CPHON EXAM QUESTIONS WITH COMPLETE
SOLUTIONS
Autoimmune |Hemolytic |Anemia |is |a |group |of |disorders |characterized |by |- |CORRECT |
ANSWER✔✔-malfunction |of |the |immune |system |where |antibodies |are |produced |against |
antigens |on |the |surface |of |RBSs, |resulting |in |hemolysis
T/F |RBC |survival |is |proportional |to |the |amount |of |antibody |on |the |RBC |surface; |therefore |the |
greater |the |amount |of |antibody |the |more |rapidly |the |RBC |is |destroyed. |- |CORRECT |
ANSWER✔✔-True
Intravascular |Hemolysis |is |- |- |CORRECT |ANSWER✔✔-RBC |lysis |in |circulation |- |Antibodies |bind |
to |the |RBC |membrane |therefore |activating |the |complement |cascade |- |damaged |membrane |
causes |increased |osmotic |pressure |within |cell |and |the |cell |bursts
Extravascular |hemolysis |is |- |CORRECT |ANSWER✔✔-occurs |when |complement |fixation |to |RBC |
fails |to |activate |complement |cascade |- |the |complement |on |the |RBC |surface |interacts |with |
receptors |in |macrophages |in |the |lungs, |liver, |and |spleen |-> |RBC |phagocytosis
Causes |of |AIHA |(4) |- |CORRECT |ANSWER✔✔-1. |Autoimmune |disorders |(LUPUS) |2. |Infections |
(hepatitis, |EBV, |myco |pneu) |3. |Drugs |(peni |and |quinine) |4. |Hematologic |disorders(Evan's |
syndrome |and |paroxysmal |nocturnal |hemoglobinuria)
Incidence |of |AIHA |- |CORRECT |ANSWER✔✔-1 |case |per |80,000 |persons
Clinical |Symptoms |of |Severe |AIHA |- |- |CORRECT |ANSWER✔✔-- |pallor |- |jaundice |- |fatigue |- |
tachycardia |-hypoxia |--> |organ |damage |- |splenomagaly
,What |labs |should |be |ordered |if |AIHA |is |suspected? |- |CORRECT |ANSWER✔✔-cbc |d/p, |retic, |
peripheral |smear, |Coombs |test, |bilirubin, |LDH, |and |haptoglobin
Labs |findings |that |suggest |AIHA |is |possible: |- |CORRECT |ANSWER✔✔-1. |Coombs |direct |(DAT) |: |
+ |which |indicates |antibodies |against |the |RBC |2. |Low |Hemoglobin |3. |Increased |Retic |4. |
Spherocytes, |schistocytes, |or |erythrocyte |agglutination |on |blood |smear |5. |Increased |LDH |6. |
Decreased |haptoglobin |7. |Hemoglobinuria |8. |Increased |Unconj |bilirubin
Possible |parts |of |the |Treatment |Plan |of |AIHA |- |CORRECT |ANSWER✔✔-1. |Stop |medication |if |
suspected |as |cause |2. |Prednisone |2-4 |mg/kg/day |3. |High |Dose |IVIG |4.Splenectomy |5. |pRBC |
transfusion |6. |Folic |Acid |supplementation |7. |Plasmapheresis |(b/c |IgM |is |confind |to |the |
intravascular |space) |8. |Cytotoxic |agents |9. |Immunosuppressive |agents |(Cyclosporine) |10. |
Hormonal |therapy |(danazol)
What |are |the |three |types |of |cytoxic |agents |that |can |be |used |for |AIHA? |- |CORRECT |
ANSWER✔✔-1. |Antimetabolites |(6-mecaptupurine, |azathioprine) |2. |alkylating |agents |
(cyclophosphamide) |3. |Mitotic |agents |(vincristine, |vinblastine)
T/F |Cold |Antibody |AIHA |is |most |common |AIHA, |in |whcih |the |autoantibodies |become |most |
active |and |attack |RBCs |usually |at |temperatures |well |below |normal. |. |- |CORRECT |ANSWER✔✔-
False. |75% |of |cases |are |warm |body
Pathophysiology |of |Warm |Body |AIHA |IgG |- |CORRECT |ANSWER✔✔-is |the |most |common |
antibody |> |attaches |to |RBC |> |recognized |by |monocytes |and |macrophages |in |the |spleen |> |
destroy |RBC |membrane> |RBC |changes |shape |and |singled |out |for |destruction
T/F |50% |of |cases |if |warm |anitbody |AIHA |are |idiopathic |(primary) |- |CORRECT |ANSWER✔✔-True
Prognosis |of |AIHA |- |- |CORRECT |ANSWER✔✔-Usually |transient |- |less |than |3 |months |- |usually |
resolve |spontaneously
, Cold |Antibody |AIHA |is |most |common |in |children |when |- |. |- |CORRECT |ANSWER✔✔-secondary |
to |infection |- |IgM |or |IgG |cold |reacting |antibodies |that |cross |react |with |the |ABO |antigens |on |
the |surface |of |RBCs |are |produced
What |organ |is |the |main |site |of |hemolysis |in |cold |antibody |AIHA? |- |CORRECT |ANSWER✔✔-Liver
Primary |cold |agglutinin |disease |is |: |- |CORRECT |ANSWER✔✔-chronic |or |transient |chronic
Most |common |infection |causing |secondary |cold |antibody |AIHA |is: |- |CORRECT |ANSWER✔✔-
Mycoplasma |pneumoniae |but |also |viral |(measles, |mumps, |flu, |EBV, |Adeno, |VZV, |CMV) |and |
bacterial |(syphilis |and |HIB)
T/F |Blood |products |should |be |washed |and |warmed |before |transfusion |for |persons |with |Cold |
Antibody |AIHA |- |CORRECT |ANSWER✔✔-True
6 |nursing |assessment |and |interventions |for |AIHA |- |CORRECT |ANSWER✔✔-1. |Read |labs |for |
decreased |hemoglobin |2. |Monitor |for |anemia |3. |Monitor |for |transfusion |complications |(rxn |
and |fluid |overload) |4. |Maximize |child's |physical |tolerance |5. |Teach |family |about |AIHA |6. |Teach |
aout |post |slenectomy |care |prn
Definition |of |Sickle |Cell |Disease |- |- |CORRECT |ANSWER✔✔-a |hemogloinopathy |-DNA |mutation |
for |hbg |production |- |normal |hemoglobin |or |hgb |A |is |absent, |but |hbg |S |is |present |(alone |or |in |
combination |with |another |form |of |abnormal |hemoglobin)
Who |first |described |SCD? |- |CORRECT |ANSWER✔✔-James |Herrick |(1904
SCD |pathophysiology |- |- |CORRECT |ANSWER✔✔-Hbg |two |pairs |of |polypeptide |chains |(alpha |
and |beta) |> |on |6th |position |on |the |Beta |chain |in |hbg |A |- |glutamic |acid |is |replaced |by |valine |> |
decreasing |pliability |and |changing |RBC |biconcave |nature |> |cells |then |sickle |due |to |
polymerization, |forming |microtubules |or |stiff |rods |within |the |cell |they |get |clogged |in |
vasculature> |leading |to |tissue |ischemia
SOLUTIONS
Autoimmune |Hemolytic |Anemia |is |a |group |of |disorders |characterized |by |- |CORRECT |
ANSWER✔✔-malfunction |of |the |immune |system |where |antibodies |are |produced |against |
antigens |on |the |surface |of |RBSs, |resulting |in |hemolysis
T/F |RBC |survival |is |proportional |to |the |amount |of |antibody |on |the |RBC |surface; |therefore |the |
greater |the |amount |of |antibody |the |more |rapidly |the |RBC |is |destroyed. |- |CORRECT |
ANSWER✔✔-True
Intravascular |Hemolysis |is |- |- |CORRECT |ANSWER✔✔-RBC |lysis |in |circulation |- |Antibodies |bind |
to |the |RBC |membrane |therefore |activating |the |complement |cascade |- |damaged |membrane |
causes |increased |osmotic |pressure |within |cell |and |the |cell |bursts
Extravascular |hemolysis |is |- |CORRECT |ANSWER✔✔-occurs |when |complement |fixation |to |RBC |
fails |to |activate |complement |cascade |- |the |complement |on |the |RBC |surface |interacts |with |
receptors |in |macrophages |in |the |lungs, |liver, |and |spleen |-> |RBC |phagocytosis
Causes |of |AIHA |(4) |- |CORRECT |ANSWER✔✔-1. |Autoimmune |disorders |(LUPUS) |2. |Infections |
(hepatitis, |EBV, |myco |pneu) |3. |Drugs |(peni |and |quinine) |4. |Hematologic |disorders(Evan's |
syndrome |and |paroxysmal |nocturnal |hemoglobinuria)
Incidence |of |AIHA |- |CORRECT |ANSWER✔✔-1 |case |per |80,000 |persons
Clinical |Symptoms |of |Severe |AIHA |- |- |CORRECT |ANSWER✔✔-- |pallor |- |jaundice |- |fatigue |- |
tachycardia |-hypoxia |--> |organ |damage |- |splenomagaly
,What |labs |should |be |ordered |if |AIHA |is |suspected? |- |CORRECT |ANSWER✔✔-cbc |d/p, |retic, |
peripheral |smear, |Coombs |test, |bilirubin, |LDH, |and |haptoglobin
Labs |findings |that |suggest |AIHA |is |possible: |- |CORRECT |ANSWER✔✔-1. |Coombs |direct |(DAT) |: |
+ |which |indicates |antibodies |against |the |RBC |2. |Low |Hemoglobin |3. |Increased |Retic |4. |
Spherocytes, |schistocytes, |or |erythrocyte |agglutination |on |blood |smear |5. |Increased |LDH |6. |
Decreased |haptoglobin |7. |Hemoglobinuria |8. |Increased |Unconj |bilirubin
Possible |parts |of |the |Treatment |Plan |of |AIHA |- |CORRECT |ANSWER✔✔-1. |Stop |medication |if |
suspected |as |cause |2. |Prednisone |2-4 |mg/kg/day |3. |High |Dose |IVIG |4.Splenectomy |5. |pRBC |
transfusion |6. |Folic |Acid |supplementation |7. |Plasmapheresis |(b/c |IgM |is |confind |to |the |
intravascular |space) |8. |Cytotoxic |agents |9. |Immunosuppressive |agents |(Cyclosporine) |10. |
Hormonal |therapy |(danazol)
What |are |the |three |types |of |cytoxic |agents |that |can |be |used |for |AIHA? |- |CORRECT |
ANSWER✔✔-1. |Antimetabolites |(6-mecaptupurine, |azathioprine) |2. |alkylating |agents |
(cyclophosphamide) |3. |Mitotic |agents |(vincristine, |vinblastine)
T/F |Cold |Antibody |AIHA |is |most |common |AIHA, |in |whcih |the |autoantibodies |become |most |
active |and |attack |RBCs |usually |at |temperatures |well |below |normal. |. |- |CORRECT |ANSWER✔✔-
False. |75% |of |cases |are |warm |body
Pathophysiology |of |Warm |Body |AIHA |IgG |- |CORRECT |ANSWER✔✔-is |the |most |common |
antibody |> |attaches |to |RBC |> |recognized |by |monocytes |and |macrophages |in |the |spleen |> |
destroy |RBC |membrane> |RBC |changes |shape |and |singled |out |for |destruction
T/F |50% |of |cases |if |warm |anitbody |AIHA |are |idiopathic |(primary) |- |CORRECT |ANSWER✔✔-True
Prognosis |of |AIHA |- |- |CORRECT |ANSWER✔✔-Usually |transient |- |less |than |3 |months |- |usually |
resolve |spontaneously
, Cold |Antibody |AIHA |is |most |common |in |children |when |- |. |- |CORRECT |ANSWER✔✔-secondary |
to |infection |- |IgM |or |IgG |cold |reacting |antibodies |that |cross |react |with |the |ABO |antigens |on |
the |surface |of |RBCs |are |produced
What |organ |is |the |main |site |of |hemolysis |in |cold |antibody |AIHA? |- |CORRECT |ANSWER✔✔-Liver
Primary |cold |agglutinin |disease |is |: |- |CORRECT |ANSWER✔✔-chronic |or |transient |chronic
Most |common |infection |causing |secondary |cold |antibody |AIHA |is: |- |CORRECT |ANSWER✔✔-
Mycoplasma |pneumoniae |but |also |viral |(measles, |mumps, |flu, |EBV, |Adeno, |VZV, |CMV) |and |
bacterial |(syphilis |and |HIB)
T/F |Blood |products |should |be |washed |and |warmed |before |transfusion |for |persons |with |Cold |
Antibody |AIHA |- |CORRECT |ANSWER✔✔-True
6 |nursing |assessment |and |interventions |for |AIHA |- |CORRECT |ANSWER✔✔-1. |Read |labs |for |
decreased |hemoglobin |2. |Monitor |for |anemia |3. |Monitor |for |transfusion |complications |(rxn |
and |fluid |overload) |4. |Maximize |child's |physical |tolerance |5. |Teach |family |about |AIHA |6. |Teach |
aout |post |slenectomy |care |prn
Definition |of |Sickle |Cell |Disease |- |- |CORRECT |ANSWER✔✔-a |hemogloinopathy |-DNA |mutation |
for |hbg |production |- |normal |hemoglobin |or |hgb |A |is |absent, |but |hbg |S |is |present |(alone |or |in |
combination |with |another |form |of |abnormal |hemoglobin)
Who |first |described |SCD? |- |CORRECT |ANSWER✔✔-James |Herrick |(1904
SCD |pathophysiology |- |- |CORRECT |ANSWER✔✔-Hbg |two |pairs |of |polypeptide |chains |(alpha |
and |beta) |> |on |6th |position |on |the |Beta |chain |in |hbg |A |- |glutamic |acid |is |replaced |by |valine |> |
decreasing |pliability |and |changing |RBC |biconcave |nature |> |cells |then |sickle |due |to |
polymerization, |forming |microtubules |or |stiff |rods |within |the |cell |they |get |clogged |in |
vasculature> |leading |to |tissue |ischemia
