Family Nurse Practitioner (FNP) > Hematology > Flashcards

Hematology Flashcards

Recognize, evaluate, and treat common hematologic disorders including anemia, clotting disorders, and malignancies. (53 cards)

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1
Q

What are the characteristics used to classify anemia?

A
  • Size (MCV)
  • Color (MCH)
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2
Q

Fill in the blank:

Anemia characterized by small red blood cells is termed ______.

A

Microcytic anemia

Microcytic anemia is defined by small red blood cells with low hemoglobin concentration.

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3
Q

What does hypochromic anemia indicate about red blood cells?

A

Pale in color

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4
Q

What is the most common type of anemia?

A

Iron deficiency anemia

(IDA)

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5
Q

List the three major causes for iron deficiency anemia (IDA).

A
  • Blood loss (generally GI tract, GYN)
  • Reduced absorption (e.g., celiac disease, bariatric surgery)
  • Decreased dietary intake
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6
Q

What are common symptoms of iron deficiency anemia?

A
  • Fatigue
  • Pica
  • Restless legs syndrome
  • Headache
  • Exercise intolerance
  • Exertional dyspnea
  • Weakness
  • Pallor
  • Dry skin
  • Alopecia
  • Koilonychia (spoon-shaped nails)
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7
Q

What laboratory findings are indicative of iron deficiency anemia?

A
  • Microcytic and hypochromic anemia
  • Low RBC
  • Low reticulocytes
  • Increased platelets
  • Low ferritin (<30 ng/mL) or transferrin saturation (TSAT) <20%
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8
Q

True or False:

A normal ferritin level rules out iron deficiency anemia.

A

False

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9
Q

What is the goal ferritin level when treating iron deficiency anemia?

A

Typically, a minimum of 50 ng/mL

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10
Q

What are the indications for IV iron supplementation?

A
  • Unable to tolerate PO iron
  • Malabsorption
  • Ongoing blood loss
  • Second and third trimesters of pregnancy
  • Rapid correction needed
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11
Q

Fill in the blank:

The most common side effects of oral iron supplementation are ______ symptoms.

A

GI

GI side effects include constipation, nausea, vomiting, diarrhea and gas.

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12
Q

What is the typical duration for hemoglobin normalization with iron supplementation?

A

6 to 8 weeks

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13
Q

What are the risk factors for vitamin B12 deficiency?

A
  • Vegan diet
  • Strict vegetarian diet
  • Breastfed infant from a vitamin B12 deficient mother
  • Post bariatric surgery
  • Crohn’s disease
  • Celiac disease
  • Pancreatic insufficiency
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14
Q

Which medications can impair vitamin B12 absorption?

A
  • Metformin
  • Neomycin
  • Nitrous oxide
  • PPIs
  • H2 blockers
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15
Q

What are the risk factors for folate deficiency?

A
  • Increased requirements due to pregnancy/lactation
  • Decreased intake (substance use disorders, malnutrition, restrictive dieting)
  • Chronic excessive alcohol use
  • Residing where cereal/grains are not supplemented with folic acid
  • Goat’s milk as main source of food in infants/toddlers
  • Hemodialysis
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16
Q

What are the common neurological symptoms associated with vitamin B12 deficiency?

A
  • Symmetric paresthesias
  • Numbness
  • Gait problems

Neurological symptoms are a late finding.

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17
Q

What is the typical treatment for vitamin B12 deficiency?

A

Replacement B12 therapy, available as intramuscular or deep subcutaneous injection, oral, or sublingual

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18
Q

Fill in the blank:

Folate deficiency is generally corrected with oral folic acid at a dose of ______ daily.

A

1mg to 5mg

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19
Q

What is the typical dosing schedule for intramuscular vitamin B12 replacement in adults?

A

1000mcg once a week for 3 to 4 weeks, then once a month or every other month

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20
Q

True or False:

Parenteral replacement of B12 or folate is required if anemia is severe or neurological symptoms are present.

A

True

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21
Q

What characterizes anemia?

A
  • Decrease in red blood cells (RBC), hemoglobin (Hgb), or hematocrit (Hct)
  • Characterized by size (MCV) and color (MCH)
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22
Q

Fill in the blank:

Microcytic anemia is characterized by RBCs that are ______ in size.

Study These Flashcards
A

small

(<80 femtoliters)

23
Q

What is the normal range for mean corpuscular volume (MCV) in normocytic anemia?

Study These Flashcards
A

80-100 femtoliters

Lab values can vary based on the lab.

24
Q

What does serum ferritin measure?

Study These Flashcards
A

How much iron is in storage

25
What does a **peripheral smear** provide?
A visual description of RBCs
26
What is **pancytopenia**?
Combination of anemia, thrombocytopenia, and neutropenia
27
What is the **normal variation** in red cell distribution width (RDW)?
<15% variation in RBC size
28
What **type of anemia** is characterized by microcytic and hypochromic RBCs?
Iron deficiency anemia
29
# Fill in the blank: Low ferritin (<30 ng/mL) is confirmatory for \_\_\_\_\_\_ \_\_\_\_\_\_ \_\_\_\_\_\_.
iron deficiency anemia
30
What **dietary changes** are recommended for treating iron deficiency anemia?
* Increase red meat * Organ meat * Peas * Whole grains * Dark leafy greens
31
What is **thalassemia**?
Inherited, microcytic and hypochromic anemia
32
What is the diagnostic test for **thalassemia**?
Hgb electrophoresis/genetic testing | (globin gene testing)
33
What is a **major difference** in lab findings between thalassemia and iron deficiency anemia?
Normal serum iron, ferritin, RDW, and TIBC in thalassemia
34
What is the **recommended treatment approach** for thalassemia?
* Refer to hematology * Do NOT supplement with iron * Consider reproductive counseling
35
What characterizes anemia of **chronic disease**?
Normocytic and normochromic anemia
36
What is a **common presentation** for anemia of chronic disease?
Suspect in a patient with acute or chronic infectious process, inflammatory disorder, or malignant condition, who has normocytic, normochromic anemia
37
What are **common underlying disorders** associated with anemia of chronic disease?
* Rheumatoid arthritis * Inflammatory bowel disease * Congestive heart failure * COPD * Advanced kidney disease * Infection (e.g., HIV, endocarditis)
38
What is the typical **presentation** of vitamin B12 and folate deficiencies?
* Macrocytic anemia * Fatigue * Jaundice (if both B12 and folate deficiencies are present) * Neurological symptoms (more common in vitamin B12 deficiency)
39
What characterizes **sickle cell anemia**?
Inherited disorder, characterized by the presence of hemoglobin S (Hb S)
40
What are the **diagnostic tests** for sickle cell anemia?
* High performance liquid chromatography (HPLC) * Isoelectric focusing (IEF) * Gel electrophoresis * Polymerase chain reaction (PCR) * DNA sequencing
41
Patients with sickle cell anemia should be co-managed with what speciality?
Hematology
42
# True or False: Patients with sickle cell anemia should remain current with age appropriate recommended vaccinations.
True
43
Patients with sickle cell anemia should be started on prophylactic penicillin by what age?
3 months ## Footnote Prophylactic penicillin is often continued until 5 years of age.
44
# Fill in the blank: Hydroxyurea reduces cell sickling by increasing \_\_\_\_\_\_.
Fetal hemoglobin | (HbF) ## Footnote Hydroxyurea increases production of fetal hemoglobin, which inhibits sickling of red blood cells and reduces vaso-occlusive episodes in patients with sickle cell disease.
45
What are the **normal ranges** for white blood cell count (WBC)?
3.8 to 10.4 | (×10^3/microL) ## Footnote Values can vary based on lab.
46
What does a **high red cell distribution width** (RDW) indicate?
Variation in red blood cell size; common in mixed anemia or early iron deficiency.
47
What are the **normal platelet count ranges** for men?
152 to 324 | (×10^3/microL) ## Footnote Lab values can vary based on the lab.
48
# True or False: A high mean corpuscular volume (MCV) is often due to iron deficiency.
False
49
What does a **low reticulocyte count** indicate?
The bone marrow is not producing enough new RBCs.
50
What are the **normal ranges for hemoglobin** (Hgb) in women?
11.9 to 14.8 g/dL ## Footnote Lab values can vary based on the lab.
51
What is the **normal platelet count range** for men?
152 to 324 (×10^3/microL) ## Footnote Lab values can vary based on the lab.
52
What is **thrombocytosis**?
High platelet count
53
What **conditions** can cause thrombocytopenia?
* Bone marrow suppression * Autoimmune destruction (ITP) * Blood loss
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