Hematology

Question 1

What is the normal range for an MCV level?

Answer 1

80-100 fl

Question 2

microcytic MCV is?

Answer 2

80fl

Question 3

macrocytic MCV is?

Answer 3

100fl

Question 4

normochromic levels of hemoglobin are?

Answer 4

32-36

Question 5

MCV measures what?

Answer 5

the average volume and size of individual erythrocytes

Question 6

RCDW od RDW measures what?

Answer 6

red cell distribution width

Question 7

what does reticulocyte count tell you?

Answer 7

number of new RBC in circulation

Question 8

what is a normal reticulocyte count?

Answer 8

1-2%

Question 9

what happens to the reticulocyte count with iron deficiency anemia?

Answer 9

DOWN

possibly 0%

Question 10

A child presents as microcytic and hypochromic you know this could be what kinds of anemia?

Answer 10

Iron deficiency, thalassemia or lead poisoning

Question 11

normocytic/ normochromic may be related to what kind of anemia?

Answer 11

acute blood loss, early IDA, anemia of chronic disease

AND SICKLE CELL

Question 12

macrocytic, normochromic anemia maybe related to what?

Answer 12

vitamin B12 deficiency, folate deficiency, pernicious anemia

Question 13

what can cause iron deficiency anemia?

Answer 13

solely breastfed, drinking cows milk by 9 mo, heavy menarche

Question 14

Is iron-binding capacity increased or decreased with iron def anemia?

Answer 14

Increased

Question 15

hemoglobin is 7, HCT is , MCV is 75, RBC is 3, RDW is increased, low retic count, serum ferritin <30ug, increased TIBC What is your diagnosis?

Answer 15

Iron deficiency anemia

d/t Inc RDW, Inc TIBC, low ferritin, low retic count

Question 16

orange juice increases or decreases absorption of iron?

Answer 16

increases absorption

Question 17

pt presents with decreased hgb, decreased MCV, hypochromic RBC, Increased retic count, increased ferritin. What is your diagnosis?

Answer 17

Thalassemia

Increased retric AND inc ferritin

Question 18

what is the management for sicklecell anemia?

Answer 18

hydroxyurea (this stimulates fetal hgb which doesnt sickle), immunize with pneumovax.

also prophylactic penicillin form ages 3mo-5y (to be managed by hematologist)

Question 19

Most commone hemophilia is a loss of factor?

Answer 19

Factor 8

Question 20

does hemophillia A occur in M or F, who carries it M or F?

Answer 20

M are affected

F are carriers

Question 21

Lead poisioning is definied at more than \_\_\_ per d/?
A.4
B. 10.
C.2
D.5

Answer 21

D
5

however do not refer until 10 or higher
(also capillary samples can be higher than venous so good in real practice to recheck venous)

Question 22

what is the burtonian line?

Answer 22

blue discoloration of gingival border, that would indicate lead poisoning

Question 23

what level of of lead poisoning required chelation therapy?

Answer 23

Greater than 45

Question 24

what labs would allow you to differentiate between thalassemia and IDA?

Answer 24

TIBC (high in IDA)
ferritin (high in thalessemia)
Retic (high in thalassemia)

Question 25

Labs show the patient has Howell-Jolly bodies, what condition does this patient have?

Answer 25

Sickle cell anemia

Question 26

what lead level requires referral to a hematologist?

Answer 26

level 10 or higher

Question 27

Do sickle cell patients have a high, low or normal MCH?

Answer 27

Normal- or normochromic

Question 28

normal labs for thalessemia?

Answer 28

low hgb, low mcv, high ferritin, high total bili, high retic

Question 29

Pikilocytes and target cells are seen in what disorder?

Answer 29

thalessemia

Question 30

what is the most frequent period of iron deficiency in pediatrics?

Answer 30

times of rapid growth, often in childhood and adolescense

Question 31

is iron better absorbed with food or on an empty stomach.

Answer 31

EMPTY this helps absorb twice as fast give with food only with GI upset, Orange juice helps in aid of iron absorption

Question 32

``` 2 y/o with hypochromic, microcytic anemia differntial is? A. pernicious anemia B. lead poisoning C. hemophilia D. folic acid deficiency ```

Answer 32

B lead poisoning cause hypochromic, microcytic anemia