked. Sickle cell anemia is an autosomal recessive trait. Glucose-6-phosphate dehydrogenase deficiency anemia is an X-linked recessive genetic disease
A 55-year-old patient with a known history of stage 3 chronic kidney disease (CKD) complains of fatigue, palpitations, and shortness of breath on exertion. These symptoms have been persistent over the last 2 months. Their blood pressure is well-controlled on antihypertensive medications, and they have been adherent to their prescribed low-protein diet. A recent complete blood count (CBC) reveals a normocytic, normochromic anemia. Which laboratory test would best confirm the suspected diagnosis?
A.Serum vitamin B12
B.Red cell folate
C.Serum erythropoietin
D.Serum ferritin
Answer: C. Serum erythropoietin
The patient’s history of stage 3 CKD and the presence of a normocytic, normochromic anemia strongly suggest anemia of CKD as the cause. The kidneys play a crucial role in producing erythropoietin, a hormone that stimulates red blood cell production. In CKD, the kidneys may not produce adequate amounts of erythropoietin, leading to reduced red blood cell production and anemia. This can be confirmed by a serum erythropoietin level. A serum vitamin B12 level would be used to diagnose vitamin B12 deficiency, which typically presents with a macrocytic anemia. A red cell folate level would be used to diagnose folate deficiency, which also presents with macrocytic anemia. Serum ferritin level would be used to diagnose iron-defici
What is the most common type of hemophilia in the United States
A.Hemophilia B
B.Hemophilia C
C.Von Willebrand disease
D.Factor VIII deficiency
Answer: D. Factor VIII deficiency
Factor VIII deficiency (hemophilia A) is a genetic disorder that is X-linked recessive. It is the most common type of hemophilia in the United States. Hemophilia B is an inherited deficiency of factor IX, also called Christmas disease. Also an X-linked recessive disorder, it is less common than hemophilia A. Hemophilia C is an inherited deficiency of factor XI, also called Rosenthal syndrome. It is an autosomal recessive disorder.
A patient presents with complaints of progressive fatigue, pallor, and forgetfulness. Their history reveals heavy alcohol consumption and a diet primarily composed of processed foods. Examination shows no signs of peripheral neuropathy, and blood tests reveal macrocytic anemia. Which of the following laboratory tests would the nurse practitioner order next to confirm a suspected diagnosis?
A.Serum homocysteine levels
B.Serum methylmalonic acid (MMA) levels
C.Hemoglobin A1C
D.Thyroid-stimulating hormone (TSH) levels
Answer: A. Serum homocysteine levels
In this patient presenting with macrocytic anemia, progressive fatigue, pallor, and forgetfulness, a folate deficiency is strongly suspected. This suspicion is supported by the patient’s diet history and heavy alcohol consumption, both of which can contribute to folate deficiency. Elevated serum homocysteine levels can indicate folate deficiencies
Serum methylmalonic acid (MMA) levels would be the test of choice if the clinical picture suggested
Vitamin B 12 def
Which laboratory test is most helpful in distinguishing iron-deficiency anemia from anemia of chronic disease?
A.Serum ferritin
B.Total iron-binding capacity
C.Transferrin saturation
D.Serum iron
serum ferritin
Which serological test is most commonly used to diagnose acute hepatitis B infection?
A.Hepatitis B surface antigen (HBsAg)
B.Hepatitis B surface antibody (HBsAb)
C.Hepatitis B e antigen (HBeAg)
D.Hepatitis B core antibody (HBcAb)
Answer: A. Hepatitis B surface antigen (HBsAg)
The presence of HBsAg in a patient’s blood is indicative of acute infection with the hepatitis B virus. HBsAg is the most commonly used serological marker for diagnosing acute hepatitis B infection. It is the first detectable marker during the acute phase of the infection and represents the presence of the virus in the bloodstream. HBsAb is typically detected in individuals who have been previously infected or vaccinated against hepatitis B, and it indicates immunity rather than acute infection. HBeAg and HBcAb are additional markers used to assess the stage and progression of the infection, but they are not specific to acute hepatitis B infection.
A 55-year-old patient with a known history of stage 3 chronic kidney disease (CKD) complains of fatigue, palpitations, and shortness of breath on exertion. These symptoms have been persistent over the last 2 months. Their blood pressure is well-controlled on antihypertensive medications, and they have been adherent to their prescribed low-protein diet. A recent complete blood count (CBC) reveals a normocytic, normochromic anemia. Which laboratory test would best confirm the suspected diagnosis?
A.Serum vitamin B12
B.Red cell folate
C.Serum erythropoietin
D.Serum ferritin
Answer: C. Serum erythropoietin
The patient’s history of stage 3 CKD and the presence of a normocytic, normochromic anemia strongly suggest anemia of CKD as the cause. The kidneys play a crucial role in producing erythropoietin, a hormone that stimulates red blood cell production. In CKD, the kidneys may not produce adequate amounts of erythropoietin, leading to reduced red blood cell production and anemia. This can be confirmed by a serum erythropoietin level. A serum vitamin B12 level would be used to diagnose vitamin B12 deficiency, which typically presents with a macrocytic anemia. A red cell folate level would be used to diagnose folate deficiency, which also presents with macrocytic anemia. Serum ferritin level would be used to diagnose iron-deficiency anemia, which presents with microcytic, hypochromic anemia.
A 4-year-old patient is brought to the clinic by their parents, who are concerned about recent changes in their child’s behavior. The child is frequently irritable, has a reduced appetite, and is lagging in their developmental milestones. The parents mention that they live in an older house that was recently renovated. On examination, the child has a bluish line along their gums. A blood lead level test is ordered, and it returns with a level of 45 mcg/dL. Which of the following would be the most appropriate initial management approach?
A.Administer oral calcium disodium edetate (CaNa2EDTA) immediately
B.Prescribe high-dose iron supplementation
C.Administer oral chelation therapy with succimer
D.Advise the parents to remove all lead-based paint from their house
Answer: C. Administer oral chelation therapy with succimer
The patient’s symptoms and the blood lead level of 45 mcg/dL strongly suggest lead poisoning. This can occur in children living in older houses with lead-based paint, especially if the house was recently renovated, which can cause the release of lead dust. Symptoms of lead poisoning include developmental delay, irritability, loss of appetite, and a bluish line on the gums. The appropriate treatment for lead poisoning with a blood lead level above 45 mcg/dL is oral chelation therapy with succimer to help remove the lead from the patient’s body. Administering oral CaNa2EDTA immediately is not appropriate because this form of chelation therapy is usually reserved for severe, life-threatening cases of lead poisoning with blood lead levels above 70 mcg/dL. High-dose iron supplementation is not a treatment for lead poisoning; although iron deficiency can increase the risk of lead poisoning, this child’s symptoms and history strongly suggest lead exposure as the primary issue. Although removal of all lead-based paint from the house reduces the risk for future exposure, it does not address the immediate need for treatment in a patient who already has elevated blood lead levels.
Which serological test is most commonly used to diagnose acute hepatitis B infection?
A.Hepatitis B surface antigen (HBsAg)
B.Hepatitis B surface antibody (HBsAb)
C.Hepatitis B e antigen (HBeAg)
D.Hepatitis B core antibody (HBcAb)
Answer: A. Hepatitis B surface antigen (HBsAg)
The presence of HBsAg in a patient’s blood is indicative of acute infection with the hepatitis B virus. HBsAg is the most commonly used serological marker for diagnosing acute hepatitis B infection. It is the first detectable marker during the acute phase of the infection and represents the presence of the virus in the bloodstream. HBsAb is typically detected in individuals who have been previously infected or vaccinated against hepatitis B, and it indicates immunity rather than acute infection. HBeAg and HBcAb are additional markers used to assess the stage and progression of the infection, but they are not specific to acute hepatitis B infection.
The mean corpuscular hemoglobin (MCH) is:
A.A measure of the average size of the red blood cells in a sample of blood
B.The average hemoglobin content in a red blood cell
C.A measure of the average hemoglobin concentration per red blood cell
D.The average volume (size) of the red blood cells
Answer: B. The average hemoglobin content in a red blood cell
The MCH is the average hemoglobin content in a red blood cell. The mean corpuscular volume (MCV) is the average volume (size) of the red blood cells. Mean corpuscular hemoglobin concentration (MCHC) is the average hemoglobin concentration per red blood cell. Red cell distribution width (RDW) is a measure of the variation in red blood cell size.
Reed sternberg cells are in
classic hodgkins disease
An adult patient comes to the clinic for an annual wellness exam. As part of the routine screening, the nurse practitioner orders a complete blood count (CBC), which shows a hemoglobin level of 14.5 g/dL. What statement is true regarding this value?
A.The level is abnormally low for an adult regardless of sex.
B.The level is low for an adult male but within the normal range for an adult female.
C.The level is within normal ranges for an adult regardless of sex.
D.The level is within the normal range for an adult male but abnormally high for an adult female.
Answer: C. The level is within normal ranges for an adult regardless of sex.
Hemoglobin levels vary slightly between men and women. For female adults, the normal range is generally between 12.0 and 16.0 g/dL; for male adults, the range is 14.0 to 18.0 g/dL. The patient’s hemoglobin level of 14.5 g/dL falls within both ranges.
