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Med Surg 1 > Hematology > Flashcards

Hematology Flashcards

1
Q

What is another name for platelets?

A

Thrombocytes

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2
Q

Is Platelet count 20,000/mm3 normal?

A

No it’s too low

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3
Q

What is the normal Platelet count?

A

150,000-450,000/mm3

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4
Q

Increase of PLT is called?

A

Thrombocytosis

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5
Q

Decrease of PLT is called?

A

Thrombocytopenia

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6
Q

Thrombocytopenia s/s

A

Ecchymosis, pale, risk for bleeding

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7
Q

Is 12,000/mm3 normal for WBC?

A

No it’s too high

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8
Q

What is the normal range for WBC?

A

4500-11000/mm3

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9
Q

What is too much WBC called?

A

Leukocytosis

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10
Q

What is WBC deficiency called?

A

Leukopenia

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11
Q

What does a high number of neutrophil, bonds, and segments indicate?

A

Bacterial infections, inflammation, and some leukemias

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12
Q

What does a high and low number of eosinophils indicate?

A

High: allergic responses, some leukemia
Low: infections

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13
Q

What does a high number of basophils indicate?

A

Hyperthyroidism, ulcerative colitis, bone marrow disorders

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14
Q

What does a high number of lymphocytes indicate?

A

Viral infections, chronic bacterial infections, some leukemias

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15
Q

What does a high number of monocytes indicate?

A

Chronic inflammatory disorders, some leukemias

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16
Q

Normal male RBC value?

A

4.71-5.14 million/mm3

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17
Q

Female normal RBC value?

A

4.2-4.87 million/mm3

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18
Q

What is too much RBC called?

A

Polycythemia

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19
Q

What is low RBC indicate?

A

Anemia

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20
Q

What is normal hct level for male?

A

43%-49%

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21
Q

Female hct normal amount

A

38%-44%

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22
Q

High hct means?

A

Dehydration, chronic hypoxia

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23
Q

Low hct means?

A

Anemia

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24
Q

Normal hgb male level?

A

14-17.3 g/100ml

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25
Q

Female hgb normal value?

A

11.7-15.5 g/100ml

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26
Q

What are reticulocytes?

A

Immature RBCs

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27
Q

Normal range of reticulocytes

A

1.5%-2.5%

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28
Q

Where are blood cells produced?

A

In the red bone marrow

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29
Q

How does the body react to hypoxia?

A

Stimulates kidney to produce erythropoietin, increase the rate of RBC production

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30
Q

What nutrition do you need to produce healthy RBCs?

A

Protein, vit B12, iron, folic acid

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31
Q

What produces platelets in the red bone marrow?

A

Megamaryocytes

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32
Q

What does lymph vessels absorb

A

Fat and fat-soluble vitamins

33
Q

Which quadrant is spleen at?

A

Upper left

34
Q

What happens if you get a splenectomy?

A

Immunocompromised for the lifetime

35
Q

What to do before a bone marrow biopsy?

A

Premedicate!

36
Q

What is lymphangiography?

A

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
Q

What does cryoprecipitates have?

A

Clotting factors

38
Q

Link between iron and vit C

A

Vit C helps breakdown and absorb iron

39
Q

Iron deficiency s/s

A

Mouth fissures, glossitis, spoon-shaped nails

40
Q

Pernicious anemia cause and s/s

A

Loss of intrinsic factors and deficiency of vit B12.
Hand/feet paresthesia, weakness, glossitis, memory problems

41
Q

Serum iron, ferritin, and total iron binding capacity (TIBC) tests are for what purpose?

A

Diagnose iron deficiency anemia

42
Q

Aplastic anemia patho

A

Red bone marrow is empty, low production of all blood cells, cause pancytopenia.
Caused by exposure to toxins, chemo…

43
Q

What is the most definitive test for aplastic anemia?

A

Bone marrow biopsy!

44
Q

What are sickle cells?

A

Abnormal RBCs that stick together and preventing good blood flow

45
Q

How can sickle cells be corrected?

A

When O2 level goes back to normal

46
Q

One of sickle cell anemia’s s/s is hand and foot syndrome which means?

A

Unequal growth (size) of fingers and toes

47
Q

Pt education on sickle cell anemia

A
  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
Q

What can be used to treat sickle cell crisis?

A
  1. Antibiotics, usually penicillin
  2. Hydroxyuria: can reduce crisis but have severe effects
  3. Pain management
  4. Fluids
  5. O2
49
Q

Standard tx for polycythemia

A
  1. Phlebotomy
  2. Chemo
  3. Antihistamine for itching
50
Q

Pt education for polycythemia

A
  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
Q

Disseminated Intravascular Coagulation (DIC) patho

A

Clotting too fast, deficiency of clotting factors, bleeding

52
Q

If patient have DIC, what will the result be for PT and PTT?

A

Prolonged

53
Q

Immune Thrombocytopenia Purpura (ITP) patho

A

Immune system destroy platelets, risk for bleeding acute or chronic.
Caused by immune system dysfunction, acute viral illness, drug reaction

54
Q

What can be used to treat ITP?

A
  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
Q

Hemophilia patho

A

Missing clotting factors 8 and 9
Hereditary disease
Can form a platelet plug but no clotting factors so will still bleed

56
Q

Is hemophilia curable?

A

No

57
Q

What is the PTT result for hemophilia?

A

Prolonged

58
Q

What can be used to treat hemophilia?

A
  1. DDAVP (desmopressin)
  2. Clotting factors 8 and 9
  3. Blood transfusion
59
Q

What is DDAVP (desmopressin)?

A

Antidiuretic hormone.
Stimulates the body to release more clotting factors.
Injection/nasal inhalation

60
Q

Pt education for hemophilia

A

Cannot play contact sports b/c will bleed!
Bleeding precaution

61
Q

Leukemia patho

A

High number of immature WBCs, bone marrow packed and can’t produce any other blood cells

62
Q

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)

A
  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
Q

Special s/s for leukemia

A

Rib/sternal pain due to crowding in bone marrow

64
Q

What can leukemia lead to?

A

Pancytopenia

65
Q

Multiple myeloma patho

A

Cancer of plasma cells in bone marrow, tumors grow and destroy bone tissue, all blood cell types are affected

66
Q

What do the bones look like with multiple myeloma?

A

Weak bones, have holes, and can lead to pathological fractures

67
Q

What’s the most common complaint of multiple myeloma?

A

Constant, unrelieved bone pain

68
Q

A very important s/s of multiple myeloma

A

Hypercalcemia!
Because bones break and calcium goes into blood stream!

69
Q

S/s of hypercalcemia

A

Anorexia, nausea, vomiting, mental changes, seizures, weakness, fatigue, kidney stones.
Can end up with pancytopenia

70
Q

Most identifiable diagnostic test result for multiple myeloma is?

A

Bence-Jones proteins in urine.
(C-reactive protein = inflammation marker)

71
Q

interventions for multiple myeloma

A
  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
Q

Pt education for multiple myeloma

A

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
Q

Hodgkin lymphoma patho

A

Caused by virus, genetic, or immune dysfunction
Presence of Reed-Sternberg cells

74
Q

Non-hodgkin lymphoma patho

A

Arise from B and T cells
Absence of Reed-Sternberg cells
Caused from virus, H. pylori, immune dysfunction, occupational exposures

75
Q

Hodgkin’s vs non-hodgkin’s

A
  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
Q

Why is splenectomy last resort?

A

Because pt will be immunocompromised for the lifetime if spleen gets removed

77
Q

Pre-op splenectomy

A

Get baseline vitals and labs, teach coughing and deep breathing

78
Q

Post-op splenectomy

A

Infection control, monitor vitals and bleeding, cough and deep breathe and ambulate, can administer narcotics for pain

Med Surg 1 (3 decks)

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