Hematology

Question 1

A 13 year old female who is diagnosed with iron deficiency anemia is being treated with ferrous sulfate. Proper treatment typically leads to the resolution of anemia within:

Answer 1

3 months

Question 2

A patient on warfarin (Coumadin) therapy for recurrent deep vein thrombosis (DVT) is about to have lumbar spinal fusion surgery. The patient’s warfarin is put on hold starting 5 days prior to the surgery and subcutaneous enoxaparin (Lovenox) has been ordered for DVT prophylaxis until the resumption of the warfarin. The nurse practitioner knows that the patient’s postoperative warfarin dose should be restarted based on the:

Answer 2

baseline PT and INR values

Question 3

Progression to Acute Myelogenous Leukemia (AML) is a risk for untreated or poorly responsive:

Answer 3

Myelodysplastic syndrome

Question 4

Hemophilia A

Answer 4

An X linked genetic disorder which affects males and is caused by factor VIII deficiency.

Question 5

Hemoglobin in males

Answer 5

13.6-16.9

Question 6

Hemoglobin in females

Answer 6

12-16

Question 7

Hematocrit

Answer 7

Proportion of RBS in 1ml of plasma

Question 8

Hematocrit for males

Answer 8

40-50%

Question 9

Hematocrit for femles

Answer 9

36-44%

Question 10

Mean corpuscular volume

Answer 10

The average size of RBCs

Question 11

Normal MCV

Answer 11

80-100

Question 12

MCV <80

Answer 12

microcytic anemiaMC

Question 13

MCV 80-100

Answer 13

normocytic anemia

Question 14

MCV>100

Answer 14

macrocytic anemia

Question 15

Mean corpuscular hemoglobin

Answer 15

Average concentration of hemoglobin per RBC

Question 16

Normal MCH value

Answer 16

32-35%

Question 17

Mean corpuscular hemoglobin concentration

Answer 17

Average hemoglobin content per RBC

Question 18

Normal MCHC value

Answer 18

25-35pg/cell

Question 19

Low MCHC means..

Answer 19

hypochromic anemia
- IDA
- Thalassemia

Question 20

High MCHC means….

Answer 20

hyperchromic anemia
- Folic acid deficiency
- B12/pernicious anemia

Question 21

Total iron binding capacity level

Answer 21

300-360

Question 22

Total Iron Binding capacity

Answer 22

Available unbound transferrin available to transport iron around the body. Level is increased when there is not enough iron to transport.

Question 23

In IDA what happens to the TIBC?

Answer 23

It is increased

Question 24

In thalasemia, B12 deficiency and folic acid deficiency what happens to TIBC?

Answer 24

It stays the same

Question 25

Serum ferritin

Answer 25

Stored form of iron in the body. Normal level is 40-200

Question 26

Serum iron

Answer 26

Iron in the blood. Decreased in IDA, normal to elevated in thalassemia and macrocytic anemias. 60-150.Re

Question 27

Reticulocytes

Answer 27

Immature RBCs This level increased with active bleeding

Question 28

Folate

Answer 28

<2ng is deficiency

Question 29

B12

Answer 29

<200 is deficiency

Question 30

Foods high in folate

Answer 30

- asparagus - broccoli - avocado - brussel sprouts - leafy greens - eggs - liver

Question 31

Foods high in B12

Answer 31

Beef, dairy, eggs, cereal, salmon

Question 32

WBC normal level

Answer 32

4,500-11,000

Question 33

Platelets normal level

Answer 33

150-350

Question 34

Blood levels in IDA

Answer 34

Low iron Low ferritin High TIBC

Question 35

Blood levels in thalassemia

Answer 35

normal ferritin normal TIBC level

Question 36

What kind of anemia is IDA?

Answer 36

Microcytic & hypochromic - iron and ferritin are low - MCV<80 - MCHC low

Question 37

What kind of anemia is thalassemia?

Answer 37

Microcytic & hypochromic - iron and ferritin are normal - MCV<80 - MCHC low

Question 38

What kind of anemia is B12 deficiency anemial?

Answer 38

Macrocytic / normochromic - MCV>100 - MCHC 32-35% - B12 is low In pernicious anemia there are also antibodies to IF present

Question 39

What kind of anemia is folate deficiency anemia?

Answer 39

Macrocytic / normochromic - folate low -homocystine low - MCV>100 - MCHC 32-35%

Question 40

Anemia of chronic disease

Answer 40

Normocytic/normochromic - hx of chronic inflammatory disease - MCV 80-100 - MCHC 32-35%

Question 41

Treatment for IDA

Answer 41

325mg ferrous sulfate TID - between meals or with OJ

Question 42

Treatment for thalassemia

Answer 42

Refer to hematology

Question 43

Treatment for B12 deficiency anemia

Answer 43

Parenteral or PO B12

Question 44

Treatment for folic acid deficiency anemia

Answer 44

1-5mg PO folate daily

Question 45

Pancytopenia

Answer 45

Leukopenia (low WBC), Anemia (low Hgb), thrombocytopenia (low platelets)

Question 46

Aplastic anemia treatment

Answer 46

Urgent referral to hematology

Question 47

Aplastic anemia

Answer 47

A rare and serious blood disorder that occurs when the bone marrow doesn't produce enough new blood cells. This can happen when stem cells in the bone marrow are damaged.

Question 48

Hemochromatosis

Answer 48

- genetic disorder with increase in intestinal absorption of iron leading to iron overloadT

Question 49

Treatment for hemachromotoais

Answer 49

Phlebotomy

Question 50

Neuropathy is associated with which type of anemia?

Answer 50

B12 deficiency anemia

Question 51

Glucose 6 Phosphate Dehydrogenase Deficiency Anemia (G6PD)

Answer 51

Oxidative injury destroys red blood cells. X linked recessive s/s include: jaundice, fatigue, SOB, tachycardia, dark urine, May be severe or self limiting Infants at high risk for neonatal jaundice

Question 52

G6PD dad carrier

Answer 52

daughters 100% affected sons 100% not affected

Question 53

G6PD mom carrire

Answer 53

Daughters 50% affected, 50% unaffected Sons 50% unaffected, 50% G6PD