HemOnc Flashcards
MCV is used to measure what?
Mean corpuscular volume
= RBC size
Microcytic = small cells
Macrocytic =Large cells
MCH measures what ?
Mean corpuscular hemoglobin = Weight of Hgb in average RBC
hypochromic - low in color
hyerpchromic - too much color
What is RDW?
Degree of variation in RBC size
<15% is normal
What is serum iron vs serum ferritin?
Serum Iron = measure of iron in circulation
serum ferritin -> Iron in storage –> ferritin is a protein that stores iron
what will a reticulocyte count show?
ability of bone marrow to produce RBCs
Reticulocyte = baby RBC — check levels 1-2 weeks after tx to verify bone marrow is producing RBCs
What does elevated Total iron binding capacity indicate?
Iron deficiency
Elevated = lots of seats on the bus to hold iron
Name the 5 causes of microcytic anemia
- Fe deficiency
- Thalassemia
- Anemia of chronic disease
- sideroblastic anemia
- lead toxicity
What is Desrrioxamine (Desferal) Used for?
drug that chronically transfused patients use to remove EXCESS IRON from their bodies.
USED in THALASSEMIA pts
what type of anemia is desferrioxamine used in?
Thalassemia patients!!!!!!!!!
also pts who receive frequent transfusion
A low serum fe, high TIBC and possibly low ferritin may indicate what type of anemia? `
Iron deficiiency
Nutritional guidelines to improve iron deficiency anemia?
Organ meats/red meats
dried peas/beans
dark leafy greens
whole grains
Pharm tx for iron deficiency anemia
150-200mg/Day of elemental iron for 4-6 months!
- Ferrous fumarate 325mg = 106mg of elemental iron
- Ferrous sulfate 325mg = 65mg of elemental iron
- Ferrous gluconate 325mg = 33mg of elemental iron
Education when prescribing elemental iron
- Take on EMPTY stomach
2. Take with VITAMIN C
what does deserrioxamine do?
remove excess iron
what causes anemia of chronic disease?
CHRONIC inflammation = destruction of RBC –> typically only last 60-90days
what might a normocytic normochromic anemia indicate?
acute blood loss OR anemia of chronic disease (if longstanding will eventually become microcytic hypochromic)
RBC lifespan in anemia of chronic disease?
60-90 days
What kind of anemia is typically seen in a MACROcytic anemia?
B12 folate deficiency
what are the main causes of B12 folate deficiency?
Low intake (vegetarians) malapsorbption loss of parietal cells autoimmune disease pancreatic insufficiency
What often co-exisits with a b12 anemia?
folate deficiency!
What is B12?
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
what are the dietary intakes of b12
dairy
animal products
What differs pernicious anemia from B12 deficiency anemia?
Pernicious = not enough B12 BUT do to ANUTOIMMUNE disease that attacks the PARIETAL cells resulting in an inability to absorb b12
Management of B12 deficiency
B12 (Cobalamin)
Folic acid - PO –> tx 1-4 months post recovery
What constitutes thrombocytopenia?
PLT <150kl
managment for thrombocytopenia?
Refer to Hem/Onc
Prednisone 4-6 weeks
AVOID ASA – risk for bleeds
What is the most common leukemia affecting adults worldwide?
Chronic lymphocytic leukemia!
Insidious, typically discovered incidentally
Unique symptom for Chronic Myloid (CML) leukemia
Priapism
Unique symptoms for CLL ( Chronic Lymphocytic leukemia)
Pallor
Petechiae
What do blastocytes on a CBC indicate?
Blastocytes = immature WBC = ALWAYS ABNORMAL FINDING
Blastocytes are normally found in bone marrow, not serum
refer to hem/onc
G6PD hemolytic anemia
often Mediterranian / AA descent Genetic Normally asymptomatic until exposed to....: -Antimalarial -sulfonamides -bactrim!!!!!!! -Fava beans -nitrofurantoin
When does RH incompatibility occur?
RH - mom & RH + baby
what complication occurs in RH incompatibility?
hemolytic disease of newborn
when do we give Rogham?
28 weeks pregnant
then 72 hours of delivery
What anemia is associated with intrinsic factor and reduced absorption of Vitamin B12?
Pernicious anemia
Assessment Findings for Vit B12 deficiency
cognitive impairment ataxia spasticity peripheral neuropathy!!!!!!!!! Glossitis bleeding gums insomnia
Type of anemia where bone marrow produces ringed sideroblasts rather than healthy RBCs
Sideroblastic anemia
how much elemental iron does ferrous fumarate 325mg contain?
106mg
how much elemental iron does ferrous sulfate 325mg contains?
65mg
how much elemental iron does ferrous gluconate 325mg contain?
33mg of elemental iron
what does anisocytosis and poikilocytosis indicate?
anisocytosis = variation in RBC size
poikilocytosis = variation in RBC shape
assessment findings in newborns with hemoly
