Hematology

Question 1

Marrow cannot produce adequate numbers of erythrocytes

• decreased reticulocyte count

Answer 1

Hypoproliferative anemia

Question 2

Premature destruction of a erythrocytes results in the liberation of hemoglobin from the erythrocytes into the plasma.
• released hemoglobin is converted in large part to billirubin in there for the billirubin concentration rises. Increased our erythrocyte destruction leads to tissue hypoxia which in turn stimulate erythropoietin production

Answer 2

Hemolytic anemia

Question 3

Iron deficiency
Vitamin b12 deficiency
Folate deficiency
Decreased erythropoietin production

Answer 3

Hypoliferative anemia

Question 4

Sickle cell anemia 
Thalassemia 
Hypersplenism
Drug induced anemia 
Auto immune anemia 
Mechanical heart valve related anemia

Answer 4

Hemolytic anemia

Question 5

Mostly seen in young children, pregnant women, menstruation, vegetarians, and the elderly
_*Gastric bypass surgery, removed parts of stomach, cannot absorb iron suff

Answer 5

Iron deficiency Anemia

Question 6

Chemotherapy, Exposure to certain chemicals: benzenes products,
Poor dietary intake of Folic acid/B12/ iron.

Answer 6

Causes of hypopoliferative anemia

Question 7

o Fatigue/ weakness – usually in slow blood loss
o Pallor – usually in slow blood loss - Skin and mucous membrane, conjunctiva
o Dyspnea
o Chest pain: in rapid blood loss (hemorrhaging) Tissue hypoxia, angina not enough blood in body
o Muscle pain, Asses mouths, Change in LOC

Answer 7

Clinical manifestation of anemia

Question 8

o A decrease in circulation RBC will result in
o An increase HR, RR, Increase Cardiac output (compensate by becoming tachycardia)
o Oxyhemoglobin dissociation- what ever hgb is circulating in blood system will be given off O2 at a faster rate
o Redistribution of blood flow to vital organs- shunts to brain, heart, lungs and kidneys when patient is hemorrhaging. Periphery become cold clammy dyapheritic

Answer 8

Compensatory mechanisms of anemia

Question 9

• beefy red, ulcers and sore.

Peripheral nervous system- numbness, tingling, to extremities, ataxia

Answer 9

B12 megoblastic anemia

Question 10

• ulcers corner of mouth has two sores. Iron deficiency anemia.

Answer 10

Angular cheiliosis

Question 11

Heart failure
Parathesias
Confusion

Answer 11

Complications of anemia

Question 12

To much iron or too little in blood stream

Answer 12

Total iron binding capacity (TIBC).

Question 13

• protein found inside of the cells to stores iron for body to use later when needed

Answer 13

Ferritin

Question 14

Bone marrow aspiration- most invasive and last resort. Go threw iliac crest or sternum.
o Ferritin- low, Hgb- low, Serum iron- low, MCV- diminished (very small RBC), when low iron causes small rbc to be made
o TIBC- will be elevated. Red blood cells have open areas for iron to bind to. If you don’t have enough iron you have more open spaces on the RBC and the total iron binding capacity increases

Answer 14

Iron deficiency anemia

Question 15

• organ meats (Livers), beans (black, pinto, garbonzo), dark green leafy vegetables (spinach, kale, swiss chard, broccoli), raisins, molasses

Answer 15

Food sources high in iron

Question 16

o B12 or Folic Acid Anemia
o RBC are large (MCV Increased)
o Bone marrow = hyperplasia
▪ Large and bizzare appearance

Answer 16

MEGALOBLASTIC anemia

Question 17

▪ Green leafy veg
▪ Organ meats
▪ Mushrooms
▪ Oatmeal
▪ peanut butter
▪ beans
▪ soy products
▪ melons

Answer 17

Food sources of folate

Question 18

o Alcoholics- malnutrition to begin with
o Need more folic acid  bc not absorbed
o Elderly
o Pregnant
o People who don’t eat uncooked vegetable
o Chronic hemolytic anemia’s
o sickle cell,
o thalassemia
o hyperemalisys drugs, autoimmune, mechanical heart valve)
o Malabsorptive disease of small bowel
o Sprue/celiac disease
▪ genetic disorder with a wheat or gluten sensitivities
o Meds
o Oral Contraceptive
o Sulfar Antibiotic
o anti-seizure medication

Answer 18

Risk groups for folic acid deficiency

Question 19

o Suppresses appetite causing
o Anorexia
o wt loss
o Fatigue/weakness/tiredness
o Pale skin
o Tachycardia
o Glositis
o No neuro symptoms like B12

Answer 19

Clinical manifestations of folic acid deficiency

Question 20

o Pernicious anemia
o Weakness, Listlessness, Fatigue
o Glossitis
o Diarrhea
o Paleness to mucus membrane
o Mental Changes
o Confusion
o Memory loss
o Neurological impairment
o Paresthesias/ numbness tingling of feet and hands
o Proprioception loss
o Unsteady gate  - ataxia
▪ poor balance and coordination  - SAFETY

Answer 20

Clinical manifestation of B12 anemia

Question 21

Condition in which hemaglobin concentration is lower than normal it reflects the presence of fewer than normal erythrocytes within the circulation
As a result the amount of oxygen delivered to body is diminished

Answer 21

Anemia

Question 22

Heart failure
Parathesia
Delirium

Answer 22

Complications of anemia

Question 23

• Sudden chest pain
• Asymmetry of chest movement
• Unilateral retractions
• Oxygen desaturation

Answer 23

Pneumothorax

Question 24

Rare disease caused by a decrease in or damage to marrow stem cells damage to the microenvironment within the marrow, and replacement of the marrow with fat. T-cells mediate an inappropriate attack against the bone marrow, resulting in bone marrow aplasia
• significant neutropenia

Answer 24

Aplastic anemia

Question 25

Bone marrow aspirate shows an extremely hypoplastic or even aplastic marrow replaced with fat

Answer 25

Aplastic anemia

Question 26

Smooth sore red tongue 
Mild diarrhea 
Pale
Confusion
Numbness and tingling in feet and lower legs 
Lose position sense

Answer 26

Pernicious anemia

Question 27

Classic method of determining the use of vitamin b12 deficiency
Patient receives a small oral dose of radioactive vitamin B12 followed by a few hours by a large non radioactive parent dose of b12

Answer 27

Schilling test

Question 28

150,000-400,000/mm3

Answer 28

Platelets

Question 29

5,000-10,000/mm3

Answer 29

WBC

Question 30

60-70 seconds

Answer 30

Partial Thromboplastin Time (PTT)

Question 31

30-40 seconds

Answer 31

Activated Partial Thromboplastin Time (aPTT)

Question 32

11-12.5 seconds

Answer 32

Prothrombin Time (PT)

Question 33

1. 5-2.0 DVT prophylaxis
2. 0-3.0 Orthopedic surgery, DVT, AF
3. 0-4.0 Prosthetic valve prophylaxis
4. 5-3.5 Pulmonary embolism

Answer 33

International Normalized Ratio (INR)

Question 34

• Male 42-52%

* Female 37-47%

Answer 34

Hematocrit (Hct)

Question 35

Male: 14-18 g/dL
Female: 12-16 g/dL

Answer 35

Hemoglobin (Hgb)

Question 36

– Viral infection, aplastic and pernicious anemia, lymphoblastic leukemia, chemo agents destroy stem cells, toxic agents, certain meds, poisons, massive infection, graves or addison’s disease

Answer 36

decrease WBC count

Question 37

polycythemia. Dehydration. Diarrhea. High altitude. Poisoning. Exercise.

Answer 37

Increase WBC

Question 38

Stem cell disorder within bone marrow marked by increase platelet production occurs with the platelet count consistently greater than 600,000/mm3

Answer 38

Primary thrombocythemia

Question 39

Usually Asymptomatic
Symptoms exceed 1 million/mm3
Occlusion may occur in many vessels

Answer 39

Primary thrombocythemia

Question 40

Low platelet level
Can result from various factors within bone marrow
Increased destruction of platelets
Or increased consumption of platelets

Answer 40

Thrombocytopenia