Hematology Quiz on Blood Functions

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Questions and Answers

Which of the following is NOT a function of the hematologic system?

Protect against invasion of pathogens

Circulate oxygen

Produce hormones (correct)

Maintain fluid and acid-base balance

What is the primary site of hematopoiesis?

Liver

Lymph nodes

Bone marrow (correct)

Spleen

Which of the following blood cell types is responsible for fighting infection?

White blood cells (correct)

Red blood cells

Platelets

Plasma

What is the medical term for a low platelet count?

Thrombocytopenia (B) Signup and view all the answers

Which of the following organs plays a role in clotting factor production?

Liver (D) Signup and view all the answers

What are some of the possible causes of sclera yellowing, other than hyperbilirubinemia?

Carotenemia (D) Signup and view all the answers

Which of the following is NOT a stage of hemostasis?

Blood vessel repair (A) Signup and view all the answers

What are some elements involved in platelet plug formation during hemostasis?

Platelets, von Willebrand factor (vWF), fibrin (A) Signup and view all the answers

Which of the following lab values is typically used to monitor the effectiveness of heparin?

PTT (B) Signup and view all the answers

What is the most common site for a bone marrow aspiration?

Posterior superior iliac crest (C) Signup and view all the answers

What is the main cancer type associated with the overabundance of abnormal plasma cells?

Multiple Myeloma (B) Signup and view all the answers

Which of the following is a common clinical feature of Multiple Myeloma?

Hypercalcemia (B) Signup and view all the answers

What condition often results from the crowding of abnormal plasma cells in bone marrow?

Pancytopenia (D) Signup and view all the answers

What is one potential complication associated with hypercalcemia in patients with Multiple Myeloma?

Acute Kidney Injury (AKI) (B) Signup and view all the answers

Which symptoms are considered common in both Hodgkin Lymphoma (HL) and Non-Hodgkin Lymphoma (NHL)?

Dyspnea and recurrent infections (C) Signup and view all the answers

What is a primary risk associated with Heparin Induced Thrombocytopenia (HIT)?

Bleeding is slow to stop from minor cuts (B) Signup and view all the answers

Which treatment is specifically contraindicated for a patient with hemophilia?

NSAIDs like aspirin for inflammation (B) Signup and view all the answers

In the treatment of hemarthrosis for hemophilia, which intervention is recommended?

Rest, Ice, Compression, and Elevation (RICE) (C) Signup and view all the answers

What distinguishes Hodgkin's lymphoma from Non-Hodgkin's lymphoma?

Presence of Reed-Sternberg cells in Hodgkin's lymphoma (C) Signup and view all the answers

Which of the following is a common symptom of both Hodgkin's and Non-Hodgkin's lymphoma?

Swollen, painless lymph nodes (D) Signup and view all the answers

What is a common cause of microcytic anemia?

Iron deficiency due to GI bleeding (D) Signup and view all the answers

Which of the following describes the primary focus of nursing care for patients with hematologic problems?

Preventing hypoxia, infection, and bleeding (D) Signup and view all the answers

What is the result of pancytopenia?

Too few of all types of blood cells (D) Signup and view all the answers

What should be monitored when administering iron to pediatric patients?

Potential for iron overdose (D) Signup and view all the answers

What is one potential complication of folic acid treatment in the context of anemia?

It may mask symptoms of pernicious anemia (D) Signup and view all the answers

What is the cause of joint pain in sickle cell disease?

Sickling and clumping of cells in small vessels (B) Signup and view all the answers

Which treatment should be administered for pernicious anemia?

Subcutaneous or intramuscular Vitamin B12 (D) Signup and view all the answers

What is a common consequence of leukopenia?

Frequent infections (A) Signup and view all the answers

Which drug is primarily used to stimulate the production of red blood cells?

Epoetin alpha (A) Signup and view all the answers

What is a potential serious adverse effect of administering Epogen to a patient with a hemoglobin level of 12 or higher?

Acute myocardial infarction or cerebrovascular accident (D) Signup and view all the answers

How do colony-stimulating factors primarily benefit chemotherapy patients?

Allow higher doses of chemotherapy (A) Signup and view all the answers

Which condition should lead to the avoidance of administering filgrastim?

Active infection (C) Signup and view all the answers

What common complication is associated with polycythemia?

Increased blood viscosity (B) Signup and view all the answers

What is a recommended intervention for managing polycythemia?

Therapeutic phlebotomy (D) Signup and view all the answers

In leukemia treatment, what symptom may indicate engrafting following a bone marrow transplant?

Increase in RBCs and platelets (C) Signup and view all the answers

Which of these is a common adverse effect associated with hematopoietic growth factors?

Anorexia and nausea (A) Signup and view all the answers

Which drug is a platelet-promoting agent that stimulates the immune system?

Romiplostim (C) Signup and view all the answers

In the context of leukemia, which symptom is most indicative of anemia?

Pallor and fatigue (C) Signup and view all the answers

Study Notes

Hematology Overview

Hematology is the study of blood, blood cells, lymph, and organs involved in blood formation and storage
Blood consists of plasma and cells.
Key functions of the hematologic system include circulating oxygen, nutrients, hormones, and metabolic wastes; protecting against pathogens; and maintaining coagulation, fluid and acid-base balance, body temperature

Hematopoiesis

Hematopoiesis is the process of blood cell formation in bone marrow
Pluripotent stem cells in the bone marrow are crucial for this process
Red blood cells (RBCs) carry oxygen; low RBCs lead to hypoxia
White blood cells (WBCs) fight infections; low WBCs lead to infections
Platelets aggregate to form clots; low platelets lead to bleeding

Accessory Organs of Blood Formation

Spleen: Stores WBCs, RBCs, and platelets; filters blood and destroys old cells; removal increases infection risk
Liver: Produces clotting factors (prothrombin); stores blood and iron; liver problems can cause clotting/bleeding issues

Jaundice Assessment

Sclera, palate, palms, and skin can turn yellow in cases of jaundice.
Follow up checking for hyperbilirubinemia by checking the following body areas.

Stages of Hemostasis

Vessel injury: Causes spasms, restricting blood flow
Vascular spasm: Vessel constricts to reduce blood loss
Platelet plug formation: Platelets aggregate and form a plug to stop bleeding
Coagulation: Complex cascade of clotting factors leading to fibrin mesh clot formation.
Clot retraction/growth factors: Edges of wound contract, attracting new cells to repair the injury
Clot dissolution(fibrinolysis): The breakdown of the clot as healing progresses.

Anti-clotting forces

Plasminogen activators activate plasmin, an enzyme that breaks down fibrin clots.
This process is crucial for preventing blood clots from becoming too large or staying in place.
The clot eventually breaks down into fibrin degradation products, completing the process of fibrinolysis.

Hematological Assessment

History: OPQRSTU (Present Illness); past medical history; family history; nutrition.
Physical Exam: Skin, HEENT, Respiratory, Cardiovascular, GU, MS, GI, and Neuro.

Hematological Lab Values

RBC (4.2-5.14)
Hemoglobin (Hgb) (12-18)
Hematocrit (Hct) (38-49)
WBC (5-10)
Platelets (PLT) (150-450)
PT (10-13 seconds)
INR (0.8-1.1) - normal; (2.0-3.5) - if on warfarin (coumadin)
PTT (21-35 seconds) - normal for Heparin therapy

Other Diagnostic Tests

Bone marrow aspiration: Posterior superior iliac crest is most commonly used site.
Local anesthetic is used
Apply pressure for 5-10 minutes to help stop bleeding
Monitor for bleeding, treat pain
Educate patient about signs/symptoms of infection after procedure

Bone mass and intracellular fluids decrease with age
Decreased blood volume and liver function
Decreased albumin
Decreased hematopoiesis and iron binding
Anemia
Increased risk of infection
Increased risk of bleeding

Care of Patients with Hematologic Problems

Prevent hypoxia, infection, and bleeding

Anemia

Insufficient oxygen transport leads to cellular hypoxia
Various causes, including poor diet, malabsorption, genetic disorders, and bone marrow disease
Classifications (microcytic, macrocytic, etc) based on RBC size are used for diagnosis

Anemia Treatment

Erythropoietin: stimulates bone marrow RBC production
Iron: crucial for Hb formation; deficiencies lead to anemia
Vitamin B12: critical for proper RBC production
Folic Acid: needed for DNA synthesis for cell division
Addressing underlying causes and implementing supportive measures are essential for treatment.

Anemia Medication Concerns

Folic acid can mask signs of pernicious anemia, requiring proper diagnosis before treatment
Iron administration dosage in children should be monitored carefully due to potential overdose concerns.

Hematopoietic Growth Factors

Erythropoietic drugs (stimulate RBC production)
Colony-stimulating factors (increase WBC and platelet production)
Platelet-promoting drugs (promote platelet production)

Common Adverse Effects of Hematopoietic Drugs

Cardiovascular effects (edema).
Gastrointestinal issues (anorexia, nausea, vomiting).
Integumentary effects (rash, alopecia, skin infections). Respiratory effects
Others (fever, bone pain)

Contraindications for Hematopoietic Drugs

Known allergies
Elevated Hgb (Epogen)
Infection (Filgrastim)

Interactions of Hematopoietic Drugs

Colony-stimulating factors and myelosuppressive drugs may cancel each other out if administered within 24 hours.

Polycythemia

Too many RBCs leads to increased blood viscosity,
Problems with oxygen transport and blood flow.
Treatment usually involves therapeutic phlebotomy or apheresis to reduce the blood cell count.

Leukemia

Cancer of the WBCs, characterized by an overabundance of immature, ineffective WBCs.
Frequent infections, anemia, and bleeding problems are common.

Leukemia Treatment

Chemotherapy
Radiation
Bone marrow transplant

Care of Immunosuppressed Patients

Avoid raw fruits, veggies, standing water (longer than 15 minutes), crowds/sick individuals, fresh plants/flowers and avoid rectal temps/suppositories

Myelodysplastic Syndromes

Group of disorders characterized by the ineffective production of blood cells.
Pancytopenia (low levels of all blood cells).
Chronic hypoxia, frequent infections, and bleeding are common symptoms.

Care of Patients with Thrombocytopenia

Avoid injury; use soft bristle toothbrush, electric razors, stool softeners, and maintain a clutter-free environment
Avoid rectal temps, intercourse, blowing nose
Avoiding injections and non-essential blood draws is crucial to avoid further bleeding risk.

Thrombocyte Disorders (Clotting Problems): ITP & TTP

ITP: Autoimmune disorder with increased destruction of platelets by the spleen
TTP: Disruption of the clotting process due to abnormal platelet clumping
Treatment for ITP may include immunesuppressants while TTP requires addressing the underlying cause.

Clotting Factor Disorders: Hemophilia and HIT

Hemophilia: Genetic deficiency of clotting factors, leading to prolonged bleeding from minor injuries, and other complications.
HIT: Autoimmune response to heparin, resulting in potentially serious blood clots and thrombotic complications.

Hemophilia Teaching

Important to avoid injury, maintain good hygiene, and teach patients/caregivers how to assess for bleeding abnormalities.

Hemophilia Treatment

Bleeding/injury management- administer missing clotting factor
Administer antifibrinolytics to prevent clot breakdown
Desmopressin to increase platelet aggregation
RICE for injury management
Acetaminophen as needed; avoiding NSAIDs because further impairing platelet aggregation. Avoid NSAIDs.

Lymphomas

Hodgkin and Non-Hodgkin's are cancers of lymphocytes leading to swollen lymph nodes
Multiple symptoms include weight loss, night sweats, persistent fever, and cough
Diagnosis and treatment vary greatly from the type

Multiple Myeloma

Cancer of plasma cells (B-lymphocytes)
Characterized by overabundant abnormal plasma cells, bone marrow crowding, and the formation of cancer tumors in the bone.
Can cause pathological fractures.
Associated with hypercalcemia (high blood calcium levels)
Diagnosis and treatment vary greatly from the type.

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Description

Test your knowledge on the hematologic system with this quiz. Explore topics like hematopoiesis, blood cell function, and hemostasis. Challenge yourself with questions on various blood conditions and their clinical features.