NR 507 MIDTERM EXAM GUIDE Q&A
Treatment of Type 4 Hypersensitivity Rash - Answer-A non-severe case of contact
dermatitis would be treated with a topical steroid
Why would we not use epinephrine or antihistamine?
Epi is for emergent type 1 anaphylactic reactions
Antihistamines act on the H1 receptors
Type 4 doesn't involve mast cell and H1 receptors
Abx are not appropriate due to no infection
Primary Immunodeficiency - Answer-Result of single gene defects
Something is lacking with the immune system itself
Example: B-lymphocyte deficiency- one of the most severe forms of a primary
immunodeficiency
Secondary Immunodeficiency - Answer-Complication of some other physiologic
condition of disease
***Malnutrition is one of the most common causes
Example: Pt with HIV gets pneumocystis carinii
Hematology - Answer-Anemia is the focus
involves RBCs
***Most of our iron stores come from recycling of iron from old RBCs
Iron Deficiency Lab Values - Answer-Serum Ferritin : D
RBC: I
Serum Iron: D
Total iron-binding capacity: I
Transferrin: D
Thalassemia Lab Values - Answer-Serum Ferritin: I
RBC: N/I
Serum Iron: N/I
Total iron-binding capacity: N
Transferrin: N/I
Anemia of Chronic Disease Lab Values - Answer-Serum Ferritin: N/I
RBC: N
Serum Iron: N/D
Total iron-binding capacity: Slightly D
Transferrin: N/ slightly D
Sideroblastic Anemia Lab Values - Answer-Serum Ferritin: N/I
RBC: I
Serum Iron: N/I
, Total iron-binding capacity: N
Transferrin: N/I
Mean Corpuscular Hemoglobin Concentration (MCHC) - Answer-Measure of the
average concentration inside a single RBC
Examples of Anemias with normal MCHC - Answer-Aplastic anemia
Post-hemorrhagic anemia
hemolytic anemia
Examples of Anemias with low MCHC - Answer-Iron deficiency anemia
Siderblastic anemia
Thalassemia
Examples of Anemias with high MCHC - Answer-Hereditary Spherocytosis- a result of
mild cellular dehydration, MVC is low bc of membrane loss and cell Dehydration
Liver disease
Hyperthyroidism
Sickle Cell
Iron Deficiency anemia - Answer-Is a microcytic/hypochromic anemia
Caused by disorders of hemoglobin synthesis, particularly iron deficiency
Ferritin is an important measure that reflects the body's total iron stores
The NP will order ferritin level to get an idea of body's iron stores
Low ferritin reflects anemia, but does not tell you what type
Major Lab Markers for Anemia - Answer-Increased RBC distribution width (RDW) is one
of the earliest lab markers in developing microcytic and macrocytic anemia
Folate Deficiency - Answer-Can cause megaloblastic anemia
Alcoholics can easily get folate deficiency
Vitamin B-12 Deficiency - Answer-Fatigue
Dyspnea
***Peripheral neuropathy in BLE
Risk factors: older adults, H-pylori infection, affects Vitamin B-12 absorption
Hemolytic Anemia - Answer-Who is at risk?
RBCs are destroyed
Mismatched blood types- destroy RBCs (cytotoxic type 2)
Autoimmune hemolytic anemia due to autoantibodies against erythrocytes that the
immune system perceives as an antigen and then attacks it
Allergic Reaction to drug causes drug induced hemolytic anemia
Acute Blood Loss - Answer-Trauma victims who are losing blood
Treatment of Type 4 Hypersensitivity Rash - Answer-A non-severe case of contact
dermatitis would be treated with a topical steroid
Why would we not use epinephrine or antihistamine?
Epi is for emergent type 1 anaphylactic reactions
Antihistamines act on the H1 receptors
Type 4 doesn't involve mast cell and H1 receptors
Abx are not appropriate due to no infection
Primary Immunodeficiency - Answer-Result of single gene defects
Something is lacking with the immune system itself
Example: B-lymphocyte deficiency- one of the most severe forms of a primary
immunodeficiency
Secondary Immunodeficiency - Answer-Complication of some other physiologic
condition of disease
***Malnutrition is one of the most common causes
Example: Pt with HIV gets pneumocystis carinii
Hematology - Answer-Anemia is the focus
involves RBCs
***Most of our iron stores come from recycling of iron from old RBCs
Iron Deficiency Lab Values - Answer-Serum Ferritin : D
RBC: I
Serum Iron: D
Total iron-binding capacity: I
Transferrin: D
Thalassemia Lab Values - Answer-Serum Ferritin: I
RBC: N/I
Serum Iron: N/I
Total iron-binding capacity: N
Transferrin: N/I
Anemia of Chronic Disease Lab Values - Answer-Serum Ferritin: N/I
RBC: N
Serum Iron: N/D
Total iron-binding capacity: Slightly D
Transferrin: N/ slightly D
Sideroblastic Anemia Lab Values - Answer-Serum Ferritin: N/I
RBC: I
Serum Iron: N/I
, Total iron-binding capacity: N
Transferrin: N/I
Mean Corpuscular Hemoglobin Concentration (MCHC) - Answer-Measure of the
average concentration inside a single RBC
Examples of Anemias with normal MCHC - Answer-Aplastic anemia
Post-hemorrhagic anemia
hemolytic anemia
Examples of Anemias with low MCHC - Answer-Iron deficiency anemia
Siderblastic anemia
Thalassemia
Examples of Anemias with high MCHC - Answer-Hereditary Spherocytosis- a result of
mild cellular dehydration, MVC is low bc of membrane loss and cell Dehydration
Liver disease
Hyperthyroidism
Sickle Cell
Iron Deficiency anemia - Answer-Is a microcytic/hypochromic anemia
Caused by disorders of hemoglobin synthesis, particularly iron deficiency
Ferritin is an important measure that reflects the body's total iron stores
The NP will order ferritin level to get an idea of body's iron stores
Low ferritin reflects anemia, but does not tell you what type
Major Lab Markers for Anemia - Answer-Increased RBC distribution width (RDW) is one
of the earliest lab markers in developing microcytic and macrocytic anemia
Folate Deficiency - Answer-Can cause megaloblastic anemia
Alcoholics can easily get folate deficiency
Vitamin B-12 Deficiency - Answer-Fatigue
Dyspnea
***Peripheral neuropathy in BLE
Risk factors: older adults, H-pylori infection, affects Vitamin B-12 absorption
Hemolytic Anemia - Answer-Who is at risk?
RBCs are destroyed
Mismatched blood types- destroy RBCs (cytotoxic type 2)
Autoimmune hemolytic anemia due to autoantibodies against erythrocytes that the
immune system perceives as an antigen and then attacks it
Allergic Reaction to drug causes drug induced hemolytic anemia
Acute Blood Loss - Answer-Trauma victims who are losing blood
