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FNP Exam Study Cards > Hematology > Flashcards

Hematology Flashcards

1
Q

Blood loss of 15% or higher results in what?

A

orthostatic hypotension

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2
Q

when checking a CBC, the initial H&H during active bleeding may be?

A

in the normal range

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3
Q

the normal bone marrow will respond to blood loss by releasing what?

A

immature RBC, reticulocytosis

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4
Q

An absolute neutrophil count of less than 1500 is what?

A

neutropenia

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5
Q

individuals with what condition have frequent infections (especially bacterial) with sx of fever, sore throat, oral thrush, and so forth

A

neutropenia

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6
Q

gradual onset of symmetrical peripheral neuropathy is a symptoms of what

A

vitamin b12 deficiency

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7
Q

A cancer of the beta lymphocytes (B cells)

A

hodgkin’s lymphoma

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8
Q

symptoms of hodgkin’s lymphoma

A

night sweats, fevers, and pain with alcohol consumption; generalized pruritus with painless enlarged lymph nodes (neck), anorexia, weight loss

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9
Q

Identified by the presence of Reed-Sternberg cells

A

Hodgkin’s lymphoma

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10
Q

a cancer of the lymphocytes (usually B cells) and killer cells

A

non-hodgkin’s lymphoma

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11
Q

symptom’s of non-hodgkin’s lymphoma

A

night sweats, fever, weight loss, generalized lymphadenopathy (painless)

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12
Q

usually occurs in the older adults and has a poor prognosis

A

non-hodgkin’s lymphoma

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13
Q

cancer of the plasma cells

A

multiple myeloma

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14
Q

symptoms of multiple myeloma

A

fatigue, weakness, and bone pain that is usually in the back or chest

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15
Q

causes proteinurua with Bence-Jones proteins, hypercalcemia, normocytic anemia

A

multiple myeloma

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16
Q

platelet count less than 150,000

A

thrombocytopenia

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17
Q

the gold standard test to diagnose hemoglobinopathies such as sickle cell and thalassemia

A

hemoglobin electrophoresis

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18
Q

chronic smokers, individuals with long-term COPD, long term residents of high altitudes or EPO treatment have a higher incidence of what

A

secondary polycythemia

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19
Q

microcytic, hypochromic anemia (most common)

A

iron deficiency anemia

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20
Q

pallor of the skin, conjunctiva and nails beds, complaints of daily fatigue, exertional dyspnea. may have glossitis (sore and shiny red tongue) and angular cheilitis (irritated skin or fissures at the corners of the mouth), cravings for pics, spoon-shaped nails, systolic murmurs, tachycardia, and heart failure

A

symptoms of IDA

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21
Q

etiology of IDA

A

blood loss, heavy menses, pregnancy, poor diet, GI blood loss, postgastrectomy

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22
Q

Treatment for IDA

A

iron rich foods, identify cause of anemia, supplementation

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23
Q

which foods are high in iron

A

organ meats, red meat, dried peas and beans, dark green leafy vegetables, whole grains

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24
Q

what is the average lifespan of an RBC

A

100-120 days

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25
Q

how much elemental iron must be given for supplementation for IDA

A

150-200 mg of ELEMENTAL iron

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26
Q

How long does a patient need to be on iron supplementation for IDA

A

at least 4-6 months to rebuild iron stores

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27
Q

microcytic hypochromic anemia (next most common)

A

thalassemia

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28
Q

a genetic disorder in which the bone marrow produces abnormal hgb

A

thalassemia

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29
Q

common in mediterranean decent

A

thalassemia

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30
Q

3 criterion for anemia

A
  1. hemoglobin
  2. hematocrit
  3. RBC count
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31
Q

Name 3 reasons people become anemic

A
  1. blood loss
  2. bone marrow not producing RBCs
  3. increased destruction of RBCs
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32
Q

How does poorly managed chronic disease affect the H&H

A

reduce them

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33
Q

Those who live in high altitudes like Denver, CO tend to have _(higher or lower)__ hemoglobin and hematocrit

A

higher

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34
Q

what part of the CBC describes the size of the RBC

A

MCV (think V volume/size)

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35
Q

what part of the CBC describes the color of the RBC?

A

MCH (think CH - chromic)

36
Q

what part of the CBC indicates the degree of variation in RBC size?

A

RDW (think Doughnuts and Donut holes)

37
Q

serum iron measures what?

A

measure of iron in CIRCULATION

38
Q

serum ferritin measures what?

A

measure of iron in STORAGE

39
Q

what indicates the ability of the bone marrow to produce RBCs

A

Reticulocyte count

40
Q

what is the name of the immature RBC that is produced by the bone marrow? How many days does it take to mature?

A

reticulocyte; 3 days

41
Q

which test provides a visual description of the RBC

A

peripheral smear

42
Q

what is the term for 2 concurrent anemias?

A

mixed anemia

43
Q

in patients mixed anemia, what is the most valuable test?

A

peripheral smear

44
Q

with IDA: If the iron count is high, the TIBC is _____

45
Q

with IDA: if the iron count is low, the TIBC is____

46
Q

what is the average lifespan of a platelet

47
Q

how do older (symptomatic) adults with IDA present?

A

exacerbation of comorbidities (angina, worsening dementia)

48
Q 
Which dx fits the following:
hemoglobin decreased
hematocrit decreased
serum iron decreased
serum ferritin decreased
MCV decreased
MCH decreased
TIBC elevated
RDW elevated
49
Q

if the ferritin level is low, the patient has what?

50
Q

if the ferritin level is normal to high, the pt has what?

A

thalassemia

51
Q

which iron supplement is best tolerated by patients? How much should they take? What should they take it with?

A

ferrous sulfate, one tab TID, can take with vitamin C

52
Q

A patient’s hemoglobin is 10.2, hct 30.6. Which findings are consistent with IDA?

  1. MCV 76; MCH: 28
  2. MCV 84; MCH 26
  3. MCV 120, MCH 30
  4. MCV 76; MCH 25
A
  1. MCV 76; MCH 25
53
Q

What effect does long standing IDA have on RDW?

A

normal, less than 15% (all the cells are small)

54
Q

Which form of iron is given to pregnant women to prevent IDA?

A

ferrous gluconate

55
Q

A pt has been diagnosed with mild IDA 6 weeks ago. she was started on iron supplements and has been compliant. what should be done today?
6 weeks ago H&H 11.5/34.8
today H&H 12.8/37.8
1. okay to stop iron supplementation
2. continue iron x 4 weeks
3. serum ferritin should guide decision
4. a reticulocyte count should guide decision

A
  1. serum ferritin will guide decision
56
Q

How much should H&H increase after 4 weeks of iron supplementation?

A

hct 3 pts, hgb 1 point

57
Q

how many months does it take to replace iron stores?

58
Q 
An active 85 year old female has been dx with IDA (stool for occult blood neg). she has poor eating habits and no obvious loss of blood. she has taken 200 mg of elemental iron daily for the last 4 weeks,. which of the following actions are appropriate today?
hgb 4 weeks ago 10; hct 31
today hgb 10.2; hct 31.8
1. check b12 and folate level
2. continue iron for a month
3. measure retic count
4. measure serum ferritin
A
  1. Check retic

is the bone marrow producing?

59
Q

what is the most common genetic disorder in the world?

A

thalassemia

60
Q

what test might be used to diagnose thalassemia?

A

hemoglobin electrophoresis

61
Q

what lab test might indicate IDA that is long standing?

  1. low MCV, low MCH
  2. Low MCH, increased serum iron
  3. increased RDW, low serum ferritin
  4. normal RDW, low serum ferritin
A
  1. normal RDW, low serum ferritin
62
Q

Where does excess iron go in the body?>

A

to the liver

63
Q

which anemia has mild to moderate normocytic, normochromic anemia associated with infections, inflammation, or malignancies?

A

anemia of chronic disease/anemia of chronic inflammation

64
Q

What is the RBC lifespan in anemia of chronic disease?

A

60-90 days

65
Q

A patient’s hemoglobin is 10; hct 30.6, which findings are consistent with a normocytic normochromic anemia? MCV 84-102; MCH 29-35

  1. MCV 90, MCH 38
  2. MCV 84, MCH 23
  3. MCV 93; MCH 29
  4. MCV 83; MCH 35
A
  1. MCV and MCH normal
66
Q

How do you manage anemia of chronic disease?

A

treatment is aimed at control of the underlying condition, or to diagnose the underlying disease or condition

67
Q

What are the 2 most common macrocytic anemias?

A

b12 and folate deficiency

68
Q

____ is an absorption problem, rarely a dietary deficiency

A

B12 decifiency

69
Q

A 45 y/o patient has suspected b12 and folate deficiencies, what typical symptoms might he exhibit?

  1. pale skin and fatigue
  2. jaundice and petechiae
  3. paresthesias and unexplained weakness
  4. joint aches and LE swelling
A
  1. paresthesias and unexplained weakness
70
Q

A 75 y/o patient has suspected b12 and folate deficiencies, what typical symptoms might he exhibit?

  1. pale skin and fatigue
  2. jaundice and petechiae
  3. unexplained weakness and cognitive changes
  4. joint aches and LE swelling
A
  1. unexplained weakness and cognitive changes
71
Q

B12 deficiency will eventually be symptomatic, ____ deficiency is almost never symptomatic.

72
Q

What are two diagnostic tests that can help differentiate folate and b12 deficiency?

A

homocysteine and MMA levels

73
Q

What is the tx plan for B12 deficiency?

A

B12 IM/SQ daily x 1 week, then weekly x 1 month, then monthly for life

74
Q

_______ rapidly increases and peaks in 7-10 days after b12 deficiency treatment is initiated

A

reticulocyte count

75
Q

How long do you typically treat folate deficiency?

A

1-4 months

76
Q

What is the term for decreased platelet count?

A

thrombocytopenia

77
Q

What is ITP?

A

idiopathic thropmbocytopenia purpura

78
Q

what are two names for neutrophils?

A

segs/polys

79
Q

when polys and lymphs are close numerically, what should you be thinking?

A

viral in nature

80
Q

which cell comes out after 24 hours?

81
Q

what two cells are the first responders?

A

polys/lymphs

82
Q

what do elevated eosinophils indicate?

A

allergic reactions or parasitic infections

83
Q

what are bands?

A

immature WBC released from bone marrow

84
Q

what lab test probably should not be ordered if a patient is taking an iron supplement daily for anemia?

  1. peripheral smear
  2. serum iron level
  3. serum ferritin level
  4. reticulocyte count
A

2 - because if they are taking the iron, the serum level will be elevated or normal

85
Q

A patient is found to have a mixed anemia (IDA and B12) what might his MCV most likely be? (normal MCV 80-96)

  1. 90
  2. 76
  3. 100
  4. 104
A
  1. normal. the two abnormal MCVs average to normal

FNP Exam Study Cards (4 decks)

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