Blood and Circulatory System Disorders Flashcards
1
Q
what does a complete blood count include (CBC)
A
hemoglobin/hematocrit, RBC, WBC, platelets
2
Q
standard INR (warfarin) value
A
0.8-1.5
3
Q
therapeutic range of INR
A
2-3.5
4
Q
standard value of PT
A
10-14 sec
5
Q
therapeutic range of PT
A
16-30 sec (critical value = >46)
6
Q
standard range of PTT (heparin)
A
25-35 sec
7
Q
________: oxygen carrying protein of the erythrocyte
A
hemoglobin
8
Q
______: % of concentration of RBC
A
hematocrit
9
Q
INCREASED H/H =
A
acute bleeding or dehydration
10
Q
DECREASED H/H = chronic bleeding or overhydration
A
11
Q
partial thromboplastin time (PTT) is related to the use of ______
A
heparin
12
Q
what is the antidote for heparin
A
protamine sulfate
13
Q
prothrombin time (PT) and international normalized ratio (INR) is related to the use of ______
A
warfarin
14
Q
what is the antidote for warfarin
A
vitamin k
15
Q
name the chief function of the hematologic system
A
DELIVERY: of nutrients needed for cellular metabolism in the tissues
REMOVAL: of wastes of cellular metabolism from the tissues
DEFENSE: against invading microorganisms and injury
MAINTENANCE: of acid-base balance
16
Q
_______: production of blood cells
A
hematopoiesis
17
Q
where does hematopoiesis occur in adults and where does it occur in a fetus
A
adults: bone marrow
fetus: spleen
18
Q
_____: red blood cells
A
erythrocytes
19
Q
most abundant cell in the blood
A
erythrocytes
(carry oxygen to cells and tissue; 120 day life cycle)
20
Q
_____: development of RBCs
A
erythropoiesis
21
Q
_______: hormone made by the kidney and drives RBC production
A
erythropoietin
22
Q
RBC production is stimulated by what
A
hypoxia
23
Q
______: white blood cells
A
leukocytes
(-cytosis = high; =penia = low)
24
Q
function of leukocytes
A
fight infection, manage inflammation, remove debris/dead cells
25
where do leukocytes primarily act
in tissues (can be transported in circulation)
26
______ count: how effective the body is working in creating red blood cells
reticulocyte count
27
name the granulocytes
neutrophils, eosinophils, basophils and mast cells
28
_______ are the most numerous WBC
neutrophils
29
neutrophils are predominant phagocytes in _____ inflammation
early
30
eosinophils are induced by _____
IgE allergic response and parasitic infection
31
mast cells and basophils are predominant in what
inflammation of connective tissue
32
name the agranulocytes
monocytes and lymphocytes
33
_______ = mononuclear phagocyte system (MPS)
monocytes
34
what is the key organ in MPS
spleen
35
immature macrophages mature into what
macrophages
36
where are macrophages found
in tissues
37
______: primary cells of the immune response
lymphocytes
(function decreases with age)
38
39
what do lymphocytes mature into
T cells, B cells
40
what is the life cycle of thrombocytes
10 days
41
what are platelet levels maintain by
thrombopoietin
(stimulates platelet production)
42
where are senscent (old) platelets destroyed
in the spleen
(numbers decrease with age)
43
in coagulation, the final clot consists mainly of what
fibrin
44
name the process that initiates coagulation (5 steps)
- vascular injury leads to transient vasoconstriction or vascular spasm
- formation of platelet plug
- activation of clotting cascade
- formation of a blood clot
- clot retraction and clot dissolution
45
what will eventually break down the clot
plasmin
46
_____: a protein that is made when a clot dissolves
D-dimer
47
is an elevated d-dimer normal
NO; it is usually found after a clot has formed and is in the process of breaking down
48
each step of the coagulation system serves as a ______, which does what
catalyst; amplifies the next reaction
49
what is the result of both coagulation pathways
fibrin (clot)
50
why can heparin and warfarin be given together
they affect different places in the coagulation system
51
what is blood typing based on
red blood cell antigens
52
are antigens or antibodies on a cell
antigens
53
what are systemic clotting problems usually the result of
a significant hematological event
54
a localized clotting problem is usually a problem in what
either the vein or artery (or an injury to a vessel or a clot within a vessel)
55
to control bleeding RICE can be used, what does this stand for
R = rest
I = ice
C = compression
E = elevation
56
______: condition where there are too few erythrocytes or an insufficient volume of erythrocytes in the blood
anemia
57
anemia = low what
RBC and H/H
(loss oxygen to cells = less cellular reproduction)
58
what are four reasons anemia can be developed
1. blood loss
2. impaired erythrocyte production
3. increased erythrocyte destruction
4. combination of all three factors
59
initial signs of anemia (9-11 gm/dL)
- fatigue
- pale skin, mucous membranes, lips, nail beds, conjunctive
- dyspnea
- SOB on exertion
- dizziness
- lethargy
60
name two compensation mechanisms for anemia
tachycardia and peripheral vasoconstriction
61
chronic/late anemia symptoms ( below 8 gm/dL)
- inflamed/ulcerated digestive tract
- inflamed/cracked lips
- slower healing
- beefy/red, painful tongue
(brittle, thin, coarsely rigid spoon-shaped nails)
62
severe anemia (below 6 mg/dL) can lead to what
angina or heart failure or death
63
name the most common form of anemia
iron deficiency anemia
64
iron is required for the synthesis of what
hemoglobin
65
what are some causes of iron deficiency anemia
1. BLOOD LOSS (acute or chronic)
2. dietary deficiency
3. impaired absorption (celiac, fat absorption disorders)
4. increased requirement
5. chronic diarrhea
66
what is the treatment of iron deficiency anemia
iron replacement therapy (oral, IM, IV)
67
pernicious anemia is caused by a deficiency in what
vitamin B12 (due to intestinal malabsorption)
68
what allows for intestinal absorption of vitamin B12
intrinsic factor
69
with pernicious anemia there is a lack of intrinsic factor in where
the stomach (parietal cells)
70
cobalamin (vitamin B12) is necessary for a healthy what
myelin sheath
71
name three causes of pernicious anemia
chronic gastritis, gastrectomy, vegetarian diet
72
what is the main s/s of pernicious anemia
feeling of pins and needles = tingling in limbs
73
what is the treatment of pernicious anemia
cyanocobalamin (B12)
74
____ anemia = impairment or failure of bone marrow
aplastic anemia
75
name three causes of aplastic anemia
- idiopathic (primary; autoimmune)
- secondary (chemical agents ionizing radiation)
- infections (certain viruses)
76
______: low bone marrow function = low RBC/WBC/platelets
pancytopenia
77
s/s of pancytopenia
bleeding, infection, fatigue; hypoxia, pallor, weakness, fever, dyspnea
78
name some treatments for aplastic anemia
bone marrow transplant, stem cell transplant, removal of bone marrow suppressants
79
if there is failure to identify the cause and effectively treat aplastic anemia what can happen
death; it is life-threatening!
80
what type of anemia is genetic
sickle cell
81
is sickle cell anemia a dominant or recessive trait
recessive
(most common in african and mediterranean descendents)
82
sickle cell anemia is production of an atypical type of hemoglobin called _____
hemoglobin S
83
sickle cell crisis is driven by what
hypoxemia and dehydration
(other stressors: fever, infections, stress, high altitude, surgery, blood loss, dehydration, decrease pH, low temperature (hypothermia), and/or decreased plasma volume)
84
sickled red blood cells are UNABLE to pass capillaries, which causes
clogged vessels
85
sickled cells slow _____, promote ____, and increase ____
slow blood flow, promote hypoxia, increase sickling
86
a decrease in blood pH and a decreased affinity for O2 causes what to drop adn increases what
PO2 drops and sickling increases
87
is sickling permanent
no; most erythrocytes regain normal shaper after reoxygenation, a return of Po2 and rehydration
88
what can reduce the risk of sickle cell crisis
health promotion activities
89
name some acute s/s of sickle cell anemia
- SEVERE PAIN (from clots/obstructions and resulting in ischemia)
- pallor, weakness, tachycardia, dyspnea
- swelling of joints
- HYPERBILIRUBINEMIA AND JAUNDICE
90
chronic manifestations of sickle cell anemia
delay of growth and development
(splenomegaly, renal failure, neuropathy, heart failure, priapism - sustained, engorged, painful penile erections)
91
acute treatment of sickle cell anemia crisis
H.O.P (hydrate, O2, pain management, transfusion therapy)
92
_______: number/volume of erythrocytes is excessive
polycythemia
93
Tumor of kidney or autosomal dominant mutation that causes increased secretion of erythropoietin
primary polycythemia (polycythemia vera)
94
primary polycythemia is a rare type of polycythemia that occurs in ____
older adults
95
________ is the most common type of polycythemia
secondary polycythemia
96
secondary polycythemia is a physiologic response to hypoxia leading to what
increased erythropoietin secretion
97
what are causes of secondary polycythemia
airway diseases and high altitude
98
s/s of polycythemia
increased blood volume and viscosity
(distended blood vessels; ruddy/red color of face, hands, feet, ears, mucous membranes; increased BP; visual disturbances; dyspnea)
99
treatment for primary polycythemia
suppression of bone marrow activity (drugs/chemo)
100
treatment for both primary and secondary polycythemia
periodic phlebotomy
101
most common inherited clotting disorder
hemophilia A
102
what type of trait is hemophilia A
x-linked recessive and manifested in men but carried by women
(all races/ethnicities are susceptible)
103
what do s/s of hemophilia a depend on
concentration of clotting factors
104
diagnostic tests for hemophilia A
decreased serum factor VIII, PTT/aPTT increased, platelets/PT remain normal
105
treatment for hemophilia A
desmopressin (DDAVP): factor VIII replacement
(recombinant factor - control or prevent future bleeds)
106
_______: acquired clinical syndrome characterized by WIDESPREAD ACTIVATION OF COAGULATION
disseminated intravascular coagulation
(results in formation of fibrin clots in medium/small vessels or microvasculature)
107
disseminated intravascular coagulation can be what (3)
acute, subacute, chronic
108
what can widespread clotting lead to
blockage of blood flow to organs resulting in multiple organ failure
109
excess clotting may result in consumption of platelets and clotting factors leading to what
a tendency to bleed
110
name some causes of widespread clotting
MAJOR TRAUMA, sepsis, adenocarcinomas, extensive surgery, burns, obstetrical complications
111
what is the diagnosis of disseminated intravascular coagulation based on
clinical symptoms and confirmed lab tests
(D-dimer elevated/low)
112
treatment of disseminated intravascular coagulation
find and remove stimulus/cause
(maintain organ function, control thrombosis)
113
______: risk for venous thrombosis
thrombophilia-hypercoagulability
114
what is virchow's triad
development of thrombi related to:
1. injury og blood vessel endothelium
2. abnormalities of blood flow
3. hypercoagulability of blood
115
diagnostics for Thrombophilia- Hypercoaguability
PT, PTT levels, protein C and S
116
_____: stationary clot attached to a vessel
thrombus
117
____: clot that has detached from a vessel wall and circulates within blood stream - may lodge in tissue or organ and lead to ischemia
embolus
118
a clot in the carotid artery will move where
to the brain (stroke)
119
clots in veins of the leg (DVT) will move to where
vessels in lungs (PE)
(life threatening and can cause sudden death)
120
name three drug therapies commonly used for thrombophilia
anticoagulants, antiplatelets, thrombolytics/fibrinolytics
121
____: high wbc
neutrophilia
(caused by infection or inflammation)
122
_____ shift = premature release of immature WBCs; what does this mean
left; infection worsening
123
_____ shift = WBCs returning to normal; what does this mean
right; infection is improving
124
_____: low WBCs
neutropenia
(causes = prolonged/severe infection, decreased neutrophil production, reduced lifespan)
125
difference btwn lymphocytosis and pymphocytopenia
lymphocytosis = high lymphocytes (acute viral infections)
lymphocytopenia = low lymphocytes
126
_____: acute, self-limiting viral infection of B-lymphocytes
(may last a few weeks but full recovery may take months)
infectious mononucleosis
127
common causes of infectious monomucleosis
EBV, herpesvirus - transmitted by saliva through personal contact, breastfeeding, sexual transmission
128
acute s/s of infectious mononucleosis can last how long; name some examples
up to 4-6 weeks
severe fatigue, fever, sore throat, cervical lymph node enlargement
129
lasting s/s of infectious mononucleosis can last up to how long; name some examples
6-8 months
mild to moderate fatigue, mild splenomegaly and hepatomegaly
130
diagnostic test for infectious mononucleosis
monospot test (blood test for EBV)
131
treatment for infectious mononucleosis
usually self limiting (recovery in a few wks)
- avoid strenuous activity/contact sports
- fatigue can last 1-2 months
132
____: bone marrow cancer
leukemia
133
leukemia is uncontrolled production of what
immature WBC
(decreased immune system)
134
with leukemia other hematopoietic tissues are reduced causing a risk for what
anemia
135
name the types of acute leukemia
ALL, AML
(mostly affect younger people)
136
ALL primarily affects what
production of lymphocytes
137
AML affects what
production of myeloblasts, RBC, platelets
138
chronic leukemia mostly affects what population
older adults
139
chronic leukemia has a _____ onset
slow (mild s/s)
140
what is a cause of chronic leukemia
exact cause is unknown; exposure to radiation; genetic conditions with perdisposition
141
what is the primary treatment for leukemia
chemotherapy
142
what is epoetin alpha
artificial drug form of erythropoietin
143
what is epoetin alpha used for
renal failure and severe anemia
144
when should you stop giving epoetin alpha
if hemoglobin > 11g/dL (life-threatening)
145
with age, what happens to RBC
erythrocyte life span remains normal but they are replaced more slowly
146
what happens to lymphocytes with age
function decreases with age and there is a decrease in cellular immunity
147
what happens to platelets with age
decrease in number and adhesiveness increases
