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Questions and Answers
A patient presents with fatigue and shortness of breath. Their hemoglobin level is 11.5 g/dL, and their reticulocyte count is 0.3%. Which of the following is the MOST likely cause of these findings?
A patient presents with fatigue and shortness of breath. Their hemoglobin level is 11.5 g/dL, and their reticulocyte count is 0.3%. Which of the following is the MOST likely cause of these findings?
- Iron, folate, or vitamin B12 deficiency. (correct)
- Overhydration leading to hemodilution.
- Normal physiological response to high altitude.
- Increased red blood cell production due to hemolysis.
A male patient has a red blood cell count of $4.0 \times 10^6/\mu L$ and a hematocrit of 30%. What is his Mean Corpuscular Volume (MCV)?
A male patient has a red blood cell count of $4.0 \times 10^6/\mu L$ and a hematocrit of 30%. What is his Mean Corpuscular Volume (MCV)?
- 85 fL
- 80 fL
- 70 fL
- 75 fL (correct)
Which of the following conditions would MOST likely result in an elevated reticulocyte count?
Which of the following conditions would MOST likely result in an elevated reticulocyte count?
- Folate deficiency
- Iron deficiency anemia
- Vitamin B12 deficiency
- Hemolytic anemia (correct)
A female patient's lab results show a red blood cell count of $3.8 \times 10^6/\mu L$ and a hemoglobin level of 11.8 g/dL. How should these results be interpreted?
A female patient's lab results show a red blood cell count of $3.8 \times 10^6/\mu L$ and a hemoglobin level of 11.8 g/dL. How should these results be interpreted?
Which of the following BEST describes the role of red blood cells?
Which of the following BEST describes the role of red blood cells?
In the context of cancer prognosis, what does a positive BRCA status generally indicate?
In the context of cancer prognosis, what does a positive BRCA status generally indicate?
How do ER/PR (Estrogen Receptor/Progesterone Receptor) levels typically correlate with the effectiveness of hormonal therapy in cancer treatment?
How do ER/PR (Estrogen Receptor/Progesterone Receptor) levels typically correlate with the effectiveness of hormonal therapy in cancer treatment?
What is the general implication of higher HER2 expression in cancer cells regarding the rate of recurrence?
What is the general implication of higher HER2 expression in cancer cells regarding the rate of recurrence?
Which of the following is the most common sample used for Arterial Blood Gas (ABG) analysis?
Which of the following is the most common sample used for Arterial Blood Gas (ABG) analysis?
What is the normal range for pH in an arterial blood gas (ABG) analysis?
What is the normal range for pH in an arterial blood gas (ABG) analysis?
What does a PaCO2 value greater than 45 mmHg typically indicate in the context of arterial blood gas (ABG) analysis?
What does a PaCO2 value greater than 45 mmHg typically indicate in the context of arterial blood gas (ABG) analysis?
Which organ primarily regulates homeostasis through respiration?
Which organ primarily regulates homeostasis through respiration?
A patient's arterial blood gas (ABG) results show a pH of 7.48. According to this information, what condition is the patient most likely experiencing?
A patient's arterial blood gas (ABG) results show a pH of 7.48. According to this information, what condition is the patient most likely experiencing?
Which condition is likely indicated by an intracellular potassium level that is lower than normal alongside inhibited intake?
Which condition is likely indicated by an intracellular potassium level that is lower than normal alongside inhibited intake?
A patient's lab results show a magnesium level of 1.5 mg/dL. How should this result be interpreted?
A patient's lab results show a magnesium level of 1.5 mg/dL. How should this result be interpreted?
If a patient's sodium level is reported as 150 mEq/L after a meal, what condition might this indicate?
If a patient's sodium level is reported as 150 mEq/L after a meal, what condition might this indicate?
Which range of serum calcium levels represents a normal physiological state, according to the information?
Which range of serum calcium levels represents a normal physiological state, according to the information?
How does hypomagnesemia relate to mortality in stable patients, based on the provided information?
How does hypomagnesemia relate to mortality in stable patients, based on the provided information?
In a patient experiencing metabolic alkalosis, what change would you expect to observe in their HCO3 levels?
In a patient experiencing metabolic alkalosis, what change would you expect to observe in their HCO3 levels?
A patient presents with a pH of 7.30 and elevated PaCO2. Which condition is MOST likely to be affecting them?
A patient presents with a pH of 7.30 and elevated PaCO2. Which condition is MOST likely to be affecting them?
In a patient with metabolic acidosis, what compensatory mechanism would the respiratory system employ?
In a patient with metabolic acidosis, what compensatory mechanism would the respiratory system employ?
If a patient's lab results show a normal pH, elevated HCO3, and elevated PaCO2, what is the MOST probable primary acid-base disorder?
If a patient's lab results show a normal pH, elevated HCO3, and elevated PaCO2, what is the MOST probable primary acid-base disorder?
What role does the renal system play in compensating for respiratory acidosis?
What role does the renal system play in compensating for respiratory acidosis?
A patient's arterial blood gas shows: pH 7.50, PaCO2 30 mmHg, and HCO3 24 mEq/L. The patient's acid-base disorder is:
A patient's arterial blood gas shows: pH 7.50, PaCO2 30 mmHg, and HCO3 24 mEq/L. The patient's acid-base disorder is:
The anion gap is MOST useful in evaluating which type of acid-base imbalance?
The anion gap is MOST useful in evaluating which type of acid-base imbalance?
In a patient with a consistently high PaCO2 due to a chronic respiratory condition, what renal compensation would you anticipate?
In a patient with a consistently high PaCO2 due to a chronic respiratory condition, what renal compensation would you anticipate?
Which of the following best describes renal clearance?
Which of the following best describes renal clearance?
Why is it important to consider whether a substance is bound to albumin when assessing its renal clearance?
Why is it important to consider whether a substance is bound to albumin when assessing its renal clearance?
In the management of hyperkalemia, which of the following medications helps by shifting potassium into cells rather than directly enhancing renal potassium excretion?
In the management of hyperkalemia, which of the following medications helps by shifting potassium into cells rather than directly enhancing renal potassium excretion?
Why is calcium gluconate administered in the management of hyperkalemia?
Why is calcium gluconate administered in the management of hyperkalemia?
A patient with hypocalcemia also has hypophosphatemia. Which of the following treatments is LEAST appropriate?
A patient with hypocalcemia also has hypophosphatemia. Which of the following treatments is LEAST appropriate?
Which of the following scenarios would warrant careful assessment and potential management of sympathetic nervous system (SNS) activity?
Which of the following scenarios would warrant careful assessment and potential management of sympathetic nervous system (SNS) activity?
What role do additives play in intravenous magnesium sulfate (MgSO4) infusions?
What role do additives play in intravenous magnesium sulfate (MgSO4) infusions?
How could a pharmacist contribute to the management of a patient receiving intravenous magnesium sulfate (MgSO4)?
How could a pharmacist contribute to the management of a patient receiving intravenous magnesium sulfate (MgSO4)?
Which lab value is MOST critical to monitor daily in a patient receiving Total Parenteral Nutrition (TPN) to avoid refeeding syndrome?
Which lab value is MOST critical to monitor daily in a patient receiving Total Parenteral Nutrition (TPN) to avoid refeeding syndrome?
A patient on TPN develops hyperglycemia. Which modification to the TPN order is MOST appropriate to address this issue?
A patient on TPN develops hyperglycemia. Which modification to the TPN order is MOST appropriate to address this issue?
A patient's pre-albumin level is low. How does this affect monitoring of nutritional status?
A patient's pre-albumin level is low. How does this affect monitoring of nutritional status?
A patient on long-term TPN is at risk for trace element deficiencies. Which of the following is the MOST important trace element to monitor regularly?
A patient on long-term TPN is at risk for trace element deficiencies. Which of the following is the MOST important trace element to monitor regularly?
Which vitamin is MOST important to consider supplementing in a patient receiving TPN to prevent Wernicke's encephalopathy?
Which vitamin is MOST important to consider supplementing in a patient receiving TPN to prevent Wernicke's encephalopathy?
A patient has the following Arterial Blood Gas (ABG): pH= 7.30, $PCO_2$ = 60 mmHg, $HCO_3$ = 26 mEq/L. Which nutritional intervention would be MOST appropriate, considering this information?
A patient has the following Arterial Blood Gas (ABG): pH= 7.30, $PCO_2$ = 60 mmHg, $HCO_3$ = 26 mEq/L. Which nutritional intervention would be MOST appropriate, considering this information?
A patient with liver dysfunction is started on TPN. Regular liver function tests (LFTs) reveal a serum ammonia level of 90 $\mu$mol/L (reference range: 12-55 $\mu$mol/L). Which modification to their TPN order is MOST appropriate?
A patient with liver dysfunction is started on TPN. Regular liver function tests (LFTs) reveal a serum ammonia level of 90 $\mu$mol/L (reference range: 12-55 $\mu$mol/L). Which modification to their TPN order is MOST appropriate?
Which of the formulas is the MOST accurate option for calculating caloric needs of a patient?
Which of the formulas is the MOST accurate option for calculating caloric needs of a patient?
A patient is receiving TPN and lab results reveal an aPPT > 13. What does this result indicate?
A patient is receiving TPN and lab results reveal an aPPT > 13. What does this result indicate?
A patient receiving TPN has triglycerides (TGs) measured at 14 mmol/L. How should this result be interpreted?
A patient receiving TPN has triglycerides (TGs) measured at 14 mmol/L. How should this result be interpreted?
Flashcards
Red Blood Cell Indices
Red Blood Cell Indices
Measurements that provide information about the size and hemoglobin content of red blood cells.
Mean Corpuscular Volume (MCV)
Mean Corpuscular Volume (MCV)
Estimate of the average volume of red blood cells, calculated by dividing hematocrit by RBC count.
Anemia Symptoms
Anemia Symptoms
Common symptoms include fatigue and shortness of breath due to low hemoglobin levels.
Reticulocyte Count
Reticulocyte Count
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Mean Corpuscular Hemoglobin (MCH)
Mean Corpuscular Hemoglobin (MCH)
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CA19-9
CA19-9
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BRCA
BRCA
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ER/PR status
ER/PR status
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HER2
HER2
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ABG
ABG
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pH range in ABG
pH range in ABG
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PaCO2 normal range
PaCO2 normal range
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Alkalosis
Alkalosis
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HCO3 Levels
HCO3 Levels
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Metabolic Acidosis
Metabolic Acidosis
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Metabolic Alkalosis
Metabolic Alkalosis
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Anion Gap
Anion Gap
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Renal Response
Renal Response
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Respiratory Response
Respiratory Response
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PaCO2 Levels
PaCO2 Levels
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pH Levels
pH Levels
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Normal Potassium Levels
Normal Potassium Levels
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Hypokalemia
Hypokalemia
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Hyperkalemia
Hyperkalemia
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Magnesium Levels
Magnesium Levels
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Mortality in Stable Patients
Mortality in Stable Patients
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Renal Clearance
Renal Clearance
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MgSO4
MgSO4
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Ionized Calcium
Ionized Calcium
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Ca Gluconate
Ca Gluconate
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Additives
Additives
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Pharmacists Role
Pharmacists Role
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SNS Management
SNS Management
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Venal Clearance
Venal Clearance
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Nutrition Support Team
Nutrition Support Team
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Liver Function Tests (LFTs)
Liver Function Tests (LFTs)
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Coagulation Tests
Coagulation Tests
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Hypercoagulability
Hypercoagulability
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Thiamine
Thiamine
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Zinc
Zinc
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Ascorbic Acid
Ascorbic Acid
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Albumin/Pre-Albumin
Albumin/Pre-Albumin
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Basic Metabolic Panel (BMP)
Basic Metabolic Panel (BMP)
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Trace Elements
Trace Elements
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Study Notes
Hematology and Coagulation
- Red Blood Cell (Corpuscle):
- Function: Oxygen transport
- Male range: 4.7-6.1 x 1012/L
- Female range: 4.2-5.4 x 1012/L
- Hemoglobin:
- Function: Carries oxygen
- Male range: 13.8-17.2 g/dL
- Female range: 12.1-15.1 g/dL
- Hematocrit:
- Percentage of red blood cells in total blood volume
- Male range: 40.7-50.3%
- Female range: 36.1-44.3%
- Anemia:
- Reduced red blood cell count or hemoglobin
- Symptoms: Fatigue, weakness, shortness of breath
- Causes: Iron deficiency, folate deficiency, vitamin B12 deficiency, hemolysis
- Reticulocyte count: measures immature red blood cells
- Red Blood Cell Indices:
- MCV: Mean corpuscular volume (average red blood cell size)
- MCH: Mean corpuscular hemoglobin (average amount of hemoglobin per red blood cell)
- MCHC: Mean corpuscular hemoglobin concentration (concentration of hemoglobin in red blood cells)
- Coagulation:
- APTT/PT: Measure clotting time and monitor anticoagulants
- APTT: Measures the intrinsic pathway
- PT: Measures the extrinsic pathway
- Normal APTT: ~30 seconds
- Normal PT: ~12 seconds
Coagulation (cont'd)
- Unfractionated Heparin:
- Causes conformational change when bound to factor Xa, preventing it from binding to and activating thrombin
- 18 sacc. long required to map to become irreversible
- Low Molecular Weight Heparin:
- Inhibits factor Xa
- Shorter than unfractionated heparin (less than 18 saccharide chain length)
- Cannot be measured by activated partial thromboplastin time. Can be measured by Anti-Xa assay
- D-Dimer:
- Breakdown product of blood clots
- Used for assessing blood clots
- Prothrombin Time (PT):
- Measures factors II, V, VII, and X
- INR (International Normalized Ratio):
- Used to monitor patients taking warfarin
- Normal INR: 1-2 (some cases 2-3)
Rheumatology
-
Autoimmune Diseases:
- Antibodies attack the patient's own tissues and organs.
-
Tests to Determine Autoantibodies:
- Anti-Citrullinated Protein Antibodies (ACPA): Target an amino acid in joints most common in Rheumatoid Arthritis (RA)
- Rheumatoid Factor (RF): Targets the Fc portion of IgG, present in RA
- Antinuclear Antibodies (ANA): Target nucleic acids, commonly found in Lupus
- Antineutrophil Cytoplasmic Antibodies (ANCA): Targets neutrophil cytoplasmic antigens, present in vasculitis.
- HLA-B27: Located on the surface of RBCs, associated with autoimmune diseases
-
Rheumatoid Arthritis (RA):
- Autoimmune disease affecting joints
- Chronic inflammation which worsens over time
- Symptoms: Pain, swelling, stiffness in multiple joints
-
Juvenile Idiopathic Arthritis (JIA):
- Begins before age 16
- Clinical diagnosis, no definitive test
Cancer
- Tumor Markers:
- Proteins produced by tumor cells, found in tissue or blood
- Examples: CA 19-9, HER2, BRCA, HCG
- Biological Markers:
- BRCA genes, ER/PR status, and HER2 status aid in recurrence risk assessment and treatment stratification in cancer.
Pulmonary Labs
- ABG (Arterial Blood Gas):
- Measures blood pH, PaCO2, and HCO3 for assessing acid-base balance
- Pulmonary Function Tests (PFTs):
- Determine lung function and evaluate disorders like asthma and COPD
- Spirometry
- measures expiratory and inspiratory volumes
- FEV1/FVC estimates amount of lung destruction
Nutrition, Fluid & Electrolytes
- Electrolytes:
- Sodium (Na+): 135-145 mEq/L
- Potassium (K+): 3.5-5.0 mEq/L
- Calcium (Ca2+): 8.6-10.2 mg/dL
- Magnesium (Mg2+): 1.8-2.8 mg/dL
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Description
This quiz covers the interpretation of blood counts (hemoglobin, red blood cell count, reticulocyte count, MCV) and their clinical implications. It also addresses the significance of BRCA status, ER/PR levels, and HER2 expression in cancer prognosis and treatment. Assess your knowledge of hematology and oncology.
