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AGACNP Board Review > Hematology/Oncology > Flashcards

Hematology/Oncology Flashcards

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1
Q

What is Anemia?

A

Anemia is the reduction below the normal erythrocytes, hemoglobin, or volume of RBCs

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2
Q

What is Hgb?

A

Hemoglobin. It is the protien in RBCs that combines with a transports O2 to the rest of the body.

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3
Q

What is Hct?

A

Hematocrit. It is the % of a given volume of whole blood that is occupied by erythrocytes.

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4
Q

What is TIBC?

A

Total Iron Binding Capacity

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5
Q

What is MCV?

A

Mean corpuscular volume. Average volume and size of individual erythrocytes.

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6
Q

What is MCH?

A

Mean corpuscular hemoglobin. Average amount and weight of Hgb in individual eryhtrocytes.

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7
Q

What conditions does low MCV indicate?

A
  1. Iron deficiency anemia
  2. Thalassemia
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8
Q

What conditioons does high MCV indicate?

A
  1. Folate acide deficiency
  2. Alcoholism
  3. Liver Failure
  4. Effects of drugs
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9
Q

What conditions does normocytic cells indicate?

A

Anemia of chronic disease
Sickle cell disease
Renal failure
Blood loss
Hemolysis

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10
Q

What is IDA?

A

Iron deficiency anemia is a microcytic, hypochromic anemia due to an overall deficiency of iron

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11
Q

What are common causes of IDA?

A
  1. Malnutrition
  2. Blood loss
  3. Malabsorption
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12
Q

Signs and symptoms of IDA

A
  1. Pica
  2. Dyspnea
  3. Fatigue
  4. Headache
  5. Palpitations
  6. Weakness
  7. Tachycardia
  8. Postural Hypotension
  9. Pallor
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13
Q

Lab/Diagnostics of IDA

A
  1. Low Hgb
  2. Low HCT
  3. Low MCV
  4. Low RBC
  5. Low serum iron
  6. Low serum ferritin
  7. High TIBC
  8. High RDW

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14
Q

Management of IDA

A
  1. Ferrous Sulfate (up to TID)
  2. Ferrous Gluconate (up to TID)
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15
Q

Foods high in Iron

A
  1. Raisins
  2. Green leafy vegetables
  3. Red meats
  4. Citrus products
  5. Fortified cereals and bread
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15
Q

What is Thalassemia?

A

A genetic disorder resulting in abnormal HgB production and microcytic, hypochromic anemia

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16
Q

What populations is thalassemia found in?

A

Meditteranean
African
Middle Eastern
Indian
Asian

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17
Q

Signs and symptoms of thalassemia

A

Generally well appearance and PE is unremarkable

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18
Q

Common causes of Thalassemia

A

Reduced or absent production of beta globin chains resulting in decreased adult hemoglobin production

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19
Q

What are the two types of thalassemia?

A

Minor and Major

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20
Q

What is thalassemia minor?

A

Has only one copy of the beta thalassemia chain thats attached to a normal beta-chain gene

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21
Q

What is thalassemia major?

A

Has two genes for beta-thalassemia with no normal beta chain gene

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22
Q

What are signs and symntoms of Thalassemia major?

A
  1. Also called Cooleys anemia
  2. Anemia within the first few months of life
  3. Failure to thrive
  4. Feeding difficulties
  5. Fever
  6. Diarrhea
  7. Jaundice
  8. Hepatosplenomegaly
  9. Maxillary enlargment
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23
Q

Management of Thalassemia

A
  1. RBC transfusion
  2. Folic acid supplementation
  3. Iron chelation
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23
Laboratory/Diagnositcs for Thalassemia
1. Decreaed Hgb 2. Low MCV 3. Low MCHC 4. Normal TIBC 5. Normal Ferritin 6. Abnormal HBB screen
24
What is Folic Acid Deficiency?
A macrocytic, normochromic anemia due to folic acid deficiency
25
What are the causes of folic acid deficiency?
Inadequate intake or malabsorption of folic acid
26
Signs and Symptoms of folic acid deficiency
1. Fatigue 2. Dyspnea 3. Pallor 4. Headache 5. Tachycardia 6. Anorexia 7. Glossitis 8. Negative for neurological findings
27
Laboratory/Diagnostic findings in FAD
1. Low Hct 2. Low RBC 3. Elevated MCV 4. Normal MCHC 5. Low serum folate 6. RBC folate <100 ng/mL
28
Management of FAD
1. Folate, 1 mg, QD
29
Foods high in folate
1. Bannanas 2. Peanut butter 3. Fish 4. Green leafy vegetables 5. Fortified breads and cereals
30
What is pernicious anemia?
A macrocytic, normchromic anemia due to deficiency of vitamin B12
31
Signs and symptoms of PA
1. Weakness 2. Glossitis 3. Palpitations 4. Dizziness 5. Anorexia 6. Parasthesia 7. Pallhypesthesia 8. Ataxia 9. Positive Romberg 10. Positive Babinski
32
Laboratory/Diagnositics for PA
1. Low hgb 2. Low Hct 3. Low RBC 4. High MCV 5. Serum B12 low 6. Anti-IF abnormal
33
Management of PA
1. Cyancobalmin IM x1 week 2. Needs Vitamin B 12 replacement for life
34
What is anemia of chronic disease?
Anemia of chronic disease is a chronic normocytic, normochromic anemia associated with chronic inflammation, infection, renal failure, and malignancy
35
Causes of anemia of chronic disease
Eitology is unclear
36
Signs and symptoms of anemia of chronic disease
1. Fatigue 2. Weakness 3. Dyspnea 4. Anorexia
37
Lab/Diagnotics for anemia of chronic disease
1. Low hgb 2. Low Hct 3. Normal MCV 4. Normal MCHC 5. Serum iron low 6. Serum TBIC low 7. Serum ferritin is high
38
Management of anemia of chronic disease
1. Treat the underlying diease 2. Nutrition
39
What is Sickle Cell Anemia?
SCA is a chronic hemolytic anemia that is genetic of nature. The genetic mutation causes a sickle shape in the RBCs
40
What is the pathophysiology of SCA?
Acute exacerbations cause RBCs become sickle-shaped and cause vessel obstruction. Cellular hypoxia results in acidosis and tissue ischemia. Ischemia causes severe pain.
41
What are examples of percipitating factors for SCA?
1. Hypoxia 2. Infections 3. High Altitudes 4. Dehydration 5. Physical stress 6. Emotional stress 7. Surgery 8. Blood Loss 9. Acidosis
42
Lab/Diagnostics for SCA
1. Low Hgb 2. Blood smear shows sickle-shaped RBCs
43
Management of SCA
1. Fluids 2. Analgesics 3. Oxygen
44
What is Von Willebrand Disease?
A genetic disorder that is caused by a mutation in von Wilebrand facotr and clotting factor VIII. It results in the reduced ability to create blood clots.
45
Signs and symptoms of Von Willebrand Disease
Frequent, prolonged, severe episodes of bleeding Easy bruising
46
Management of Von Willebrand Disease
1. Desmopressin 2. vWF/factor VIII concentrate
47
What is a leukemia?
Leukemia are neoplasms arising from the hematopoietic cells in the bone marrow
48
What are the classifications of Leukemia?
1. Acute Myelogenous Leukemia 2. Acute lymphocytic Leukemia 3. Chronic Lymphocytioc Leukemia 4. Chronic Myelogenous Leukemia
49
What are the hallmarks of AML?
1. 80% of all leukemias in adults 2. Remission rate from 50-90% 3. 40% long-term survival
50
What are the hallmarks of ALL?
1. Difficult to cure in adults 2. Pancytopenia with circulation blasts
51
What are the hallmarks of CLL?
1. Most common leukemia in adults 2. Occurs in both middle and old age 3. Median survival is 10 years
52
What are the hall marks of CML?
1. Occurs most often in adults 40 and over 2. 5-year survival rate is 65% 3. Philadelphia chromosome seen in leukemic cells
53
Signs and symptoms of Leukemia
1. Asymptomatic 2. Fatigue 3. Weakeness 4. Anorexia 5. Generalized Lymphandenopathy 6. Weight Loss
54
Lab/Diagnostics for Leukemia
1. CBC with subnormal RBCs and neutrophils 2. ESR is elevated 3. Pheripheral Blood Smear 4. Bone marrow biopsy
55
Management of Leukemia
1. Chemotherapy 2. Initate allopurinol to reduce TLS 3. Bone marrow transplant 4. Supportive treatments
56
What is Lymphoma?
Lymphotic malignancy
57
How many stages are in lymphomas?
4
58
How is lymphoma diagnosed?
Biopsy taken of enlarged lymph nodes
59
What is Stage One Lymphoma?
Disease localized to single lymph node or group
60
What is Stage Two Lymphoma
Two or more groups noted on one side of the diaphram
61
What is stage three Lymphoma?
Nodes on both sides of the diaphram or nodes with invovlvement of the diaphram
62
What is stage four Lymphoma?
Nodes on both side of the diaphram with spleen, liver, and bone marrow invovlement
63
What the two types of lymphoma?
Non-Hodgkins Lymphoma Hodgkins Disease
64
What are the halmarks of NHL?
1. Unknown, but probably viral cause 2. Lymphadenopathy 3. Neoplasm occurs between 20-40 years 4. Unpredictable 5. Advanced stages are normally present
65
What are the hallmarks of Hodgkins Disease?
1. Unknown cause 2. Common in males aged 32 and higher 3. Presents with cervical adenopathy and spreads in a predicatable fashion 4. Has characteristically Reed-Sternberg cells to diiferentiate from NHL
66
Lab/Diagnositcs for Lymphoma
CT XRAY Ultrasound MRI Biopsy to confirm diagnosis
67
Management of Lymphoma
Radiation Chemotherapy Bone Marrow transplant
68
What is ITP?
Idiopathic thrombocytopenia purpura is thrombocytopenia resulting from autoimmune destructions of platelets with or without suppression of thrombopoiesis
69
Lab/Diagnostics for ITP?
1. Bone marrow analysis 2. Thrombocytopenio with out causes ruled out 3. History of brusining/bleeding
70
Management of ITP
1. Necessary with PLT is <20,000 2. Corticosteroids 3. IV gamma globulin 4. PLT Transfusion 5. Bleeding percautions
71
What is the treatment for HIT?
Heparin-induced thrombocytopenia is treated with agatroban and lepirudin
72
What is DIC?
Disseminated Intravascular Coagulation is an acquried coagulation disorder which results from intravascular activation of both coagulation and fibrinolysis systems causing simultaneous thrombosis and hemorrhage
73
Etiology of DIC
1. Malignant neoplams 2. Infection/Sepsis 3. Liver Disease 4. Massive Trauma 5. Extensive Burns 6. Shock 7. Obsterical complications 8. Acute Leukemia
74
Pathophysiology of DIC
1. Thrombin converts fibrinogen to fibrin causing fibrin clots thus reducing coagulation factors are reduced 2. Circulating plasmimn activated the fibrinolytic systems which lyses fibrin clots into fibrin degradtion products 3. Hemorrhage results from the FDPs and depletion of coagulaation factors
75
Signs and Symptoms of DIC
1. Bleeding vs Thrombosis 2. Severe bleeding bruising on physical exam
76
Lab/Diagnostics for DIC
1. Thrombocytopenia 2. Hypofibrinogenemia 3. Decreased RBCs 4. Increased FDPs 5. Prolonged PT 6. Prolonged PTT 7. Elevated D-Dimer
77
Management of DIC
1. Treat the underlying condition 2. Platelet transfusions 3. FFP 4. Cryoprecipitate 5. Maybe heparin? 6. Aim to provide hemostasis, increase serum fibrinogen and PLT counts, and decreae FDPs

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