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SRNAHealthAssessment > HEMATOLOGY > Flashcards

HEMATOLOGY Flashcards

1
Q

Reticulocyte Count

A

Increases during rapid blood loss or hemolytic diseases where RBCs are destroyed prematurely

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2
Q

Low Reticulocyte count Indicate 3 conditions

A
  1. Decreased production of RBCs by the bone marrow which can be caused by aplastic anemia, etc.
  2. Exposure to radiation • Chronic infection •
  3. Certain meds that damage bone marrow
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3
Q

• MCV –

A

Mean Corpuscular Volume

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4
Q

• MCH –

A

Mean Corpuscular Hemoglobin

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5
Q

• MCHC -

A

Mean Corpuscular Hemoglobin Concentration

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6
Q

• RDW –

A

Red Cell Distribution Width

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7
Q

Mean Corpuscular Volume MCV

A

average volume of red cells in a specimen.

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8
Q

Differentiates microcytic or macrocytic anemia • Low MVC = • Normal MVC = • High MVC =

A

microcytic anemia normocytic macrocytic anemia

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9
Q

Microcytic causes (TIA)

A

Thalassemmia Iron deficiency Anemia of chronic renal disease

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10
Q

Macrocytic causes are BAC-DRAMHypo)

A

B12 folate deficiency

Alcohol use

Chronic liver disease

Drugs

Reticulocytosis

Aplastic anemia

Myelodysplastic

Hypothyroidism

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11
Q

Mean Corpuscular Hemoglobin (MCH)

A

• Measure of the average MASS of hemoglobin contained by a rbc

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12
Q

Low MCH =

A

microcytic anemias;

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13
Q

High MCH =s

A

macrocytic anemia

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14
Q

Normal MCH

A

• Normal: 27 - 31 picograms/cell

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15
Q

Mean Corpuscular Hemoglobin Concentration (MCHC)

A

• Measure of the concentration of hemoglobin in a given volume of RBCs

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16
Q

Normal MCHC

A

• 32-36 g/dL

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17
Q

Low MCHC

A

(hypochromic) in microcytic anemias

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18
Q

Normal MCHC

A

(normochromic) in macrocytic anemias (due to larger cell size)

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19
Q

High MCHC (hyperchromic) in

A

spherocytosis, sickle cell and Hb C ds. w/ splenomegaly

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20
Q

Red Cell Distribution Width RDW

A

• Shows the difference in size between the smallest and largest red blood cells in a sample.

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21
Q

RDW normal

A

Normal range is ~ 12-15% variation in size

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22
Q

RDW average red cells are

A

6–8 micrometers

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23
Q

Questions during exam: meds that affect blood are Dont forget: ______ May need to question ________

A

• Medications list • Meds that affect the blood (ex. ASA, NSAIDS, Warfarin, Pentoxifylline, erythropoietin, neupogen, etc.) • Don’t forget HERBAL/VITAMINS/ SUPPLEMENTS • May need to question FAMILY HISTORY

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24
Q

Symptoms of Anemia Depend on HCDR

A

• Hgb level • Decrease in O2 carrying capacity of blood • Change in total blood volume • Rate at which these change

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25
Q

The concentration of DISSOLVED oxygen in the blood (CdO2) is _____________. This is known as the ________

A

directly proportional to the partial pressure of oxygen (PO2) in the gas. This is known as Henry’s Law.

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26
Q

The solubility coefficient of oxygen in blood (aO2) =

A

0.0031 mL / mmHg of oxygen / dL of blood.

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27
Q

CdO2 = Constant is

A

aO2 x PO2 (aO2 = 0.0031 mL O2/ mmHg O2 / dL blood) aO2 0.0031

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28
Q

• What would the concentration of dissolved oxygen be in the blood when the partial pressure of oxygen in the alveolar gas is 100 mmHg?

A

15 mL O2

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29
Q

Causes of Prolongation PTc

A

• Normal: INR 0.8-1.2 • Normal: PT 12-14 se

30
Q

PT/INR evaluates how well together.

A

all of the coagulation factors in the extrinsic and common pathways of the coagulation cascade work

31
Q

Included in PT/INR are:

A

factors I (Fibrinogen), II (Prothrombin), V, VII and X

32
Q

Decrease in factor production or increase in factor destruction = prlonged PT

A

• Warfarin therapy • Vitamin K deficiency • Liver disease • DIC

33
Q

Causes of Prolongation of PTT Normal PTT –

A

25-35 secs

34
Q

What does PTT measure?

A

the integrity of the intrinsic system (Factors VIII, IX, XI, XII) and common clotting pathway

35
Q

Abnormalities leading to prolonged PTT (VHHLD)

A

• Heparin - binds to antithrombin • Very severe vitamin K deficiency • Hemophilia A, B, and C • Liver disease • DIC

36
Q

Fibrinogen Level  Synthesized by

A

the liver

37
Q

Fibrinogen Acute-phase reactant (APR =

A

proteins whose plasma concentrations increase in response to inflammation)

38
Q

Extrinsic

A

3, 7

39
Q

Fibrinogen Normal levels are

A

160-350 mg/dL

40
Q

Fibrinogen levels less than

A

 Levels < 100 mg/dL may be inadequate to form clot

41
Q

Activated Clotting Time (ACT) Evaluate the

A

Evaluates the intrinsic and common pathways of coagulation

42
Q

Normal clotting time is

A

90-120 seconds

43
Q

Thromboelastography

A

 Test that rotates blood sample to initiate clot formation  Management of transfusion therapy in OR

44
Q

Thromboelastography Measures clot formation: R value

A

Reaction time in min before the first evidence of clot is detected (efficacy of coagulation factors & fibrin formation)

45
Q

Thromboelastography K value –

A

time from end of R until clot reaches 20mm tracing (speed of clot formation)

46
Q

Thromboelastography Alpha angle –

A

size of angle formed by tangent line from beginning of K until 20mm point (information similar to K - reflects speed of fibrin accumulation & crosslinking)

47
Q

Thromboelastography MA - Maximum amplitude –

A

greatest amplitude of tracing (reflection of maximum clot strength) 80% platelet function + 20% fibrin  Assesses platelet count/function +fibrinogen activity

48
Q

Thromboelastograph LY30 - Clot lysis index –

A

percentage of clot lysed after 30 min.

49
Q

TEG interpretation Prolonged R Time =

A

↓ clotting factors – treat w/ FFP

50
Q

TEG interpretation Low MA =

A

↓ platelets – give platelets

51
Q

TEG interpretation Prolonged K Time and/or low α angle =

A

↓ fibrinongen – treat w/ cryoprecipitate

52
Q

TEG interpretation High LY30 =

A

↑ fibrinolysis – treat w/ antifibrinolytics (aminocaproic acid)

53
Q

Hemophilia A

A

Factor VIII/antihemophiliac deficiency

54
Q

Hemophilia B

A

Factor IX/Christmas deficiency

55
Q

Hemophila C

A

Factor XI/Rosenthal deficiency)

56
Q

Fibrinogen deficiency

A

Factor I

57
Q

Prothrombin deficiency

A

Factor II

58
Q

Sickle cell

A

Hgb S is a variant Hgb produced by substitution of valine for glutamic acid in position 6 of the beta chain due to a defect on chromosome 11

59
Q

Premature Infant EBV

A

90-100 mL/kg

60
Q

Parturient EBV

A

100 mL/Kg

61
Q

Full-term Newborn Infant EBV

A

80-90 mL/kg

62
Q

Infant 3 mo – 3 yrs of age EBV

A

75-80 mL/kg

63
Q

Children > 6 yrs EBV

A

•65-70 mL/kg

64
Q

Males EBV

A

75 mL/kg

65
Q

Females EBV

A

65 mL/kg

66
Q

Obese EBV

A

45-55 mL/kg

67
Q

ABL=

A

EBV x (Original Hct – target Hct)/Original Hct

68
Q

How much does one unit of platelets (250ml) raise the platelet count?

A

• 30,000-60,000/uL

69
Q

How much does 1 unit of PRC increase hematocrit?

A

1g hct 3%

70
Q

Identify the condition

A

Polycythermia Vera

SRNAHealthAssessment (20 decks)

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