hematopoiesis

Question 1

What is hematopoiesis?

Answer 1

Formation of blood cells.

Question 2

What hormone regulates erythropoiesis?

Answer 2

Erythropoietin.

Question 3

What does erythropoietin stimulate?

Answer 3

Production of red blood cells (RBCs).

Question 4

Where is erythropoietin primarily secreted from?

Answer 4

90% kidneys, 10% liver.

Question 5

What is the primary signal to increase erythropoietin secretion?

Answer 5

Hypoxia.

Question 6

Why are patients with kidney disease common users of erythropoietin-stimulating drugs?

Answer 6

Because their kidneys can’t make enough erythropoietin.

Question 7

What do colony-stimulating factors (CSFs) do?

Answer 7

Increase production of leukocytes (WBCs).

Question 8

How are CSFs named?

Answer 8

According to the type of blood cells they stimulate.

Question 9

Who are CSFs used for?

Answer 9

Patients receiving chemo, radiation, transplants, or with certain malignancies.

Question 10

How does platelet production begin?

Answer 10

Megakaryocytes shed membrane-bound packets that become platelets.

Question 11

What controls megakaryocyte production?

Answer 11

Thrombopoietin.

Question 12

Where is thrombopoietin made?

Answer 12

Liver and bone marrow.

Question 13

What is epoetin alfa/darbepoetin alfa used for?

Answer 13

Anemia related to CRF, chemotherapy, HIV (zidovudine), pre-surgery.

Question 14

Major adverse effects of epoetin/darbepoetin?

Answer 14

Hypertension, thrombotic events, DVT, headache, body aches.

Question 15

What must be done before starting therapy if the patient has HTN?

Answer 15

HTN must be controlled.

Question 16

What Hgb levels increase the risk of thrombotic events?

Answer 16

Hgb ≥ 11 g/dL or ↑ > 1 g/dL in 2 weeks.

Question 17

When can DVT occur with epoetin therapy?

Answer 17

Pre-op use.

Question 18

Iron level goals before/during therapy?

Answer 18

Transferrin saturation ≥ 20%, Ferritin ≥ 100 ng/mL.

Question 19

Contraindications for epoetin/darbepoetin?

Answer 19

Uncontrolled hypertension, certain cancers.

Question 20

Administration route and precautions of epoiten alfa?

Answer 20

SQ or IV bolus, do not shake or mix with other meds.

Question 21

What should be monitore for epoitin?

Answer 21

BP, thrombotic events, Hgb/Hct, iron (transferrin & ferritin).

Question 22

What is the action of filgrastim/pegfilgrastim?

Answer 22

Stimulates bone marrow to increase neutrophil production.

Question 23

Who is filgrastim used for?

Answer 23

Patients with neutropenia to lower infection risk.

Question 24

Major adverse effects of filgrastim?

Answer 24

↑ uric acid, LDH, ALP; bone pain, leukocytosis, splenomegaly.

Question 25

What lab values indicate leukocytosis?

Answer 25

WBC > 100,000 / mm³ or Absolute Neutrophils > 10,000 / mm³.

Question 26

What are signs of splenic rupture?

Answer 26

LUQ pain or left shoulder tip pain.

Question 27

Contraindication of filgrastim?

Answer 27

Sensitivity to E. coli protein.

Question 28

Use filgrastum with caution in?

Answer 28

Bone marrow cancer, sickle-cell, respiratory disease, breastfeeding, children.

Question 29

Administration route and precautions of filgrastim?

Answer 29

SQ or IV; do not shake vial.

Question 30

What should be monitored with filgrastim?

Answer 30

CBC.

Question 31

What is the use of sargramostim?

Answer 31

Stimulates WBC production post bone marrow transplant.

Question 32

What are common adverse effects of sargramotisn?

Answer 32

Diarrhea, weakness, rash, malaise, bone pain.

Question 33

What lab values indicate leukocytosis/thrombocytosis?

Answer 33

Neutrophils ≥ 20,000 / mm³, WBC ≥ 50,000 / mm³, Platelets ≥ 500,000 / mm³.

Question 34

Contraindication for sargramostim?

Answer 34

Yeast allergy.

Question 35

Use sargramostism with caution in?

Answer 35

Lung, cardiac, kidney, hepatic disease, hypoxia, peripheral edema, pleural/pericardial effusion.

Question 36

Administration route and precautions?

Answer 36

SQ or IV; do not shake vial.