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Cardioresp > 11 > Flashcards

11 Flashcards

1
Q

what is blood in terms of tissue

A

Specialist connnective tissue

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2
Q

what are the major constituents of blood

A

plasma and cells

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3
Q

what percentage of total extracellular fluid does plasma make up

A

20%

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4
Q

what is plasma made up of (percentages)

A

Water (90%)​
Solvent, lubricant, cushion, heat dissipator​

Glucose, salts and other dissolved chemicals (2%)​

Protein (8%)​
Albumin (60%) (transport and oncotic pressure prevents fluid from leaking)​
Globulin (36%) (immune)​
Fibrinogen (4%) (blood haemostasis)

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5
Q

what ions are found in plasma

A

Inorganic ions (potassium, sodium, calcium, chloride, bicarbonate, phosphate)​

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6
Q

what is the function of ions in plasma

A

electrolyte balance

(maintain BP and support heart and muscle contraction​)

dissolved carbon dioxide as carbonic acid, hydrogen and bicarbonate ions or bound to amino groups of proteins – including haemoglobin (maintenance of pH)​

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7
Q

what does blood pH depends on

A

on the ratio of CO2 / HCO3-

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8
Q

where does excess H plus ions in the blood come from and what do they cause

A

metabolic process and metabolic waste

cam cause acidosis

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9
Q

what can blood acting as a buffer prevent

A

acidosis

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10
Q

whats another name for WBC

A

leucocytes

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11
Q

what cells make up the blood

A

RBC
WBC
Platelets

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12
Q

where is blood made

A

bone marrow

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13
Q

where can bone marrow be extracted from

A

pelvis bone

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14
Q

whats hematopoesis

A

The production of all of the cellular components of blood and blood plasma

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15
Q

lifespan of RBC

A

120 days

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16
Q

what hormone stimulates the production of RBC

A

EPO

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17
Q

what happens to alpha and beta subunits when oxygen binds

A

it changes conformation

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18
Q

what molecules promote O2 release in tissues

A

H+ , CO2 and 2,3 DPG

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19
Q

what is anaemia

A

Low hemoglobin concentration

NOT a DIAGNOSIS its underlying a cause

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20
Q

whats the commonest blood disorder

A

anemia 25%

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21
Q

what is the guideline for defining male and female anamia

A

Hb<130g/L for males

Hb<115 females​

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22
Q

what’s the cause of anaemia

A 
Decreased production: Haematinic deficiency​
Anaemia of chronic disease​
Medications ​
Infiltration​
Aplasia

or increased loss​ of blood:
Bleeding​
Haemolysis

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23
Q

how does the body try to compensate for anaemia

A

Anemia: reduced oxygens supply to kidneys –> increased EPO and increased RBC production by BM but it takes a long time to put Hb back up again.

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24
Q

what are some symptoms of anaemia

A

Tiredness​
Faint​
Shortness of breath​
Worsening of heart related pain (angina)​
Rapid heart beat (experienced as palpitations)

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25
Q

what are some signs of anaemia

A 
Pale​
Rapid heart beat (tachycardia)​
Bounding pulse​
Systolic flow murmur​
Cardiac failure​
Retinal haemorrhages
26
Q

What are the three types of anaemia and whats the main difference between them

A

microcytic <80 fL
Normocytic 80-100 fL
Macrocytic >100 fL

They differ in Mean Cell Volume

27
Q

what causes Microcytic Anemia

A

Iron deficiency​

Thalassaemia​

28
Q

what causes Normocytic Anemia

A 
Acute blood loss​
Anaemia of chronic disease ​
(e.g. infections, malignancy)​
Renal failure​
Leukaemia​
Sickle cell anaemia
29
Q

what causes Marcocytic Anemia

A

B12/folate deficiency ​
(megaloblastic anaemia)​
Alcohol​
Liver disease

30
Q

what type of anaemia represents the most cases

A

99% microcytic

31
Q

B12 and folate uses

A

to make cells

32
Q

how can you determine wether anaemia is caused by increased destruction or reduced production

A

reticulocyte count

33
Q

what does a low reticulocyte count indicate in terms of bone marrow efficacy

A

BM is not fine

34
Q

what does a high reticulocyte count indicate in terms of bone marrow efficacy

A

BM is fine

35
Q

what causes iron deficiency anaemia

A

Menstrual loss (young females)​
Infection (hookworm) leads to gut bleeding​
Growth spurt, pregnancy ​
Gastrointestinal loss: ​
Bleeding ulcers, inflammatory bowel disease, CANCER

36
Q

what are platelets

A 
Small circulating cells (2 - 3 ul)​
without a nucleus​
Fragments of megakaryocytes ​
from bone marrow​
1 million/second​
10 day lifespan​
Involved in coagulation​
Platelet plug​
Coagulation cascade​
​
37
Q

what pathology is characterised by low platelet levels

A

thrombocytopenia which can cause bleeding and bruising

38
Q

what are neutrophil

A 
About twice as big as red cell​
2 -4 lobes, fine granules​
Normally the most common white cell - levels very dynamic​
Half-life 6-8 hours​
1011/day=1 million/second​
​
39
Q

whats neutrophilia

A

Increase in number of neutrophils

40
Q

whats neutropneia

A

decrease in number of neutrophils

41
Q

what causes neutrphilia

A

Infection​
Inflammation​
Tissue damage​
Haemorrhage

42
Q

what causes neutropneia

A 
Overwhelming sepsis (blood poisoning)​
HIV​
Bone marrow failure (no blood cells produced) – aplastic anaemia, leukaemia​
Medications​
B12/folate deficiency
43
Q

what are eosinophils

A 
Bilobed nucleus​
Bright orange granules​
Increase in​
Parasitic (worm) diseases​
Skin disorders​
Asthma​
44
Q

what are basophils

A

2 - 3 lobed nucleus​
Large blue granules containing histamine​
Variety of causes of increased levels​

45
Q

what are monocytes

A

Large with kidney shaped nucleus​
Similar function to myeloid cells, turn into macrophages​
Also important in immune system – presents foreign substance (antigen) to lymphocytes​
Increased in chronic infections and viral infections​

46
Q

what are lymphocytes

A 
Small and dense with little cytoplasm. Few granules​
T cells: Coordinate immune responses​
B cells: produce antibody​
NK cells: viral and tumour immunity​
Increased in viral infections​
Lifespan: 1 week-100 years​
47
Q

whats the result of bone marrow failure

A

Anaemia, thrombocytopenia, leucopenia​
Fatigue, bleeding, infections, DEATH​

caused by
Leukaemia and other haematological cancers​
Aplastic anaemia​
Chemotherapy, toxins, radiation​
B12/folate deficiency​
48
Q

how do we detect haematological problems

A

blood count

blood films

49
Q

RBC

A

absolute number x 10^12/L

50
Q

Mean cell volume

A

average size in fl

51
Q

hemoglobin

A

​Amount in whole blood in g/dL​
Mean cell haemoglobin (MCH) - aberage amount of Hb in a red cell (in png)​
Reduced if cells are small​
- mean cell haemoglobin concnetratiobn (MCHC( - concentration of hemoglobin in a red cell – in %​
Reduced if hemoblobin in cel is low

52
Q

what are cell/plasma components

A

Cell/plasma components​
Hematocrit (Hct) or packed cell volume (PCV) - ratio of packed cells​
​
Platelets​
Platelet count – absolute number x 10^9/L​
​
WBC​
White cell count (WCC or WBC) absolute number x 10^9/L​
White cell differential (different tupes of cells seens​
Absolute number/L​
% of total white cells (neutrophils, lymphocytes…)​

53
Q

blood films

A

Spread on glass​
Fixed with alcohol, stained with May-grunwald giemsa​
Used to examine morphology of cells​
Bone marrow biopsy may be considered​

54
Q

other blood tests

A 
Coagulation tests​
Prothrombin time and APTT​
Fibrinogen, clotting factor tests, vWF​
​
Ferritin, iron/trasnferrin/ITBC/iron saturations​
Vitamin B12 and folate​
Immunoglobulins and serum free light chains​
Serum EPO​
Specialist hematology cancer diagnosits​
55
Q

what percentage of blood does plasma make up

A

55%

56
Q

in blood, everything that makes up the blood other than plasma is called

A

formed elements (includes WBC, platelets)

57
Q

what causes High reticulocyte count

A

bleeding

hemolysis

58
Q

what causes low reticulocyte count

A 
Haematinic deficiency​
Anaemia of chronic disease​
Medications ​
Infiltration​
Aplasia
59
Q

which cells are granulocytes

A

neutrophil
eosinophils
basophil
lymphocytes

60
Q

what are lymphocytes

A

T cell
B cell
NK cells

61
Q

Most blood cancers are from ​

A

wbc

Cardioresp (23 decks)

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