HEMATOLOGY

Question 1

Lead poisoning

Answer 1

ABNORMAL LEAD LEVELS ARE > 80 POISONING, TX > 40 WITH SYMPTOMS TX.
OVER 5 IS ELEVATED
s/s n/v, fatigue, loss of appetite, abdomen and joint pain, slowed growth, mental disability

Question 2

Thalassemia

Answer 2

MICROCYTIC HYPOCHROMIC.
Check Ferritin - this will be either normal or slightly elevated. HEMOGLOBIN ELECTROPHORESIS GOLD
STANDARD TO DX.

Question 3

Iron deficiency anemia

Answer 3

microcytic hypochromic. 
TIBC Increased. 
Ferritin/iron Decreased. 
Angular cheilitis, glossitis,
spoon-shaped nails, pica. 
Check reticulocyte wk post starting iron to make sure u don’t have bone marrow suppression. Must do 3-6 months. 150-250 elementary iron. 
Ferrous sulfate 325 mg po TID.
Take with calcium helps to absorb.
 SE constipation black colored stools.

Question 4

Macrocytic normochromic anemias

Answer 4

Folate/B12

Question 5

Which anemias have neuro symptoms?

Answer 5

B12 and pernicious

Question 6

pernicious anemia

Answer 6

Pernicious (autoimmune destruction of parietal cells in fundus)
think ppl that get their stomach taken out w/ pernicious must do b12 injections lifelong.

Question 7

B12/Folate Deficiency

Answer 7

Folate:doesn’t cause neuro s/sx. Folic acid 1-5 mg/d. Prego need 400 mcg 1 mo. Prior to prego. Dec.
neuro deficits. Eat things green.

Question 8

B12 foods

Answer 8

all meat products of animal origin

Question 9

Sickle cell

Answer 9

CBC is SCREENING
HGB electro is GOLD STAND diagnosis (don’t get a screening test and a gold standard test mixed up on the boards). Could do 8-10 prego a CVS or Amnio to check
for sickle. Give sickle cell patients their vaccines to protect from illnesses such as pneumonia/flu.