HEMATOLOGY

Question 1

ANEMIA

Answer 1

DECREASED IN RBC

Question 2

ANEMIA IN MEN

Answer 2

<13 AND <42% HCT

Question 3

ANEMIA IN WOMEN

Answer 3

<12 AND <36 HCT

Question 4

SYMPTOMS OF ANEMIA

Answer 4

COLD PALE DIZZY, CP, SOB, LOW BP, FAINTING, MI, WEAK

Question 5

MCV

Answer 5

MEAN CORPUSCULAR VOLUME 80-100

AVERGAE SIZE OF THE RBC

Question 6

MCH

Answer 6

27-33

AMOUNT OF HEMOGLOBIN IN A SINGLE RBC

Question 7

MHCH

Answer 7

32-36 HEMOGLOBIN CONCENTRATION

AVERAGE GIVEN THE VOLUME

Question 8

LOW MCV (DECREASED)

Answer 8

IRON DEFICIENCY ANEMIA, THALASSEMIA AND ANEMIA OF CHRONIC DISEASE

Question 9

Most common anemia worldwide
* Common cause blood loss from GI and GU system
* Gastric or small bowel surgery without adequate iron
supplements
* Blood donations
* Iron requirements increase during pregnancy
* Long term ASA
* Menorrhagia or other uterine bleeding
* Chronic hemoglobinuria; traumatic hemolysis resulting
from abnormally functioning cardiac valve.
* Repeated pregnancies with breastfeeding.

Question 9

IRON DEFICIENCY ANEMIA IS

Answer 9

MICROCYTIC HYPOCHROMIC AND DEPLETED IRON STORES

STATE IN WHISH IRON STORES INT HE BODY ARE INADEQUATE TO PRESERVE HOMEOSTAIS AND PATIENT RESPONDS TO IRON TEHRAPY

Question 10

Labs you would see in iron deficiency

Answer 10

Decrease iron serum. Decrease ferritin and increase TIBC. 

Question 11

IRON DEF ANEMIA

Answer 11

Most common anemia worldwide
* Common cause blood loss from GI and GU system
* Gastric or small bowel surgery without adequate iron
supplements
* Blood donations
* Iron requirements increase during pregnancy
* Long term ASA
* Menorrhagia or other uterine bleeding
* Chronic hemoglobinuria; traumatic hemolysis resulting
from abnormally functioning cardiac valve.
* Repeated pregnancies with breastfeeding.

Question 12

Management for iron deficiency IM or PO 

Answer 12

Iron IV or I am is reserved for intolerance or noncompliance with PO medication 

Question 13

Retic site response after giving IV or IM or or PO iron 

Answer 13

Reticular site response will increase hematocrit should be seen in 7 to 10 days 

Question 14

If you fail to respond to iron therapy in 5 to 8 weeks, what should happen?

Answer 14

Should be worked up for noncompliance, impaired absorption, gastric or bowel pathology, blood or an incorrect diagnosis 

Question 15

This type of deficiency is macrocytic normal chromic anemia. It is a decrease.  red blood cells, and a hemoglobin content caused by impaired production related to decrease serum folate

Answer 15

Folic acid deficiency

Question 16

If you have celiac disease, tropical, sprue, or gluten sensitivity enteroPathy, what are you at risk for? 

Answer 16

Folic acid deficiency 

Question 16

Predisposing factors for folic acid deficiency

Answer 16

Poor nutritional intake of folate ETOH anorexia, old age with poor dietary intake or on a special diet you have a lack of absorption or an inadequate conversion of folate to tetra Hydro folate 

Question 17

Foods rich in folate

Answer 17

Dark, leafy greens, spinach, kale, collard greens, asparagus, brussels sprouts, broccoli, peas, certain beans, kidney, black, or pinto, fruits, oranges, bananas, avocados, peanuts, and some sunflower seeds. Other sources are from yes we just why gluten-free people can get this. 

Question 18

We can also have an increase need in folate during what process

Answer 18

Pregnancy malignancy, or homolysis can be induced by certain drugs, like methotrexate can cause this deficiency 

Question 19

Normal body store of folate

Answer 19

5000 to 20,000 mcg

Question 20

Is Foley acid a micro or macrocytic anemia?

Answer 20

Macrocytic MCV usually greater than 115 may gradually increase over several months to years 

Question 21

This is a lack of intrinsic factor produced by the parietal cells of the gastric mucosa and it could be autoimmune in origin

Answer 21

Pernicious anemia

Question 22

Pernicious anemia is what

Answer 22

Impaired production of intrinsic factor by the gut we need in intrinsic factor to buy B12. Thus it leads to a B12 deficiency and your B12 cannot be absorbed. 

Question 23

Subjective findings of pernicious anemia

Answer 23

Shortness of breath, poor memory, headache, depression, difficulty maintaining balance, sore tongue, nausea, poor appetite, weight loss, bleeding gums, and weakness

Question 24

A physical exam finding for pernicious anemia

Answer 24

Pale and mildly, abnormal reflexes so positive Babinsky positive Romberg, ataxia, and Glasso papillae with tenderness 

Question 25

You can give these patients all the B12 in the world and they still won’t absorb

Answer 25

Pernicious anemia because they lack intrinsic factor

Question 26

This pernicious anemia considered a auto immune?

Answer 26

Yes, you can have other associated autoimmune diseases like rheumatoid arthritis, graves disease, myxedema, thyroiditis, hyperthyroidism, vitiligo, Crohn’s disease, celiac disease anything, and then that would also cause you to have a lack of intrinsic factor, lack of intrinsic factor leads to decrease B12 absorption and thus pernicious anemia 

Question 27

Treatment for pernicious anemia/management 

Answer 27

B12 100 to 1000 Mike’s sub Q daily times seven days 500 mics intranasally into one nostril once a week, once a week, one month monthly for life, should do an endoscopy every five years if asymptomatic just to check the gut as well, folic acid should not be given without B12 And hypokalemia may coincide within the first week of B12 replacement 

Question 28

These are added labs that will be elevated in pernicious anemia as well as elevated in a B12 deficiency 

Answer 28

MMA, and homocystine levels will be elevated because the body cannot convert these amino acids and clear them properly if they don’t have B12 

Question 29

When you see this card, text the acute care group that she really didn’t say anything. Make sure you know for B12 or for anemia of chronic disease. 

Question 30

This is a hypochromic, microcytic, anemia inherited disorder, that results defective production of the globin portion of hemoglobin 

Answer 30

Thalassemia 

Question 31

Inherited hemoglobin Pathy most common with Mediterranean, Middle Eastern, Southeast Asia, and African

Answer 31

Thalassemia

Question 32

This is an autosomal, recessive, inheritance

Answer 32

Thalassemia

Question 33

Lab findings for thalassemia

Answer 33

Decrease hemoglobin decrease hematocrit decrease MCV decrease MCH with normal or increase red blood cells would also have normal to increase iron in the serum iron in the plasma normal to increase ferritin and normal TIBC 

Question 34

Physical exam Findings for thalassemia

Answer 34

Cooley anemia facies. Growth retardation. Cardiac failure dilation. Hepatosplenomegaly jaundice

Question 35

Treatment that they will need for life thalassemia 

Answer 35

Blood transfusions for life as well as iron translation therapy with severe Beta. Their hemoglobin goal is 9 to 10 desirable to get a bone marrow transplant if they need it, they might need a splenectomy due to splenomegaly 

Question 36

Hemolytic anemia inherited disorder caused by a mutant he 

Answer 36

Sickle cell anemia 

Question 37

Subjective findings for sickle cell

Answer 37

Generalized pain, long bones, joints, back chest and abdomen fever, fatigue, malaise dyspnea, abdominal pain, nausea, vomiting, decrease appetite, swelling in the hands feet and joy de depression and priapism

Question 38

Confirmation for sickle cell anemia

Answer 38

Hemoglobin electrophoresis 

Question 39

Treatment for sickle cell patients

Answer 39

Keep them well hydrated we want to prevent and reduce reoccurrence of crisis give the immunizations to prevent infection. Manage their stress and prevent deoxygenation so give oxygen to hypoxic patients with the PAO two less than 60 to 70. We can give them pain management analgesic pain, relieves get fluids give blood transfusions give non-opioid analgesic NSAIDs or acetaminophen for mild to moderate pain. The narcotic analgesic is to enhance analgesia for Severe 3-4l per day extra hydration ****

Question 40

Most common reason why sickle cell patients are hospitalized

Answer 40

Vasoclusive disease it ends up having homolysis splenic equation. You have a decreased, hemoglobin and hematocrit and red blood cell count. They have an increase white blood cell count. 2-6 days extremely painful!