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Hematology/Oncology > Heme/onc > Flashcards

Heme/onc Flashcards

1
Q

HgB

A

Main component of RBC’s and the essential protein that combines with and transports O2 to the body.
Males: 14-18
Females 12-16

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2
Q

Hct

A

Measures % of a given volume of whole blood that is occupied by erythrocytes; the amount of plasma to total RBC mass.
Males: 40-54%
Females: 37-47%

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3
Q

TIBC

A

Total iron binding capacity

Normal= 250-450

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4
Q

Serum iron

A

Normal 50-150

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5
Q

MCV

A

Expression of the average volume and size of individual erythrocytes
Normal: 80-100
Microcytic= <80
Macrocytic= >100

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6
Q

MCH

A

Expression of average amount and weight of Hgb contained in a single erythrocyte
Normal: 26-34

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7
Q

MCHC

A

Normal: 32-36%
Hypochromic= <32
Hyperchromic= 36%

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8
Q

Low MCV

A

Iron deficiency and thalassemia

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9
Q

High MCV

A

B12 or folate deficiency, alcoholism, liver failure and drug effects

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10
Q

Normochromic

A

Anemia of chronic disease, sickle cell disease, renal failure, blood loss, hemolysis

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11
Q

Iron deficiency anemia

A

Microcytic (<80), hypochromic (<32)
Most common cause of anemia
Iron loss exceeds intake–decrease in iron available for RBC formation!

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12
Q

S/S of IDA

A 
Usually slow onset w/ few symptoms if Hgb >30
Pica
dyspnea
HA
palpitations
weakness
tachycardia
postural hypotension
pallor
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13
Q

Labs for IDA

A

LOW: Hgb, hct, MCV, MCHC, RBC, iron, ferritin
HIGH: TIBC, RDW

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14
Q

Management of IDA

A

Oral ferrous sulfate 300-325mg 1-2 hours after meals
DO NOT take with antacids
Vitamin C INCREASES absorption

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15
Q

Foods high in iron

A

Raisins, green leafy veggies, red meats, citrus products, and iron fortified foods

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16
Q

Thalassemia

A

Genetically inherited disorders resulting in abnormal Hgb production and Microcytic, Hypochromic anemia
Typically Mediterranean, African, middle eastern, indian and Asian populations

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17
Q

S/s of thalassemia

A

Typically unremarkable unless severe

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18
Q

Labs for thalassemia

A

LOW: Hgb, MCV, MCHC
Normal: TIBC, ferritin

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19
Q

Management of thalassemia

A

No tx for mild to mod
Severe= RBC transfusion/splenectomy
IRON is contraindicated

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20
Q

Folic Acid deficiency

A

Macrocytic (>100), normochromic (32-36%)

Inadequate intake/malabsorption of folic acid (needed for RBC production)

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21
Q

S/S of FAD

A 
Fatigue
Dyspnea on exertion
Pallor
HA
Tachycardia
Anorexia
Glossitis
Aphthous ulcers
NEUROLOGIC symptoms are what differentiates FAD from B12 deficiency
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22
Q

Labs for FAD

A

LOW: Hct, Hgb, folate
HIGH: MCV
Normal: MCHC

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23
Q

Management of FAD

A

Folate 1mg orally daily

24
Q

Foods high in folic acid

A

Bananas, PB, fish, green leafy veggies, iron fortified

25
Pernicious Anemia
Macrocytic (>100), normochromic (32-36%) | Deficiency of intrinsic factor, which results in malabsorption of B12
26
S/S of PA
``` Weakness Glossitis Palpitations Dizziness Anorexia Parasthesia Loss of vibratory sense Loss of fine motor control + Romberg, + Babinski ```
27
Labs for PA
Low: Hgb, Hct and RBC's, B12 High: MVC Anti-IF (intrinsic factor) and antiparietal cell antibody tests affirm a deficiency Schilling test may help determine cause
28
Management of PA
B12 (cyanocobalamin) 100 IM daily x1 week | Maintenance tx requires continuous, lifelong monthly admin
29
Anemia of chronic disease
Chronic normochromic, normocytic anemia associated with chronic inflammation, infection, renal failure, and malignancy Involves decreased erythrocyte life span Second most common cause of anemia
30
S/S of anemia of chronic disease
Fatigue, weakness, dyspnea on exertion, anorexia
31
Labs for anemia of chronic disease
Low hgb & hct Low iron and TIBC MCV and MCHC normal High ferritin
32
Sickle cell anemia
Chronic, hemolytic anemia that is genetically transmitted Acute, periodic exacerbation in which RBC's become sickle-shaped and cause vessel obstruction Cellular hypoxia results in acidosis and tissue ischemia
33
Factors that precipitate sickling
``` infection Hypoxia high altitudes dehydration physical/emotional stress surgery blood loss acidosis ```
34
S/S of SCD
``` Delayed growth and development in infancy or early childhood Sudden onset of severe pain aching joint pain weakness dyspnea ```
35
Labs for SCD
Decreased Hgb Peripheral smear shows classic distorted sickle-shaped RBC's Cellulose acetate and citrate agar gel electrophoresis to confirm Hgb genotype
36
Management of SCD
Acute: fluids, analgesics, oxygen
37
Acute Nonlymphocytic Leukemia/Acute Myelogenous Leukemia
ANL/AML 80% of acute leukemia in adults Remission rates from 50-85% Long term survival rates about 40%
38
Acute Lymphocytic Leukemia
ALL More difficult to cure in adults than children Pancytopenia with circulating blasts (hallmark)
39
Chronic Lymphocytic Leukemia
CLL Most common leukemia in adults Lymphocytosis (hallmark)
40
Chronic Myelogenous Leukemia
CML | Philadelphia chromosome seen in leukemic cells (hallmark)
41
Labs for leukemia
CBC with subnormal RBC's and neutrophils Elevated ESR *Peripheral blood smear usually distinguishes acute and chronic leukemia's but a bone marrow biopsy is required for confirmation
42
Stage 1 Lymphoma
Disease localized to single lymph node or group
43
Stage 2 lymphoma
more than one lymph node group involved; confined to one side of the diaphragm
44
Stage 3 lymphoma
Lymph nodes or the spleen involved; occurs on both sides of the diaphragm
45
Stage 4 lymphoma
Liver or bone marrow involvement
46
Non-Hodgkin's lymphoma
Lymphadenopathy Most common neoplasm between 20-40 Less predictable pattern of spread then Hodgkin's
47
Hodgkin's lymphoma
Unknown cause More common in males Cervical adenopathy and spread in a predictable fashion through the lymph nodes Reed-Sternberg cells*** differentiate non-hodgkins from hodgkins
48
TNM classification of Malignant tumors
Cancer staging system developed and maintained by the Union for international caner control Not all cancers have TNM classifications (brain tumors)
49
TNM
T: A, is, 0, 1-4 Size or direct extend of the primary TUMOR N: 0-3, spread to regional NODES M: 0/1, Distant METASASIS
50
Polycythemia
Idiopathic and chronic marrow disorder, due to genetic mutation, resulting in INCREASED RBD and Hct
51
S/S of polycythemia
Fatigue, weakness, visual disturbances, HA
52
Labs for polycythemia
Hgb >18.5 in men and > 16.5 in women | Presence of JAK2617VF or similar genetic mutation
53
Management of polycythemia
Phlebotomy Aspirin Referral
54
Hemochromatosis
Disorder that results in excessive levels of iron
55
S/s of hemochromatosis
Fatigue Joint pain pain in knuckles or pointer and middle fingers -Liver disease, hyperpigmentation and diabetes
56
Management of hemochromatosis
Iron chelation | Don't eat iron containing foods
57
Immunosenescence
the immune systems diminished function with age which leads to a decline in response to infection

Hematology/Oncology (1 decks)

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