CPHON-Hematology Questions and Answers

CPHON-Hematology Questions and Answers Bone Marrow Failure: examples of Autoimmune hemolytic anemia, fanconi's anemia, dyskeratosis congentia, shwachman-diamond syndrome Platelet/ coagulation diseases ITP, Thrombosis, thrombophilia, hemophilia, VWD RBC disease: examples SCD, thalassemia, Glucose 6-phosphate dehydrogenase deficiency, heredity spherocytosis A child with dysmorphic thumbs is newly dx with myelodyplastic syndrome. What does the RN anticipate an additional evaluation for? Fanconi Anemia Von Willebrand is missing... V, W factor Iron def & Thalassemia: What are the lab differences between them Iron def- Fe & ferritin levels are low Thalassemia- Fe & ferritin levels are both normal to high 3 Factors that increase risk of thromboembolism Factor V Leiden Protein C & S deficiency Protein C & S act as Vitamin K dependent proteins which are anticoagulants Thalassemia : How does it gets transmitted genetically? B-Thal = autosomal recessive SCD: What is the main symptom of spleenic infarction with SCD disease? ULQ pain, severe Pneumocystis Pneumonia: The causative organism of A Fungus Amylase & lipase : what are they Amylase- breakdown starches Lipase- digest fats What electrolytes have an inverse relationship with each other? potassium - magnesium Phosphate-calcium Sodium-water PTT-fibrinogen B cells purpose Humoral immunity- makes antibodies, memory cells Eosinophils: purpose Prominent in allergic rxs Can selectively destroy parasites/ have function in immediate allergic/hypersensitivity reactions/ produced prifivrinolysin - form fubrinolysin - digests fibrin- dissolves clots Stem cells mature into RBC, granulocytes, monocytes, lymphocytes, plts Monocytes purpose Phagocytosis Large phagocytic cells involved in early stage of inflammatory reaction natural killer cells (NK cells) purpose Destroy viruses & malignant cells non specifically Neutrophils purpose Ingest & destroy microorganisms, primary defense against bacterial infections Primary defense in infection/phagocytize and kill bacteria T lymphocytes (T cells) purpose Cell mediated immunity- attacks invaders a lymphocyte They are circulated through the thymus gland- ralidly- divide & produce T-cells that are sensituzed to antigen-killer cells- play a role in body's resistance to proliferation of cancer cells Malignant stem cells are Cells that lose the ability to regulate cell division and differentiate to mature functioning cells Blasts accumulate where and what does this cause Marrow spaces, peripheral vasculature, and organs Normal cell proliferation is blocked d/t lack of space/nutrients Diploid 46 chromosomes G6PD: A ______ retic count and _____Coombs test are found in glucose 6 phosphate deficiency High; negative Pseudodiploid 46 chromosomes with structural changes Hyperdiploidy and prognosis Fewer than 50 chromosomes and good prognosis Platelet life span 7-10 days Lymphocytes Involved in development of antibodies and delayed hypersensitivity RBC lifespan 120 days (4 months) Hemoglobin is broken down into Iron- iron is used by bone marrow to make more RBC and bilirubin which is excreted by liver as bile Erythopoietin: What happens when it is released into the bloodstream It stimulates the bone marrow to make new RBCs Basophils Healing phase of inflammation- become mast cells on tissue- responsible for histamine release- allows WBCs to exit vessels at site of injury Erythropoietin is produced by _____in response to_____ Kidneys Tissue Hypoxia Platelets decrease after chemo 7-21 days Cancer cell deviations No present number of divisions before death Not inhibited by contact Don't require usual amount of growth factors- some produce their own Elevated retic count without tissue hypoxia/increased destruction of RBC Could indicate BM failure Retic Count Production if RBC by bone marrow Platelets release Serotonin- which causes vasoconstriction Granulocytes Neutrophils, basophils, esoninophils survive in bld 1214 hrs in tissues 5 days Epoiten alfa Boots Hgb levels in place of transfusion Fanconi's anemia may not be diagnosed until they present with these diseases Myelodysplastic syndrome Acute Myelogenous leukemia Which of the following findings is consistent with a dx of autoimmune hemolytic anemia? -Negative coombs test -Increased unconjugated bilirubin -Normal retic count - High plt count Increased unconjugated bilirubin What protozoal organism is responsible for causing resp distress, tachypnea, and fever? Pneumocystis jiroveci A child presents with malaise, dizziness, jaundice, dyspnea & tachycardia. What does the nurse expect the lab results to reveal? -Pancreatitis -Renal toxicity -Anemia -Neutropenia Anemia -clinical presentation includes: behavioral changes, skin color changes, dyspnea, & tachycardia Why is recombinant factor VIIa given to a hemophilia A pt with inhibitors? The development of an inhibitor to factor VIII requires the use of a bypassing agent to stop the bleeding Autoimmune hemolytic anemia test... Positive coombs SCD: Conditions which increase chances of hypoxia or acidosis in SCD: (4) infection fever exposure to extreme temps dehydration