hematology havoc

leuk i am your father

100

what is the main patho change in leukemia

excessive growth of immature leukocytes 

200

name the main early sign + 2 later signs in leukemia

early: recurrent infections 

late: increase in bleeding, weakness/fatigue 

300

what is the gold standard diagnostic

bone marrow biopsy 

will see leukemic blast phase cells

400

name 5 infection prevention nursing interventions 

assess for infections

meds: antibacterial, antiviral, antifungal

hand-washing

hepa air filters

skin care - chlorhexidine 

pulm hygiene 

reverse precautions 

500

explain the different levels of platelets/bleeding precautions 

<50,000 high risk for bleeding - fall precautions, no invasive interventions, soft toothbrush 

<20,000 risk for spontaneous bleed - neuro checks, need to intervene and give platelets 

node to self

100

what is the main diagnostic for HL

Reed-Sternberg cells on biopsy

200

explain the difference in growth patterns between HL and NHL

HL - predictable spread from one group of lymph node to the next 

NHL - less predictable pattern, tumors can spread to another organ 

300

explain the difference in treatment options for HL depending on the stage of the cancer

stage I + II - external radiation 

stage III + IV - radiation and chemo

400

name 5 things to take into consideration for a patient undergoing radiation and/or chemo

N/V

pancytopenia, infection, anemia, bleeding

skin care

secondary cancer 

sterility 

500

what interventions (pharm) are used for NHL?

chemotherapy combination 

monoclonal antibodies 

radiation therapy 

plasma cell problems

100

what is the basic patho of MM

cancer of mature plasma B-cells leads to excessive monoclonal antibodies

200

what 2 organ systems can be impacted by MM 

renal and skeletal 

300

why can MM lead to bone destruction and renal dysfunction 

increased cytokines cause bone destruction, leading to hypercalcemia and fractures

renal dysfunction from trying to filter out all excess calcium 

400

what must be ruled out before diagnosing MM, and what 2 diagnostics will be seen in MM?

rule out MGUS (monoclonal gammopathy of undetermined significance) 

will see monoclonal paraprotein in the blood, and Bence Jones protein in the urine 

500

name 5 treatment interventions 

bisphosphonates to prevent fractures

bone pain management 

fall precautions 

monitor for renal failure 

immunomodulating drugs 

steroids

stem cell transplant 

chemo

all counts down

100

what are some causes of pancytopenia 

leukemia

chemo 

myeloma 

aplastic anemia

200

when is a platelet transfusion required in thrombocytopenia? (what count)

<10,000

300

when are neutropenic precautions implemented? (what count) 

<500-1000

400

name 6 implementations when someone is on neutropenic precautions

hand hygiene, avoid crowds/sick people, wear a mask, avoid raw food, use clean utensils, avoid gardening, monitor for signs of infection, get vaccines, no rectal temps, no flowers in the room 

500

for a patient with pancytopenia, when should an opened drink be discarded? 

after an hour 

clotting gone wrong

100

normal platelet production but formation of an antiplatelet antibody occurs, what is this? 

autoimmune thrombocytopenic purpura (ITP) 

200

what are 3 symptoms of ITP

bruising

petechiae 

stroke, IC bleeding 

300

abnormal clumping of platelets in capillaries leaves no platelets left for times when clotting is needed, what is this 

thrombotic thrombocytopenic purpura (TTP)

400

this type of thrombocytopenia is fatal if untreated, leads to ischemic events, and can be treated with plasmaphoresis and immune suppressive therapy 

TTP

500

name 3 risk factors for HIT, how many days it can occur after exposure, and treatment 

risks: heparin > 1 week, F, post-surgical therapy, unfractionated heparin 

up to 100 days after exposure 

treated w cessation of heparin and admin of direct thrombin inhibitor: argatroban