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3P > HemOnc > Flashcards

HemOnc Flashcards

1
Q

MCV is used to measure what?

A

Mean corpuscular volume

= RBC size

Microcytic = small cells
Macrocytic =Large cells

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2
Q

MCH measures what ?

A

Mean corpuscular hemoglobin = Weight of Hgb in average RBC

hypochromic - low in color
hyerpchromic - too much color

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3
Q

What is RDW?

A

Degree of variation in RBC size

<15% is normal

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4
Q

What is serum iron vs serum ferritin?

A

Serum Iron = measure of iron in circulation

serum ferritin -> Iron in storage –> ferritin is a protein that stores iron

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5
Q

what will a reticulocyte count show?

A

ability of bone marrow to produce RBCs

Reticulocyte = baby RBC — check levels 1-2 weeks after tx to verify bone marrow is producing RBCs

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6
Q

What does elevated Total iron binding capacity indicate?

A

Iron deficiency

Elevated = lots of seats on the bus to hold iron

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7
Q

Name the 5 causes of microcytic anemia

A
  1. Fe deficiency
  2. Thalassemia
  3. Anemia of chronic disease
  4. sideroblastic anemia
  5. lead toxicity
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8
Q

What is Desrrioxamine (Desferal) Used for?

A

drug that chronically transfused patients use to remove EXCESS IRON from their bodies.

USED in THALASSEMIA pts

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9
Q

what type of anemia is desferrioxamine used in?

A

Thalassemia patients!!!!!!!!!

also pts who receive frequent transfusion

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10
Q

A low serum fe, high TIBC and possibly low ferritin may indicate what type of anemia? `

A

Iron deficiiency

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11
Q

Nutritional guidelines to improve iron deficiency anemia?

A

Organ meats/red meats
dried peas/beans
dark leafy greens
whole grains

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12
Q

Pharm tx for iron deficiency anemia

A

150-200mg/Day of elemental iron for 4-6 months!

  1. Ferrous fumarate 325mg = 106mg of elemental iron
  2. Ferrous sulfate 325mg = 65mg of elemental iron
  3. Ferrous gluconate 325mg = 33mg of elemental iron
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13
Q

Education when prescribing elemental iron

A
  1. Take on EMPTY stomach

2. Take with VITAMIN C

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14
Q

what does deserrioxamine do?

A

remove excess iron

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15
Q

what causes anemia of chronic disease?

A

CHRONIC inflammation = destruction of RBC –> typically only last 60-90days

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16
Q

what might a normocytic normochromic anemia indicate?

A

acute blood loss OR anemia of chronic disease (if longstanding will eventually become microcytic hypochromic)

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17
Q

RBC lifespan in anemia of chronic disease?

A

60-90 days

18
Q

What kind of anemia is typically seen in a MACROcytic anemia?

A

B12 folate deficiency

19
Q

what are the main causes of B12 folate deficiency?

A 
Low intake (vegetarians)
malapsorbption 
loss of parietal cells 
autoimmune disease 
pancreatic insufficiency
20
Q

What often co-exisits with a b12 anemia?

A

folate deficiency!

21
Q

What is B12?

A

essential vitamin obtained from diet or supplementation

Stores of b12 remain in liver for YEARS so onset of deficiency may occur over motnths to years

22
Q

what are the dietary intakes of b12

A

dairy

animal products

23
Q

What differs pernicious anemia from B12 deficiency anemia?

A

Pernicious = not enough B12 BUT do to ANUTOIMMUNE disease that attacks the PARIETAL cells resulting in an inability to absorb b12

24
Q

Management of B12 deficiency

A

B12 (Cobalamin)

Folic acid - PO –> tx 1-4 months post recovery

25
Q

What constitutes thrombocytopenia?

A

PLT <150kl

26
Q

managment for thrombocytopenia?

A

Refer to Hem/Onc
Prednisone 4-6 weeks
AVOID ASA – risk for bleeds

27
Q

What is the most common leukemia affecting adults worldwide?

A

Chronic lymphocytic leukemia!

Insidious, typically discovered incidentally

28
Q

Unique symptom for Chronic Myloid (CML) leukemia

A

Priapism

29
Q

Unique symptoms for CLL ( Chronic Lymphocytic leukemia)

A

Pallor

Petechiae

30
Q

What do blastocytes on a CBC indicate?

A

Blastocytes = immature WBC = ALWAYS ABNORMAL FINDING

Blastocytes are normally found in bone marrow, not serum

refer to hem/onc

31
Q

G6PD hemolytic anemia

A 
often Mediterranian / AA descent 
Genetic 
Normally asymptomatic until exposed to....:
-Antimalarial 
-sulfonamides
-bactrim!!!!!!!
-Fava beans
-nitrofurantoin
32
Q

When does RH incompatibility occur?

A

RH - mom & RH + baby

33
Q

what complication occurs in RH incompatibility?

A

hemolytic disease of newborn

34
Q

when do we give Rogham?

A

28 weeks pregnant

then 72 hours of delivery

35
Q

What anemia is associated with intrinsic factor and reduced absorption of Vitamin B12?

A

Pernicious anemia

36
Q

Assessment Findings for Vit B12 deficiency

A 
cognitive impairment 
ataxia
spasticity 
peripheral neuropathy!!!!!!!!!
Glossitis 
bleeding gums 
insomnia
37
Q

Type of anemia where bone marrow produces ringed sideroblasts rather than healthy RBCs

A

Sideroblastic anemia

38
Q

how much elemental iron does ferrous fumarate 325mg contain?

A

106mg

39
Q

how much elemental iron does ferrous sulfate 325mg contains?

A

65mg

40
Q

how much elemental iron does ferrous gluconate 325mg contain?

A

33mg of elemental iron

41
Q

what does anisocytosis and poikilocytosis indicate?

A

anisocytosis = variation in RBC size

poikilocytosis = variation in RBC shape

42
Q

assessment findings in newborns with hemoly

A

3P (16 decks)

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