Assessment Flashcards
Define ecchymosis
Bruising
Define erythropoiesis
RBC production
Happens in the bone marrow
Define fibrinolysis.
Breakdown of fibrin clot
Define hematopoiesis
Blood cell production (all blood cells)
Define hemolysis
Destruction of RBCs
This is a normal process in liver, spleen for removing abnormal, defective, old, damaged RBCs.
Bilrubin is byproduct of this.
Define leukopenia
Shortage of WBCs
Define neutropenia
Shortage of neutrophils
Define pancytopenia
Shortage of RBCs, WBCs and platelets
Define reticulocyte.
Immature RBC
Define thrombocytopenia
Shortage of platelets
Define thrombocytosis
Too many platelets
Think inflammation, cancer
Normal lab value for RBCs in
Female?
Male?
Female: 4.2—5.4
Male: 4.7—6.1
Think generally 4—6 with men being slightly higher.
Normal lab value for WBCs?
Critical low?
Critical high?
5—10K
Critical low=<2K
Critical high=>30K
Normal lab value for hemoglobin in
Female?
Male?
Critical low?
Critical high?
Female: 12—16
Male: 14-18
Think about this as females mature earlier than males
Critical low: <6.6
Critical high: >20
Normal lab value for hematocrit in
Female?
Male?
Critical low?
Critical high?
Female: 37–47%
Male: 42—-52%
Critical low: <20%
Critical high: >60%
Normal lab value for platelets?
Critical low?
Critical high?
150K—–400K
Critical low: <30K
Critical high: >1,000,000
What is a normal PT value?
What is the test for?
What is normal INR?
Their relationship?
11—12.5 seconds
This is to measure how long it takes for your blood to clot.
INR: 0.8–1.1
These 2 are always done together. They aren’t exactly the same but INR is a different measurement of the PT result.
A high PT/INR would indicate what?
Slow clotting (reduce anticoags)
This test is used often to figure out balance of heparin/warfarin for patient.
What is the relationship between PT and APTT?
They are both used to test clotting time. However, there are slight differences between which factors in clotting cascade they test. This is important when trying to diagnose a problem with a specific factor deficiency.
APPT is also used to monitor anticoagulant therapy.
What is normal value for ESR?
High ESR indicates what?
<20
This is measure of how quickly RBCs settle to bottom of sample.
Chronic inflammation
Infection
Anemia
Autoimmune
Cancer
Crohns
and lots of different other problems
What are normal fibrinogen levels?
Critical low?
Critical high?
200—400
Low: <80 (think late stage DIC)
High: >800 (inflammation, infection, trauma)
What are normal D-Dimer levels?
What does this measure?
<250
Anything >250 indicates there has been a clot somewhere in body.
PE
MI
CVA
DVT
DIC (all the little clots that happen early)
Eclampsia
What does MCV measure? What is normal value?
Size of RBC
80—95
What does MCH measure? What is normal value?
Average amount of hemoglobin on RBC (in weight)
27—31
What does MCHC measure?
Average concentration of hemoglobin in sample of RBCs (in volume)
32—-36%
What do MCV, MCH, MCHC all tell you?
The health of the RBCs
Where is red bone marrow located?
Flat, irregular bones
What is a hematopoietic stem cell?
An immature blood cell that can differentiate into any blood cell
How much of the blood is plasma?
What does plasma contain?
55%
Proteins, electrolytes, gases, nutrients, clotting factors, waste.
What is serum?
Plasma minus the clotting factors
What protein maintains oncotic pressure?
albumin
This can be given as a volume expander.
Why is the shape of RBCs important?
Their flexibility makes it possible to get into tiny capillaries.
What does erythropoietin do?
Stimulates RBC production from the bone marrow.
Normal life span of RBC
120 days
What is hemastasis?
Stopping the bleeding
How should supplemental iron be taken?
Without dairy
With calcium
Empty stomach
What are the 3 types of granulocytes in WBCs? What is their main job?
Neutrophils
Basophils
Eosinophils
–Phagocytosis–
What is the most common granulocytes? What percentage of WBCs?
Neutrophils
65–75% of WBCs
What could an elevated eosinophil count indicate?
Parasitic infection
When basophil count elevated, could be an indication of?
Allergic and inflammatory process
What are the two types of agranulocytes within WBCs?
Monocytes
Lymphocytes
What is job of monocytes?
Powerful macrophages
Some are resident macrophages in specialized areas (like alveolar)
What are the 2 main types of lymphocytes? Where are lymphocytes stored?
T cells
B cells
Stored in spleen and other lymphoid tissues
What is job of T cells?
T cells differentiate into different types of “killers”
They do this by cell mediated response. This means cells are “marked” for destruction. T cells show up to do the job.
What is job of B cells?
They make antibodies to start their attack. This is called humoral response. Humoral in Latin means “in fluid”. B cells stay in blood and lymph.
What is a thrombocyte?
Platelet
How should a swollen (but normal) lymph node feel?
Sore
Firm but not hard
Movable
Should not be >1 cm
If a lymph node is hard and immovable, what should we suspect?
Cancer
What are some important health hx questions to ask if we suspect hematological problems?
Energy levels
Meds
Smoking/alcohol
Recent surgeries
Diet
Unusual bleeding/bruising
Dizziness
Heavy periods
What are flat or slightly raised purple/red discolorations called?
Pupura
Indicated hyper coagulability
What are round, red centers with branching radiations called?
Spider angiomas
or Spider nevus
Indicated high estrogen or liver disease
What are raised red warty looking skin lesions?
Angiomas
Benign
