ATI-MedSurge-HEMATOLOGY PROBLEMS
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| Thalassemia is? | the body's inability to produce enough healthy red blood cells and hemoglobin (↓ globin synthesis)
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| Tay-Sachs disease is? | a rare inherited disorder that progressively destroys nerve cells in the brain and spinal cord
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| Sideroblastic anemia | ↓porphyrin
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| The severity of anemia is usually tested by _____ levels. | Hemoglobin (Hgb)
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| Microcytic anemia | "Find Those Small Cells"
Fe deficiency
Thalassemia
Sideroblastic
Chronic disease
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| Mild Anemia : reference range | Hgb 10-12 g/dL
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| Moderate Anemia : reference range | Hgb 6-10 g/dL
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| Severe Anemia : reference range | Hgb <6 g/dL
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| Metrorrhagia is? | uterine bleeding at irregular intervals, between the expected menstrual periods
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| Icteric sclera is? | a condition in which the whites of the eyes become yellow
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| The fingernails of anemic persons may appear _____-_____. | spoon shaped
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| The tongue of anemic persons may appear _____. | glossitic (beefy, red)
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| Some neurologic issues an anemic person may display are? | roaring in ears, confusion, loss of vibration sense, unsteady gait
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| Cobalamin (Vit B12), food sources? | red meats (liver), eggs, enriched grains
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| Folic acid, food sources? | green leafy veges, liver, meat, fish , legumes, whole grains
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| Iron, food sources? | liver & muscle meats, eggs, dried fruits, legumes, dark leafy veges, whole grains, enriched grains
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| Pyridoxoine (Vit B6), food sources? | meats, wheat germ, legumes potatoes, cornmeal, bananas
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| Amino Acids, food sources? | eggs, meat, milk & products, poultry, fish , legumes, nuts
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| Ascorbic Acid, food sources? | citrus fruits, green leafy veges, strawberries, cantaloupe
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| Drugs that interfere with absorption/use of folic acid? | methotrexate, anti-seizure drugs (phenobarbital, dilantin),
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| Megaloblastic anemia is caused by? | Folic acid deficiency
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| Folic acid deficiency is treated by? | replacement therapy (usually 1mg PO daily), in malabsorption states - 5mg
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| Pt. with anemia should be protected from? | burns, falls, and trauma; pt. have diminished sensation of heat/pain
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| Congenital causes of aplastic anemia include? | Fanconi syndrome, Congenital dyskeratosis, Amegakaryocytic thrombocytopenia, Schwachman-Diamond syndrome
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| Prognosis of severe untreated aplastic anemia is approximately ______% | 70% fatal
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| 10% loss in blood volume, clinical manifestations? | none
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| 20% loss in blood volume, clinical manifestations? | tachycardia with exercise, slight postural HTN
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| 30% loss in blood volume, clinical manifestations? | postural HTN with exercise, normal supine BP and pulse at rest
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| 40% loss in blood volume, clinical manifestations? | ↓BP, central venous pressure, and cardiac output at rest; pulse: rapid/thready; skin: cold/clammy
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| 50% loss in blood volume, clinical manifestations? | shock → death
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| Sickle Cell Disease is a mutation of? | Beta-globin located on chromosome 11
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| Sickling episodes are commonly triggered by? | low oxygen tension in the blood, dehydration, acidosis, plasma osmolality, decreased plasma volume, low body temperature
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| Clinical hallmarks of sickle cell disease include? | vaso-occlusive phenomena and hemolysis
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| Hemochromatosis is? | an iron overload disorder
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| Hemochromatosis occurs secondary to? | thalassemia ad sideroblastic anemia
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| Severe Hemochromatosis, leads to? | cirrhosis of the liver
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| Hemochromatosis, treatment? | removal 500mL of blood weekly for 2-3 yrs. to deplete iron stores
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| Most platelet disorders are (inherited / acquired)? | acquired
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| Most common form of acquired thrombocytopenia? | Immune Thrombocytopenic Purpura
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| Hemophilia A, mutation is of clotting factor _____. | VIII
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| Hemophilia B, mutation is of clotting factor _____. | IX
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| Analgesics that should never be used as treatment for hemophiliacs? | Aspirin and aspirin containing products
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| Acute Myelogenous Leukemia, presentation? | abrupt onset & dramatic, serious infection/bleeding, hyperplasia of bone marrow
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| Acute Lymphocytic Leukemia, presentation? | most common type in children, most of B-cell origin, abrupt onset with bleeding or fever, CNS manifestations (Leukemic meningitis)
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| Chronic Myelogenous Leukemia, presentation? | stages: chronic stable → more acute, "blastic phase"
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| Chronic Lymphocytic Leukemia, presentation? | most common in adults, large B-cell non-Hodgkin's lymphoma called Richter's syndrome
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| Hodgkin's Lymphoma is? | a cancer of lymph tissue found in the lymph nodes, spleen, liver, bone marrow, and other sites
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| In Hodgkin's Lymphoma, initial enlargement is seen in _____, ____, or lymph nodes? | cervical, axillary, or inguinal
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| Dextrose solutions or lactated Ringer's solution will cause _____ to RBCs? | hemolysis
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