Hematology Flashcards
1
Q
What is another name for platelets?
A
Thrombocytes
2
Q
Is Platelet count 20,000/mm3 normal?
A
No it’s too low
3
Q
What is the normal Platelet count?
A
150,000-450,000/mm3
4
Q
Increase of PLT is called?
A
Thrombocytosis
5
Q
Decrease of PLT is called?
A
Thrombocytopenia
6
Q
Thrombocytopenia s/s
A
Ecchymosis, pale, risk for bleeding
7
Q
Is 12,000/mm3 normal for WBC?
A
No it’s too high
8
Q
What is the normal range for WBC?
A
4500-11000/mm3
9
Q
What is too much WBC called?
A
Leukocytosis
10
Q
What is WBC deficiency called?
A
Leukopenia
11
Q
What does a high number of neutrophil, bonds, and segments indicate?
A
Bacterial infections, inflammation, and some leukemias
12
Q
What does a high and low number of eosinophils indicate?
A
High: allergic responses, some leukemia
Low: infections
13
Q
What does a high number of basophils indicate?
A
Hyperthyroidism, ulcerative colitis, bone marrow disorders
14
Q
What does a high number of lymphocytes indicate?
A
Viral infections, chronic bacterial infections, some leukemias
15
Q
What does a high number of monocytes indicate?
A
Chronic inflammatory disorders, some leukemias
16
Q
Normal male RBC value?
A
4.71-5.14 million/mm3
17
Q
Female normal RBC value?
A
4.2-4.87 million/mm3
18
Q
What is too much RBC called?
A
Polycythemia
19
Q
What is low RBC indicate?
A
Anemia
20
Q
What is normal hct level for male?
A
43%-49%
21
Q
Female hct normal amount
A
38%-44%
22
Q
High hct means?
A
Dehydration, chronic hypoxia
23
Q
Low hct means?
A
Anemia
24
Q
Normal hgb male level?
A
14-17.3 g/100ml
25
Female hgb normal value?
11.7-15.5 g/100ml
26
What are reticulocytes?
Immature RBCs
27
Normal range of reticulocytes
1.5%-2.5%
28
Where are blood cells produced?
In the red bone marrow
29
How does the body react to hypoxia?
Stimulates kidney to produce erythropoietin, increase the rate of RBC production
30
What nutrition do you need to produce healthy RBCs?
Protein, vit B12, iron, folic acid
31
What produces platelets in the red bone marrow?
Megamaryocytes
32
What does lymph vessels absorb
Fat and fat-soluble vitamins
33
Which quadrant is spleen at?
Upper left
34
What happens if you get a splenectomy?
Immunocompromised for the lifetime
35
What to do before a bone marrow biopsy?
Premedicate!
36
What is lymphangiography?
Inject dye into hand/foot lymphatic tissues to check flow and blockages of lymph.
Dressing after and immobilize!
Watch for edema in lymph and check motor and sensation.
Repeat Q24hrs.
Educate pre-op: skin, urine, feces can turn blue for 2 days
37
What does cryoprecipitates have?
Clotting factors
38
Link between iron and vit C
Vit C helps breakdown and absorb iron
39
Iron deficiency s/s
Mouth fissures, glossitis, spoon-shaped nails
40
Pernicious anemia cause and s/s
Loss of intrinsic factors and deficiency of vit B12.
Hand/feet paresthesia, weakness, glossitis, memory problems
41
Serum iron, ferritin, and total iron binding capacity (TIBC) tests are for what purpose?
Diagnose iron deficiency anemia
42
Aplastic anemia patho
Red bone marrow is empty, low production of all blood cells, cause pancytopenia.
Caused by exposure to toxins, chemo...
43
What is the most definitive test for aplastic anemia?
Bone marrow biopsy!
44
What are sickle cells?
Abnormal RBCs that stick together and preventing good blood flow
45
How can sickle cells be corrected?
When O2 level goes back to normal
46
One of sickle cell anemia's s/s is hand and foot syndrome which means?
Unequal growth (size) of fingers and toes
47
Pt education on sickle cell anemia
1. Yearly pneumococcal flu shot
2. Avoid activity that increases O2 demand b/c can lead to sickle cell crisis
3. Avoid decreased circulation and vasoconstriction!
48
What can be used to treat sickle cell crisis?
1. Antibiotics, usually penicillin
2. Hydroxyuria: can reduce crisis but have severe effects
3. Pain management
4. Fluids
5. O2
49
Standard tx for polycythemia
1. Phlebotomy
2. Chemo
3. Antihistamine for itching
50
Pt education for polycythemia
1. 3L of water/day b/c need to thin blood
2. Avoid restrictive clothing
3. Elevate feet
4. Report chest pain and s/s of bleeding
5. TED HOSE!!!
51
Disseminated Intravascular Coagulation (DIC) patho
Clotting too fast, deficiency of clotting factors, bleeding
52
If patient have DIC, what will the result be for PT and PTT?
Prolonged
53
Immune Thrombocytopenia Purpura (ITP) patho
Immune system destroy platelets, risk for bleeding acute or chronic.
Caused by immune system dysfunction, acute viral illness, drug reaction
54
What can be used to treat ITP?
1. Steroids: suppress immune system
2. Immunoglobulin IVIG: contains antibodies that bind to cells in the spleen, protect platelets from being destroyed
3. Splenectomy: last resort
55
Hemophilia patho
Missing clotting factors 8 and 9
Hereditary disease
Can form a platelet plug but no clotting factors so will still bleed
56
Is hemophilia curable?
No
57
What is the PTT result for hemophilia?
Prolonged
58
What can be used to treat hemophilia?
1. DDAVP (desmopressin)
2. Clotting factors 8 and 9
3. Blood transfusion
59
What is DDAVP (desmopressin)?
Antidiuretic hormone.
Stimulates the body to release more clotting factors.
Injection/nasal inhalation
60
Pt education for hemophilia
Cannot play contact sports b/c will bleed!
Bleeding precaution
61
Leukemia patho
High number of immature WBCs, bone marrow packed and can't produce any other blood cells
62
4 common types of leukemia
1. Acute Lymphocytic Leukemia (ALL)
2. Acute Myelogenous (Myeloblastic) Leukemia (AML)
3. Chronic Lymphocytic Leukemia (CLL)
4. Chronic Myelogenous Leukemia (CML)
1. Most common in children
2. Pt > 60 y.o. have poor prognosis
3. Adults are more common
4. Philadelphia chromosome, older adults more common
63
Special s/s for leukemia
Rib/sternal pain due to crowding in bone marrow
64
What can leukemia lead to?
Pancytopenia
65
Multiple myeloma patho
Cancer of plasma cells in bone marrow, tumors grow and destroy bone tissue, all blood cell types are affected
66
What do the bones look like with multiple myeloma?
Weak bones, have holes, and can lead to pathological fractures
67
What's the most common complaint of multiple myeloma?
Constant, unrelieved bone pain
68
A very important s/s of multiple myeloma
Hypercalcemia!
Because bones break and calcium goes into blood stream!
69
S/s of hypercalcemia
Anorexia, nausea, vomiting, mental changes, seizures, weakness, fatigue, kidney stones.
Can end up with pancytopenia
70
Most identifiable diagnostic test result for multiple myeloma is?
Bence-Jones proteins in urine.
(C-reactive protein = inflammation marker)
71
interventions for multiple myeloma
1. High dose of steroids
2. Control serum calcium (biphosphonates: inhibit bone absorption, so when bone breaks, calcium level won't be too high)
3. Stem cell transplantation
72
Pt education for multiple myeloma
Increase fluids at ALL times!!!
Urine output needs to be 1.5-2L/day!
Because need to get excessive calcium out of blood stream!
73
Hodgkin lymphoma patho
Caused by virus, genetic, or immune dysfunction
Presence of Reed-Sternberg cells
74
Non-hodgkin lymphoma patho
Arise from B and T cells
Absence of Reed-Sternberg cells
Caused from virus, H. pylori, immune dysfunction, occupational exposures
75
Hodgkin's vs non-hodgkin's
1. Painless swollen lymph nodes: both
2. Reed-Sternberg cells: hodgkin's
3. Prognosis: hodgkin's better, non-hodgkin's poor
4. Alcohol induced pain: hodgkin's
76
Why is splenectomy last resort?
Because pt will be immunocompromised for the lifetime if spleen gets removed
77
Pre-op splenectomy
Get baseline vitals and labs, teach coughing and deep breathing
78
Post-op splenectomy
Infection control, monitor vitals and bleeding, cough and deep breathe and ambulate, can administer narcotics for pain
