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Kol- 410 Med Surg II > Jacked up WBC > Flashcards

Jacked up WBC Flashcards

1
Q

pancytopenia will result in what 4 assessment findings/symptoms?

A

Fatigue, infection, bruising, bleeding

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2
Q

type of cancer:

Uncontrolled production of immature WBC’s in bone marrow that enter blood stream +decrease production of normal blood cell types =

A

leukemia

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3
Q

leukemia findings

A

-infections
-anemia
-bleeding
-shitty perfusion
-tachycardia/pnea
-liver/spleen enlargement
-n/v/weigh loss
-loc
-fatigue/pain

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3
Q

leukemia findings

A

-infections
-anemia
-bleeding
-shitty perfusion
-tachycardia/pnea
-liver/spleen enlargement
-n/v/weigh loss
-loc
-fatigue/pain

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4
Q

match with acute or chronic leukemia:

-sudden onset with severe symptoms

-slow growing with milder symptoms

A

acute = sudden onset with severe symptoms

chronic = sudden onset with severe symptoms (chronic can become acute)

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5
Q

is a prolonged aptt indicative of good or bad clotting? what will you see with leukemia?

A

bad! slow clotting with leukemia

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6
Q

diagnostic tests for leukemia (2)

A
  • Bone Marrow Aspiration and Biopsy
  • Chromosome analysis (AKA cytogenic studies)
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7
Q

leukemia teaching:

patient with leukemia has temp increase in 1 degree- okay or not okay?

A

not okay! call provider for 1 degree temp increase with leukemia

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8
Q

what kind of precautions do we put someone on with leukemia?

A

neutropenic

  • Neutropenic diet
  • Handwashing, Hand Sanitizing
  • Bathe daily
  • Vaccinate
  • Avoid contact with trash
  • Avoid contact with animals
  • Avoid houseplants, cut flowers, gardens
  • Avoid Humidifiers
  • Avoid using Denture cups
  • Avoid crowds
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9
Q

3 phases of leukemia treatment

A
  • Induction
  • Consolidation
  • Maintenance
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10
Q

during the induction phase of leukemia treatment they will do combination therapy- what is it?

A

7 plus 3
* 7 days of IV cytosine arabinoside
* 3 days anthracycline

  • Complications: INFECTION; Liver/Kidney/Cardiac Toxicity; n/v/d/; stomatitis; alopecia
  • Infection related deaths more common during this period
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11
Q

what are the consolidation and maintenance phases of leukemia treatment?

A

conoslidation = chemo early in remission
maintenance = months to years of chemo after consolidation

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12
Q

re leukemia: what is this drug and why do it care- Imatinib mesylate (Gleevac)

A

First line drug for leukemia

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13
Q

true or false we can treat leukemia with a allogenein hempatopoietic stem cell transplants?

A

true

  • Option increased survival or possible cure
  • Risk for mortality
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14
Q

top 2 chemo complications with leukemia

A
  • infection
  • poor clotting
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15
Q

what platelet count occurs with which thing:

< ? = risk for *bleeding *
< ? = risk for spontaneous bleeding
< ? = platelet *transfusion *

A
  • < 50,000 High risk for bleeding
  • < 20,000 Risk for spontaneous bleed
  • < 10,000 Platelet* transfusion*
16
Q

what platelet count occurs with which thing:

< ? = risk for *bleeding *
< ? = risk for spontaneous bleeding
< ? = platelet *transfusion *

A
  • < 50,000 High risk for bleeding
  • < 20,000 Risk for spontaneous bleed
  • < 10,000 Platelet transfusion
17
Q

what is nadir?

A

Period of greatest bone marrow suppression during chemo

18
Q

what are the defining charcteristics of multiple myeloma

A

cancer of mature B lymphocytes (plasma cells) causing :
* excess antibodies
* excess cytokines
* pancytopenia

19
Q

a cancerous plasma cell is called a ____ cell

A

myeloma cell

20
Q

this cancer is specifically linked to herpes virus 8 but also largely unknown causes like all the cancers

A

multiple myeloma

21
Q

you will see elevated ____ levels with multiple myeloma but you have to rule out ______

A

find: urine protein or paraprotein levels

rule out: MGUS

22
Q

MGUS vs MM

A
  • MM =10% of bone marrow is infiltrated, paraprotein in blood or urine, osteolytic bone lesions (bone changes)
  • MGUS = + paraprotein in blood and urine, can turn into MM
23
Q

top 3 MM findings

bonus question: all the protein will damage what organ down the line?

A
  • Fatigue
  • Bone pain
  • Bruising

kidneys! glomerulus not happy about all the protein

24
Q

diagnostics for MM

A
  • immunoglobulin and plasma protein levels high
  • bence jones protein in peepee
  • > 10% bones marrow infiltrated (biopsy)
  • Xray (swiss cheese bones)
25
Q

top intervention for MM

A

bone pain management
–> biophosphonates (denosumab)

26
Q

do we do bone marrow stem cell translpant for MM patients?

A

sure fucking do but not that many people do it

also chemo, steroids, protease inhibitors, immunomodulators

27
Q

patient education for MM

A

watch for fatigue, infection, bleeding

28
Q

this cancer is characterized by:
- uncontrolled growth of lymphocytes accumulate in lymph tissue

A

lymphoma

common for solid tumors in lymph node and spleen
*Less likely in bone marrow!!

29
Q

hodgkins vs non hodgkins lymphoma

who has reed sternberg cells?
who is predictable?
who starts in a single place?
who is easier to treat?

A

Hodkins
- yes reed sternberg
- yes predictable
- yes single starting place
- yes easier to treat

Non Hodgkins
- no reed sternberg
- no predictable
- no easy treatment

NOn hodgkins is a NO

30
Q

assessment findings for all the lymphomas

A

-large painless lymph node
-b symptoms: night sweats, weight loss w/o trying, perpetuating fever

31
Q

how do we know if you have reed sternberg cells or not?

A

biopsy

32
Q

what system do they use to stage hodgkins lymphoma

A

Lugano Modification of the Ann Arbor Staging System

33
Q

Not sure if we need to know the hodgkins lymphoma stages but this card is for the borad strokes on the differences in the 4 stages

A

I: single lymph node
II: 2 or more lymph nodes on same side of diaphragm
III: lymph nodes on both sides of diaphragm
IV: shits all over - liver, lung, skin, marrow

34
Q

what is the system they use to categroize and stage Non Hodgkins lymphoma?

A

WHO classification

35
Q

Hodgkins- whats the treatment? prognosis?

A

chemo , radiation
yes good prognosis but late complications can occur

idk how much of this we need to know so I made it a food note:

“Late effects” / Complications
Can occur years to decades after tx with radiation and chemo.
* Cardiovascular disease
* Secondary malignancies
* Restrictive lung disease
* Endocrine dysfunction
* Hypothyroidism
* Infertility
* Premature menopause

36
Q

non-hodgkins treatment?

A

chemo, MABS, radiation, radiolabeled antibodies, Chimeric Antigen Receptor (CAR) T cells , novel therapies

(a lot more different things they try than hodgkins)

37
Q

tell me about Chimeric Antigen Receptor (CAR) T Cells - what does it treat? what does it do? is it chill- biggest side effect?

A
  • Treats Non Hodgkins Lymphoma
  • Charges up the immune system, releasing lots of inflammatory cytokines.
  • Side effectL cytokine storm!!

cytkine storm:
* Last 5-7 days
* Flu like symptoms
* Fever
* Fatigue
* Body aches
* Hypotension
* Edema
* Decreased UOP

38
Q

iggy pages per harrell

looks at these if you will but I ain’t cracking no damn textbook

A
  • Chapter 37; pages 802-815, page 818-819.
  • Chapter 20; pages 377-393

Kol- 410 Med Surg II (27 decks)

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