INCOMPLETE Cardiovascular (Si)

Question 1

ANEMIA

Answer 1

lower than normal count of RBC

Question 2

Anemia: DX Tests

Answer 2

• CBC
• Erythrocyte Indices
• Peripheral Smear
• Schilling Test/Megaloblastic Anemia Profile
• Gastric Analysis
• Radiologic Studies (MRI, CT)
• Bone Marrow Aspiration/Biopsy
• Lymphangiography

Question 3

CBC

Answer 3

• routine screening, provides info on hematologic and other organ systems
• info on RBC, Hgb, Hct, Erythrocytes, Platelets, WBC (differential)

Question 4

Erythrocyte Indices

Answer 4

provides info on SIZE, WEIGHT. Helps to categorize ANEMIAS

• Size (MCV) = Mean Corpuscular Volume
• Weight (MCH) = Mean Corpuscular Hemoglobin
• Hgb Conc (MCHC) = Mea Corpuscular Hgb conc.

Question 5

Erythrocyte Indices: MCV

Answer 5

MCV (size): Mean Corpuscular Volume, measures average volume, SIZE of 1 RBC, HCT/RBC

normal: adult/elderly/child 80-95mm

Question 6

Erythrocyte Indices: MCH

Answer 6

MCH (weight): Mean Corpuscular Hemoglobin,
measures average AMT of Hgb in 1 RBC, Hgb/RBC

normal: adult/elderly/child 27-31pg

Question 7

Erythrocyte Indices: MCHC

Answer 7

MCHC (Hgb Conc): Mean Corpuscular Hgb conc, measures avg concen or % of Hgb in 1 RBC, Hgb/HCT

normal: adult/elderly/child 32 - 36g/dl or 32 - 36%

Question 8

Normocytic, Normochromic, Anemia

Answer 8

SEE SLIDE

Question 9

Peripheral Smear

Answer 9

Used to differentiate anemias and blood dyscrasias

• 1 drop blood on slide, under microscope
• NO FASTING required
• Examines RBC, WBC, PLTs
• size, shape, color, intracellular content

Question 10

Schilling Test

Answer 10

*NOT FOR PREGN or BRST FEEDing (d/t radiactive B12)
-to Dx Pernicious Anemia
-ingest radioactive B12 PO, then urine in 1-2hrs,
-Normal: excretion 10-40%
-Abnormal: little to zero (indicates body is not absorbing B12 which is why nothing is being excreted by kidneys in urine)
-lack of intrinsic factor = no B12 absorbtion
(sx removing stomach etc, Intrinsic Factor made in stomach)

Question 11

Megaloblastic Anemia Profile

Answer 11

• REPLACES Schilling Test

- blood test to measure 4 compounds. If all 4 compounds UP then = Vit B12 LO

Question 12

Gastric Analysis

Answer 12

• rarely used (too invasive)
• to detect peptic ulcer disease and Pernicious Anemia
• NPO after midnight
• insert GTube
• Aspirate q15min for 90min to test fluid

Question 13

Development of Blood Cells

Answer 13

SEE SLIDE pg

Mnemonic:
Grandpa Ben eats little monkeys
(Granulocytes, (BEN:Basophyls, Eonocytes, Nutrophil), Lymphocytes, Monocytes

Question 14

WBC mnemonic

Answer 14

Never Let Monkeys Eat Bananas

• types of white blood cells, from most to least numerous, in the blood.
• *Neutrophil, Lymphocyte, Monocyte, Eosinophil, Basophil**

Question 15

Bone Marrow Exam

Answer 15

• Biopsy and Aspiration (2 steps)
• to confirm Diff blood dyscrasias
• from soft spongy tissue in bones (sternum, ribs, pelvis, femur, tibia, humerous

Question 16

Hematopoesis

Answer 16

formation of cells

Question 17

Bone Marrow Biopsy (step 1)

Answer 17

-removal of soft tissue
-location: (posterior illiac crest, not sternum due to rise for lung puncture
-Local Anetsthetic: Lidocaine usually
-needle into illiac crest
-feel PRESSURE
-~20min
RSK: bleeding, infection, needle breaking
-Contraindicated: Cooag disorder, uncoop pts

Question 18

Bone Marrow Aspiration (step 2)

Answer 18

• w/draw liquid portion of marrow

- DRY Tap: when nothing is aspirated, no more marrow, or compaction d’t HI amount of marrow cells

Question 19

Aplastic Anemia

Answer 19

no platelets to clot, so bleed out

Question 20

Bone Marrow BiopsyAsp: NI

Answer 20

• VS, pre/post
• apply sterile bandage and pressure
• apply pressure
• bebdrest 1 hr post procedure
• monitor puncture site for erythema, bleeding, tenderness, ifection
• admn, mild analgesic PRN