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HEME/ONC > HEME/ONC > Flashcards

HEME/ONC Flashcards

1
Q

Normal Hgb for females

A

12-16g/100ml

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2
Q

Normal Hgb for males

A

14-18g/100ml

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3
Q

normal HCT for females

A

37-47%

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4
Q

normal HCT for males

A

40-54%

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5
Q

normal TIBC

A

250-450ug/dl

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6
Q

normal serum iron

A

50-150ug/dl

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7
Q

normal MCV

A

80-100fl

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8
Q

microcytic MCV

A

<80

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9
Q

normocytic MCV

A

80-100

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10
Q

macrocytic MCV

A

>100

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11
Q

normal MCH (mean corpuscular volume)

A

26-34pg

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12
Q

normal MCHC (mean corpuscular hgb concentration)

A

32-36% (aka -normochromic)

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13
Q

hypochromic

A

<32%

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14
Q

Differential dx of microcytic MCV

A

thalassemia IDA

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15
Q

Differential dx of normocytic MCV

A

anemia of chronic disease (renal failure) *blood loss *hemolysis sickle cell disease

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16
Q

Differential dx of macrocytic MCV

A

B12 or folate deficiency alcoholism liver failure drug effects

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17
Q

most common cause of anemia

A

IDA

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18
Q

causes of IDA

A

-blood loss (GIB) -inadequate iron intake -impaired absorption of iron

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19
Q

S&S of IDA

A

-**PICA -dyspnea, mild fatigue w/exercise -HA -palpitations -weakness -tachycardia -postural hypotension -pallor

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20
Q

LAB findings in IDA

A

-low Hgb/Hct -low RBC -low MCV (microcytic) -low MCHC (hypochromic) -low serum iron -**low serum ferritin **high TIBC -high RDW

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21
Q

Treatment of IDA

A

oral ferrous sulfate 300-325mg 1-2 hr AFTER meals (food dec absorption)

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22
Q

Teaching points necessary to teach patients who will be taking oral iron

A

-take 2 hrs after food -avoid w/antacids -do not take with Vit C (inc absorption)

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23
Q

Food high in iron

A

raisins green leafy veges red meats citrus products iron-fortified bread & cereals

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24
Q

LAB findings in thalassemia

A

-dec Hgb -low MCV (microcytic) -low MCHC (hypochromic) -*normal TIBC -normal ferritin -decrease alpha or beta Hgb chains

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25
Q

Management of thalasemia

A

-generally not needed if mild -if severe–> RBC transfusion, splenectomy **NO iron –> can lead to iron overload

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26
Q

what differentiates folate vs Vit B12 deficiency?

A

*no neuro sxs in folate deficiency

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27
Q

LAB findings in folate deficiency

A

-low Hct & RBC -high MCV (macrocytic) -NL MCHC (normochromic) -serum folate decreased

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28
Q

Treatment of folate deficiency

A

Folate 1mg PO q D

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29
Q

foods high in folic acid

A

bananas peanut butter fish green leafy veges iron-fortified breads & cereals

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30
Q

Cause of pernicious anemia

A

d/t lack of intrinsic factor which results in malabsorption of Vit B12

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31
Q

S&S of pernicious anemia

A

weakness

glossitis (beefy tongue)

palpitations dizziness

anorexia

**NEURO SXS paresthesia, loss of vibratory sense, loss of fine motor control, positive romberg &babinski

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32
Q

LAB findings in pernicious anemia

A

dec Hgb, Hct, RBC -inc MCV (macrocytic) NL MCHC (normochromic) dec serum B12 (<0.1mcg.ml)

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33
Q

Diagnosis of pernicious anemia

A

anti-IF & antiparietal cell antibody test -schilling test may help determine cause

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34
Q

Treatment of pernicious anemia

A

Vit B12 (cyanocobalamin) 100mcg IM daily x 1 wk *will require lifelong monthly injections

35
Q

Second most common cause of anemia

A

anemia of chronic disease

36
Q

most common cause of anemia in the hospital and in the elderly

A

anemia of chronic disease

37
Q

LAB findings in anemia of chronic disease

A

-dec Hgb/hct -serum iron & TIBC low -serum ferritin high (>100ng/ml) MCV normal -MCHC normal

38
Q

LAB findings in sickle cell disease

A

-Hgb decreased **peripheral smear shows classic distorted sickle cell shaped RBCs electrophoresis to confirm Hgb genotype

39
Q

cause of VWD

A

mutation or deficiency in VWF & clotting Factor VIII –> unable to create blood clots

40
Q

treatment of VWD

A

-Desmopression -recombinant vWF -vWF/Factor VIII concentrate

41
Q

Definition of leukemias

A

neoplasmas arising from hematopoietic cells in bone marrow

42
Q

Leukemias are more common in ____.

A

men

43
Q

Which leukemia constitutes 80% of adult leukemia?

A

AML

44
Q

Remission rates for AML?

A

50-85%

45
Q

Long term survival for AML

A

40%

46
Q

Which leukemia is more difficult to cure in adults than children?

A

ALL

47
Q

remission rate in children w/ALL

A

90%

48
Q

Hallmark of ALL

A

pancytopenia w/circulating blasts

49
Q

Most common leukemia in adults

A

CLL

50
Q

median survival of CLL

A

10yrs

51
Q

onset of CLL

A

occurs in middle & old age

52
Q

Hallmark of CLL

A

lymphocytosis

53
Q

onset of CML

A

occurs in persons >/=40yr

54
Q

median survival of CML

A

3-4yr

55
Q

hallmark of CML

A

philadelphia chromosome in leukemic cells

56
Q

S&S of leukemia

A

*lymphadenopathy -weight loss -fatigue -anorexia -weakness

57
Q

What test is necessary to confirm dx of leukemia?

A

Bone marrow biopsy

58
Q

Treatment of leukemias

A

CHEMO -allopurinol to prevent TLS in high risk pts -bone marrow transplant -sxs management

59
Q

LAB derangements seen in TLS

A

-hypocalcemia -hyperuricemia -hyperphosphatemia -hyperkalemia

60
Q

Diagnosis of lymphoma

A

biopsy of enlarged nodes

61
Q

stage I lymphoma

A

disease localized to a single lymph node or group

62
Q

stage II lymphoma

A

more than 1 lymph node gropu involved; confined to 1 side of the diaphragm

63
Q

stage III lymphoma

A

lymph nodes or SPLEEN involved; occurs on both sides of diaphragm

64
Q

stage IV lymphoma

A

liver or bone marrow involvement

65
Q

Which lymphoma has a worse outcome?

A

non-hodgkins

66
Q

Common presenting clinical manifestation of non-hodgkins lymphoma?

A

lymphadenopathy

67
Q

most common neoplasm b/t 20-40yr

A

non-hodgkins lymphoma

68
Q

Average age of hodgkins lymphoma

A

32

69
Q

Classic presentation of hodgkins lymphoma

A

cervical lymphadenopathy & spreads in predictable fashion along lymph node groups

70
Q

In which gender is hodgkins lymphoma more common?

A

men

71
Q

hallmark of hodgkins lymphoma

A

Reed -sternberg cells

72
Q

Treatment of lymphoma

A

**XRT -chemo -bone marrow transplant

73
Q

NL Platelet Count

A

150-400,000

74
Q

In which gender is ITP more common?

A

women (3:1) *usu seen in young females

75
Q

Cause of ITP

A

thrombocytopenia resulting from autoimmune destruction of platelets

76
Q

Diagnosis of ITP

A

bone marrow bx -other causes of TCP ruled out

77
Q

Treatment of ITP

A

high dose steroids IVIg (*preferred to steroids is HIV patients)

78
Q

Thrombocytopenia precautions

A

avoid constipation no flossing, shaving hold press x 5 min on cuts/lacs

79
Q

Treatment of HIT

A

Argatroban Lepirudin (Refludan)

80
Q

How to differentiate b/t ITP & SLE?

A

bone marrow biopsy

81
Q

LAB derangements seen in DIC

A

-TCP (<150) -hypofibrinogenemia (<170) -dec RBCs -inc FDPs (>45mcg/ml or present at >1:100 dilution) -prolonged PT (>19sec) -prolonged PTT (>42sec) -D DImer (+ at 1:8 dilution)

82
Q

Purpose of cryoprecipitate

A

replace fibrinogen

83
Q

Purpose of FFP

A

replace clotting factors

HEME/ONC (1 decks)

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