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Hematology/Oncology/Immunology- ACNPC-AG boards with verified answers Four categories of leukemia CORRECT ANSWER -AML -CML -ALL -CLL" "Acute management for sickle cell crisis CORRECT ANSWER -fluids for hydration -analgesics for pain -oxygen for hypoxemia" "Anemia of chronic disease CORRECT ANSWER Chronic normocytic normochromic anemia associated with chronic inflammation, infection, renal failure and malignancy -low hgb/hct -norm MCV -norm MCHC -serum iron & TIBC low" "Angioedema is cause by CORRECT ANSWER
- Allergic reaction to food Environment or commonly prescribed medications" "Circulating immature white blood cells and pancytopenia is the hallmark sign for?
CORRECT ANSWER
Acute lymphocytic leukemia (ALL)" "Differential dx for high MCV CORRECT ANSWER macrocytic anemia -B12 of folate deficiency -alcoholism -live failure -drug effects" "Differential dx for low MCV CORRECT ANSWER Microcytic anemia -iron deficiency -thalacemia" "differential dx for normocytic anemia CORRECT ANSWER -anemia of chronic disease -sickle cell disease -renal failure -blood loss -hemolysis" "Disseminated Intravascular Coagulation (DIC) CORRECT ANSWER Complex, acquired disorder in which clotting and hemorrhage simultaneously occur" "Folic acid deficiency CORRECT ANSWER macrocytic, normochromic anemia d/t folic acid deficiency cause: inadequate intake/malabsorption of folic acid (which is needed for RBC production)"
"immune mediated reactions type 1 CORRECT ANSWER Type one reactions are mediated by IgE antibodies
- anaphylaxis, angioedema, urticaria" "Immune mediated reactions type II CORRECT ANSWER cytotoxic reaction mediated by igG or igM antibodies -this is an autoimmune response" "in a sickle cell crisis, patients may experience what symptoms CORRECT ANSWER -sudden onset of severe pain in extremities, back, chest and abd -aching joint pain -weakness -dyspnea." "in acute periodic sickle cell exacerbation, what happens to the RBC? CORRECT ANSWER the RBC become sickle-shaped and cause vessle obstruction -cellular hypoxia results in acidosis and tissue ischemia -high amounts of pain result from this" "iron deficiency anemia CORRECT ANSWER a microcytic-hypochromic cause: blood loss, inadequate iron intake, or impaired absorption of iron" "Key identifier for HIT CORRECT ANSWER First sign (90%) drop in platelets by 50%, +/- thrombocytopenia -thrombosis (50%), venous> arterial, first sign noticed." "lab and dx findings in DIC CORRECT ANSWER -plt <150,000 (thrombocytopenia) -PT >19 sec (prolonged)
-PTT >42 sec (prolonged) -elevated d-dimer" "management for tumor lysis syndrome CORRECT ANSWER -ICU
- Aggressive ivy hydration, 2 to 3L/day, -maintaining a urine output of 100 to 200 mL/hr
- Allopurinol 100 milligrams PO q8 hours for 3-7 days
- Loop diuretics or Manitol to promote diuresis can be considered
- Hemodialysis for severe electrolyte disturbances and or inability to self-diuresis" "management of DIC includes: CORRECT ANSWER -Tx underlying cause & control bleeding! -platelet transfusion (for thrombocytopenia) -FFP fresh frozen plasma (to replace clotting factors)" "MCV in macrocytic anemia CORRECT ANSWER greater than 100" "MCV in microcytic anemia CORRECT ANSWER less than 80" "MCV in normocytic anemia CORRECT ANSWER 80-100" "myasthenia gravis (MG) CORRECT ANSWER a chronic autoimmune disorder in which antibodies destroy the communication between nerves and muscle, resulting in weakness of the skeletal muscles" "normal hct CORRECT ANSWER Men-42%-52% Women-37%-47% -Increases with Hypovolemia and dehydration -decreases with hemorrhage"
"S/S of DIC (disseminated intravascular coagulation) CORRECT ANSWER -ecchymosis -oozing from sites of trauma (venipuncture sites, catheters, drains or mucosa) -petechiae" "S/S of folic acid deficiency CORRECT ANSWER -Fatigue -Dyspnea on exertion -Pallor -HA -Tachycardia -Anorexia -Glossitis--big beefy red tongue -no neuro signs are seen- this sis what differentiates B!@ from folic acid deficiency!" "S/S of iron deficiency anemia CORRECT ANSWER Pica-unusual food cravings (ice, clay, etc.) dyspnea & mild fatigue w/ exercise h/a, palpitations, weakness, tachycardia, postural hypotension, pallor" "S/S of Pernicious Anemia: B12 deficiency CORRECT ANSWER -weakness -glossitis-red beefy tongue -palpitations
-dizziness -anorexia -paresthesia -loss of vibratory sense -loss of fine motor control -positive Romberg -positive Babinski" "S/S of tumor lysis syndrome (TLS) CORRECT ANSWER Nausea with or without vomiting loss of appetite fatigue dark urine reduced urine output flank pain numbness seizures hallucinations muscle cramps or spasms heart palpitations oliguria or anuria can lead to volume overload, hypertension, and pulmonary edema high BUN can be severe enough to result in pericarditis" "Sickle Cell Anemia (SCA) CORRECT ANSWER chronic hemolytic anemia that is genetically transmitted characterized by sickle cell shaped RBC" "Superior vena cava syndrome CORRECT ANSWER Tumor can compress SVC and cause swelling of face, JVD, and visible chest veins
"What are the good control identifiers for HIV/AIDS CORRECT ANSWER CD4 count: high as possible (>200) Viral load: low as possible (undetectable is best)" "What are the signs and symptoms of Hodgkin's lymphoma CORRECT ANSWER B symptoms (fever, night sweats, unintended weight loss, lymphadenopathy
- Asymptomatic lymphatanopathy or a mass on chest radiograph" "what factors precipitate the sickling effect? CORRECT ANSWER -hypoxia -infections -high altitudes -dehydration -physical or emotional stress -surgery -blood loss -acidosis" "What is the treatment for myasthenia gravis CORRECT ANSWER thymectomy, IVIG, pyridostigmine, steroids, immunosuppressants" "what medications can cause angioedema CORRECT ANSWER ACE inhibitors NSAIDS" "
