priority deck 2021 (including haem/onc)

Question 1

Hb normal range?

Answer 1

130-180 males

120-160 females

Question 2

WCC normal range?

Answer 2

4.0 - 11.0

Question 3

neutrophils normal range?

Answer 3

2.0 - 7.5

Question 4

platelets normal range?

Answer 4

150 - 400

Question 5

define neutropenia & outline interventions?

Answer 5

neutrophils <2.

G-CSF may be indicated - granulocyte colony-stimulating factor

strict hand hygiene, monitor for signs of infection

Question 6

another name for G-CSF?

Answer 6

filgrastin

Question 7

what is AML?

Answer 7

acute myeloid leukaemia

AML is defined as an overproduction of immature white blood cells (myeloblasts)

the group of leukaemias that develop in the myeloid cell line in the bone marrow

Question 8

what are the myeloid cells?

Answer 8

red blood cells, platelets and all white blood cells excluding lymphocytes.

Question 9

what is petechial rash?

Answer 9

tiny purple, red, or brown spots on the skin

petechiae look like a rash, they’re actually caused by bleeding under the skin

Question 10

common symptoms of AML?

Answer 10

Anaemia: tiredness, dizziness, pale in colour, SOB

Frequent infections/generally feeling unwell (due to lack of normal WCC/neutrophils)

Unexplained bruising/bleeding/petechial rash (caused by thrombocytopenia)

Bone pain, swollen lymph nodes, chest pain and abdominal discomfort due to a swollen spleen or liver.

Question 11

AML: fast or slow progressing?

Answer 11

fast

Question 12

AML pre-treatment workup?

Answer 12

· Cytogenetic testing

· HLA typing (if patient is likely to require an allogeneic stem cell transplant)

· Central line insertion (usually PICC line)

· Gated Blood Pool Scan (checks heart function to ensure patient is able to tolerate chemotherapy)

· Consideration of fertility preservation

Question 13

nursing considerations for AML?

Answer 13

· Strict monitoring hand hygiene and considerations for neutropenic patients.

· Often have high blood transfusion requirements

· Monitoring pts for early complications of induction chemotherapy such as TLS and DIC.

Question 14

treatment for AML?

Answer 14

chemotherapy - induction (1st cycle) to to destroy the leukaemia cells and induce a remission, then ongoing ‘consolidation’ cycles to prevent relapse

when there is a high risk of relapse the patient may go on to have an allogeneic stem cell transplant

Question 15

what is ALL?

Answer 15

acute lymphoblastic leukaemia

same as AML, but in lymphoblasts not myeloblasts

as in AML, the lymphoblasts proliferate and crowd the bone marrow, preventing the production of functional blood cells

immature cells may also spill into the blood stream and then accumulate in organs - brain and spinal cord, lymph nodes, spleen, liver