hematology

Question 1

how to treat jaundice at home

Answer 1

breastfeed

Question 2

bruising following a viral illness

Answer 2

ITP

Question 3

test to diagnosis sickle cell

Answer 3

hemoglobin electrophoresis

Question 4

normocytic and normochromic anemia

Answer 4

G6PD

Question 5

phenytoin causes anemia bc of absence of what substance

Answer 5

folic acid

Question 6

test to diagnose sickle cell

Answer 6

peripheral blood smear-standard

cbc w hgb 6 to 8

Question 7

triggers of ITP

Answer 7

viral illness, chronic infections

Question 8

patho of ITP

Answer 8

platelet is covered w increased amounts of IgG–these platelets get destroyed by phagocytosis

Question 9

bone marrow failure diseases

Answer 9

intravascular coagulation
hemolytic uremic syndrome
thrombotic thrombocytopenia

Question 10

dx of ITP

Answer 10

CBC with peripheral smear–will see large granulated platelets
Type and screen
Direct antiglobulin test, coombs
Don’t usually have to do bone marrow

Question 11

itp tx

Answer 11

refer to hematology
Observation + bleeding precautions
IVIG (binds to fc receptor to prevent platelet destruction)
Corticosteroids
Anti-D immunoglobulin

Question 12

ITP who’s at risk of chronic ITP

Answer 12

girls
Age >11 at presentation
No preceeding infection

Question 13

hemophilia inhertiance

Answer 13

x linked

Question 14

hemophilia a pato

Answer 14

def of factor viii (higher def=more severe)

Question 15

hemophilia b patho

Answer 15

def of factor ix (1 in 5k men) (higher def=more severe) 6-40%=mild anything less=more severe

Question 16

heavy bleeding after dental procedure, surgery, or accident.

Answer 16

think hemophilia

Question 17

hemophilia labs

Answer 17

normal platelet count on CBC if bleeding will have normocytic anemia
PT will be normal
PTT will be prolonged

Question 18

acute hemarthrosis patho

Answer 18

hemophilia patients bleed into the joints and damage them

Question 19

acute hemarthrosis signs and symptoms

Answer 19

Kid w bleeding disorder
pain
swelling
new limp
limited ROM

Question 20

acute hemarthrosis tx

Answer 20

splinting, ice, immobilization, elastic bandages, analgesia, factor infusion to 80/100%

Question 21

pale skin, lips or hands, tachy, dyspnea, fatigue, dizzy, ha. irritable, amenorrhea, glossitis,

Answer 21

anemia

Question 22

anemia symptoms

Answer 22

pale skin, lips or hands, tachy, dyspnea, fatigue, dizzy, ha. irritable, amenorrhea, glossitis, splenomegaly or hepatomegaly

Question 23

nutritional causes of anemia

Answer 23

iron def
folate def
vitamin b12 def

Question 24

anemia work up

Answer 24

CBC with diff
Ferritin
Iron binding copacity
Vitamin b12
Folate
Hgb Electrophoresis
Bone marrow

Question 25

anemia MCV values

Answer 25

80-100 is normal >100 is elevated MCV <80 is reduced MCV

Question 26

What causes microcytic anemia: MCV less than 80

Answer 26

``` iron def inherited deficiency (thalassemia) ```

Question 27

what causes normocytic anemia: MCV 80-100

Answer 27

iron def chronic disease b12 deficiency w iron def

Question 28

what causes macrocytic anemia MCV>100

Answer 28

``` b12 deficiency-most common Folate def (less common) Myelodysplastic syndrome-rare ```

Question 29

causes of b12 deficiency

Answer 29

vegetarian, pregnancy

Question 30

what causes folate def

Answer 30

chron's, celiacs antibiotics alcoholism, pregnancy

Question 31

lab values for iron def anemia

Answer 31

MCV under 80 ferritin typically under 15 but iron def when under 40 Total iron binding capacity elevated Elevated platelet count--corrects when anemia improves

Question 32

Iron def anemia symptoms

Answer 32

pica, fatigue, hair loss, brittle nails, sores on the side of the mouth, dyspnea

Question 33

PE of iron def anemia

Answer 33

pale conjunctiva, brittle nails, cristomg pm sodes pf ,pitj

Question 34

What to do for iron def anemia

Answer 34

check led level. look for fecal occult blood to make sure they aren't bleeding somewhere

Question 35

iron def anemia tx

Answer 35

any iron the pt will take. can take w vitamin c

Question 36

when will iron def improve by

Answer 36

in 4 weeks

Question 37

sickle cell patho

Answer 37

inherited disorder

Question 38

sickle cell types

Answer 38

``` HGB SS (hgb of 9 and under) HGB SC (hgb 10-14) HGB S Beta thal (hgb 8-11) ```

Question 39

sickle cell anemia

Answer 39

hydroxyurea (induces fetal hgb that is protective against sickling) transfusion

Question 40

hemachromatosis

Answer 40

iron overload

Question 41

thalassemia patho

Answer 41

reduction or absence of alpha or beta globin chains

Question 42

most common type of thalessemia

Answer 42

alpha or beta thal minor

Question 43

alpha or beta thal minor symptoms and tx

Answer 43

asymptomatic, borderline anemia, diagnosis b/c micricytic anemia, hypochromic red cells, may have reduced hgb

Question 44

beta thal major tx

Answer 44

chronic transfusion

Question 45

clinically sig ITP

Answer 45

platelet under 30k

Question 46

mentzer index

Answer 46

mcv/rbc count. less than 13 thalassemia is more likely. if greater it is most likely iron def anemia