OCN ACTUAL EXAMS SCRIPT QUESTIONS AND
ANSWERS SET A+
✔✔DIC - ✔✔Accelerated activation of the coagulation cascade. Clots form in random
places leaving the body open to bleeding without protection
✔✔Platelet count, Fibrinogen level, D Dimer, FDP Titer - ✔✔Tests to diagnose DIC
✔✔How to treat DIC - ✔✔Treat underlying cause
✔✔What does FFP do? - ✔✔Contains all of the clotting factors except platelets. Used to
supplement red blood cells when whole blood is not available or to correct a bleeding
problem of unknown cause. It is also used to correct DIC.
✔✔Most common cancer associated with DIC? - ✔✔Leukemia, specifically APL
✔✔Signs/Symptoms of DIC - ✔✔bleeding from 3 unrelated sites
hypoxia
SOB
fever
mottled extremities
✔✔Causes of DIC - ✔✔Delivery (of baby)
Infection
Cancer
✔✔How does Heparin help DIC? - ✔✔Interferes with thrombin production. Maintain PTT
at 1-2 times the normal level (18-28 seconds)
✔✔S/S of septic shock - ✔✔Fever
Tachycardia
Hypotension
,✔✔Most common cause of sepsis - ✔✔Gram (-) bacteria
✔✔DIC - ✔✔Accelerated activation of the coagulation cascade. Clots form in random
places leaving the body open to bleeding without protection
✔✔Platelet count, Fibrinogen level, D Dimer, FDP Titer - ✔✔Tests to diagnose DIC
✔✔How to treat DIC - ✔✔Treat underlying cause
✔✔What does FFP do? - ✔✔Contains all of the clotting factors except platelets. Used to
supplement red blood cells when whole blood is not available or to correct a bleeding
problem of unknown cause. It is also used to correct DIC.
✔✔Most common cancer associated with DIC? - ✔✔Leukemia, specifically APL
✔✔Signs/Symptoms of DIC - ✔✔bleeding from 3 unrelated sites
hypoxia
SOB
fever
mottled extremities
✔✔Causes of DIC - ✔✔Delivery (of baby)
Infection
Cancer
✔✔How does Heparin help DIC? - ✔✔Interferes with thrombin production. Maintain PTT
at 1-2 times the normal level (18-28 seconds)
✔✔S/S of septic shock - ✔✔Fever
Tachycardia
Hypotension
✔✔Most common cause of sepsis - ✔✔Gram (-) bacteria
✔✔Granulocytopenia - ✔✔failure of the bone marrow to make enough
white blood cells (neutrophils)
✔✔Highest risk factor for sepsis - ✔✔Prolonged granulocytopenia (less than 500/mm3)
✔✔What cancer commonly produces TLS? - ✔✔High grade lymphoma
✔✔Define Tumor Lysis Syndrome (TLS) - ✔✔metabolic imbalance that occurs with
rapid tumor kill
, ✔✔Lab results indicating DIC - ✔✔Increased D Dimer
Increased FDP
Decreased fibrinogen
Decreased platelets
✔✔Lab results indicitave of TLS - ✔✔Hyperkalemia (>5.0)
Hyperphosphatemia (>4.5)
Hyperuricemia (>8.0)
Hypocalcemia (>10.5)
Increased BUN (>20)
Increased creatinine (>1.2)
Increased LDH (>333)
✔✔Lab tests done to monitor TLS - ✔✔K
Phos
Uric Acid
Calcium
LDH
Renal function (BUN, Creatinine)
✔✔How to treat severe hyperkalemia - ✔✔hypertonic glucose and insulin. Shifts
extracellular K back into intracellular stores
✔✔How does Allopurinol work? - ✔✔decreases uric acid production and decreases uric
acid deposits in kidney
✔✔How does Rasburicase work? - ✔✔catalyses the conversion of uric acid to allantoin
✔✔S/S of hyperkalemia - ✔✔muscle weakness
muscle cramps
bradycardia
tall T waves
✔✔S/S of hypokalemia - ✔✔decreased reflexes
irregular pulse
fatigue
N/V
flat t wave
V fib if severe
✔✔Calcium normal range - ✔✔8.5-10.5 meq/L
✔✔S/S of hypercalcemia - ✔✔fatigue
lethargy
ANSWERS SET A+
✔✔DIC - ✔✔Accelerated activation of the coagulation cascade. Clots form in random
places leaving the body open to bleeding without protection
✔✔Platelet count, Fibrinogen level, D Dimer, FDP Titer - ✔✔Tests to diagnose DIC
✔✔How to treat DIC - ✔✔Treat underlying cause
✔✔What does FFP do? - ✔✔Contains all of the clotting factors except platelets. Used to
supplement red blood cells when whole blood is not available or to correct a bleeding
problem of unknown cause. It is also used to correct DIC.
✔✔Most common cancer associated with DIC? - ✔✔Leukemia, specifically APL
✔✔Signs/Symptoms of DIC - ✔✔bleeding from 3 unrelated sites
hypoxia
SOB
fever
mottled extremities
✔✔Causes of DIC - ✔✔Delivery (of baby)
Infection
Cancer
✔✔How does Heparin help DIC? - ✔✔Interferes with thrombin production. Maintain PTT
at 1-2 times the normal level (18-28 seconds)
✔✔S/S of septic shock - ✔✔Fever
Tachycardia
Hypotension
,✔✔Most common cause of sepsis - ✔✔Gram (-) bacteria
✔✔DIC - ✔✔Accelerated activation of the coagulation cascade. Clots form in random
places leaving the body open to bleeding without protection
✔✔Platelet count, Fibrinogen level, D Dimer, FDP Titer - ✔✔Tests to diagnose DIC
✔✔How to treat DIC - ✔✔Treat underlying cause
✔✔What does FFP do? - ✔✔Contains all of the clotting factors except platelets. Used to
supplement red blood cells when whole blood is not available or to correct a bleeding
problem of unknown cause. It is also used to correct DIC.
✔✔Most common cancer associated with DIC? - ✔✔Leukemia, specifically APL
✔✔Signs/Symptoms of DIC - ✔✔bleeding from 3 unrelated sites
hypoxia
SOB
fever
mottled extremities
✔✔Causes of DIC - ✔✔Delivery (of baby)
Infection
Cancer
✔✔How does Heparin help DIC? - ✔✔Interferes with thrombin production. Maintain PTT
at 1-2 times the normal level (18-28 seconds)
✔✔S/S of septic shock - ✔✔Fever
Tachycardia
Hypotension
✔✔Most common cause of sepsis - ✔✔Gram (-) bacteria
✔✔Granulocytopenia - ✔✔failure of the bone marrow to make enough
white blood cells (neutrophils)
✔✔Highest risk factor for sepsis - ✔✔Prolonged granulocytopenia (less than 500/mm3)
✔✔What cancer commonly produces TLS? - ✔✔High grade lymphoma
✔✔Define Tumor Lysis Syndrome (TLS) - ✔✔metabolic imbalance that occurs with
rapid tumor kill
, ✔✔Lab results indicating DIC - ✔✔Increased D Dimer
Increased FDP
Decreased fibrinogen
Decreased platelets
✔✔Lab results indicitave of TLS - ✔✔Hyperkalemia (>5.0)
Hyperphosphatemia (>4.5)
Hyperuricemia (>8.0)
Hypocalcemia (>10.5)
Increased BUN (>20)
Increased creatinine (>1.2)
Increased LDH (>333)
✔✔Lab tests done to monitor TLS - ✔✔K
Phos
Uric Acid
Calcium
LDH
Renal function (BUN, Creatinine)
✔✔How to treat severe hyperkalemia - ✔✔hypertonic glucose and insulin. Shifts
extracellular K back into intracellular stores
✔✔How does Allopurinol work? - ✔✔decreases uric acid production and decreases uric
acid deposits in kidney
✔✔How does Rasburicase work? - ✔✔catalyses the conversion of uric acid to allantoin
✔✔S/S of hyperkalemia - ✔✔muscle weakness
muscle cramps
bradycardia
tall T waves
✔✔S/S of hypokalemia - ✔✔decreased reflexes
irregular pulse
fatigue
N/V
flat t wave
V fib if severe
✔✔Calcium normal range - ✔✔8.5-10.5 meq/L
✔✔S/S of hypercalcemia - ✔✔fatigue
lethargy
