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Hematology/Oncology > Heme/onc > Flashcards

Heme/onc Flashcards

1
Q

HgB

A

Main component of RBC’s and the essential protein that combines with and transports O2 to the body.
Males: 14-18
Females 12-16

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2
Q

Hct

A

Measures % of a given volume of whole blood that is occupied by erythrocytes; the amount of plasma to total RBC mass.
Males: 40-54%
Females: 37-47%

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3
Q

TIBC

A

Total iron binding capacity

Normal= 250-450

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4
Q

Serum iron

A

Normal 50-150

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5
Q

MCV

A

Expression of the average volume and size of individual erythrocytes
Normal: 80-100
Microcytic= <80
Macrocytic= >100

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6
Q

MCH

A

Expression of average amount and weight of Hgb contained in a single erythrocyte
Normal: 26-34

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7
Q

MCHC

A

Normal: 32-36%
Hypochromic= <32
Hyperchromic= 36%

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8
Q

Low MCV

A

Iron deficiency and thalassemia

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9
Q

High MCV

A

B12 or folate deficiency, alcoholism, liver failure and drug effects

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10
Q

Normochromic

A

Anemia of chronic disease, sickle cell disease, renal failure, blood loss, hemolysis

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11
Q

Iron deficiency anemia

A

Microcytic (<80), hypochromic (<32)
Most common cause of anemia
Iron loss exceeds intake–decrease in iron available for RBC formation!

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12
Q

S/S of IDA

A 
Usually slow onset w/ few symptoms if Hgb >30
Pica
dyspnea
HA
palpitations
weakness
tachycardia
postural hypotension
pallor
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13
Q

Labs for IDA

A

LOW: Hgb, hct, MCV, MCHC, RBC, iron, ferritin
HIGH: TIBC, RDW

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14
Q

Management of IDA

A

Oral ferrous sulfate 300-325mg 1-2 hours after meals
DO NOT take with antacids
Vitamin C INCREASES absorption

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15
Q

Foods high in iron

A

Raisins, green leafy veggies, red meats, citrus products, and iron fortified foods

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16
Q

Thalassemia

A

Genetically inherited disorders resulting in abnormal Hgb production and Microcytic, Hypochromic anemia
Typically Mediterranean, African, middle eastern, indian and Asian populations

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17
Q

S/s of thalassemia

A

Typically unremarkable unless severe

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18
Q

Labs for thalassemia

A

LOW: Hgb, MCV, MCHC
Normal: TIBC, ferritin

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19
Q

Management of thalassemia

A

No tx for mild to mod
Severe= RBC transfusion/splenectomy
IRON is contraindicated

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20
Q

Folic Acid deficiency

A

Macrocytic (>100), normochromic (32-36%)

Inadequate intake/malabsorption of folic acid (needed for RBC production)

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21
Q

S/S of FAD

A 
Fatigue
Dyspnea on exertion
Pallor
HA
Tachycardia
Anorexia
Glossitis
Aphthous ulcers
NEUROLOGIC symptoms are what differentiates FAD from B12 deficiency
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22
Q

Labs for FAD

A

LOW: Hct, Hgb, folate
HIGH: MCV
Normal: MCHC

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23
Q

Management of FAD

A

Folate 1mg orally daily

24
Q

Foods high in folic acid

A

Bananas, PB, fish, green leafy veggies, iron fortified

25
Q

Pernicious Anemia

A

Macrocytic (>100), normochromic (32-36%)

Deficiency of intrinsic factor, which results in malabsorption of B12

26
Q

S/S of PA

A 
Weakness
Glossitis
Palpitations
Dizziness
Anorexia
Parasthesia
Loss of vibratory sense
Loss of fine motor control
\+ Romberg, + Babinski
27
Q

Labs for PA

A

Low: Hgb, Hct and RBC’s, B12
High: MVC
Anti-IF (intrinsic factor) and antiparietal cell antibody tests affirm a deficiency
Schilling test may help determine cause

28
Q

Management of PA

A

B12 (cyanocobalamin) 100 IM daily x1 week

Maintenance tx requires continuous, lifelong monthly admin

29
Q

Anemia of chronic disease

A

Chronic normochromic, normocytic anemia associated with chronic inflammation, infection, renal failure, and malignancy
Involves decreased erythrocyte life span
Second most common cause of anemia

30
Q

S/S of anemia of chronic disease

A

Fatigue, weakness, dyspnea on exertion, anorexia

31
Q

Labs for anemia of chronic disease

A

Low hgb & hct
Low iron and TIBC
MCV and MCHC normal
High ferritin

32
Q

Sickle cell anemia

A

Chronic, hemolytic anemia that is genetically transmitted
Acute, periodic exacerbation in which RBC’s become sickle-shaped and cause vessel obstruction
Cellular hypoxia results in acidosis and tissue ischemia

33
Q

Factors that precipitate sickling

A 
infection
Hypoxia
high altitudes
dehydration
physical/emotional stress
surgery
blood loss
acidosis
34
Q

S/S of SCD

A 
Delayed growth and development in infancy or early childhood
Sudden onset of severe pain
aching joint pain
weakness
dyspnea
35
Q

Labs for SCD

A

Decreased Hgb
Peripheral smear shows classic distorted sickle-shaped RBC’s
Cellulose acetate and citrate agar gel electrophoresis to confirm Hgb genotype

36
Q

Management of SCD

A

Acute: fluids, analgesics, oxygen

37
Q

Acute Nonlymphocytic Leukemia/Acute Myelogenous Leukemia

A

ANL/AML
80% of acute leukemia in adults
Remission rates from 50-85%
Long term survival rates about 40%

38
Q

Acute Lymphocytic Leukemia

A

ALL
More difficult to cure in adults than children
Pancytopenia with circulating blasts (hallmark)

39
Q

Chronic Lymphocytic Leukemia

A

CLL
Most common leukemia in adults
Lymphocytosis (hallmark)

40
Q

Chronic Myelogenous Leukemia

A

CML

Philadelphia chromosome seen in leukemic cells (hallmark)

41
Q

Labs for leukemia

A

CBC with subnormal RBC’s and neutrophils
Elevated ESR
*Peripheral blood smear usually distinguishes acute and chronic leukemia’s but a bone marrow biopsy is required for confirmation

42
Q

Stage 1 Lymphoma

A

Disease localized to single lymph node or group

43
Q

Stage 2 lymphoma

A

more than one lymph node group involved; confined to one side of the diaphragm

44
Q

Stage 3 lymphoma

A

Lymph nodes or the spleen involved; occurs on both sides of the diaphragm

45
Q

Stage 4 lymphoma

A

Liver or bone marrow involvement

46
Q

Non-Hodgkin’s lymphoma

A

Lymphadenopathy
Most common neoplasm between 20-40
Less predictable pattern of spread then Hodgkin’s

47
Q

Hodgkin’s lymphoma

A

Unknown cause
More common in males
Cervical adenopathy and spread in a predictable fashion through the lymph nodes
Reed-Sternberg cells*** differentiate non-hodgkins from hodgkins

48
Q

TNM classification of Malignant tumors

A

Cancer staging system developed and maintained by the Union for international caner control
Not all cancers have TNM classifications (brain tumors)

49
Q

TNM

A

T: A, is, 0, 1-4 Size or direct extend of the primary TUMOR
N: 0-3, spread to regional NODES
M: 0/1, Distant METASASIS

50
Q

Polycythemia

A

Idiopathic and chronic marrow disorder, due to genetic mutation, resulting in INCREASED RBD and Hct

51
Q

S/S of polycythemia

A

Fatigue, weakness, visual disturbances, HA

52
Q

Labs for polycythemia

A

Hgb >18.5 in men and > 16.5 in women

Presence of JAK2617VF or similar genetic mutation

53
Q

Management of polycythemia

A

Phlebotomy
Aspirin
Referral

54
Q

Hemochromatosis

A

Disorder that results in excessive levels of iron

55
Q

S/s of hemochromatosis

A

Fatigue
Joint pain
pain in knuckles or pointer and middle fingers
-Liver disease, hyperpigmentation and diabetes

56
Q

Management of hemochromatosis

A

Iron chelation

Don’t eat iron containing foods

57
Q

Immunosenescence

A

the immune systems diminished function with age which leads to a decline in response to infection

Hematology/Oncology (1 decks)

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