NURP 532 HEM/ONC (week 10) QUESTIONS WITH
COMPLETE SOLUTIONS
acute leukemia Correct Answers involves blast-type cells and
primarily affects children
Anemia of chronic disease Correct Answers Microcytic anemia
with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and
normal or ↑ ferritin.
most common in elderly
aplastic anemia Correct Answers failure of blood cell
production in the bone marrow stem cell
causes of thrombocytopenia Correct Answers -drug induced
-immune (ITP)
-viruses=HIV,Hep C, Varicella/Zoster, Epstein Barr,
Cytomegalovirus)
-Hypersplenism (often related to chronic liver disease/portal
hypertension)
-Blood cancers
-EtOH toxicity/Vit B12 &folate deficiencies
-Autoimmune disease (lupus)
Drug induced immune thrombocytopenia Correct Answers Can
be any med taken over the past month
Ask about quinine containing products
Platelets <20K
,Onset 5-10 days after starting causative agent
Often causes mucocutaneous bleeding
Tx: possible transfusion, stop causative agent. Should resolve
within 1 week of stopping med
Erythropoietin Correct Answers a glycoprotein secreted by the
kidneys that stimulates the production of red blood cells.
Induces erythroid precursor cells to differentiate, which
increases new RBC production
etiologies of anemia Correct Answers RBC production
disorders (IDA, anemia of CKD, vitB12 deficiency, folate
deficiency, aplastic anemia, ACD)
RBC destruction disorders (sickle cell anemia, RBC membrane
defects such as hereditary spherocytosis and elliptocytosis,
G6PD deficiency, autoimmune hemolytic anemia)
blood loss acute or chronic (trauma,hemorrhage)
Etiologies of iron deficiency anemia (IDA) Correct Answers
Issue is with RBC PRODUCTION
1. Continual blood loss (menorrhagia, ulcers, ulcerative colitis,
GI bleeds)
2. Increased need during pregnancy
3. Insufficient dietary intake (most common in 6 months to 2
years of age)
, 4.malignancy
5.IBD or malabsorption
most common in children and pregnant women!
febrile neutropenia Correct Answers a one-time fever of 101.3
or higher is going to be diagnostic. Or sustained temperature of
more than 100.4 in conjunction with an ANC of less than 500.
get blood cultures and to start empiric antibiotics. stay on ABX
until afebrile 48-72 hours and ANC >500 for 72 hours
Folate deficiency Correct Answers Causes=
-Dietary
-Alcoholism
-Malabsorption
-Increased requirements in pregnancy
Rarely produces symptoms
Other differentials to consider: myelodysplastic syndrome, liver
disease, hypothyroidism, drug reaction, hereditary disorder,
hemolysis
high reticulocyte count indicates... Correct Answers indicates
that the bone marrow is working hard to keep up with RBC loss.
indicates hemolytic anemia or acute blood loss anemia
Hodgkin Lymphoma Correct Answers -Reed-Steinberg cells
-Adenopathy in neck, usually involves mediastinum
COMPLETE SOLUTIONS
acute leukemia Correct Answers involves blast-type cells and
primarily affects children
Anemia of chronic disease Correct Answers Microcytic anemia
with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and
normal or ↑ ferritin.
most common in elderly
aplastic anemia Correct Answers failure of blood cell
production in the bone marrow stem cell
causes of thrombocytopenia Correct Answers -drug induced
-immune (ITP)
-viruses=HIV,Hep C, Varicella/Zoster, Epstein Barr,
Cytomegalovirus)
-Hypersplenism (often related to chronic liver disease/portal
hypertension)
-Blood cancers
-EtOH toxicity/Vit B12 &folate deficiencies
-Autoimmune disease (lupus)
Drug induced immune thrombocytopenia Correct Answers Can
be any med taken over the past month
Ask about quinine containing products
Platelets <20K
,Onset 5-10 days after starting causative agent
Often causes mucocutaneous bleeding
Tx: possible transfusion, stop causative agent. Should resolve
within 1 week of stopping med
Erythropoietin Correct Answers a glycoprotein secreted by the
kidneys that stimulates the production of red blood cells.
Induces erythroid precursor cells to differentiate, which
increases new RBC production
etiologies of anemia Correct Answers RBC production
disorders (IDA, anemia of CKD, vitB12 deficiency, folate
deficiency, aplastic anemia, ACD)
RBC destruction disorders (sickle cell anemia, RBC membrane
defects such as hereditary spherocytosis and elliptocytosis,
G6PD deficiency, autoimmune hemolytic anemia)
blood loss acute or chronic (trauma,hemorrhage)
Etiologies of iron deficiency anemia (IDA) Correct Answers
Issue is with RBC PRODUCTION
1. Continual blood loss (menorrhagia, ulcers, ulcerative colitis,
GI bleeds)
2. Increased need during pregnancy
3. Insufficient dietary intake (most common in 6 months to 2
years of age)
, 4.malignancy
5.IBD or malabsorption
most common in children and pregnant women!
febrile neutropenia Correct Answers a one-time fever of 101.3
or higher is going to be diagnostic. Or sustained temperature of
more than 100.4 in conjunction with an ANC of less than 500.
get blood cultures and to start empiric antibiotics. stay on ABX
until afebrile 48-72 hours and ANC >500 for 72 hours
Folate deficiency Correct Answers Causes=
-Dietary
-Alcoholism
-Malabsorption
-Increased requirements in pregnancy
Rarely produces symptoms
Other differentials to consider: myelodysplastic syndrome, liver
disease, hypothyroidism, drug reaction, hereditary disorder,
hemolysis
high reticulocyte count indicates... Correct Answers indicates
that the bone marrow is working hard to keep up with RBC loss.
indicates hemolytic anemia or acute blood loss anemia
Hodgkin Lymphoma Correct Answers -Reed-Steinberg cells
-Adenopathy in neck, usually involves mediastinum
