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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
Management of thalasemia
-generally not needed if mild -if severe--\> RBC transfusion, splenectomy \*\*NO iron --\> can lead to iron overload
26
what differentiates folate vs Vit B12 deficiency?
\*no neuro sxs in folate deficiency
27
LAB findings in folate deficiency
-low Hct & RBC -high MCV (macrocytic) -NL MCHC (normochromic) -serum folate decreased
28
Treatment of folate deficiency
Folate 1mg PO q D
29
foods high in folic acid
bananas peanut butter fish green leafy veges iron-fortified breads & cereals
30
Cause of pernicious anemia
d/t lack of intrinsic factor which results in malabsorption of Vit B12
31
S&S of pernicious anemia
weakness glossitis (beefy tongue) palpitations dizziness anorexia \*\*NEURO SXS paresthesia, loss of vibratory sense, loss of fine motor control, positive romberg &**babinski**
32
LAB findings in pernicious anemia
dec Hgb, Hct, RBC -inc MCV (macrocytic) NL MCHC (normochromic) dec serum B12 (\<0.1mcg.ml)
33
Diagnosis of pernicious anemia
anti-IF & antiparietal cell antibody test -schilling test may help determine cause
34
Treatment of pernicious anemia
Vit B12 (cyanocobalamin) 100mcg IM daily x 1 wk \*will require lifelong monthly injections
35
Second most common cause of anemia
anemia of chronic disease
36
most common cause of anemia in the hospital and in the elderly
anemia of chronic disease
37
LAB findings in anemia of chronic disease
-dec Hgb/hct -serum iron & TIBC low -serum ferritin high (\>100ng/ml) MCV normal -MCHC normal
38
LAB findings in sickle cell disease
-Hgb decreased \*\*peripheral smear shows classic distorted sickle cell shaped RBCs electrophoresis to confirm Hgb genotype
39
cause of VWD
mutation or deficiency in VWF & clotting Factor VIII --\> unable to create blood clots
40
treatment of VWD
-Desmopression -recombinant vWF -vWF/Factor VIII concentrate
41
Definition of leukemias
neoplasmas arising from hematopoietic cells in bone marrow
42
Leukemias are more common in \_\_\_\_.
men
43
Which leukemia constitutes 80% of adult leukemia?
AML
44
Remission rates for AML?
50-85%
45
Long term survival for AML
40%
46
Which leukemia is more difficult to cure in adults than children?
ALL
47
remission rate in children w/ALL
90%
48
Hallmark of ALL
pancytopenia w/circulating blasts
49
Most common leukemia in adults
CLL
50
median survival of CLL
10yrs
51
onset of CLL
occurs in middle & old age
52
Hallmark of CLL
lymphocytosis
53
onset of CML
occurs in persons \>/=40yr
54
median survival of CML
3-4yr
55
hallmark of CML
philadelphia chromosome in leukemic cells
56
S&S of leukemia
\*lymphadenopathy -weight loss -fatigue -anorexia -weakness
57
What test is necessary to confirm dx of leukemia?
Bone marrow biopsy
58
Treatment of leukemias
CHEMO -allopurinol to prevent TLS in high risk pts -bone marrow transplant -sxs management
59
LAB derangements seen in TLS
-hypocalcemia -hyperuricemia -hyperphosphatemia -hyperkalemia
60
Diagnosis of lymphoma
biopsy of enlarged nodes
61
stage I lymphoma
disease localized to a single lymph node or group
62
stage II lymphoma
more than 1 lymph node gropu involved; confined to 1 side of the diaphragm
63
stage III lymphoma
lymph nodes or SPLEEN involved; occurs on both sides of diaphragm
64
stage IV lymphoma
liver or bone marrow involvement
65
Which lymphoma has a worse outcome?
non-hodgkins
66
Common presenting clinical manifestation of non-hodgkins lymphoma?
lymphadenopathy
67
most common neoplasm b/t 20-40yr
non-hodgkins lymphoma
68
Average age of hodgkins lymphoma
32
69
Classic presentation of hodgkins lymphoma
cervical lymphadenopathy & spreads in predictable fashion along lymph node groups
70
In which gender is hodgkins lymphoma more common?
men
71
hallmark of hodgkins lymphoma
Reed -sternberg cells
72
Treatment of lymphoma
\*\*XRT -chemo -bone marrow transplant
73
NL Platelet Count
150-400,000
74
In which gender is ITP more common?
women (3:1) \*usu seen in young females
75
Cause of ITP
thrombocytopenia resulting from autoimmune destruction of platelets
76
Diagnosis of ITP
bone marrow bx -other causes of TCP ruled out
77
Treatment of ITP
high dose steroids IVIg (\*preferred to steroids is HIV patients)
78
Thrombocytopenia precautions
avoid constipation no flossing, shaving hold press x 5 min on cuts/lacs
79
Treatment of HIT
Argatroban Lepirudin (Refludan)
80
How to differentiate b/t ITP & SLE?
bone marrow biopsy
81
LAB derangements seen in DIC
-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
Purpose of cryoprecipitate
replace fibrinogen
83
Purpose of FFP
replace clotting factors

HEME/ONC (1 decks)

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