Flashcards in Hematology Day 2 Deck (39)
which anemia is a/w restless leg?
iron deficiency anemia
what is the rule of 3 for ferritin?
take ferritin, divide by 3, gives iron level (less than 20 is iron deficiency)
what should you tell pt about iron supplements?
take with OJ or vit. C (if DM)
take with stool softener
who should get parental iron supplementation?
more severe cases
(carries risk of allergic rxn)
what are sxs of B12 deficiency?
loss of vibratory sense
who is at risk for B12 deficiency?
blind loop syndrome
which drugs cause B12 deficiency?
which inactivates B12?
what labs do you do on B12 suspicious pts?
B12, folate levels
what test is used to determine if a pt has a hemoglobinopathy?
hgb electrophoresis (specific for sickle cell)
what type of hemoglobin might be protective in sickle cell?
when does B thal major start to become symptomatic?
what is the prognosis for B thal major?
80% die in 1st 5 yrs of life
why do you have Fe overload with transfusions?
EPO increases the guts absorption of Fe
which virus would cause a B thal major pt to become aplastic?
what are smear findings of B thal major?
what is B thal minor?
asymptomatic b/c of being a trait carrier
-will show target cells on smear
what are the classes of A thal?
minima-silent carrier (lose one chains)
minor- mild anemia, hypochromic (loses two chains)
major-die w/in hours of birth (loses all chains)
what are sxs of sickle cell?
painful vasocclusive pain
acute/chronic multi-organ failure
reduced overall survival
leading cause of death is acute chest syndrome and multi-organ failure, sepsis
what are common triggers of pain crises?
what is the progression of SC?
1st few decades: infections struggle
2nd couple decades: vasocclusive pain crisis become more common
later decades: deal with multi-organ failure
what are signs of pain crises?
tenderness on PE
pain can be anywhere but some may have a typical pattern of pain
what is a neurological complication of sickle cell?
ischemia w/impaired neurocognitive function
what can methadone cause?
what is priapism?
erection lasting more than 4 hours
how do you treat a pain crisis?
careful transfusion O2 IV fluid folic acid chelating therapy (bind up iron) pain mgmt hydroxyurea? (prevents body from creating sickled cells) pt education
what is the most common finding of aplastic anemia?
petechiae (oozing from the mouth)
what is the DDx for aplastic anemia?
MDS (myelodysplastic syndrome)
marrow replacement (small cell lung CA)
what heart correction could cause hemolysis?
mechanical heart valve
what kind of genetic disorder is G6PD?
what is the problem in G6PD?
RBC membrane is fragile and can have complications b/c of foods (fava beans) and medicines
what is used to help improved cell membrane synthesis?
what is warm agglutin AIHA?
IgG related antibodies-need to stay in cool settings
what is cold agglutin AIHA?
igM antiboides-need to stay warm
where is ferritin stored?
when are ferritin levels increased?
acute phase illness
which Hgb is protective
which virus can cause aplastic crises?