Hematology Flashcards
The initial Hgb value during active bleeding may be
normal; it takes approx 24 hours after hemorrhage for CBC to show true H/H.
s/s of Vitamin B12 deficiency
peripheral neuropathy, ataxia, impaired memory, dementia
a cancer of the b cells
Hodgkin’s lymphoma
risk factors for Hodgkin’s lymphoma
age 20-40 or older than 60, white, male
s/s of Hodgkin’s lymphoma
night sweat, fever, pain with ingestion of alcohol, painless enlarged neck lymph nodes, anorexia
A cancer of B cells and killer cells
Non-Hodgkin lymphoma
risk factor for Non-Hodgkin lymphoma
greater than 60 years old
which lymphoma has worse prognosis
non-hodgkin
a cancer of the plasma cells
multiple myeloma
s/s of multiple myeloma
fatigue, weakness, and bone pain in back or chest
diagnostic findings in multiple myeloma
proteinuria with Bence-Jones protein, hypercalcemia, normocytic anemia
thrombocytopenia is
platelet less than 150,000
normal platelet count
150,000 - 450,000
bruising in children
normal if in distal upper and lower extremities. Abnormal if accompanied by petechiae/purpura, large hematomas
Normal H&H in males
Hgb: 14-18
Hct: 42-52%
Normal H&H in females
Hgb: 12-16
Hct: 37-47%
Hgb in those who live in high-altitude areas are
elevated (secondary polycythemia)
a measure of the avg color of the RBC in a sample of blood
MCHC
A measure of available transferrin that is left unbound to iron
TIBC
TIBC is elevated in ____
iron deficiency anemia b/c there is not enough iron for transport
labs in thalassemia
low H&H, low MCV, low MCHC, low MCH, normal TIBC, high RDW, normal ferritin
Most sensitive test for iron deficiency anemia
serum ferritin
measure of the variability of the size of RBC
RDW
reticulocytes are immature RBCs that still have ____; they mature into RBC in
nuclei; 24 hours
reticulocytosis occurs after
supplementation of iron, vit B12, folate, acute bleeding, hemolysis, leukemia
poikilocytosis is seen with
severe iron deficiency anemia
Types of microcytic anemia
iron deficiency, thalassemia, sideroblastic
Types of macrocytic anemia
vitamin B12, folate deficiency, pernicious
Types of normocytic anemia
anemia of chronic disease, sickle cell, aplastic, hemolytic
gold standard test to diagnose for sickle cell and thalassemia
hemoglobin electrophoresis
causes of secondary polycythemia
chronic smokers, COPD, residents of high-altitude
s/s of iron deficiency anemia
fatigue, pallor, glossitis (shiny red tongue), angular chelitis (irritated fissures at corners of mouth), pica.
most common cause of iron deficiency anemia
blood loss
labs in iron deficiency anemia
low H&H, low MCV, low MCHC/MCH, low ferritin, low iron, high TIBC, high RDW
Diagnostic test for pernicious anemia
high antiparietal antibodies
anemia in those with chronic disease or inflammatory disease such as RA
normocytic anemia
Howell-Jolly bodies seen in
sickle cell anemia
trx for iron deficiency anemia
ferrous sulfate 325 mg TID between meals x3-6 months
examples of iron rich foods
red meat, black beans, green leafy veggies
avoid taking iron supplements with
antacids, dairy, quinolones, tetracyclines
A genetic disorder in which the bone marrow produces abnormal hgb
thalassemia
Alpha thalassemia is more common in
Chinese, filipinos, thai
beta thalassemia is more common in
Mediterranean’s
trx for thalassemia minor
none
it compliant patient with iron deficiency anemia has failure to respond, then consider
thalassemia, malabsorption (Celiac)
Educate about iron poisoning in children less than
6 years old
destruction of all blood cells caused by either radiation, viral infection, adverse rx to drug
aplastic anemia
gold standard diagnostic for aplastic anemia
bone marrow aspiration
an autoimmune disorder caused by destruction of parietal cells in the fundus resulting in loss of intrinsic factor production
pernicious anemia
This is needed to absorb vitamin B12
intrinsic factor
causes of vitamin B12 deficiency
pernicious anemia, vegans, alcoholics
diet sources of vitamin B12
meat, poultry, eggs, milk, cheese
s/s of pernicious anemia
peripheral neuropathy, difficulty in fine motor skills, abnormal Romberg, decreased reflexes
treatment for perncious anemia
lifetime vit B12 (injection, nasal spray, oral)
diagnostic for pernicious anemia
decreased B12; decreased folate, positive antiparietal antibody
drugs that can cause folate deficiency anemia
dilantin, TMP-SMZ, methotrexate
labs in folate deficiency anemia
low H&H, high MCV, low folate
food high in folate
green leafy veggies, grains, beans
trx for folate deficiency anemia
folic acid 1-5 mg per day
sickle cell anemia is passed by
genetics (autosomal recessive)
Screening test for sickle cell disease
Sickledex, but diagnosed by hemoglobin electrophoresis
When evaluating a patient with high MCV (macrocytic), next step is to
order folate and vitamin B12
Sideroblastic anemia is a lead level of
greater than 10
G6PD is passed down as
x-linked recessive
meds to avoid with G6PD deficiency
antimalarials, sulfa, aspirin, nitrofurantoin, Bactrim
meds that an cause vitamin B12 deficiency
cochicine, PPI, biguanide
treatment for neonatal hyperbilirubinemia
increase breastfeeding, phototherapy
cause of neonatal hyperbilirubinemia
High levels of unconjugated bilirubin d/t Hgb breakdown and inability of liver to excrete
Rh incompatibility occurs when a Rh ____ mother has a Rh ____ infant
negative; positive
this vaccine should be given in those undergoing a splenectomy
pneumonia 2 weeks prior
most common congenital bleeding disorder
Von Willebrand’s
labs for von willebrand’s
normal CBC, PT/PTT/INR;
test for factor VIII and vWF
labs in hemophilia
normal PT/PTT/INR;
aPTT prolonged
labs in acute lymphocytic leukemia
VERY high WBCs (blast cells), low RBC, low platelets
hallmark of chronic myelocytic leukemia (CML)
Philadelphia chromosome
most common s/s of CML
splenomegaly
diagnosis of Hodgkin lymphoma
presence of Reed-Sternberg cells
during a viral infection, a CBC will have
neutrophil (poly) and lymphocytes will be close in number
monocytes become elevated when
patient has been sick for more than 24 hours
during a bacterial infection, a CBC will have
high WBC; neutrophil (poly) and lymphocytes will be far apart in number
