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Pathophysiology 2 > Blood & Blood Disorders > Flashcards

Blood & Blood Disorders Flashcards

1
Q

Blood is specialized ________ tissue derived from the _______ germ layer

A

connective

mesodermal / mesenchymal

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2
Q

The process of blood formation is known as ________

A

hematopoiesis / hemopoiesis

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3
Q

The major bones containing bone marrow generating blood cells are __________

A

flat bones of axial skeleton - sternum, ribs, pelvic bones
vertebrae
skull

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4
Q

The functions of blood are _________

A
  • carrying O2 and CO2
  • buffering and enabling metabolic reactions
  • elimination of waste
  • delivery of nutrients
  • distribution of hormones and other chemical messengers
  • clotting and prevention of excessive bleeding
  • immune defense
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5
Q

Whole blood is composed of _________

A

plasma - amino acids, nutrients, proteins, nitrogenous waste, electrolytes, gases

formed elements - WBCs, platelets, RBCs

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6
Q

Red bone marrow functions to ________

Yellow bone marrow functions to ________

A

generate formed elements of blood

nourish and support red bone marrow

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7
Q

Myelophthisis is __________. This process is seen in disorders such as __________

A

the degeneration of red bone marrow with the substitution by yellow bone marrow

blood / bone marrow cancers

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8
Q

Active bone marrow is generally termed ________

A

myeloid

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9
Q

When pluri-potent stem cells develop into white blood cell colonies, they differentiate into ________ progenitors and ______ progenitors

A

myeloid progenitors

lymphoid progenitors

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10
Q

Myeloid stem cells mature into what types of white blood cells?

A

monocytes, neutrophils, basophils, eosinophils

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11
Q

Lymphoid stem cells mature into what types of white blood cells?

A

T lymphocytes

B lymphocytes

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12
Q

Cancer of white blood cells are generally termed ______ and are categorized as either _____________ or __________

A

leukemia

myeloid/myelogenous/myelocytic

lymphoid/lymphocytic/lymphoblastic

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13
Q

List major endocrine hormones involved in hematopoiesis and their origins

A

erythropoietin - derives form KD

thrombopoietin - derives from LV

testosterone - derives from testicles/ovaries/adrenal glands

(Thrombin will activate production of fibrin from fibrinogen molecules, supplied by the liver - blood clotting)

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14
Q

Explain the difference in normal Hematocrit levels between males and females

A

Testosterone is more abundant in males than in females leading to more RBC production

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15
Q

Hematocrit is _________ and is measured in ______

A

the packed volume of formed elements (mainly RBCs) per volume unit of whole blood

percentage

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16
Q

The normal value range of Hct in a female is ___ ; in a male it is ___

A

37-46%

41-53%

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17
Q

What is hemoglobin concentration per volume of blood (Hb)?

A

A measure of the total amount of the oxygen-carrying protein in the blood, which generally reflects the number of red blood cells in the blood

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18
Q

What is Mean Corpuscular Volume (MCV)?

A

a measurement of the average size of a single red blood cell

Macrocytic
Microcytic

Normocytic

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19
Q

What is Mean corpuscular hemoglobin (MCH)?

A

a calculation of the average amount of hemoglobin inside a single red blood cell

Hyperchromic
Hypochromic

Normochromic

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20
Q

What is Mean corpuscular hemoglobin concentration (MCHC)?

A

a calculation of the average concentration of hemoglobin inside a single red blood cell

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21
Q

What is Red cell distribution width (RDW)?

A

a calculation of the variation in the size of RBCs

Variety in size is ether high or low

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22
Q

What is the difference between plasma and serum?

A

serum is plasma that has clotting factors removed

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23
Q

List the immediate precursor for each of the following:
erythrocyte
thrombocyte
neutrophil

A

reticulocyte

megakaryocyte

band cell

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24
Q

Leukocytosis is _________. It usually signifies excess of what type of WBC?

A

an excess amount of WBCs in the blood

neutrophils

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25
Q

List examples of excessive white blood cells types

A

neutrophilia, lymphocytosis, eosinophilia, basophilia, reticolocytosis, bandemia, thrombocytosis

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26
Q

Leukopenia is _______

A

a deficient amount of WBCs

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27
Q

An excess of RBCs or all lines of blood cells is called ________

A

polycythemia

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28
Q

Define anemia

A

a state of a diminished count of erythrocytes and/or content of hemoglobin

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29
Q

Anemia can result from one or more of 3 basic mechanisms: _________________

A
  • blood loss
  • deficient erythropoiesis (nutrient deficit)
  • excessive hemolysis (sickle cell anemia, thalassemia, malaria, auto-immune, etc.)
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30
Q

Describe iron deficiency anemia

A

lack of iron leads to insufficient hemoglobin production
RBCs are smaller than normal and have an increased zone of central pallor
There is also increased anisocytosis (variation in RBC size) and poikilocytosis (variation in shape)

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31
Q

Describe folate deficiency anemia

A

lack of folate leads to large red blood cells (deficient production of DNA) and can lead to macrocytic (megaloblastic) anemia

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32
Q

Describe B12 (Cyanocobalamin) Deficiency anemia

A

lack of B12 leads to large red blood cells(deficient production of DNA) and can lead to macrocytic (megaloblastic) anemia

33
Q

Describe pernicious anemia

A

It is a special type of B12 deficiency anemia due to deficient absorption of vitamin B12. It is caused by auto-immune injury of gastric mucosa w/ the atrophy of parietal cells (produces intrinsic factor complex - carrier protein for B12)

34
Q

Describe aplastic anemia

A

a rare disease in which the bone marrow, and the hematopoietic stem cells that reside there, are damaged,. causing a deficiency of all three blood cell types

35
Q

The most common cause of iron deficiency anemia within the USA is __________

A

chronic bleeding (genito-urinary or gastro-intestinal)

36
Q

Describe the character of RBCs in iron deficiency

A

microcytic and hypochromic RBCs

37
Q

List signs and symptoms of iron deficiency anemia

A

glossy tongue, nail deformities (koilonychia), pagophagia, pica

38
Q

How is iron deficiency anemia diagnosed?

A

TIBC test (Total Iron-Binding Capacity) along with serum iron test

39
Q

In iron deficiency, the storage of iron (in the form of _____ ) is ______, while TIBC is _________

A

ferritin

depleted

increased

40
Q

The major storage source of iron in the body is _____. TIBC measures __________

A

ferritin

binding of iron to transferrin

41
Q

List major nutritional sources of:
Iron

Vitamin B12

Folate

A
  • liver, meat, shellfish
  • shellfish, liver, fish
  • green leafy vegetables, liver, legumes
42
Q

List general steps of hemostasis

A

1) initial brief vasospasm
2) temporary platelet plug formation
3) coagulation cascade
4) clot retraction
5) clot dissolution

43
Q

In temporary platelet plug formation, platelet adhesion requires presence of _____ a glycoprotein manufactured by ________ and ______.

A

vWF (von Willebrand factor)

endothelium of blood vessels

liver

44
Q

In addition to its role in temporary platelet plug formation, vWF also _________

A

is a complex carrier for clotting factor VIII

45
Q

Instrinsic coagulation cascade is initiated ________
Extrinsic coagulation cascde is initiated ________
Both coagulation cascades lead to common step of ________ and production of ________.

A

within an injured blood vessel

when the blood is exposed to the surrounding injured tissues (trauma)

factor X activation

thrombin

46
Q

In hemostasis, thrombin will activate production of _____ from ______, supplied by the liver

A

fibrin

fibrinogen

47
Q

Platelets are _______ and function to ________

A

anuclear cellular fragments of megakaryocytes

initiate clotting process (coagulation cascade)

48
Q

Bandemia is _______ and suggests __________

What are BLASTS? If you see BLASTS what does this suggest?

A

increase in immediate precursor cells for neutrophils (polys)

initial stage of an acute bacterial infection

BLASTS are immature WBC (undifferentiated WBC should not see in the blood it belongs in the bone marrow). We can assume leukemia.

49
Q

Reticulocytosis is an indication of _______ and suggests _________

A

anemia or hypoxia

chronic bleeding, respiratory pathology, smoking, change of altitude

50
Q

Relative polycythemia is due to ________

A

diminished plasma volume (dehydration)

51
Q

Absolute polycythemia is subdivided into _______ and _______

A

primary - bone marrow malignancy

secondary - renal cell carcinoma w/ excess EPO or hypoxia

52
Q

Normocytic and normochromic anemia suggests ________

A

anemia of chronic disease or acute blood loss

53
Q

Deficiency of Vitamin B12 (aka __________) leads to accumulation of pro-inflammatory amino acid __________. This substance contributes to ______ injury and eventually to chronic _________

A

cyanocobalamin

homocysteine

vascular

ischemic heart disease and other chronic vascular pathological events

54
Q

Deficiency of Vitamin B12 is known to result in significant _______ deficit, which may progress to irreversible _________

A

neurological

peripheral neuropathies, dementia, loss of coordination

55
Q

What is the prognosis if B12 defciency is mistaken for folate deficiency and treated exclusively with folic acid supplementation?

A

Anemia might improve but neurological deficit will likely become irreversible

56
Q

Sickle cell anemia is ___________ anemia which is caused by _______ on the gene coding for _________. It is of an _________ inheritance mode

A

hereditary hemolytic

point mutation

beta chain of adult Hemoglobin A

autosomal-recessive

57
Q

Instead of normal Hemoglobin A, sickle cell anemia leads to production of _______, which is prone to ______ which in turn leads to ________

A

Hemoglobin S

crystallization

sickling of the RBCs in peripheral circulation

58
Q

Sickling is an event of RBCs becoming ________. It prompts ________ and leads to ________

A

rigid and assuming “ice pick” shapes

thrombosis

generalized ischemia

59
Q

The major pathogenesis of sickle cell anemia is __________

A

generalized hemolysis with thrombosis and ischemia

60
Q

Major factors contributing to sickling of RBCs in SC anemia are __________

A

hypoxia, acidosis, stress, dehydration

61
Q

Clinical presentations of sickle cell anemia include ___________

A

severe jaundice/icterus, priapism, trophic ulcers, neuropathies

62
Q

Hemophilia A and B are both hereditary disorders of ___________ inheritance mode. Von Willebrand disease is hereditary disorder of ________ inheritance mode

A

X-linked recessive

mostly autosomal

63
Q

Hemophilia A presents with deficiency of ________
Hemophilia B presents with deficiency of _________
Von Willebrand diseases presents with deficiency of _________

A

clotting factor VIII

clotting factor IX

vWF (qualitative or quantitative)

64
Q

Hemophilia A and B are diagnosed by ___________

A

clinical presentations, prolonged bleeding times, genetic testing

65
Q

Von Willebrand disease is diagnosed by __________

A

essaying certain clotting factors and investigating bleeding times

66
Q

The therapeutic approach for bleeding disorders in general is based on ______________

A

replenishment of the deficient component needed for proper clotting to occur

67
Q

Which bleeding disorder is known as Christmas disease? why?

A

Hemophilia B was first reported in the medical literature in 1952 in a patient with the name of Stephen Christmas

68
Q

The most common leukemia of childhood is ________

A

ALL - Acute Lymphocytic Leukemia

69
Q

Philadelphia chromosome is the mutual translocation between _________ and is found in 95% of cases of ______ and 5% of cases of __________

A

chromosome 9 and 22

CML - chronic myeloid leukemia

ALL - acute lymphocytic leukemia

70
Q

Reed-Sternberg cells are __________ and are a characteristic feature of _________

A

bi-nucleated immature B lympthocytes

Hodgkin’s lymphoma

71
Q

List major signs of leukemias and lymphomas

A

painless lymphodenopahty, bruising, nose bleeds, fatigue, fluctuating tidal fever, profuse sweating, “stubborn” infections

72
Q

Multiple Myeloma is a cancer of __________ cells

A

monoclonal plasma cells

73
Q

In Multiple Myeloma, ____ cells, which are __________, are immature and spread indefinitely within the bone and peripheral blood, secreting ______ that clamp together and form ________, obstructing peripheral circulation and especially ___________

A

plasma

activated B lymphocytes

abnormal fragments of antibodies

Bence-Jones proteins

kidney tubules

74
Q

How does Hodgkin’s lymphoma differ from non-Hodgkin’s lymphoma?

A

Hodgkin’s lymphoma is cancer of lymphatic structure only

Non-Hodgkin’s lymphomas can have a simultaneous component of lymphocytic leukemia as well

75
Q

Multiple Myeloma presents with ____________

A

initial onset - bone pain worse at night (dull, gnawing, fixed pain)
immuno-deficiency - chronic infections
abnormal indurations

76
Q

Hemolytic anemias can be caused by ___________

A

infections, genetic disease

77
Q

Folate deficiency is more common than Vitamin B12 deficiency because __________

A

folate cannot be readily stored in the body

78
Q

Primary absolute polycythemia is aka _______________

A

Polycythemia Rubra Vera

Pathophysiology 2 (8 decks)

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