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FNP~Hematology

QuestionAnswer
Normal Hgb values... 14-18g/100ml (males)....12-16g/100ml (females)
Normal Hct values... 40-54% (males)....37-47% (females)
Normal value of TIBC (total iron binding capacity) 250-450 ug/dl
Why is TIBC increased in iron deficiency? because a decrease in iron means more spaces are empty to bind to
When are sx's likely to be present in a patient with low Hgb Hgb <10
Normal value of Serum Iron... 50-150 ug/dl
What is the MCV and the normal value? size of individual RBC's; 80-100 u3
What value is "microcytic", "normocytic", "macrocytic"? ~micro <80 ~normo 80-100 ~macro >100
What is the MCHC and the normal value? average Hgb concentration = color; 32-36%
What value is "hypochromic", "normochromic", "hyperchromic"? ~hypo <32% ~normo 32-36% ~hyper >36% (*usually not possible)
What is the differential dx of "Low MCV"? iron deficiency anemia and thalassemia (microcytic, hypochromic)
What is the differential dx of "High MCV"? pernicious anemia/B-12 deficiency or folate deficiency; alcoholism, liver failure and drug affects (macro-, normo-)
What is the differential dx of "Normocytic"? anemia of chronic dz, sickle cell dz, renal failure, blood loss, hemolysis (normo-, normo-)
What are the lab results in iron deficiency anemia? ~microcytic <80 (small cells) ~hypochromic <32% (pale) ~^TIBC
Most common causes of iron deficiency anemia.. ~blood loss (menses, GI bleed) ~inadequate iron intake ~impaired absorption of iron
Management of iron deficiency anemia... ~oral ferrous sulfate 300-325mg ~diet: raisins, green leafy veggies, red meats, citrus, Fe bread and cereals
Thalassemia is... inherited disorders resulting in abnormal Hgb production and microcytic, hypochromic anemia
Thalassemia lab results will show... ~low MCV ~low MCHC ~normal TIBC (*there is NO need for iron) ~ferritin (*NO need for iron)
Management of Thalassemia... ~no tx for mild to moderate forms ~iron is contraindicated, overload can result
Hallmark s/sx of folic acid deficiency... glossitis
What is the cause of folic acid deficiency? inadequate intake/malabsorption (elderly, alcoholics, poor) of folic acid (needed for RBC production)
T/F: neuro signs are seen in folic acid deficiency False
What would labs show in folic acid deficiency? ~MCV^ ~MCHC normal ~
Management of folic acid deficiency... ~Folate 1mg po qd ~diet: bananas, peanut butter, fish, green leafy veggies, Fe breads and cereals
What is pernicious anemia? anemia due to deficiency of intrinsic factor = in malabsorption of B12
What would labs show in pernicious anemia? ~increased MCV >100 ~serum B12 low ~
T/F: nuero signs are seen in pernicious anemia True
Management of pernicious anemia ~B12 100mcg IM daily x 1 wk ~maintenance treatment = lifelong monthly admin
What is anemia of chroinc dz associatesd with? ~chronic inflammation ~infection ~renal failure (decrease in erythropoeitin production =decreased RBC production)
Etiology of anemia of chronic dz... unclear, but involves decreased erythrocyte life span; 2nd most common cause of anemia
What would labs show in anemia of chronic dz? ~MCV normal (size) ~MCHC normal (color)~serum ferritin is high >100 (stores high)
Management of anemia of chronic dz... ~tx associated dz ~provide nutritional support
What would sickle cell anemia labs show? ~MCV normal ~MCHC normal ~decreased Hgb ~peripheral smear shows classic distorted sickle-shaped RBC's
Job of Neutrophils (polys, segs)... against bacteria, 60% of diff
Job of Lymphocytes... against virus, 30% of diff
Job of Monocytes... against debris, clean up after trauma dead tissue, 6% of diff
Job of Eosinophils... activated with allergies, parasites (worms, wheezes, weird dz), 3%
Job of Basophils... immune mediaters, 1%
What does a "Left shift" indicate... more neutrophils in response to bacterial infection
Leukocytosis... Elevation in TWBC =>10,000
Neutrophilia... increase in number of available neutrophils to >70% TWBC (normal in adults 50-70%)
Bandemia... absolute band count (normal 0-4%)
Created by: KimmiNP