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