Hematology Flashcards
A 13 year old female who is diagnosed with iron deficiency anemia is being treated with ferrous sulfate. Proper treatment typically leads to the resolution of anemia within:
3 months
A patient on warfarin (Coumadin) therapy for recurrent deep vein thrombosis (DVT) is about to have lumbar spinal fusion surgery. The patient’s warfarin is put on hold starting 5 days prior to the surgery and subcutaneous enoxaparin (Lovenox) has been ordered for DVT prophylaxis until the resumption of the warfarin. The nurse practitioner knows that the patient’s postoperative warfarin dose should be restarted based on the:
baseline PT and INR values
Progression to Acute Myelogenous Leukemia (AML) is a risk for untreated or poorly responsive:
Myelodysplastic syndrome
Hemophilia A
An X linked genetic disorder which affects males and is caused by factor VIII deficiency.
Hemoglobin in males
13.6-16.9
Hemoglobin in females
12-16
Hematocrit
Proportion of RBS in 1ml of plasma
Hematocrit for males
40-50%
Hematocrit for femles
36-44%
Mean corpuscular volume
The average size of RBCs
Normal MCV
80-100
MCV <80
microcytic anemiaMC
MCV 80-100
normocytic anemia
MCV>100
macrocytic anemia
Mean corpuscular hemoglobin
Average concentration of hemoglobin per RBC
Normal MCH value
32-35%
Mean corpuscular hemoglobin concentration
Average hemoglobin content per RBC
Normal MCHC value
25-35pg/cell
Low MCHC means..
hypochromic anemia
- IDA
- Thalassemia
High MCHC means….
hyperchromic anemia
- Folic acid deficiency
- B12/pernicious anemia
Total iron binding capacity level
300-360
Total Iron Binding capacity
Available unbound transferrin available to transport iron around the body. Level is increased when there is not enough iron to transport.
In IDA what happens to the TIBC?
It is increased
In thalasemia, B12 deficiency and folic acid deficiency what happens to TIBC?
It stays the same
Serum ferritin
Stored form of iron in the body. Normal level is 40-200
Serum iron
Iron in the blood. Decreased in IDA, normal to elevated in thalassemia and macrocytic anemias.
60-150.Re
Reticulocytes
Immature RBCs
This level increased with active bleeding
Folate
<2ng is deficiency
B12
<200 is deficiency
Foods high in folate
- asparagus
- broccoli
- avocado
- brussel sprouts
- leafy greens
- eggs
- liver
Foods high in B12
Beef, dairy, eggs, cereal, salmon
WBC normal level
4,500-11,000
Platelets normal level
150-350
Blood levels in IDA
Low iron
Low ferritin
High TIBC
Blood levels in thalassemia
normal ferritin
normal TIBC level
What kind of anemia is IDA?
Microcytic & hypochromic
- iron and ferritin are low
- MCV<80
- MCHC low
What kind of anemia is thalassemia?
Microcytic & hypochromic
- iron and ferritin are normal
- MCV<80
- MCHC low
What kind of anemia is B12 deficiency anemial?
Macrocytic / normochromic
- MCV>100
- MCHC 32-35%
- B12 is low
In pernicious anemia there are also antibodies to IF present
What kind of anemia is folate deficiency anemia?
Macrocytic / normochromic
- folate low
-homocystine low
- MCV>100
- MCHC 32-35%
Anemia of chronic disease
Normocytic/normochromic
- hx of chronic inflammatory disease
- MCV 80-100
- MCHC 32-35%
Treatment for IDA
325mg ferrous sulfate TID
- between meals or with OJ
Treatment for thalassemia
Refer to hematology
Treatment for B12 deficiency anemia
Parenteral or PO B12
Treatment for folic acid deficiency anemia
1-5mg PO folate daily
Pancytopenia
Leukopenia (low WBC), Anemia (low Hgb), thrombocytopenia (low platelets)
Aplastic anemia treatment
Urgent referral to hematology
Aplastic anemia
A rare and serious blood disorder that occurs when the bone marrow doesn’t produce enough new blood cells. This can happen when stem cells in the bone marrow are damaged.
Hemochromatosis
- genetic disorder with increase in intestinal absorption of iron leading to iron overloadT
Treatment for hemachromotoais
Phlebotomy
Neuropathy is associated with which type of anemia?
B12 deficiency anemia
Glucose 6 Phosphate Dehydrogenase Deficiency Anemia (G6PD)
Oxidative injury destroys red blood cells.
X linked recessive
s/s include: jaundice, fatigue, SOB, tachycardia, dark urine,
May be severe or self limiting
Infants at high risk for neonatal jaundice
G6PD dad carrier
daughters 100% affected
sons 100% not affected
G6PD mom carrire
Daughters
50% affected, 50% unaffected
Sons
50% unaffected, 50% G6PD
