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Flashcards in FNP-Hematology Deck (20)
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1
Q

What is Reticulocytosis?

A

immature RBCs, slightly larger than a RBC

2
Q

Lab value for neutropenia

A

ANC <1,500/mm^3

3
Q

Vitamin B12 Deficiency

[know the lab results, s/sx, common causes)

A

Peripheral smear: shows macroovalocytes, some megaloblasts & multisegmented neutrophils (>5-6 lobes)

Neurological signs (numbness, ataxia with positive Romberg test, loss of vibration, possible sense, impaired memory, dementia in severe cases).

Common cases: malabsorption (d/t pernicicious anemia, gastric disease/infection or medications).

4
Q

Multiple Myeloma

Definition & symptoms

A

Cancer of plasma cells
Symptoms-fatigue, weakness & bone pain
Causes proteinuria w/ Bence-Jones proteins, hypercalcemia, normocytic anemia

5
Q

Normal MCV value

A

80-100 (Size of RBC’s)
<80: microcytic
>100: macrocytic

6
Q

Normal value of Mean Corpuscular Hgb Concentration (MCHC)

A

31.0-37.0g/dL

Measure color of RBCs

7
Q

Which anemia(s) has decrease MCHC?

A

iron-deficiency anemia & thalassemia (hypochromic)

8
Q

Is total iron-binding capacity (TIBC) increased or decreased in iron-deficiency anemia?

A

TIBC is a measure of available transferrin that is left unbound (to iron) & it is ELEVATED when there is not enough iron to transport

9
Q

What lab test is most sensitive for iron-deficiency anemia?

A

Serum ferritin (not serum iron b/c it is not as sensitive as ferritin & can be affected by recent blood transfusions)

10
Q

What is poikilocytosis?

A

Abnormal RBCs w/ variable shapes seen on peripheral smear. Seen w/ severe deficiency anemia

11
Q

What is Anisocytosis?

A

Variable sizes of RBCs

12
Q

What is the gold-standard test to diagnose hemoglobinopathies such as sickle cell anemia & thalassemia?

A

Hemoglobin electrophoresis

13
Q

Iron-deficiency Anemia (know symptoms & lab results)

A

Pallor of skin, conjunctiva & nail beds, daily fatigue, exertional dyspnea, may have glossitis (sore & shiny red tongue, angular cheilitis, pica, konilonychia (in severe cases), systolic murmurs, tachycardia, or heart failure.

Microcytic & hypochromic (small & pale RBCs)

14
Q

Name some macrocytic anemias

A

Pernicious anemia, folate deficiency, Vitamin B12 deficiency

15
Q

What are the RBC changes in thalassemia minor?

A

Abnormal in Beta-thalassemia (microcytic, hypochromic), Normal if alpha-thalassemia

16
Q

What should you avoid taking iron pill with?

A

Antacid-wait about 4 hours (b/c it minimize binding)

Tetracycline antibiotics, levothyroxine & bisphosphonates (iron decreases its effectiveness)

17
Q

What are food sources of Vitamin b12?

A

all foods of animal origin (meat, poultry, eggs, milk & cheese)

18
Q

What do you always check both vitamin B12 & folate level together?

A

A pt can be deficient in both B12 & folate. H/H will go up with folate supplementation only (even if still deficient in B12).

19
Q

What is the treatment for pernicious anemia?

A

B12 injections 1000mcg (1mg) per week x4 weeks, then monthly injections OR high oral doses (1,000-2,000mcg) daily

20
Q

What lab results should cause you to suspect pernicious anemia?

A

ELEVATED Parietal antibody test (antiparietal antibody) and/ or intrinsic factor antibody tests (anti-IF)