Hematology

Question 1

beefy red, tongue

Answer 1

B12 deficiency

Question 2

You have a patient on Coumadin with a history of DVT. What do you do if their INR is 1.4?

Answer 2

Increase the Coumadin dose.

Question 3

What is the T score to diagnose osteopenia?

Answer 3

-1.0 to -2.5

Question 4

What is the T score to diagnose osteoporosis?

Answer 4

less than -2.5

Question 5

List two macrocytic, normochromic anemias.

Answer 5

B12 and folate deficiencies

Question 6

what is cyanocobalamin?

Answer 6

B12 injection

Question 7

microcytic, hypochromic, elevated RDW, decreased iron/ferritin

Answer 7

iron deficiency anemia

Question 8

treatment for iron def. anemia?

Answer 8

elemental iron 150-200mg/day and organ meats, red meat, peas, beans, dark green leafy veggies, whole grains

Question 9

microcytic, hypochromic, normal iron, normal RDW
DX?
Next step?

Answer 9

Thalaseemia
DX by electrophoresis
Refer to hematology

Question 10

range for MCV

Answer 10

microcytic < 80
normal 80-100
macrocytic > 100

Question 11

multiple myeloma

Answer 11

cancer of the bone marrow, usually of the older adult
highest in African Americans
c/o bone pain and weakness

Question 12

true/false

take iron on an empty stomach.

Answer 12

true, and take it with vitamin C to increase absorption

Question 13

describe normal RDW

Answer 13

Red cell distribution width- degree of variation in RBC SIZE

<15% variation is normal

Question 14

what is normal hgb and hct in males and females?

Answer 14

HGB 
males 13-18g, 
females 12-16g
HCT 37-52% 
(M 42-52%, F 37-47%)

Question 15

smooth swollen tongue, PICA, spoon-shaped nails

Answer 15

iron def. anemia

Question 16

koilonychia

Answer 16

spoon shaped and brittle nails

Question 17

what lab makes anemia macrocytic?

Answer 17

MCV > 100

Question 18

what anemia is associated with memory loss and numbness/tingling

Answer 18

B12 def. aka pernicious anemia

Question 19

chronic EOTH use is associated with which type of anemia?

Answer 19

folate def. anemia

Question 20

Match the foods to B12 or folate/iron:

1) meat, poultry, eggs, milk, cheese
2) red organ meat, beans, peanut butter, green leafy vegetables, beans, whole grains
3) spinach, liver, beans, broccoli, brussel sprouts.

Answer 20

1) B12
2) folate/iron
3) folate/iron

Question 21

how to diagnose sickle cell anemia

Answer 21

electrophoresis

Question 22

What happens to the spleen in sickle cell anemia?

Answer 22

hyposplenia, spleen may not be palpable

Question 23

aplastic anemia

Answer 23

Destruction of pluripotent stem cells inside the bone marrow
Causes: radiation, adverse drug effects, viral infection
Labs: pancytopenia
DX: bone marrow biopsy
Refer to hematology

Question 24

increased RBC’s (thick blood); s/s- HA, dizzy, SOB, blurred vision; risk factors- COPD, smoking, high altitude living

Answer 24

Polycythemia

Question 25

G6PD deficiency

Answer 25

Genetic, Af.American MEN
Causes: hemolytic anemia (destruction of RBCs)
TX: avoid triggers:
fava beans, aspirin, some antibiotics

Question 26

Hodgkin’s vs Non-Hodgkin’s lymphoma

Answer 26

Hodgkin’s= younger, Reed-Steinburg cells
Non-Hodgkin’s= older, poor prognosis
**both have night sweats, fever, enlarged lymph nodes

Question 27

bone pain + hypercalcemia

Answer 27

Multiple Myeloma