Hematology (APEA) OBJECTIVE ASSESMENT EXAM LATEST WAVEA+GRADEDUPDATED SYLLABUS 100% GUARANTEED PASS

Hematology (APEA) OBJECTIVE ASSESMENT EXAM LATEST WAVEA+GRADEDUPDATED SYLLABUS 100% GUARANTEED PASS Anemia is defined as reduction in one or more RBC measurements: - ANSWER RBC count Hgb Hct Lab value to look at size of RBC - ANSWER MCV Lab value to look at color of RBC - ANSWER MCH Lab value to look at degree of variation of RBC size (15% is normal) - ANSWER RDW Why would the bone marrow make small RBC? - ANSWER Not enough iron Iron lab values - ANSWER Serum iron Serum ferritin TIBC Serum iron - ANSWER Measure of iron in circulation Serum ferritin - ANSWER Measure of iron in storage TIBC (total iron-binding capacity) - ANSWER Reciprocal relationship to iron count Peripheral smear - ANSWER Visual description of RBC Should always be considered when a patient presents with anemia Reticulocytes - ANSWER Immature RBC Usually about 1% Indicates ability of bone marrow to produce RBC Microcytic anemia examples - ANSWER Iron deficiency anemia Thalassemia Iron deficiency anemia: what type & clinical presentation - ANSWER Microcytic hypochromic Young-adults: fatigue, weakness, headache, exercise intolerance Older-adults: worsening symptoms of another disease How to tell the difference between IDA and thalasemmia? - ANSWER Serum iron and ferritin will be low and TIBC will be high in IDA How much elemental iron does a person need daily for IDA and for how long? - ANSWER 150-200 mg daily for 4-6 months What is the most well-tolerated iron source? - ANSWER Ferrous sulfate What normal lab values indicates that iron supplementation may be stopped? - ANSWER Serum ferritin level What kind of anemia is anemia of chronic disease and why? - ANSWER Normocytic, normochromic RBC life is shortened Best way to treat anemia of chronic disease? - ANSWER Better control of underlying chronic disease Macrocytic anemia examples - ANSWER B12 deficiency Folate deficiency Symptoms and causes of B12 and folate anemias - ANSWER Often asymptomatic May present with neuro symptoms Often older adults, malnourished, alcohol abuse, bariatric surgery patients Multiple melanoma: What is it? Symptoms Labs - ANSWER Affects plasma cells Fatigue, weakness, bone pain Proteinuria, hypercalcemia, normocytic anemia Hemophilia A: What is it? - ANSWER Factor VIII deficiency aPTT prolonged Gold standard test to diagnosis hemoglobinopathies: - ANSWER Hemoglobin electropheresis Pernicious anemia: What is it? Treatment - ANSWER Autoimmune disorder stops intrinsic factor production (necessary for vit B 12 absorption) Tx: B12 injection every week x 4 wks, injection once a month for life Aplastic anemia: What is it? Gold standard test - ANSWER Destruction of cells in bone marrow results in pancytopenia Bone marrow biopsy Hemochromatosis: What is it? Labs Treatment - ANSWER Total body iron overload High ALT/AST, ferritin Phlebotomy Why would the bone marrow make small RBC? - ANSWER Not enough iron Iron lab values - ANSWER Serum iron Serum ferritin TIBC