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Clinical review > Hematology/Oncology > Flashcards

Hematology/Oncology Flashcards

1
Q

MCV?

A

Mean corpuscular volume:

- The average volume or size of a single RBC

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2
Q

MCH?

A

Mean Corpuscular Hemoglobin:

- Average amount of hemoglobin in RBC

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3
Q

MCHC?

A

Mean corpuscular hemoglobin concentration

- similar to MCH

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4
Q

RBW

A

Red Blood Cell distribution width

  • Indication of the variation of RBC size.
  • Indicator for anisocytosis
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5
Q

Peripheral Blood smear?

A

Involves spreading a drop of blood thinly onto a glass slide.
- Gives info on number, shape and general appearance of blood cells.

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6
Q

Causes of anemia?

A

Increased demand: rapid growth, prego, epo tx
Increased Fe loss: blood loss, menses, etc.
Decreased Fe absorption: diet, malabsorption (celiacs, crohn’s), surgery, inflammation

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7
Q

S/sx: of anemia?

A

Fatigue, tachycardia, palpations, dyspnea on exertion.

Severe: skin/mucosal changes (smooth tongue, brittle nails, koilonychia = spooning of nails, cheilosis

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8
Q

Iron deficiency anemia?

A

microcytic
Eti: most often due to blood loss, also decreased absorption
Dx: Hb and HCT low, serum ferritin levels less than 12, serum Fe low, TIBC (total iron binding capacity) high, reticulocyte count, MCV and MCHC low

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9
Q

B12 deficiency etiology

A

macrocytic
Pathophys: folate and B12 are required for DNA synthesis and effect normal cell growth and leads toward macrocyctosis
Eti: lack of intrinsic factor (IF enables body to absorb B12); altered pH in small intestine; diet, pernicious anemia (autoimmune against parietal cells or IF), bariatric surgery

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10
Q

B12 deficiency s/sx

A

Can lead to changes in the muscosal cells:
- glossitis, GI issues (anorexia, diarrhea)
Neuro: paresthesias that can lead to difficulties with balance and proprioception
Cognition: AMS, memory changes, other neuropsych sx.
Can cause jaundice, leukopenia, thrombocytopenia
Hypersegmentation of neutrophils on peripheral blood smear

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11
Q

B12 deficiency Dx and Tx:

A
  • Low serum B12 and elevated MCV
  • Hypersegmented neutrophils
  • Reduced reticulocyte
  • elevated lactate dehydrogenase
  • modest increase in bilirubin
  • increase in MMA and homocysteine
  • differentiate from folic acid def
    Tx: B12 IM or SubQ
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12
Q

Folate deficiency etiology

A
  • Most common cause inadequate dietary
  • ETOH, anorexic patients
  • diet low in fruits and veggies
  • Drugs: phenytoin (tx: seizures) , TMP-SMX, sulfasalazine (treats ulcerative colitis and RA)
  • Folic acid requirements go up in pregnancy, hemolytic anemia, exfoliative skin disease
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13
Q

Folate deficiency S/sx:

A

Similar to B12 def, except no neurologic abnormalities

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14
Q

What is PT in hemotology?

A

Prothrombin time
Used to evaluate the extrinsic pathway and the common pathway of the coagulation cascade.
It can be reported in INR, international normalized ratio

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15
Q

What is aPTT?

A

Activated partial thromboplastin time.
Used to evaluate the intrinsic coagulation system and the common pathway.
Most often used to monitor heparin therapy.

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16
Q

Reference range for platelets

A

normal: 150,000 to 400,000.

spontaneous bleeding risk starts at less than 20,000

17
Q

What are FSP

A

Fibrin split products:

Used to document a fibrin clot, shows thrombosis occurring in a patient

18
Q

Direct coombs test?

A

Used to identify immune hemolysis or to investigate a transfusion reaction.
- Demonstrates if RBCs have been attack by antibodies in patients own blood

19
Q

Indirect Coombs test?

A

Used to identify circulating AntiBs against RBCs.

Can detect minor serum antibodies other than major ABO/Rh system

20
Q

INR?

A

standard way of reporting PT time.

21
Q

D-dimer?

A

Used to assess thrombin an plasmin activity.
D-dimer is a fibrin degradation fragment that is made through lysis of cross-linked fibrin.
Think: DIC, PE, DVT, sickle cell, malignancy

22
Q

Thrombocytopenia etiology?

DDx?

A

Eti: Decreased bone marrow production, sequestration, enlarged liver, increased platelet destruction.
DDX: Infection-induced thrombocytopenia, drug-induced T, Heparin-induced T, immune T, inherited T, thrombotic thrombocytopenic purpura

23
Q

S/sx of thrombocytopenia?

Dx?

A

Petechia, possible spleenomegaly, bruising

Dx: CBC, bone marrow eval, anti-heparin/PF4, HIV, Hep C

24
Q

Thrombocytosis. Eti?

A

Body produces too many platelets
Eti: Iron deficiency, inflammation, cancer, infection.
Can also be: essential thrombocythemia, or polycythemia vera

25
Q

Thrombocytosis S/sx?

Risk?

A

S/sx: HA, visual sxs, lightheadness, atypical chest pain, acral dysesthesia
Risk: increased thombotic risk

26
Q

Aspirin. MOA, indic, CI, AE, interactions

A

MOA: irreversibly inhibits Cox 1 and 2 and blocks formation of thromboxane A2
CI; asthma, rhinitis, nasal polyps
AE: bleeding, duodenal ulcer, angioedema, bronchospasm, hepatotoxicity
Interaction: may diminish effect of ACE, w/ETOH increased liver tox.
Max dose: 4 g in 24hrs

27
Q

Heparin

A

MOA: inactivates thrombin and IX,X,XI,XII
Indic: prophylaxis of DVT. STEMI, NSTEMI
CI: recent bleed, thrombocytopenia
AE: heparin induced thrombocytopenia, bleeding risk

28
Q

LMWH

A 
Low molecular weight heparin
MOA: Inactivates Xa.
Indic: Thromboprophylaxis
CI: active major bleed, thrombocytopenia
Inter: concomitant use of anticoags or platelet inhibitors
29
Q

Warfarin

A

MOA: inhibits K dependent factors: II, VII, IX,X, protein C and S
Indic: proph of thromboembolic disorders, a-fib or valve replacement
CI: Prego, bleeding, GI ulceration, recent eye/CNS surgery
Interaction: ETOH, othe coag/platelet agents
Pt. ed: Monitor leafy green intake and monitor INR

30
Q

Ticlodipine (Ticlid)

A

MOA: irreversibly blocks GPIIb/IIa, reduces platelet aggregation
Indic: used for those intolerant of aspirin

31
Q

Clopidogrel (Plavix)

A

MOA: irreversibly blocks GPIIb/IIa, reduces platelet aggregation
Indic: Unstable angina, NSTEMI, STEMI, recent MI, TIA, CVA, PAD

Clinical review (18 decks)

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