week 8: hematology 3

Question 1

Make Normal Big Fries = ?

Answer 1

Macrocytic
Normochromic
Vitamin B12
Folate (folic acid)

Question 2

Micro Hulk, Iron man, Sid, Thanos = ?

Answer 2

Microcytic
Hypochromic
Iron
Sideroblastic
Thalassemia

Question 3

Why does sickled RBCs cause problems?

Answer 3

Sickled RBCs are rigid, not able to maneuver through small vessels → vaso-occlusion, hypoxia, ischemia

Question 4

Which type of anemia does this fall under? (sickle cell)

Answer 4

Normocytic Normochromic Anemia

Question 5

How do we treat sickle cell anemia?

Answer 5

-Stem cell transplant
-Transfusions for severe anemia
-Hydroxyurea (stimulates production of fetal hemoglobin)

Question 6

What is an acute exacerbation called? What are two specific sites we are concerned about?

Answer 6

*Painful vaso-occlusive crisis/sickle cell crisis
-Acute Chest Syndrome
-Splenic Sequestration

Question 7

What is most important in managing sickle cell crisis? What other interventions might we perform?

Answer 7

-Pain control (historically undertreated)
-IV fluids if dehydrated
-Oxygen if hypoxic (SpO2 <92%)

Question 8

What patient teaching can we provide to prevent acute crises?

Answer 8

-Avoid dehydration
-Avoid intense exercise and high altitude conditions.

Question 9

what is blood cancer?

Answer 9

excess production of blood cells (red blood cells, white blood cells, and/or platelets) that does not serve a physiological purpose (fight infection/form clots/carry oxygen)

Question 10

what are the three major categories of blood cancers?

Answer 10

-leukemia
-lymphoma
-myeloma

Question 11

what is leukemia?

Answer 11

cancer cells found circulating in the blood

Question 12

what is lymphoma?

Answer 12

cancer that involves masses or tumors in lymph tissue

Question 13

what is myeloma?

Answer 13

cancer involving tumor in bone marrow

Question 14

myeloid cells vs lymphoid cells

Answer 14

myeloid cells
-RBCs
-Platelets
-Granulocytes (neutrophils, basophils, eosinophils)
lymphoid cells (both are immune WBCs)
-T cells
-B cells

Question 15

Acute Myeloid Leukemia (AML) is found in which population? what does it affect? slow or fast progression?

Answer 15

-found in adult patients
-affects immature myeloid blast cells in the bone marrow
-fast progression

Question 16

Chronic Myeloid Leukemia (CML) is found in which population? what does it affect? slow or fast progression?

Answer 16

-found in elderly patients
-chronic excess production of platelets, RBCs, and granulocytes
-slow progression

Question 17

Acute Lymphocytic Leukemia (ALL) is found in which population? what does it affect? is there a high cure rate? slow or fast progression?

Answer 17

-most common leukemia in children
-affects immature B cells and T cells in the bone marrow
-high cure rate and survival~90%
-fast progression

Question 18

Chronic Lymphocytic Leukemia (CLL) is found in which population? what does it affect? slow or fast progression?

Answer 18

-found in elderly patients
-affects mature B cells and T cells
-slow progression

Question 19

what type of precautions do blood cancer patients get placed on and why?

Answer 19

-neutropenic precautions (aka immunocompromised precautions or reverse isolation)
-because there is an increased risk of infection due to decreased number of WBCs

Question 20

what are some of the precautions taken for blood cancer patients? examples?

Answer 20

-no fresh flowers
-neutropenic diet: no fresh fruits/vegetables, meats
-good hand hygiene
-wear PPE: gloves, gowns, masks
-limit exposure to visitors with respiratory infections

Question 21

Myeloma: bone marrow cancer (manifests as CRAB) which stands for?

Answer 21

C = calcium elevation in the blood
R = renal failure
A = anemia
B = bone lesions and bone pain