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Emergency Critical Care VTS > Blood components > Flashcards

Blood components Flashcards

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1
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A
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2
Q

What are the most abundant circulating leukocyte?

A

Neutrophils

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3
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4
Q

What is diapedesis?

A

Neutrophils squeeze between cells of the endothelium in a process called diapedesis

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5
Q

How do neutrophils know where to go?

A

They are attracted to site of potential infection or inflammation through a chemical signalling process known as chemotaxis that employs endogenous inflammatory mediators.

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6
Q

When is neutrophilia noted?

A
  1. during inflammatory disease
  2. during infectious disease
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7
Q

What is an indication of band neutrophils?

A

Band neutrophils are released prematurely in response to overhwhelming infection or inflammation.

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8
Q

What is this and its indication?

A

Band neutrophil - step before segmented, fully mature neutrophils. Increase number of band neutrophils is calld bandemia and usually indicates an infection or inflammatory process.

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9
Q

What kind of leukocyte is this?

A

Eosinophil

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10
Q

What is the primary characteristic of eosinophils?

A

red cytoplasmic granules in mature cells.

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11
Q

How long do eosinophils stay in circulating pool?

A

Nove very long. Usually migrate into tissues within hours of their release.

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12
Q

What is the function of eosinophils?

A

Reduction of local allergic and anaphylactic reactions. Their granules contain anti-inflammatory substances released at the site of allergic reaction

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13
Q

Are eosinophils phagocytic?

A

minimally phagocytic.

The phagocytic abilities they do have are against pathogenic organisms such as protozoa and some parasitic worms.

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14
Q

What does eosinophilia indicate?

A

allergic reaction
parasitic infections, eg heartworm disease or gastrointestinal parasitism.

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15
Q

What is the primary characteristic of basophils?

A

blue cytoplasmic granules in mature cells.

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16
Q

What kind of leukocyte is this?

A

Basophil

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17
Q

Are basophils common in circulation?

A

Basophils are the rarest white blood cell in circulation.

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18
Q

What do basophil granules contain?

A

histamine and heparin

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19
Q

What is the function of heparin in basophils?

A

Heparin acts as a local anticoagulant to keep blood flowing through the area of injury.

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20
Q

How do eosinophils know where to go?

A

Eosinophils are attracted to the site of allergic reaction by chemotactic factors released by basophilic granules.

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21
Q

What does basophilia indicate?

A

allergic or hypersensitivity reactions.

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22
Q

What kind of cell is this?

A

Monocyte

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23
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24
Q

Monocytes makde up what percentage of circulating white blood cells?

A

5-6%

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25
Q

What is a primary characteristic of monocytes?

A

abundant cytoplasm containing vacuoles of various sizes.

26
Q

When monocytes enter tissue, they are reclassified as what?

A

Tissue macrophages

27
Q

Where do tissue macrophages tend to reside?

A

Tissue macrophages are more prevalent in filter organs such as teh liver, spleen and lymph nodes

28
Q

What is the mononuclear phagocyte system? (MPS)

A

Monocytes and tissue macrophages.

They are responsible for clean-up of a wide variety of microscopic debris in the body: cellular debreis left over from inflammation and infection, specific antigens that have been destroyed by lymphocytes and other foreign substances.

29
Q

Indications of monocytes?

A

Associated with chronic infection

30
Q

What kind of cells are these two?

A

Lymphocytes

31
Q

Are lymphocytes phagocytic?

A

They are the only luekocyte that is not phagocytic

32
Q

What are three different types of lymphocytes?

A

T-lymphocyte
B- lymphocyte
natural killer (NK) lymphocytes

33
Q

Where are T cells produced?

A

in the thymus before they migrate to the peripheral lymphoid tissue via lymphatic vessels and fluid.

34
Q

Which lymphocyte is the most common?

A

T-cells account for up to 80% of peripheral blood lymphocytes

35
Q

How long can T-lymphocytes live

A

anywhere from 6 months to 10 years.

36
Q

What are the two subtypes of T-lymphocytes?

A

Killer T cells
helper cells

37
Q

What is the function of B lymphocytes?

A

B lymphocytes produce specifi antibody against specific foreign antigen, even if the body is naive to that antigen.

38
Q

What is humoral immunity?

A

an adaptive response from the B-lymphocyte, as it recognizes and antigen and releases antibodies specific to that antigen.

39
Q

What is the function of plasma cells derived from B-lymphocytes?

A

produce, store and release immunoglobulins (antibodies).

40
Q

Where are plasma cells found?

A

All tissues of the body but most common n lymph nodes and spleen.

41
Q

What are the physical characteristics of natural killer cells?

A

large and granular

42
Q

where are natural killer cells found?

A

mainly in secondary lymphoid organs, but can be found in bone marrow.

43
Q

Function of natural killer cells?

A

lyze variety of tumor cells by responding to substances characteristic to tumor cells.

44
Q

Communicatio of natural killer cells

A

natural killer cells also release cytokines that recruit other cells.

45
Q

Are natural killer cells phagocytic?

A

No, the function by osmotic lysis or apoptosis

46
Q

Process of platelet production

A

Thrombopoiesis

47
Q

What are the precursor cells of platelets?

A

Megakaryocytes produced in bone marrow.

48
Q

What is normal platelet count?

A

200,000-800,000/ml

49
Q

How low must platelets fall before spontaneous clinical hemorrhage can be detected?

A

30,000/microliter

50
Q

TEG: R time (reaction time)

A

Time to the initiation of the first measurable clot.
Dependent on clotting factors and will be impacted by anticoagulants

Increase R-Time: reverse anticoagulant or give FFP to give clotting factor

51
Q

TEG: K(kinetics)

A

Measure of time until 20 millimeters of clot strength.

Kinetics of patient clot is dependent on fibrinogen.

If increase K - give cryo

52
Q

TEG: alpha Angle

A

slope from initiation of clot to K-time.

Indicates the rate of clot formation (fibrin build up and cross linking)
Dependent on fibrinogen.

Decreased angle - give cryo

53
Q

TEG: Maximum amplitude

A

Maximum strength of clot formation.
Dependent on platelets, Fibrin and factors II and III

Decrease MA - give platelets

54
Q

TEG: LY30

A

% of clot lysis 30 minutes after maximum amplitude (MA)

Looking at fibrinolysis - how much of clot has been broken down.

Increase LY30 - antifibrinolytic therapy _ tranexamic acid or aminocaproic acid

55
Q
A

Increase R time and K-time
decrease maximum amplitude and decrease angle

Prolonged clot initiation time

Indicates hemophilia or anticoagulants
treatment: Give FFP or Anticoagulant reversal

56
Q
A

R - time normal
K-time increased
Maximum amplitude decreased

Normal clot initiation time
Prolonged time to form clots

Indicates thrombocytopenia, platelet blocker
Treatment: Give platelets

57
Q
A

Prolonged R-time
Prolonged K- time
decreased angle

prolonged clot initiation
Prolonged time to form clot

Indicates low fibrinogen

Give cryoprecipitate

58
Q
A

Normal R-time
Continuously decreasing MA
Increase LY30

Indicates fibrinolysis

Can see in trauma or hemorrhage

Treatment: Give antifibrinolytics - tranexamic acid or aminocaproic acid

59
Q
A

Increased R time
Increased K time
decreased maximum amplitude
decreased angle

Prolonged clot initiation
slow rate of clot formation
Low clot strength
Indicates hypocoagulation

Treatment: FFP/Platelets/Cryoprecipitate/ +/- Vit K

59
Q
A

decreased R-time
decreased K-time
Increased maximum amplitude
increased angle

clots are fast to form and many clots are formed without breaking down.

Indicated Hypercoagulation

Treatment: anti-coagulants, antithrombotics, fibrinolytics

60
Q
A
61
Q
A

Emergency Critical Care VTS (21 decks)

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