12) Hematology Flashcards
1
Q
A
2
Q
What organ makes erythropoietin?
A
Kidney
3
Q
What triggers erythropoietin release?
A
Hypoxia
4
Q
Where are RBCs primarily made in adults?
A
Bone marrow (pelvis, femur)
5
Q
RBC lifespan?
A
~120 days
6
Q
Where are old RBCs cleared?
A
Liver (main), spleen
7
Q
Main protein in plasma?
A
Albumin
8
Q
Albumin maintains what pressure?
A
Oncotic (pulls fluid into vessels)
9
Q
Bohr Effect = ?
A
↓ Hgb-O2 affinity → O2 dumped (right shift)
10
Q
Haldane Effect = ?
A
↑ Hgb-O2 affinity → O2 loaded (left shift)
11
Q
Right shift causes?
A
↓ pH, ↑ CO2, ↑ temp, ↑ 2,3-BPG
12
Q
Left shift causes?
A
↑ pH, ↓ CO2, ↓ temp, ↓ 2,3-BPG
13
Q
Sickle Cell = what type of anemia?
A
Hemolytic anemia
14
Q
False statement about sickle cell?
A
Sickled RBCs have longer lifespan ❌ (they have ↓ lifespan)
15
Q
Hemophilia A is what kind of disorder?
A
Intrinsically endued bleeding disorder (↓ Factor VIII)
16
Q
Von Willebrand disease affects what?
A
↓ vWF & platelet dysfunction
17
Q
Hemostasis 3 phases?
A
Vascular → Platelet → Coagulation
18
Q
Rx to preserve clots?
A
TXA (inhibits plasmin)
19
Q
Most abundant WBC?
A
Neutrophils
20
Q
WBCs exit vessels via?
A
Diapedesis
21
Q
Monocytes become?
A
Macrophages & dendritic cells
22
Q
T-cells mature where?
A
Thymus
23
Q
B-cells mature where?
A
Red Bone marrow
24
Q
What immunity uses Abs?
A
Humoral (B-cells)
25
What immunity uses cytotoxins?
Cellular (T-cells)
26
Which immunity acts faster?
Humoral (primary exposure)
27
What blood type is universal donor?
Type O
28
What blood type is universal recipient?
Type AB
29
Rh− mom w/ 2nd Rh+ baby risk?
Erythroblastosis fetalis → give RhoGAM
30
Goal of inflammation?
Localize damage & facilitate repair
31
Not a goal of inflammation?
Make antibodies ❌
32
Common cause splenomegaly?
Sickle Cell disease ✅
33
Hematologic condition → abnormal RBCs → likely finding?
Splenomegaly
34
What is the term for a nonspecific response by the immune system that attacks foreign substances?
Cellular immunity.
35
antibody responsible for causing a anaphylaxis
IgE.
36
What type of immunity is demonstrated when B cells produce antibodies specific to an antigen?
Humoral immunity.
37
What do antibodies do?
They search for an antigen, combine with it, and destroy it.
38
B Lymphocytes/B-Cells) “Naive” B-cells:
B-Cells "school" @:
= cells that have not yet encountered any antigens
"Haven't graduated yet"
= bone marrow
39
Nonspecific Response “Cellular/Innate Immunity”
Macrophages “Phagocytosis” “army grunts”
T-Lymphocytes (cover both sides)
40
Granulocytes:
Mast Cells:
= Neutrophils, Eosinophils, Basophils
= Contain granules rich in histamine and heparin that are released during degranulation
41
Dendritic cells:
Have many surface projections
Type of phagocytic cell
Specialized antigen presenting cell “Tells T-cells”
Abundant in the skin and mucosal linings of the lungs & GI tract
Once activated, they migrate to lymph nodes to activate T-cells
T-Cells ~found in Lymph area
42
Virus cell killers:
= NKA & T cells (NKA innate: Natural Killer Cells)
Part of the innate immune system
1st line of defense against viral infections
Have the ability to recognize and kill abnormal cells
Release chemicals that lyse the membranes of cells
Release perfuocytes
Perfusing: goes into hypertonic
“Hole Punch” cell
43
HIV cellular effect:
= Kills Helper cells
44
Specific Response “Humoral Immunity”
Built special force team
“Antibodies” B-Lymphocytes
Ige “I Give Epi” antibody response for anaphylaxis
IGG most abundant (most Gs)
Make memory cells & Antibodies as look outs POGs
Antibody Rq T-Lymphocytes
Cd8 helper
45
Eosinophils:
= Essential in triggering inflammatory response in allergic reactions (Combat parasites)
“All about parasites” Involved in allergic reactions
Signal other cells for increasing capillary permeability
46
Basophils:
Release histamine and heparin
“Like med” body makes heparin for +permabillty local
47
B Lymphocytes/B-Cells) maturing:
Plasma B-Cell:
Memory B-Cell:
= encountering an antigen, differentiates into 1 of 2 types of cells "graduates & goes into army for "MOS"
= "Grunts" bread down into antibodies (5-7days life) Exposed Respond, Replicate
= "CIA" Look out cells >10K eyes out for 1 "suspect"
48
Mast Cells:
Baso & Mast cells for anaphylaxis via degranulation
Antibodies bind to Baso & Mast cells w/ to cause degranulation
Granules releasees w/ Heparin & Mast
Histamine release
Mast biggest vasodiolater
Part of innate
= Contain granules rich in histamine and heparin that are released during degranulation
49
Non specific response
1st Line of Defense: Skin, Mucus membranes, Stomach acid (External)
2nd Line of Defense: Inflammatory response (Cap + permeability)
50
Specific / Adaptive response
Phagocytes, Neutrophils, Macrophages & Dendritic cells.
Engulf and destroy
Antigen Presenting Cells (Specific Response) “Helps protein & presents flag to T-B cells”
T cells tell B cells to build antigens
Rq cytokines
51
CD8
release perforin
Specific cell medicated T cells
Naive CD4 & 8
CD8 takes note & shows bad guy & replicates for bigger macrophage army
52
Interferon:
virus alarm
Made from infected cell to warn other cells of virus
A chemical that is released from a virus-invaded cell that provides nonspecific resistance to neighboring unaffected cells.
Interferes with viral replication
Acts as a “Whistle Blower”
warning healthy cells to prepare for a viral attack.
53
Humoral Specific Immunity
“Seal Team 6”
Branch of immune system that may occur after reexposure to a particular antigen
Occurs in the extracellular fluid
Permanent defense system against a specific antigen resulting in an attack by antibodies
This involves antibodies!!!!
Degranulation releases (histamine kills)
54
Natural Immunity aka
Innate Immunity
Genetically predetermine, breast milk passes antigens &/or via placenta
It is present at birth and has no relation no relation to previous exposure to a particular antigen
55
Artificially Acquired Immunity
Acquired through vaccinations
Dead virus
Designed to give us protection from exposure to an antigen at some point in the future
56
H1 Receptor Location & Effects:
H2 Receptor Location & Effects:
H3 Receptor Location & Effects:
H4 Receptor Location & Effects:
= Smooth Ms & endothelial cells| acute reaction
= Gastric Partial cells | Secretion of gastric acid
= CNS | Modulation of neurotransmission
= Mast, Eosin/phil, & Tcells | Immune Reg/s
57
What is a nonspecific response by the immune system that directly attacks a foreign substance called?
Cellular immunity.
58
Blood:
Plasma:
Leukocytes:
Erythrocytes:
= Mixture of water, cells, proteins, & suspended elements.
= makes up 55% of the blood volume
= WBC & platelets make up the “Buffy Coat"
= RBC make up 45%
59
Platelet Phase of hemostasis:
2nd phase, Platelets aggregate, or collect and adhere. Slows hemorrhage from capillaries and small vessels- splint fractures to decrease of clots being broken down & bleeding again
60
Coagulation Phase of hemostasis:
3rd phase Clotting factors activated and released into bloodstream through a very complex cascade of events Triggers series of chemical reactions; formation of strong protein fibers (fibrin)
61
CNS blood supply) 1 Brain's % of body weight & uses for ATP
2 Brains Oxy & glucose consumption:
Brain is supplied by:
1= 2% }Uses lots of blood & oxy, can only use glucose for ATP
2= Consumes 25% of body's glucose & 20% of oxygen supply
3= Circle of Willis} Carotid system (anterior) & Vertebrobasilar system (posterior)
62
Blood Cells:
= RBC (Erythrocytes), WBC (Leukocytes), platelets (Thrombocytes)
63
Erythrocytes F:
RBC Transport O2; critical in hypoxia or hemorrhage management.
64
Leukocytes
WBC Fight infections; increased & sent to areas of sepsis or infection.
65
Thrombocytes
= Platelets Facilitate clotting; essential in hemostasis
66
Blood's Leukocytes:
Neutrophils, Eosinophils, Lymphocytes, Monocytes
67
Neutrophils:
= First responders in bacterial infection; phagocytose pathogens & release reactive oxygen species (ROS).
68
Eosinophils
Combat parasitic infections; involved in allergic reactions by releasing histamine.
Basophils: Release histamine & heparin to mediate inflammation.
69
Monocytes
Differentiate into macrophages or dendritic cells; phagocytose pathogens & present antigens.
70
Lymphocytes
Include B cells (antibody production), T cells (cytotoxic & helper roles), & natural killer (NK) cells for tumor/virus destruction.
71
Skin Integumentary System) Keratinocytes
Melanocytes
Langerhans Cells
Merkel "tactile" Cells:
= Produce keratin for protective barrier (nails, palms, soles)
= Produce melanin for UV protection.
= Detect pathogens & trigger immune responses.
= Detect fine touch & pressure stimuli.
72
Enzymes) ATP Synthase:
Carbonic Anhydrase:
= Produces ATP using proton gradient in mitochondria.
= Catalyzes reversible conversion of CO2 & water to carbonic acid (critical in acid-base balance).
73
Proteins) blood) Hemoglobin:
Albumin:
Fibrin:
Immunoglobulins (Antibodies): Produced by plasma cells; recognize & neutralize antigens.
= Binds O2 in red blood cells; facilitates O2 & CO2 transport.
= Maintains oncotic pressure in blood plasma; binds & transports substances like fatty acids & hormones.
= Stabilizes blood clots by forming an insoluble network of fibers.
74
What is the definition of anemia?
↓ Hgb, ↓ RBCs, ↓ O₂-carrying capacity
75
What are the triggers for sickle cell crisis?
Hypoxia, infection, dehydration, stress
76
How is polycythemia defined?
↑ RBCs → ↑ blood viscosity
77
What is a common cause of polycythemia?
Chronic hypoxia (COPD, altitude, tumors)
78
What causes aplastic anemia?
Bone marrow suppression/failure
79
What is the most common inherited bleeding disorder?
vWD (Von Willebrand Disease)
80
What is the defect in vWD?
↓ vWF protein → platelet adhesion impaired
81
What factor is missing in hemophilia A?
Factor VIII
82
What is an example of intrinsically endued disorders?
Hemophilia A
83
What are examples of extrinsically endued disorders?
Liver disease, trauma-induced DIC
84
What are the signs and symptoms of febrile non-hemolytic reaction?
Fever, chills, mild dyspnea
85
What are the signs and symptoms of hemolytic transfusion reaction?
Flank pain, fever, shock, dark urine
86
What are the contents of plasma?
~90% water, 7% proteins, 3% solutes
87
What is the difference between oncotic and hydrostatic pressure?
Oncotic = pulls fluid in; Hydrostatic = pushes fluid out
88
What is the function of neutrophils?
Bacterial defense & phagocytosis
89
What do monocytes convert to?
Macrophages & dendritic cells
90
What type of immunity is cellular immunity?
T-cells → cytotoxic destruction
91
What type of immunity is humoral immunity?
B-cells → antibodies
92
What does blood type O have?
No surface antigens; A & B antibodies
93
What is the risk of Rh incompatibility?
Rh− mom + Rh+ fetus → fetal hemolysis (2nd exposure)
94
What is the convergence point of the clotting cascade?
Factor X → thrombin → fibrin
95
What is the role of vitamin K in clotting?
Required for synthesis of several clotting factors
96
What is the role of vWF in clotting?
Assists platelet adhesion + stabilizes Factor VIII
97
What is the function of plasmin?
Breaks down fibrin (clot dissolver)
98
What is fibrinolysis?
Breakdown & removal of clots
99
Which WBCs release histamine?
Basophils & mast cells
100
What is the function of eosinophils?
Respond to parasites & allergic rxns
101
What are the types of lymphocytes?
T-cells (cellular) & B-cells (humoral)
102
What is the role of T-helper cells (CD4)?
Coordinate immune response
103
What do T-cytotoxic cells (CD8) do?
Destroy infected/self-altered cells
104
What is the function of the humoral response?
Produce antibodies to neutralize pathogens
105
How is an autoimmune disorder defined?
Immune system attacks 'self' tissues
106
What are common triggers for autoimmune disorders?
Genetics, stress, infection, hormones
107
What are immunosuppressants used for?
Organ transplants & autoimmune diseases
108
What effect does HIV have on immunity?
Destroys CD4 cells → weakens response
109
What causes hemolytic anemia?
RBC destruction > production
110
What are the types of anemia?
Aplastic, Iron-def, Hemolytic, Hemorrhagic
111
What is the difference between polycythemia vera and secondary polycythemia?
Vera = bone marrow disorder; Secondary = response to hypoxia
112
What is the treatment for a transfusion allergic reaction?
Epi 0.3 mg IM, Benadryl 25–50 mg
113
What is the treatment for a transfusion hemolytic reaction?
Stop transfusion, fluids, notify lab
114
115
What is the typical transfusion timing for reaction onset?
Most occur within 15–50 mL
116
What is the universal donor blood type?
Type O (no antigens)
117
What is the universal recipient blood type?
Type AB (no antibodies)
118
When does Rh sensitization occur?
Rh− person exposed to Rh+ blood
119
When is RhoGAM used?
Rh− mom carrying Rh+ fetus
120
What is the most common anemia worldwide?
Iron-deficiency anemia
121
What disease causes pancytopenia?
Aplastic anemia
122
How is neutropenia defined?
Low neutrophil count → ↑ infection risk
123
What is the hallmark of hematologic malignancy?
Uncontrolled WBC proliferation (e.g., leukemia)
124
What is the result of DIC?
Uncontrolled clotting → factor depletion → bleeding
125
What causes aplastic anemia?
Bone marrow fails to produce RBCs
126
What is the result of iron-deficiency anemia?
↓ iron → ↓ Hgb synthesis
127
What causes pernicious anemia?
Vitamin B12 deficiency
128
What causes renal anemia?
↓ erythropoietin production
129
What is the result of hemorrhagic anemia?
Blood loss → ↓ Hct & Hgb
130
What is a complication of sickle cell disease?
Vaso-occlusive crisis
131
What is the prehospital treatment for sickle cell crisis?
O₂, fluids, pain control
132
What can trigger DIC?
Sepsis, trauma, cancer, OB emergency
133
What are the results of DIC?
Microclots + bleeding (used-up clotting factors)
134
What is the prehospital treatment for DIC?
Avoid BP cuffs, IV sticks; early recognition
135
What is the hospital treatment for DIC?
Blood products, fluids, pressors (NorEpi, dopamine)
136
What factor is missing in hemophilia A?
Factor VIII
137
What are the complications of hemophilia A?
Hemarthrosis, GI bleed, cerebral bleed
138
What are the prehospital pearls for hemophilia?
Limit sticks, pressure post IV, expect pt to carry factor
139
What is the treatment for von Willebrand disease (vWD)?
Desmopressin (mild) or Factor VIII + vWF concentrate
140
What is the risk associated with leukopenia?
↑ infection risk
141
What causes leukocytosis?
Infection, leukemia, stress response
142
What are the risks of thrombocytosis?
↑ clotting → MI, PE, CVA
143
What is the risk associated with thrombocytopenia?
Spontaneous bleeding
144
What factors affect clotting?
Wound type, movement, temp, meds, IV fluids
145
Platelet plug forms in what phase?
Platelet phase of hemostasis
146
Vasoconstriction occurs during:
Vascular phase of hemostasis
147
Fibrin mesh formed in:
Coagulation phase
148
Clotting cascade intrinsic path:
Triggered by vessel injury (measured via PTT)
149
Clotting cascade extrinsic path:
Triggered by tissue damage (measured via PT)
150
Factor X activates:
Prothrombin → thrombin
151
Thrombin converts:
Fibrinogen → fibrin
152
Role of calcium in coagulation:
Needed at multiple cascade steps
153
Clotting impaired by hypothermia because:
Enzymes slow → ↓ fibrin production
154
Excess fluid resuscitation effect:
Dilutes clotting factors → ↑ bleeding risk
155
Early sign of internal bleeding:
Anxiety, restlessness, tachyC
156
Late sign of internal bleeding:
HypoTN, pallor, AMS
157
Lab test for hemophilia A:
↑ aPTT; normal PT
158
Reticulocyte count shows:
Bone marrow response to anemia
159
Type AB blood antigens:
A & B (no antibodies)
160
Type O blood antigens:
None (has anti-A & anti-B Abs)
161
AB = universal recipient because:
No antibodies to A or B
162
O = universal donor because:
No antigens for recipient to react to
163
Febrile transfusion reaction cause:
Recipient WBCs reacting to donor WBCs
164
Delayed hemolytic transfusion rxn:
Occurs days after; mild anemia & jaundice
