Blood Patho, Disorders Of Hemostasis, Immunity, Inflammation, And Would Repair Flashcards
Functions of the hematopoietic system:
Transport, communication, temperature, and clotting
Blood is composed of:
Formed elements and plasma
Formed elements include:
Erythrocytes, leukocytes, and thrombocytes (platelets)
Plasma includes:
electrolytes, gases, nutrients, and waste products
Albumin, immunoglobulin, complement, and clotting factors are these:
Important plasma proteins
This is the result of removing clotting factors from plasma.
Serum
This represents the volume of blood occupies by RBCs
Hematocrit
The process of forming erythrocytes, leukocytes, and thrombocytes to replace blood cell populations that are constantly undergoing cell death and renewal.
Hematopoiesis
Hematopoiesis involves:
Takes place:
Cell division (mitosis) and specialization (differentiation)
Bone marrow
This is a continual process whereby self-renewing pluripotent stem cells develop into different cell populations in the context of environmental cues (hormones, growth factors)
Hematopoiesis
T lymphocytes and b lymphocytes are these:
Lymphoid lineage
Erythrocytes, neutrophils, monocytes, eosinophils, basophils, megakaryocytes that firm platelets are:
Myeloid lineage
The formation of rbcs is:
Erythropoiesis
Erythropoiesis requires:
Vitamin b12 (cobalamin), folate (folic acid), and iron
Vitamin b12 absorption requires this:
Intrinsic factor
Lack of IF results in:
Pernicious anemia
Folate and vitamin b12 are required for:
DNA synthesis
This is the oxygen-binding component of hemoglobin:
Iron
Regulation of erythropoiesis is through:
Erythropoietin (EPO) that stimulates bone marrow to increase RBC production in response to low oxygen.
A large amount of iron in the body is contained within:
Proteins such as hemoglobin and myoglobin
Remainder is found in ferritin and hemosiderin
Iron is bound to
Transferrin
Iron is largely recycled and recovered as rbcs are processed here:
Spleen
These are a type of granulocyte that are abundant, phagocytosis, immature band forms.
Neutrophils
This type of granulocyte are least abundant, mature into mast cells, are involved in allergic responses, and release histamine.
Basophils
This type of granulocyte is involved in allergic or parasitic infections.
Eosinophils
This type of agranulocyte forms macrophages, are phagocytosis, and have an inflammatory response.
Monocytes
This type of agranulocyte includes B and T cells
Lymphocyte
This is the process of forming platelets
Thrombopoiesis
These are derived from fragmentation of megakaryocytes and are important in hemostasis.
Platelets
This is a growth hormone released from the liver that stimulates thrombopoiesis.
Thrombopoietin
Refers to an abnormally low number of neutrophils.
Neutropenia
These are particularly important for fighting bacterial infections.
Neutrophils
This is an infectious viral disease caused by Epstein-Barr virus
Infectious mononucleosis
Symptoms of mono:
Flu-like symptoms: fever, sore throat, fatigue among adolescents and young adults. Spleen enlargement can also occur.
This is also typical of mono infections, especially in adolescents and young adults.
Lymphadenopathy
This virus replicated within epithelial cells, then within b lymphocytes, which stimulates t cytotoxic cells to target the infected b lymphocytes. Atypical lymphocytes are typical.
Mono
This is cancer of the blood or bone marrow characterized by an abnormal increase of immature leukocytes (blasts).
Leukemia
Signs and symptoms of leukemia include the consequences of this:
Cell deficit
This is characterized by a rapid increase in the number of immature blood cells and are the most common forms of this in children.
Acute leukemia
This is characterized by build up of relatively mature but abnormal white blood cells and generally takes months or years to progress.
Chronic leukemia
Type of leukemia where immature lymphocytes and their progenitors that originate in the bone marrow, but infiltrate the spleen, lymph nodes, CNS, and other types.
Lymphocytic leukemia
Type of leukemia that involves pluripotent myeloid stem cells I. Bone marrow and interferes with maturation of all blood cells including granulocytes, erythrocytes, and thrombocytes
Myelogenous leukemia
Most common type of leukemia in young children, but can affect adults over 65.
ALL
Typically this type of leukemia is characterized by structural and numerical changes in the chromosomes within the leukemia cells such as translocations, deletions, hyperploidy, or polyploidy that likely alters the ability to regulate normal hematopoiesis.
ALL
This type of leukemia occurs more commonly in adults than children and more commonly in men then women.
AML
This is a diverse set of leukemias affecting myeloid precursors in the bone marrow and are most often associated with genetic changes that inhibit myeloid fell differentiation.
AML
In AML undifferentiated blast cells replace the normal cells within the bone marrow causing:
Anemia, neutropenia, and thrombocytopenia
This is a clinal malignancy of B lymphocytes that most often affects adults over 55 and does not affect children. It is the most common form of Leukemia in adults and 2/3s of all cases are men.
CLL
This is a disorder of the pluripotent hematopoietic progenitor cell and is characterized by excessive proliferation of marrow granulocytes, erythroid precursors, and megakaryocytes.
CML
This is a specialized form of lymphoma that is characterized by the orderly spread of disease from one lymph node group to another and by development of systemic symptoms and advances disease.
Hodgkin’s lymphoma
These are characteristic of Hodgkin’s lymphoma when examined under the microscope.
Multinucleated Reed-Sternberg cells
This is a B-cell cancer of the plasma cells that normally produce antibodies.
Multiple myeloma
Involves prevention of blood loss from an injured vessel.
Hemostasis
Hemostasis is initiated by this that may be followed by coagulation that forms a blood clot or thrombus.
Platelet plug
Factors promoting normal blood flow include these that inhibit platelet adhesion and promote vasoconstriction.
Prostacyclin and endothelium-derives relaxing factor EDRF
These prevent or dissolve clots that may form.
Heparin, tissue factor pathway inhibitor, and TPA
Steps of hemostasis include:
Vasoconstriction, platelet plug formation, and hemostatic plug formation
This is initiated by injury to vessel and exposure to collagen .
Platelet plug
Platelets adhere to collagen through this, and bleeding problems can occur in individuals lacking it.
Von willebrand factor
Platelet plug is limited to the injury site and undamaged endothelial cells include:
Prostacyclin- inhibits platelet aggregation, acts as vasodilator
Nitric oxide- acts as vasodilator
Adenosine diphosphatase- metabolizes ADP that participates in aggregation
Conversion of the primary platelet plug into a definitive clot or secondary hemostatic plug occurs as this is formed through activation of this:
Fibrin and coagulation cascade
Two pathways can lead to fibrin formation:
- Intrinsic pathway- exposure to collagen
2. Extrinsic pathway- exposure to tissue factors
Both intrinsic and extrinsic pathways activate this:
Common pathway
Common pathway involves conversion of this into this:
Prothrombin into thrombin
Thrombin converts this into this:
Fibrinogen into fibrin monomer
Fibrin monomer is then converted to this that stabilizes the platelet plug to form the hemostatic plug.
Fibrin polymer
Anticlotting mechanisms prevent this:
Clot formation
Heparin binds to this to inactivate thrombin and other clotting factors to inhibit coagulation.
Antithrombin III
Fibrinolytic systems dissolve:
Already formed clots
This is a molecule that is normally incorporated into blood clot structure as it forms.
Plasminogen
Exposure of plasminogen to this leads to its conversion to plasma.
TPA- also urokinase or streptokinase
This digests fibrin, this dissolving the clot.
Plasmin
Thrombus is formed
Intravascularly
Hemostatic plug is formed
Extravascularly
Measures effectiveness of intrinsic pathway.
Activated partial thromboplastin time
Measures extrinsic pathway
Prothrombin time
Aspirin inhibits:
Cyclooxygenase
Warfarin competes with
Vitamin k
This is normally secreted by endothelial cells- it interacts with AT III to bind coagulation factors including thrombin and prevent hemostasis- inactivated by protamine sulfate
Heparin
Occurs as a complication of diseases that accelerate clotting, causing small blood vessel occlusion, organ necrosis, depletion of circulating clotting factors and platelets, activation of the fibrinolytic system, and consequent severe hemorrhage.
DIC
Is a deficiency of platelets as a result of immune system destroying its own platelets.
Idiopathic thrombocytopenia purpura
Hereditary bleeding disorder characterized by prolonged bleeding time.
Von willebrand disease
Loss of stem cells or bone marrow matrix causing pancytopenia. It’s caused by autoimmune reactions, congenital, drugs, radiation. Fatal in 80-90 percent of severe causes.
Aplastic anemia
Type of anemia that is common, slowly progressive, megablastic anemia- need folate for DNA synthesis.
Folic acid deficiency anemia
Type of anemia that is from the malabsorption of vitamin b12- most common megaloblastic anemia; typically occurs between 50-60 years or age.
Pernicious anemia
Type of anemia that is a heterogenous disorder with common defect preventing use of iron in hemoglobin synthesis even though there are sufficient iron stores. Caused by genetic disorders, toxin exposure, and infection. Classified as microcytic- hypochromic.
Sideroblastic anemia
Genetic disorder, where genetic change in beta-globin that cause suckling, especially when oxygen is low.
Sickle cell disease
Genetic disorders causing defect in globin chains that comprise hemoglobin. Cause hemolytic anemia. Classified microcytic- hypochromic
Thalassemia
Genetic disorder that limits the amount of oxidative stress that can be protected against in erythrocytes, resulting in hemolysis. Triggered by infections, severe stress, certain foods (favs beans), or certain medications (antimalarial drugs).
G6PD
Exposure to blood group antigens that are foreign and initiates formation of antibodies.
ABO incompatibility
Refers to when a pregnant women who is RH negative develops antibodies against an Rh positive fetus.
Rh isoimmunization
Refers to a hemolytic disease of the fetus and neonate based upon incompatibilities between fetal and maternal blood.
Erythroblastosis fetalis
The most severe form of erythroblastosis fetalis associated with profound anemia or edema.
Hydrops fetalis
Chronic disorder characterized by increased RBC mass, erythrocytosis, leukocytosis, and increased hemoglobin levels. Typically occurs between ages 40-60. The cause is unknown but likely relayed to a stem cell defect.
Primary polycythemia
Excessive RBC production due to hypoxia, tumor, or disease.
Secondary polycythemia
Increased hematocrit with a normal or low RBC mass. Results from a finished plasma volume. Caused by dehydration, hypertension, elevated serum cholesterol, or iron acid levels.
Spurious polycythemia
Involves a series of barriers (physical, biochemical, mechanical)
Innate or nonspecific immunity
A nonspecific response to infection or injury.
Inflammation
Includes antibody or cell-mediated immunity
Acquired or specific immunity
The immediate and early response to an injurious agent and is self limiting
Acute inflammation
Longer duration and follows a persistent, self-perpetuating course with the source of inflammation being unresolved
Chronic inflammation
Are formed if neutrophils and macrophages can not destroy the microbe during the acute inflammatory response.
Granulomas
Are undesirable reactions that can cause tissue injury or disease. They result from immune responses to antigens that produce inflammation and cause tissue damage.
Hypersensitivity reactions
An IgE-mediated response that leads to inflammatory mediators from sensitized mast cells.
Type I intermediate hypersensitivity
Involve antibody-mediated responses against the cell surface or extracellular matrix antigens that result in complement-mediated phagocytosis, inflammation, and cell injury or abnormal physiological responses without cell injury
Type II disorders
Involve responses generated by immune-complexes that activate complement resulting in activation of inflammatory cells that release tissue-damaging products.
Type III disorders
Involve tissue damage in which cell-mediated immune responses with sensitized T lymphocytes cause cell and tissue injury.
Type IV disorders
Are a diverse group of blood cancers that include any kind of lymphoma except Hodgkins lymphomas. They are clinically diverse of either b-cell or t-cell neoplasms that may originate from any lymphoid tissues, although they most commonly originate in the lymph nodes.
Non-hodgkins lymphoma
Donor and recipient are the same:
Autologous
Donor and recipient are identical twins:
Syngeneic
Donor and recipient share similar HLA types:
Allogenic
3 phases of transplant rejection:
- Hyperacute reaction
- Acute rejection
- Chronic rejection
Type of transplant rejection that occurs almost immediately and involves existing recipient antibodies to graft antigens.
Hyperacute reaction
Type of rejection that occurs within months of transplantation and involves cytotoxic T cell lysis and activation of inflammatory responses that attack the graft.
Acute rejections
Type of rejection that occurs over a prolonged period of time and is caused by fibrotic processes mediated by the cytotoxic T cells
Chronic rejection
Involves transplantation of immunocompetent cells into an immunocompromised recipient. The immune competent cells attack tissues in the recipient and may manifest as skin lesions and involvement of the GI tract that can become life-threatening.
Graft- vs- host disease
A group of disorders characterized by compromise to differentiation between self and nonself antigens.
Autoimmune diseases
A type of primary immunodeficiency characterized by a lack of all T and B cell function and sometimes missing NK cells.
SCID
This infection selectively infects and destroys the T helper cells (CD4) and co sequently compromises the ability to stimulate both antibody medicated and cell mediated immune responses.
HIV/AIDs
Minimal tissue damage- tissue returns to normal in short period of time- mild sunburn
Resolution
Healing process that occurs in damaged tissue in which cells are capable of mitosis- damaged tissue replaced by identical tissue
Regeneration
By connective tissue when extensive damage or when cells are incapable of mitosis
Replacement
