Blood Flashcards
Erythrocyte/RBC
Primary responsibility is to carry oxygen to the tissues
- most abundant cell in the blood
- labs = Hct
- normal (absolute count): 4.2-6.2 million
Types of leukocytes
- neutrophils
- lymphocytes
- monocytes
- eosinophils
- basophils
never let monkeys eat bananas
Divisions of WBC
Granulocyte:
- N, E, B
Agranulocytes:
- L, M
Granulocyte
Cells have nucleus and several lobes called granules
- granules release mediators w inflammatory and immunity properties
- largest group is neutrophils
Agranulocytes
Do not have granules so dont release inflammatory mediators
Neutrophils
First to arrive at site of inflammation
- bands and segs (immature v mature)
- inc w acute bacterial infections and trauma
- shift to the left aka inc bands
Lymphocyte
Primary cells of immune response (b and T cells)
- inc w chronic bacterial infection and acute viral infection
- live in the lymph nodes, no granules
Monocytes
Phagocytosis —> besties w macrophages
- inc w bacterial infections and cancers
Eosinophils
Inc w allergic rxn and parasitic infections
- worms, wheezes and weird diseases
Basophils
Inc w allergic rxn
- hypersensitivity and inflammatory rxns
Hgb
Hemoglobin: measures the Hgb in blood
Normal Hgb levels
Men: 13.5-17.5
Women: 12-15.5
Cause of low Hgb
Bleeding
Folate (b12) deficiencies
Cancer
Kidney and liver disease
High Hgb causes
Polycythemia
COPD
High altitude
Heavy smoking
Hct
Hematocrit: percentage of blood that is made up of packed RBC
Hct normal levels
Men: 41-50%
Women: 36-44%
Causes of low Hct
Anemia, bleeding, bleeding disorder, fluid imbalances
Causes of high Hct
Polycythemia, COPD, dehydration, shock, congenital heart disease
Other RBC labs
- red cell count: # of RBC in blood
- mean corpuscle volume: size of RBC
- mean corpuscle Hgb: amount of Hgb by wt
Normal WBC level
5000-10,000
Leukocytosis
Increase WBC
Leukopenia
Decreased WBC
Neutropenia
Decreased neutrophils
What do total counts of WBC give us
Degree of response to pathological process
CBC
Complete blood count
CBC w diff
Total number of WBC (absolute number)
Proportion of each of the 5 WBC in a sample of 100ml
inc in % of one means dec % of another type
Inc temp or fever
Protective mechanism that indicates something is wrong
- dec growth, improve immune response, dec virulence
Leukopenia
WBC lower than 1000
- most often cancer pt result of disease or treatment
- susceptible to bacterial infections
- start precautions: good hygiene, avoid contact with ppl who are sick, avoid raw foods and grains, keep door closed
Leukopenia treatment
Hematopenia agents—> Granulocyte colony stimulating factors
- filgrastim: leukopoietic growth factor produced by recombinant DNA tech
mononucleosis
self limiting lymphoproliferative disorder caused by infection of the B lymphocytes
- caused by epstein barr virus
- typically young adults/teens
mode of transportation: mono
contaminated saliva
pathogenesis of mono
atypical lymphocyte proliferation
onset of mono
insidious, incubation 4-8 wks
clinical manifestions of mono
- lymphadenopathy
- hepatitis
- splenomegaly
- lethargic
- labs: 12-18,000 WBC –> 95% are lymphocytes
treatment of mono
- treat the symptoms
- no vaccine
- hydrate
myelodysplastic syndrome
group of hematologic disorders characterized by change in quality and quantity of bone marrow elements
- typically affects those older than 65
clinical manifestations of myelodysplastic syndrome
- cytopenias like anemia
- infection and spontaneous bruising
etiology of myelodysplastic syndrome
unknown, thought to be env triggers
diagnostic test for myelodysplastic syndrome
lab tests and bone marrow biopsy
treatment for myelodysplastic syndrome
- supportive
- granulocyte colony stimulating factor
- erythropoietin
- chemotherapy
- bone marrow transplant
leukemia
malignant neoplasms of cells originally derived from single hematopoietic cell line
leukemia cells
- immature and unregulated
- proliferate in the bone marrow then circulate in blood
- infiltrate spleen and lymph nodes
leukemia classifications
according to predominate cell type aka either myelocytic or lymphatic
- acute lymphocytic (children)
- chronic lymphocytic leukemia (older adults)
- acte myelocytic leukemia
- chronic myelocytic leukemia
leukemia is the disease of which stem cells
- myeloid stem cells
- lymphoid stem cells
leukemia cause
unknown, inc risk if exposed to radiation and maybe specific viruses
leukemia pathogenesis
immature WBC that have inc proliferation/prolonged life span
- cannot perform function of mature lymphocytes so they are ineffective w phagocytosis
- interfere w maturation of normal bone marrow cells (platelets and RBC)
acute leukemia
ALL, AML
- sudden and stormy onset
- s/s: dec mature WBC, RBC, platelets
- diagnosis: blood/bone marrow tissue–> presence of immature WBCs
chronic leukemia
insidious onset that may be discovered during routine medical exam by blood count
- CLL, CML
CLL
older adults with relatively mature lymphocytes that are immunologically incompetent
- s/s: fatigue, wt loss, anorexia, infections
CML
adults and children with immature cell types that presents w inc granulocyte count
- s/s: fatigue, wt loss, diaphoresis, bleeding ab discomfort
leukemia treatment
cytotoxic chemotherapy or stem cell transplant
- goal to attain remission
- risks: infection, rejection, relapse
types of stem cell transplant
- allogenic: volunteer donor
- syngeneic: identical twin
- autologous: pt’s own
malignant lymphomas
neoplasms of cells derived from lymphoid tissue
- non/Hodgkins
hodgkins disease
painless, progressive, rubbery enlargement of a single node or group of nodes
- usually in neck area
distinct tumor cell found in lymph biopsy of hodgkins
reed stenberg
diagnosis of hodgkins
- peripheral blood analysis
- lymph node biopsy
- bone marrow exam
- radiographic evaluation (CT, MRI, PET)
interacting factors of hodgkins
- Epstein Barr Virus
- genetic predisposition
- exposure to toxins
hodgkins clinical manifestions
insidious onset, painless enlargement of lymph nodes and other non specific symptoms like fatigue or nigh sweats
hodgkins treatments
chemotherapy
- standard: doxorubicin, bleomycin, vinblastine, dacarbazine (2-8 cycles)
radiation
stem cell transplant
non hodgkins
neoplastic disorder of lymphoid tissue
- spreads early to liver, spleen, bone marrow
- characterized by painless, superficial lymphadenopathy, extra nodal symptoms
extra nodal symptoms
lymphatic tissue in areas that it shouldnt be like bone, GI, skin
etiology of non Hodgkins
unknown
non hodgkins clinical manifestations
painless enlargement of lymph nodes and other non specific symptoms like fever, night sweats
diagnosis of non hodgkins
same as hodgkins
- inc extra nodal sites
treatment of non hodgkins
- chemotherapy
- radiation
- refractory cases- stem cell transplant
- ritximab, ibritumonman tiuxetan, tositumomab
multiple myeloma
plasma cell cancer (B cells)
- atypical proliferation of one of immunoglobulins called M proteins which makes you unable to maintain humoral immunity
- characterized by bone fracture and pain, also have symptoms r/t impaired production of RBC/WBC
- men more likely than women, AA more likely than white
M protein
monoclonal antibody associated w multiple myeloma
- inc osteoclasts which leads to bone destruction/resorption
etiology of multiple myeloma
unknown
clinical manifestations of multiple myeloma
slow and insidious, skeletal pain, hypercalemia (due to the bone breakdown)
diagnostic of multiple myeloma
labs, radiography, bone marrow exam
- monoclonal antibody protein in serum and urine
- pancytopenia, hypercalcemia, bence jones in urine, elevated serum cr, xrays of osetolytic lesions
treatments for multiple myeloma
watching, corticosteroids, chemotherapy, biological therapy, stem cell transplant, biophosphonates, adequate hydration
