Exam (elaborations)
NURS 5315 ADVANCED PATHO HEMATOLOGIC MODULE 4 QUESTIONS AND ANSWERS
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NURS 5315 ADVANCED PATHO HEMATOLOGIC MODULE 4 QUESTIONS AND ANSWERS
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Name: Score:105 Multiple choice questions
,Term 1 of 105
What is the clinical manifestations of DIC?
This is commonly seen in persons who are immunosuppressed such as those with AIDS,
hepatitis C, EBV, and post transplantation patients (secondary to immune suppression).
H. Pylori infection increases the risk of gastric lymphoma. The median age of diagnosis is
67. This highest incidence is seen in North America, Europe, Oceania and in Africa. Risk
factors for NHL include a family history, exposure to certain chemicals, irradiation,
infection with EBV, human herpesvirus-8, HTLV virus), and immune suppression.
Clinical Presentation includes:
• Diffuse bleeding
• Bleeding from wounds, venipuncture sites
• Petechiae
• Ecchymosis, hematuria, hematemesis
• Stroke, PE, necrotic skin lesions
• Hemorrhaging into closed compartments
• "Indicators of multisystem failure include changes in level of consciousness, behavior,
and mentation; confusion; seizure activity; oliguria; hematuria; hypoxia; hypotension;
hemoptysis; chest pain; and tachycardia. Symmetrical cyanosis of the fingers and toes ("
blue finger/ toe syndrome") and, in some instances, of the nose and breasts may be
present."
A locally enlarged painless mass, lump or swelling is the presenting sign, most
commonly in the neck. They may have an asymptomatic mediastinal mass seen on CXR.
Fever, weight loss, night sweats, pruritis (itching), adenopathy, thrombocytosis,
leukocytosis, abdominal mass, eosinophilia may also be present. Overall it has a better
prognosis than Non-Hodgkin's lymphoma.
• Other laboratory findings include elevated ESR, elevated alkaline phosphatase, and
paraneoplastic syndromes
Clinical manifestations of ITP include:
• Presentation can vary
• Petechiae, purpura, and easy bruising are expected.
• Epistaxis, gingival bleeding, and menorrhagia are common.
• Overt gastrointestinal bleeding and gross hematuria are rare.
• Intracranial hemorrhage, a potentially fatal bleeding complication, is so uncommon
that there is no reliable estimate of its frequency.
• The clinical manifestations of thrombocytopenia also vary with age. Older patients may
have more severe bleeding manifestations, such as gastrointestinal bleeding and
possibly intracranial hemorrhage because of comorbidities such as hypertension
,Term 2 of 105
What is the etiology of Hemophilia A?
Hemophilia a is caused by an excess of clotting factors leading to bleeding.
Hemophilia a is a viral infection that affects blood clotting.
Hemophilia A is a sex linked recessive disease which results in a deficiency of factor VIII.
Hemophilia a is an autosomal dominant disorder affecting both genders equally.
, Term 3 of 105
What are the clinical manifestations of thrombocytopenia hemorrhage
Hemophilia A affects 1 in 4,000-5,000 males. The most common sites of bleeding in
adults are:
• Knees, elbows and ankles
• GI bleeding is common as well.
• Spontaneous bleeding is indicative of more severe disease.
• Bleeding only after injury/trauma or surgery indicates milder disease.
--The most commonly affected bones are the vertebrae, ribs, skull, and pelvis. This is a
progressive disease with a median lifespan of three years. Clinical manifestations
depend upon the area or organ affected by the neoplasm but may include
hypercalcemia (confusion, lethargy, weakness), recurrent infections, bone pain,
pathological fractures, elevated alkaline phosphatase, and renal failure. The person may
experience weakness, fatigue, weight loss, anorexia, easy bleeding or bruising and
dyspnea. Normocytic anemia will be present
Affects 1 in every 20,000-30,000 males
• Most common sites of bleeding in adults are into the joints.
• Knees, elbows and ankles
• GI bleeding is common as well.
• Spontaneous bleeding is indicative of more severe disease.
• Bleeding only after injury/trauma or surgery indicates milder disease.
• Diagnostic Testing
• Normal platelets
• Normal PT
• Abnormally prolonged aPTT
• Decreased factor IX level
Clinical manifestations of a bleed from a thrombocytopenia include:
• Mucosal bleeding such as:
• Epistaxis
• Oral bleeding
• GI or GU bleeding (in the absences of malignancy)
• Hemoptysis
• Heavy menses
• Bleeding occurs immediately after a trauma or injury
• Petechiae may be present.
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