hematology

Question 1

what is the lab value for neutropenia?

Answer 1

an absolute neutrophil count of less than 1,500/mm3.

Question 2

a platelet count less than what increases the risk for spontaneous bleeding?

Answer 2

<20,000/mm3 increases

Question 3

What is Mean Corpuscular Hemoglobin value measuring?

What are normal values?

Answer 3

Normal value is 25-35

it measures the color of RBC, a decrease in this value indicates IDA or thalessemia

it is normal in macrocytic anemias

Question 4

What TIBC lab value would you expect to see in:

IDA
Thalessemia
B12
Folate deficiency anemia

Answer 4

The TIBC will be elevated in IDA

The TIBC will be normal in Thalessemia, b12, and folate anemia

Question 5

How would you differentiate :

1. Iron deficency anemia
2. Thalassemia minor

Answer 5

both will have a MCV less than 80, and low hemoglobin (microcytic anemia)

IDA: will have a high TIBD, low ferritin
Thalassemia: normal TIBD, normal ferritin

Question 6

What are common causes of b12 anemia?

Answer 6

1. Pernicious anemia
2. Elderly poor diet
3. Vegan
4. Gastrectomy

Question 6

What are the symptoms of b12 anemia

Answer 6

This is a macrocytic normochromic anemia

symptoms are mostly neuropathic:
- difficulty walking
- paresthesia
- decreased sensation

Question 7

What lab values would you expect to see in B12 deficiency anemia?

Answer 7

MCV greater than 100
low hemoglobin
B12 less than 100pg/L

Question 8

What is pernicious anemia? what vitamin deficiency is this related to ?

Answer 8

Pernicious anemia is an autoimmune disorder that destroys the parietal cells, resulting in a decrease in intrinsic factor which absorbs b12

Therefore this is macrocytic normochromic anemia due to B12 deficiency

Question 9

How can you test for pernicious anemia?

Answer 9

You would order:

1. Antiparietal Antibody serology
2. 24 hours urine methylmalonic acid

Question 10

Who is at the highest risk for folate anemia?

Answer 10

alcoholics and elderly

Question 11

What drugs interfeare with folate absorption?

Answer 11

phenytoinin
Septra
Methotrexate

Question 12

What are the symptoms of folate deficiency anemia?

Answer 12

NO NEUROLOGICAL SYMPTOMS!! NO PARESTHESIA!!

low appetite
tender smooth tongue
diarrhea
irritable

Question 13

List normal folate and normal b12 values

Answer 13

b12 = greater than 250
Folate = 3.1-17.5

Question 14

What foods are high in b12?

Answer 14

Meat
Poultry
Eggs
Milk

THINK MEAT =B12

Question 15

What foods are high in folate?

Answer 15

Leafy greens
Beans
Grains

Question 16

What lab values would you see in a patient with Hepatitis B who has been exposed to the virus and was able to clear it naturally?

Answer 16

HBsAG (surface antigen) = neg
anti-HBs (surface antibody) = pos
anti-HBc (core antibody)= positive

Question 17

What lab value would you expect to see in a patient who is immunized against hepatitis B?

Answer 17

HBsAG (surface antigen) = neg
anti-HBs (surface antibody) = pos
anti-HBc (core antibody)= negative

Question 18

What lab value would you expect to see in a patient who has active hepatitis B?

Answer 18

HBsAG (surface antigen) = positive
anti-HBs (surface antibody) = negative
anti-HBc (core antibody)= positive

Question 19

When testing for Hepatitis A, what lab values would you expect to see in an active infection?

Answer 19

IgG anti-HAV= positive
IgM anti-HAV = positive

IgM will always be positive in acute infection, m is close to n in the alphabet, n = now

Question 20

When testing for Hepatitis A, what lab values would you expect to see in a patient who was previously infected or is immunized?

Answer 20

IgG anti-HAV = positive
IgM anti-HAV= negative