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Medical Screening Exam 1 > Screening for Hematologic Disease > Flashcards

Screening for Hematologic Disease Flashcards

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USMLE® Step 1 flashcards
1
Q

What are RBC count norms for men?

A

4.5-6.2

HGB- 37-49%

HCT- 14-17

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2
Q

What are RBC count norms for women?

A

4-5.5

HGB 36-46%

HCT- 12-15

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3
Q

What are WBC norms?

A

4,500-11,000

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4
Q

What are platelet norms?

A

150-400 K

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5
Q

What is worse thick or thin plasma?

A

thick due to too much clotting could cause DVT

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6
Q

What are common symptoms associated with RBC?

A

fatigue, dyspnea, dizziness- lack of O2

post op anemia- 8 weeks till normal aerobic capacity

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7
Q

What are common symptoms associated with WBC?

A

fevers, chill, persistent infections

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8
Q

What are common symptoms with platelet dysfunction?

A

easy bruising or bleeding

cramping, pain

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9
Q

Who should be screened for hematology issues?

A

hx of chemo/radiation, chronic NSAID use, spontaneous bleeding, recent surgery,

has rapid onset of dyspnea, chest pain, weakness, fatigue with palpations

fingernail changes (cyanosis or spooning)

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10
Q

What is anemia?

A

too few RBC, loss of iron from GI bleed?, chemo related?

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11
Q

What are sx of anemia?

A

chest pain, DOE, decreased DBP, increased HR, HA, drowsiness, depression

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12
Q

What are skin changes in anemia?

A

pale skin, pale or yellow eyes and mouth

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13
Q

What is polycythemia?

A

too many RBC more of a med emergency as blood is sticky and could clot

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14
Q

What are sx of polycythemia?

A

fatigue, SOB, pruitis, HA

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15
Q

What are common characteristics of sickle cell anemia?

A

AVN, CVA, pain

less HGB and less ability to change shape

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16
Q

Why do pts with sickle cell have enlarged spleen or livers?

A

they are being overworked trying to remove old/bad RBC

will be tender on palpation

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17
Q

What is leukocytosis?

A

too many WBC usually as a response to infection but could also be from cancer, hemorrhage, appendicitis, splenectomy

18
Q

What is leukopenia?

A

too few, possibly from bone marrow failure

19
Q

When is WBC count lowest after chemo?

A

7-14 days post chemo

20
Q

What are sx of leukopenia?

A

sore throat, high fever, chills, mouth ulcerations, dysuria, persistent infection

21
Q

What is leukemia?

A

production of lots of immature WBC

22
Q

What are 4 types of leukemia?

A

ALL- young and old people good prognosis

AML- poor prognosis

CLL- 25-60

CML

23
Q

What are risk factors for leukemia?

A

radiation exposure, prior chemo, downs syndrome

24
Q

What are sx of leukemia?

A

infection, fever, bruising, epitaxis (nosebleed), hematuria, fatigue, enlarged lymph nodes, weight loss, enlarged spleen

25
Q

What is thrombocytosis?

A

too many can be after hemorrhage, cancer related, splenomegaly

26
Q

What are sx of too many?

A

pain, clotting, bruising

27
Q

What is thrombocytopenia?

A

too few, from BM failure, leukemia, cancer, ASA or NSAIDS

28
Q

What are sx of too few?

A

bleeding, bruising, epitaxis, menorrhagia, gum bleeding, melena, joint swelling, throwing up blood

29
Q

What are petechiae?

A

small lesions less than 2 mm

30
Q

What are purpura?

A

2mm to 1 cm size lesions

31
Q

What is ecchymoses?

A

larger lesions

32
Q

What are signs and symptoms of hemophilia?

A

hot sore jt with loss of motion, muscles hemorrhages feels like muscle pulls, GI bleed

33
Q

What should be sent out immediately?

A

thrombocytopenia? rebound belly tenderness

34
Q

When should you hold PT for blood glucose?

A

under 50 or over 240

35
Q

When should you for K?

A

under 3 over 6

36
Q

When should you hold for Na?

A

under 125 or over 150

37
Q

What is absolute neutrophil count?

A

WBC x neutrophils

38
Q

What are WBC count precautions?

A

1000-1500 neutropenic precautions may ambulate in hall with MD permission

500-1000 patient needs mask to leave room

under 500 room isolation

39
Q

What is Hct cut off?

A

30% - 32% Resistive exercise to tolerance
< 25% No exercise permitted
> 25% Light exercise permitted
< 20% patient may have SOB, tachycardia

40
Q

What is Hgb cutoff?

A

< 7 g/dL No exercise permitted or ROM only
8-10 g/dl Light exercise permitted
> 10 g/dL Resistive exercise to tolerance

41
Q

What is platelet cut off?

A

≥ 50,000 – progressive resistive exercises

≤50,000 – no deep tissue massage etc, no percussion, no MMT

30,000 – 50,000 – moderate exercise

20,000 – 30,000 – light exercise no bicycle or treadmill

Less than 20,000 – AROM and necessary ADL’s only watch for bleeding.

42
Q

What is INR cutoff?

A

over 4 ok

over 5 no exercise

Medical Screening Exam 1 (6 decks)

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