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Hematology
Quiz 3
| Question | Answer |
|---|---|
| The normal lab value for K+ is | 3.5-5.5 |
| The normal lab value for Cl is | 90-110 |
| The normal lab value BUN is | 10-20 |
| The normal lab value for creatine is | 0.6-1.2 |
| The normal lab value for Na is | 135-145 |
| Normal WBC count is | 5-10 thousand |
| Normal platelet count is | 150-400,000 |
| Normal RBC count is | 4.6-6 million |
| Normal Hgb for a male is | 13-18 |
| Normal Hgb for a female is | 12-16 |
| Normal Hct for a male is | 45-52 |
| Normal Hct for a female is | 37-48 |
| What are three specific blood cells found in the heme system? | RBC (erythrocytes) WBC (leukocytes) Platelets (thrombocytes) |
| Site of hematopoesis | Bone marrow |
| Reticulocytes are immature ________ | RBCs |
| What type of hemostasis begins with vascular response, when damaged blood vessel vasoconstricts | Primary hemostasis |
| What type of hemostasis begins with platelet response, inactive factors convert to active | Secondary hemostasis |
| Clotting factor: faster, veins | Extrinsic |
| Clotting factor: slower, arteries | Intrinsic |
| What lab count is a reflection of bone marrow activity (increase with severe hemorrhage)? | Reticulocyte |
| Loss of RBCs, decreased production of RBCs, and increased destruction of RBCs are causes of what? | Anemia |
| Hypoproliferative type of anemia. Most common in children and adolescents. R/T blood loss, Fe malabsorption, increased requirements, and insufficient intake | Iron-Deficiency Anemia |
| Fatigue, HA, pale skin and mucous membranes, and smooth, sore tongue are most common symptoms of what type of anemia | Iron-Deficiency Anemia |
| CBC count is low across the board, including low ferritin when this type of anemia has occurred | Iron-Deficiency Anemia |
| Rare type of anemia, characterized by hypoplasia to stem cells in blood marrow. All cell production decreased. Fat where stem cells should be. May be congenital, acquired, or related to toxins. | Aplastic Anemia |
| Symptoms of this anemia develop slowly. Complications of bone marrow before Dx made. Typical s/s classic anemia ss, dyspnea, infection, leukopenia, thrombocytopenia, lymphadonopathy, spleenomegaly. Decreased reticulocytes | Aplastic Anemia |
| Type of anemia caused by deficiency of folic acid or B12. RBCs abnormally large. WBCs, platelets also abnormal size. Bone marrow analysis reveals hyperplasia. Has very few mature cells. | Megaloblastic Anemia |
| Hgb of 4-5, WBC 2-3, Platelets <50, and elevated MCV (usually >110) are indicative of | Pancytopenia |
| Vitamin B12 and Folic Acid deficiencies are types of what type of anemia? | Megaloblastic |
| What is the most common symptom of anemia? | Fatigue |
| What deficiencies result in megaloblastic anemia? | Folic Acid and B12 |
| What symptoms differentiate between the two megaloblastic anemias? | Neuro (Impaired balance, ataxia, etc.) with B12 |
| Lack of intrinsic factor, normally secreted in the stomach, is called __________ anemia. | Pernicious |
| Genetic disease. Recessive gene trait. Severe hemolytic anemia. Most common in African Americans and Middle Easterners. | Sickle Cell Anemia |
| Clinical manifestations of this disease are tachy HR, murmurs, and cardiomegaly. Jaundice, weakness, Expansion of bone marrow, especially in skull. Enlarged bones. | Sickle Cell Anemia |
| Three major complications of sickle cell anemia are | Sickle cell crisis Acute chest syndrome Pulmonary HTN |
| Hereditary anemia; recessive gene. Characterized by hypochromia, microcytosis, and hemolysis. Most predominant in people of Mediterranean, Africa, and SE Asian descent. | Thalassemia |
| What are two forms of Thalassemia, and what is the difference between the two? | Alpha (Mild form) Beta (Severe form) |
| Diagnosed when newborn. Minor form usually requires no treatment. Major form treated with PRBC transfusions. Curable with HSCT only before liver damage has occurred. Death often r/t heart failure | Thalassemia |
| Condition in which excess Fe+ is absorbed in the GI tract. S/S include weakness, lethargy, hyperpigmentation, dyspnea, arrythmias, cardiomyopathy, and psorosis of the liver. | Hemochromatosis |
| High Fe+, high transferrin, and normal CBC indicate what? (Therapeutic phlebotomies indicated to remove blood to reduce Fe). | Hemochromatosis |
| Goal for management of Hemochromatosis is Fe+ lab value of <_____% and Ferratin <______mcg/L | 50% 100mcg/L |
| Increased volume of RBCs. Secondary is caused by excessive production of erythropoetin. D/t decreased O2: Heavy smoker,COPD, high altitudes | Polycthemia |
| Type A and Type B. Only distinguishable difference is in lab tests. A is more common than B. Affects all ethnic groups equally. | Hemophilia |
| Inherited as x-linked trait, so most people affected are male. Females can be carriers, but usually asymptomatic. Usually diagnosed in childhood after having an injury. | Hemophilia |
| Clinical manifestations include hemorrhages, especially into the joints (75% joint related s/s). Bleeding can occur with or without pain. Most dangerous is cranial. | Hemophilia |
| Management of this includes replacement of defective blood factors, FFP, Immunosuppressive therapy, and Plasmapheresis. | Hemophilia |
| Nursing management includes LOTS of education: Coping, Safety, Prophylaxis, Dental Hygiene, Alert ID | Hemophilia |
| Genetic disorder. Deficient in vWF, which is required for factor 8 activity and platelet adhesion at site of injury. Mucosal bleeding is common. | Von Willebrand Disease (vWD) |
| Labs for this disease: WNL platelets, prolonged PT and APTT | Von Willebrand Disease (vWD) |
| Normal hemostatic mechanisms are altered. NOT a common disease. Impaired anticoagulant pathway and fibrinolytic system suppressed, which allows massive amounts of tiny clots to form in the microcirculation. | Dissemented Intravascular Disease (DIC) |
| Paradoxical effect occurs with consumption of platelets and clotting factors which result in bleeding. | Dissemented Intravascular Disease (DIC) |
| Clinical manifestations include: gradual s/s of organ dysfunction, clotting factors and platelets are being consumed by microthromboses and bleeding occurs, which can range from minimal to profuse hemorrhage. | Dissemented Intravascular Disease (DIC) |
| What disease? Early recognition is key. Must treat underlying cause is #1. Must improve oxygenation! Blood product transfution (PRBCs, platelets, FFP) Ultimate goal is to minimize bleeding and promote tissue perfusion. | Dissemented Intravascular Disease (DIC) |
| Type of leukemia: Age of onset: Peak 67 y/o. S/S=Fatigue, weakness, HA, mouth sores | AML |
| Type of leukemia: Age of onset: Peak 4 y/o. S/S=Fever, fatigue, pallor, bleeding, CNS involved | ALL |
| Type of leukemia: Age of onset: Mean 65 y/o Rare <20 y/o. No early S/S. Rare lymphadenopathy. | CML |
| Type of leukemia: Age of onset Avg 72 y/o. No early S/S; HAS lymphadenopathy | CLL |
| Increased production and presence of all blood cells, especially increased RBCs. Onset 65 y/o. Increased blood viscosity, volume. Decreased Fe reserve. Splenomegaly. | Polycthemia Vera |
| Generalized pruritis in 70% of pts. Erythromelagia (burning sensation in fingers and toes). Elevated labs across the board, including uric acid. | Polycthemia Vera |
| Which type of leukemia is most common in children? | ALL |
| What is the difference between autologous and allogenic? | Autologous= Self Allogenic= Another donor |
| Chemotherapy S/E most commonly occur in which three types of tissue? | GI, Skin, Bone Marrow |
| How much blood is removed initially on a newly diagnosed polycthemia patient? | 500ml 1-2 times a week |
| What is the goal Hct for polycthemia patient? | <45% |
| Relatively rare lymphoma and has a high cure rate. | Hodgkin Lymphoma |
| More common lymphoma in men | Hodgkin Lymphoma |
| 2 peaks of incidence: 20s and >55 y/o. Veterans w/ agent orange exposure. 5 year survival rate is 88% and the younger the person, the greater the percentage. | Hodgkin Lymphoma |
| One-sided lymphoma and can spread along same side in lymph system. Hallmark pathology is the spleen, GI tract, and liver. | Hodgkin Lymphoma |
| Has the Reed-Sternberg cell | Hodgkin Lymphoma |
| What are "B" symptoms? | Fever, drenching night sweat, and unintentional weight loss |
| Fever, drenching night sweat, and unintentional weight loss are aka what? | "B" symptoms |
| Fever, drenching night sweat, and unintentional weight loss are symptoms of what lymphoma? | Hodgkin Lymphoma |
| Uncommon, localized lymphoma. Incidence increases with age, median age is 65. Unkown etiology. Arise from primarily B lymphocytes. | Non-Hodgkin Lymphoma |
| Lymphadenopathy is most common sign, but may wax and wane. Also has "B" symptoms, but less common. | Non-Hodgkin Lymphoma |
| Which cell type confirms the diagnosis of Hodgkin's Disease? | Reed-Sternberg |
| How does the extent of disease differ between Hodgkin and Non-Hodgkin Lymphoma? | Hodgkin=Local Non-Hodgkin= Disseminated |
| Malignant disorder of plasma cells. Low survival rate. Non-functional Ig cells. Classic s/s= bone pain, back pain, rib pain. | Multiple Myeloma |
| Increased thirst, dehydration, altered LOC, and coma are S/S of what? | Hypercalcemia |
| Epistaxis, HA, paresthesias, blurred vision, thrombus or HF are symptoms of what? | Hyperviscosity |
| Hypercalcemia and hyperviscosity are S/S of what malignant disease? | Multiple Myeloma |
| CRAB is used for Dx of what? | Multiple Myeloma |
| CRAB stands for what? | increased Calcium, Renal insufficiency, Anemia, Bone lesions |
| Specific to Multiple Myeloma, what protein shows up in urinalysis? | Bence-Jones |
| You can do this! | Keep going! |
| You need a good grade! | Don't stop studying now! |
| Don't overdo it. | Take a break if you need to. |
| Don't over-think the test | Don't freakin change your answers! |
| Go with your gut | when answering questions on the test. |
| If/when you pass...... | .....treat yourself to something! You deserve it! |
| "I'm good enough, I'm smart enough..... | ...., and doggone it, people like me." -Stuart Smalley |
Created by:
mreedy
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