HemOnc

Question 1

MCV is used to measure what?

Answer 1

Mean corpuscular volume

= RBC size

Microcytic = small cells
Macrocytic =Large cells

Question 2

MCH measures what ?

Answer 2

Mean corpuscular hemoglobin = Weight of Hgb in average RBC

hypochromic - low in color
hyerpchromic - too much color

Question 3

What is RDW?

Answer 3

Degree of variation in RBC size

<15% is normal

Question 4

What is serum iron vs serum ferritin?

Answer 4

Serum Iron = measure of iron in circulation

serum ferritin -> Iron in storage –> ferritin is a protein that stores iron

Question 5

what will a reticulocyte count show?

Answer 5

ability of bone marrow to produce RBCs

Reticulocyte = baby RBC — check levels 1-2 weeks after tx to verify bone marrow is producing RBCs

Question 6

What does elevated Total iron binding capacity indicate?

Answer 6

Iron deficiency

Elevated = lots of seats on the bus to hold iron

Question 7

Name the 5 causes of microcytic anemia

Answer 7

1. Fe deficiency
2. Thalassemia
3. Anemia of chronic disease
4. sideroblastic anemia
5. lead toxicity

Question 8

What is Desrrioxamine (Desferal) Used for?

Answer 8

drug that chronically transfused patients use to remove EXCESS IRON from their bodies.

USED in THALASSEMIA pts

Question 9

what type of anemia is desferrioxamine used in?

Answer 9

Thalassemia patients!!!!!!!!!

also pts who receive frequent transfusion

Question 10

A low serum fe, high TIBC and possibly low ferritin may indicate what type of anemia? `

Answer 10

Iron deficiiency

Question 11

Nutritional guidelines to improve iron deficiency anemia?

Answer 11

Organ meats/red meats
dried peas/beans
dark leafy greens
whole grains

Question 12

Pharm tx for iron deficiency anemia

Answer 12

150-200mg/Day of elemental iron for 4-6 months!

1. Ferrous fumarate 325mg = 106mg of elemental iron
2. Ferrous sulfate 325mg = 65mg of elemental iron
3. Ferrous gluconate 325mg = 33mg of elemental iron

Question 13

Education when prescribing elemental iron

Answer 13

1. Take on EMPTY stomach

2. Take with VITAMIN C

Question 14

what does deserrioxamine do?

Answer 14

remove excess iron

Question 15

what causes anemia of chronic disease?

Answer 15

CHRONIC inflammation = destruction of RBC –> typically only last 60-90days

Question 16

what might a normocytic normochromic anemia indicate?

Answer 16

acute blood loss OR anemia of chronic disease (if longstanding will eventually become microcytic hypochromic)

Question 17

RBC lifespan in anemia of chronic disease?

Answer 17

60-90 days

Question 18

What kind of anemia is typically seen in a MACROcytic anemia?

Answer 18

B12 folate deficiency

Question 19

what are the main causes of B12 folate deficiency?

Answer 19

Low intake (vegetarians)
malapsorbption 
loss of parietal cells 
autoimmune disease 
pancreatic insufficiency

Question 20

What often co-exisits with a b12 anemia?

Answer 20

folate deficiency!

Question 21

What is B12?

Answer 21

essential vitamin obtained from diet or supplementation

Stores of b12 remain in liver for YEARS so onset of deficiency may occur over motnths to years

Question 22

what are the dietary intakes of b12

Answer 22

dairy

animal products

Question 23

What differs pernicious anemia from B12 deficiency anemia?

Answer 23

Pernicious = not enough B12 BUT do to ANUTOIMMUNE disease that attacks the PARIETAL cells resulting in an inability to absorb b12

Question 24

Management of B12 deficiency

Answer 24

B12 (Cobalamin)

Folic acid - PO –> tx 1-4 months post recovery

Question 25

What constitutes thrombocytopenia?

Answer 25

PLT <150kl

Question 26

managment for thrombocytopenia?

Answer 26

Refer to Hem/Onc Prednisone 4-6 weeks AVOID ASA -- risk for bleeds

Question 27

What is the most common leukemia affecting adults worldwide?

Answer 27

Chronic lymphocytic leukemia! Insidious, typically discovered incidentally

Question 28

Unique symptom for Chronic Myloid (CML) leukemia

Answer 28

Priapism

Question 29

Unique symptoms for CLL ( Chronic Lymphocytic leukemia)

Answer 29

Pallor | Petechiae

Question 30

What do blastocytes on a CBC indicate?

Answer 30

Blastocytes = immature WBC = ALWAYS ABNORMAL FINDING Blastocytes are normally found in bone marrow, not serum refer to hem/onc

Question 31

G6PD hemolytic anemia

Answer 31

``` often Mediterranian / AA descent Genetic Normally asymptomatic until exposed to....: -Antimalarial -sulfonamides -bactrim!!!!!!! -Fava beans -nitrofurantoin ```

Question 32

When does RH incompatibility occur?

Answer 32

RH - mom & RH + baby

Question 33

what complication occurs in RH incompatibility?

Answer 33

hemolytic disease of newborn

Question 34

when do we give Rogham?

Answer 34

28 weeks pregnant then 72 hours of delivery

Question 35

What anemia is associated with intrinsic factor and reduced absorption of Vitamin B12?

Answer 35

Pernicious anemia

Question 36

Assessment Findings for Vit B12 deficiency

Answer 36

``` cognitive impairment ataxia spasticity peripheral neuropathy!!!!!!!!! Glossitis bleeding gums insomnia ```

Question 37

Type of anemia where bone marrow produces ringed sideroblasts rather than healthy RBCs

Answer 37

Sideroblastic anemia

Question 38

how much elemental iron does ferrous fumarate 325mg contain?

Answer 38

106mg

Question 39

how much elemental iron does ferrous sulfate 325mg contains?

Answer 39

65mg

Question 40

how much elemental iron does ferrous gluconate 325mg contain?

Answer 40

33mg of elemental iron

Question 41

what does anisocytosis and poikilocytosis indicate?

Answer 41

anisocytosis = variation in RBC size poikilocytosis = variation in RBC shape

Question 42

assessment findings in newborns with hemoly