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101a Vocab > Hematology/Oncology?Psych102 > Flashcards

Hematology/Oncology?Psych102 Flashcards

1
Q

normocytic anemias are due to

A

decreased production (ACD) or increased destruction (hemolytic) of normal rbcs, or an increase in plasma volume or acute blood loss

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2
Q

Normocytic anemiia with an increased reticulocyte count is due to

A

acute blood loss

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3
Q

normocytic anemia with normal or decreased reticulocyte count

A

ACD or hemolytic anemia

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4
Q

high iron foods

A

meat, beans, raisins, spinach

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5
Q

AE of iron supplementation and how to avoid

A

can stain teeth–dilute liquid and use straw
heartburn, constipation, black tarry stool

TO avoid take with only a little food, best absorbed with acid/vit c; take with stool softener

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6
Q

small abnormally shaped rbs and decreased Hgb

A

microcytic anemia

IDA, thalassemias

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7
Q

large rbcs; due to defective DNA synthesis resulting in ineffective hematopoeisis

A

Macrocytic anemia
(large cells (megaloblasts) become trapped in marrow, decreased in life span and in #-megaloblastic anemia)
Pernicious anemia, folate deficiency anemia, alcohol-related anemia

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8
Q

quickly acquired anemia can be fatal in adults in Hgb is under

A

8

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9
Q

foods high in folate

A

leafy green vegetables, bran, dry beans, nuts

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10
Q

most common cause of megaloblastic anemia

A

folate deficiency

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11
Q

folate needed by women of childbearing age to avoid

A

neural tube defects, spina bifida

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12
Q

this anemia results in myelin degeneration causing neurological signs: paresthesias, gait disturbances, weakness, confusion

A

vitamin B12 deficiency anemia

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13
Q

infection and bleeding precautions will be needed with this anemia

A

aplastic anemia

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14
Q

enzyme made by kidneys in response to decreased oxygen carrying capacity that simulates myeloid stem cells in marrow

A

erythropoeitin (EPO)

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15
Q

Jaundice is seen in these anemias

A

hemolytic, sickle-cell anemia

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16
Q

abnormal increase in rbcs, wbcs, and plts

A

polycythemia

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17
Q

two types of polycythemia

A

Vera- caused by chromosomal mutation

Secondary- caused by hypoxia causing release of too much EPO

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18
Q

major danger of polycythemia

A

increased blood viscosity increases risk of clot

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19
Q

after treatment for polycythemia pts tend to develop

A

acute leukemia

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20
Q

dangerous plt levels

A

<10 risk for spontaneous bleeding

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21
Q

Disease where antibodies destroy platelets faster than they can be replaces

A

Immune Thrombocytopenic Purpura

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22
Q

ITP triggers

A

viral illness, SLE, pregnancy
often self-limiting in children
can be acute or chronic

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23
Q

Disease in which platelets clump abnormally and clog capillaries, causing tissue ischemia

A

Thrombotic Thrombocytopenic Purpura

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24
Q

often first sign of HIT is

A

breathing problem

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25
Q

sensitivity to heparin that forms in up to 25% of pts; antibodies formed to heparin-plt complex increasing risk of DVT or PE

A

Heparin-induced Thrombocytopenia

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26
Q

how to monitor for HIT

A

watch for decreased plt count to less than 50% of baseline 4-14 days after beginning therapy

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27
Q

In a pt with HIT, this anticoagulant is used instead of heparin

A

Agatroban

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28
Q

Classic hemophilia (80%) is this type, and is related to this CF

A

Hemophilia A; Factor VIII

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29
Q

Often is first sign of hemophilia

A

hemiarthrosis-joint bleeding

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30
Q

most common bleeding disorder; less severe than hemophilia, equally common in men and women

A

VonWillebrand’s Disease

also involves Factor VIII

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31
Q

Hemophilia B aka and involves what CF

A

Christmas disease

Factor IX

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32
Q

Vitamin K is needed

A

by liver to synthesize clotting factors

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33
Q

common sign of Vitamin K deficiency

A

bleeding mucous membranes

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34
Q

population at most risk for vitamin K deficiency

A

newborns-don’t have intestinal bacteria to make vitamin K

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35
Q

Granulocytes

A

Neutrophils, Eosinophils, and Basophils

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36
Q

agranulocytes

A

Lymphocytes and monocytes

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37
Q

stab/band cells

A

immature neutrophils

when body senses an infection band count will increase

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38
Q

involved in allergic reaction and parasite infection

A

Eosinophils

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39
Q

Philadelphia chromosome mutation results in

A

CML

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40
Q

Mutation in myeloid stem cell increases production of blast cells

A

CML

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41
Q

% of neutrophils and lymphocytes in diff

A

neutrophils: 60-70%
lymphocytes: 20-40%

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42
Q

Oral treatment for CML that inhibits cell division in only cells with the Phildelphia chromosome mutation

A

Gleevec

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43
Q

CML prognosis directly related to ability to

A

maintain a remission

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44
Q

acute exacerbation of CML

A

blast crisis

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45
Q

excess development of granulocytes, expanding marrow into the long bones, and inducing hematopoesis in liver and spleen causing them to enlarge occurs in

A

CML

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46
Q

major complication of chemotherapy treatment in any leukemia

A

Tumor Lysis Syndrome (increased uric acid, K, phos, and decreased Ca)

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47
Q

BMT for CML?

A

only in young, is a chronic disease

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48
Q

Leukemia of too many baby wbcs (granulocytes)

A

CML

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49
Q

Leukemia of too many non-functional adult lymphocytes

A

CLL

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50
Q

Leukemias are classified according to

A

which type of leukocyte is involved

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51
Q

malignant clone of (usually B) lymphocyte produces a non-functional adult appearing cell

A

CLL

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52
Q

In CLL, these become infiltrated with dysfunctional lymphocytes and enlarge

A

Lymph nodes, spleen and liver

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53
Q

CLL prognosis related to

A

extent of organ infiltration and patient wishes (no cure)

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54
Q

Typical presenting symptom on Hodgkin’s Lymphoma

A

Painless enlargement of lymph nodes

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55
Q

Reed-Sternberg cells are the malignant cell and diagnostic criterion for

A

Hodgkin’s Lymphoma

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56
Q

Lymphomas have increased incidence with exposure to

A

chronic immunosuppressive drugs and agent orange; EBV?

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57
Q

Abnormal, giant, multinucleated cells that replace other cells in the lymph nodes

A

Reed-Sternberg cells in Hodgkin’s

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58
Q

Hodgkin’s Lymphoma ususally presents in

A

20-40 years of age, more men

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59
Q

which leukemias present older?

A

Both 60+
CLL
Non-Hodgkin

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60
Q

Group of cancers originating from malignant lymphoid tissue with extensive infiltration of nodes and cells in many stages of development

A

Non-Hodgkin Lymphoma

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61
Q

Lymphoma diagnosed by

A

lymph node and/or BM biopsy

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62
Q

Suspect CLL instead of CML if these three s/s

A

splenomegaly, hepatomegaly, and presents at an older age

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63
Q

CBC results of pt with leukemia

A

WBC count 15-500

increased plts

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64
Q

unique symptom of pernicious anemia

A

tingling and numbness in extremeties

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65
Q

difference between benign and malignant neoplasm

A

tissue invasiveness

66
Q

increased fluid requirement with these two ostomies

A

Ileostomy and ascending colostomy

67
Q

no laxatives, EC or XL/XR meds with this

A

Ileostomy

68
Q

mucus fistula

A

non-functioning stoma of double barrel stoma

69
Q

this colostomy must be irrigated for regularity

A

descending colostomy

70
Q

Ileostomy with and internal pouch and tube that connects to outside

A

Koch pouch

71
Q

This ostomy produces formed stool

A

sigmoid

72
Q

after bladder removal this is used for urinary diversion

A

Ileal conduit

73
Q

a pale stoma indicates

A

anemai

74
Q

a dark red/purple stoma indicates

A

inadequate perfusion

75
Q

an edematous stoma indicates

A

obstruction or gastroenteritis

76
Q

a bleeding stoma indicates

A

a clotting problem, GI bleed, or varices.

77
Q

distal bowel to ostomy not sewn over and may be reconnected, may have mucus discharge

A

Hartman’s Pouch

78
Q

acid base balance is maintained in the body by 3 systems

A

Buffers-immediate
Respiratory-minutes to hours
Renal-2 to 3 days, but most effective

79
Q

normal arterial pH

A

7.35-7.45

80
Q

normal PaCO2

A

35-45 mmHg

81
Q

normal HCO3-

A

22-26 mEq/L

82
Q

normal PaO2

A

80-100 mmHg

83
Q

respiratory imbalance: opposite movement of

A

pH and PaCO2

84
Q

metabolic imbalance: same movement of

A

pH and HCO3-

85
Q

Causes of respiratory acidosis

A

Hypoventilation:

respiratory depression, inadequate chest expansion, airway obstruction, COPD/severe asthma

86
Q

Respiratory Alkalosis caused by

A

Hyperventilation:

anxiety, fear, pain, fever/sepsis, fever, mechanical ventilation

87
Q

Causes of metabolic acidosis

A

severe/prolonged diarrhea
DKA
starvation/malnutrition/excess exercise (lactic acid)
trauma/shock/cardiac arrest

88
Q

Body compensates for metabolic acidosis by

A

compensatory hyperventilation

medulla increases RR and depth to blow of CO2

89
Q

watch this electrolyte in acid/base imbalance because of the possibility of fatal arrhythmia

A

K

90
Q

causes of metabolic alkalosis

A

severe vomiting
excess GI suctioning
excess bicarbonate intake

91
Q

inability to recognize reality with the creation of a new reality

A

psychosis

92
Q

psychoactive drugs vs. psychotropic drugs

A

psychoactive-alter brain chemistry

psychotropic-alter brain chemistry for the purpose of treating a mental illness

93
Q

schizophrenia-increase in two NTs

A

dopamine and serotonin

94
Q

Delusion/Illusion/Hallucination

A

Delusion-false belief
Illusion-misperception of what is there
Hallucination-false perception (nothing there)

95
Q

first generation antipsychotics

A

“typicals”
increased risk of side effects
thorazine, haldol

96
Q

second generation antipschotics

A

“atypicals”
decreased side effects
Risperdal, Zyprexa, Seroquel, Geodon

97
Q

third generation antipsychotic

A

Abilify-also augment for depression

98
Q

Two types of side effects of antipsychotics

A

Anticholinergic and Extrapyramidal

99
Q

anticholinergic side effects

A

Blurred vision
urinary retention
constipation
dry mouth

100
Q

what are EPS

A

extrapyramidal side effects of antipsychotics–drug-induced movement disorders–
dystonia, pseudoparkinsonism, akatheisa, and tardive dyskinesia

101
Q

spasm of neck, jaw, and shoulders…can be fatal if tongue gets thick and eyes roll back and airway is cut off

A

Dystonia

102
Q

generalized restlessness

A

akathesia

103
Q

irreversible disfiguring involuntary facial movements with chronic antipsychotic use

A

tardive dyskinesia

104
Q

Meds to counteract/prevent EPS (not TD or akath)

A

Artand
Benadryl
Cogentin

105
Q

cancer rates higher in these two groups

A

men

Blacks

106
Q

angular cheilosis and brittle spoon shaped nails occur in

A

IDA

107
Q

pts with this are prone to iron overload, so don’t give iron supplements

A

thalassemia

108
Q

defective Hgb synthesis causes theses

A

thalassemia
sicle-cell anemia
small # hemolytic anemias

109
Q

why give steroids with thrombocytopenia?

A

decrease phagocyte response and decrease antibody formation

110
Q

multi-step orderly process of changing a normal cell into a cancer cell

A

malignant transformation

111
Q

first stage of malignant transformation

A

Initiation–mutation occurs
irreversible change in DNA, cell has the potential to develop into a clone
due to carcinogens

112
Q

initiation stage of malignant transformation inhibited by

A

tumor suppressor genes (ex. BRCA-1 and -2, p53)

113
Q

hinder cell division and cause cell death; should stop a mutated cell from dividing

A

Tumor Suppressor gene

114
Q

Second stage of malignant transformation

A

Promotion–reversible proliferation of altered cells

can follow latency period of altered cell laying dormant

115
Q

Third stage of malignant transformation

A

Progression: increased growth rate of tumor, invasion and metastasis
Detectable tumor is formed (primary tumor) , with tumor angiogenesis
metastasis-formation of secondary tumors

116
Q

the immune system can ID normal vs. abnormal cells by

A

tumor-associated antigens and immune surveillance

117
Q

system of cancer staging

A

TNM-tumor node metastasis

indicates extent of disease

118
Q

the grade of a tumor indicates

A 
degree of differentiation of cells based on histology--how closely do the cells resemble the tissue of origin
Less differentiation (anaplasia), worse prognosis
119
Q

cancer of epithelial tissue–skin, glands, brain, mucous membranes of GI/GU and respiratory tracts

A

Carcinoma

most common cancer type

120
Q

cancer of connective tissue-muscle, bone, fat

A

Sarcoma

121
Q

cancer of lymph tissue (especially nodes)

A

Lymphoma

122
Q

cancer of hematopoeitic tissue–bone marrow, spleen

A

Leukemia

123
Q

Definitive diagnosis of cancer is made by

A

biopsy

124
Q

internal radiation treatment

A

brachytherapy

125
Q

thrombocytopenia (most common cause of bleeding in cancer) is a medical emergency when plt count is <

A

50

126
Q

most serious adverse effect of chemo

A

leukopenia

127
Q

in leukopenic pt report right away a fever of

A

> 100.4

128
Q

normal wbc count

A

4.2-12.5

129
Q

normal Hct

A

women 37-47%

men 42-52%

130
Q

normal Hgb

A

women 12-16

men14-18

131
Q

normal wbc count

A

women 4.2-5.4

men 4.7-6.1

132
Q

inflammatory response causing erythema/edema to painful ulcers of mouth, secondary to chemo destroying quickly-dividing cells of oral mucosa

A

Mucositis/Stomatitis

133
Q

BMX mouth rinse

A

Benadryl
Maalox
Xylocaine
coats oral mucosa and decreases pain and inflammation

134
Q

these cause alterations in taste of salt, sour and metallic taste in cancer pts

A

cell wastes from treatment

135
Q

cachexia

A

wasting syndrome common in cancer pts

136
Q

interventions for anorexia in cancer pts

A

small frequent meals-high cal and high PRO, supplements
follow preferences
Megace-appetite stimulant

137
Q

most common side effect of chemo, usually stops when chemo is done

A

nausea

138
Q

skin reaction to radiation that resembles sunburn

A

dry desquamation

resolves on its own, use plain lotion

139
Q

skin reaction to radiation that results in skin sloughing off

A

wet desquamation

140
Q

two types of oncologic emergencies

A

metabolic and obstructive

141
Q

s/s hypercalcemia

A

fatigue, a/n/v

more severe–muscle weakness, EKG changes

142
Q

treatment of hypercalcemia

A

lots of fluids to promote excretion of calcium; Zometa

143
Q

metabolic oncologic emergencies (4)

A

Hypercalcemia
Septic Shock
SIADH
Tumor Lysis Syndrome

144
Q

oncologic emergency with high mortality rate than can be further complicated by DIC

A

Septic shock

145
Q

SIADH-def and treatment

A

Syndrome of Inappropriate Antidiuretic Hormone
too much ADH is produced, causing a dilutional state that can lead to water intoxication and coma. The excessive water retained dilutes Na.
Treatment:Fluid restriction and high dose NaCl IV

146
Q

biochemical changes resulting from destroyed cell contents quickly entering bloodstream after effective cancer treatment.

A

Tumor Lysis Syndrome

147
Q

untreated Tumor Lysis syndrome can lead to

A

increased K level and cardiac dysfunction

148
Q

how does ARF develop from Tumor Lysis syndrome?

A

purines released from cells become uric acid
uric acid precipitates in kidneys to form
sludge in tubules

149
Q

4 hallmark signs of TLS

A

Hyperuricemia
Hyperkalemia
Hyperphosphatemia
Hypocalcemia

150
Q

treatment for TLS

A

Hydrate to increase production of urine and excretions

Allopurinol to decrease uric acid concentration

151
Q

Obstructive oncologic emergencies (3)

A

SVC Syndrome
Spinal cord compression
Pericardial Effusion/Tamponade

152
Q

SVC syndrome

A

tumor compresses SVC
blocks venous return from head, neck, and arms
head and trunk swell

153
Q

first sign of spinal cord compression

A 
Back pain
then-paresthesias
loss of urethral/rectal sensation and control
muscle weakness
permanent paralysis
154
Q

Philadelphia chromosome mutation occurs in

A

CML

154
Q

cause of pericardial effusion in cancer

A

secondary to tumors or radiation pericarditis

155
Q

this condition can cause intense itching as bvs vasodilate/histamine is released and dark red skin

A

polycythemia vera

156
Q

microcytic anemias are characterized by (2)

and 2 types are

A

small abnormally shaped rbcs and decreased Hgb

IDA and thalassemias

157
Q

3 types of macrocytic anemai

A

B12 deficiency anemia
folate deficiency anemia
alcohol-related anemia

158
Q

two types of normocytic anemia

A

ACD and hemolytic anemia

159
Q

elderly pts with impaired CP reserves my show these s/s of anemia

A

CP, DOE, palpitations and dizziness

160
Q

smooth red tongue, angular cheilosis, and brittle spoon-shaped or ridged nail beds, and pica can be seen in

A

IDA

101a Vocab (9 decks)

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