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Biochem Final > Blood wk 2, clinical > Flashcards

Blood wk 2, clinical Flashcards

1
Q

what does a deficiency in factor 8 cause?

A

Hemophilia A

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2
Q

who is more commonly effected by hemophilia A?

A

males (on X chromosome)

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3
Q

what is the difference between mild, moderate and severe hemophilia?

A

mild: 49%
moderate: 6-49%
severe: less than one (could severely bleed at any time)

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3
Q

which is more likely hemophilia A or B?

A

A is 4x more common

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4
Q

what occurs with hemophilia A?

A

most people only experience issues after major bleeding event like tooth extraction or surgery

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5
Q

what are the genetics of hemophilia?

A

X inked recessive
(effected males will pass to a daughters as carriers, not sons)
30% cases spontaneous

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6
Q

what is the treatment for hemophilia A?

A

DDAVP- mild cases
Factor 8 replacements

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7
Q

what is the newest treatment for hemophilia?

A

roctavian treatment gene therapy (using virus vectors)

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8
Q

what causes hemophilia B?

A

factor IX

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9
Q

what is the treatment for hemophilia B?

A

routine treatment regimen of intravenous infusions of Factor IX
replacement products to maintain sufficient levels of clotting factor to prevent bleeding episodes

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10
Q

what is the treatments for bleeding patients with vit K deficiency?

A

fresh frozen plasma (also subcutaneous vit k)

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10
Q

what is hemgenix?

A

one-time gene therapy product given as a single dose by IV infusion

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11
Q

what do you do for a patients with supratherapeutic INR values due to being on warfarin and an antibiotic?

A

1- make sure not bIeeding
2-INR is >5, warfarin
should be withheld for at least 1 dose, and close follow-up
monitoring should be arranged

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12
Q

what is something to be aware of for patients taking warfarin?

A

need to keep a constant diet, too much K can throw everything off

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13
Q

what s the cheapest simplest thing to do for someone bIeeding and need of quick correction?

A

fresh frozen pIasma

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14
Q

what is the mechanism of warfarin?

A

vit K epoxide reductase inhibitor (keeps kit K reduced)

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15
Q

what is the site f action for heparin?

A

anti-thrombin III

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16
Q

what does heparin do?

A

reduction in activity and synthsis of thrombin

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17
Q

can you use heparin or warfarin during pregnancy?

A

heparin yes
warfarin no

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18
Q

what is von wiIIiebrand disease?

A

vWF stored in Weibel-Palade bodies of endothelial cells & alpha granules of megakaryocytes/platelets

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19
Q

what is the genetic inheridance of von wiIIiebrand?

A

autosomaI dominant

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20
Q

why is there a cIotting issue seen with VWB?

A

because the first step of co-ag cant happen, pIateIets can not ahere to the waII

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21
Q

what is thrombocytopenia?

A

low platelet count (beow 150,000)

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22
Q

what are the major pathophysiologic mechanisms of
thrombocytopenia?

A
  • Decreased platelet production in the bone marrow
  • Peripheral platelet destruction by antibodies
  • Consumption in thrombi
  • Sequestration (pooling) of platelets in the spleen in individuals with portal hypertension and/or splenomegaly
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23
Q

what are some common causes of thrombocytopenia?

A
  • Primary immune thrombocytopenia (ITP)
  • Drug-induced immune thrombocytopenia
  • Hypersplenism due to chronic liver disease
    -cancer
    -hereditary
    -aplastic anemia
24
Q

what is idiopathic thrombocytopenic purpura or ITP?

A

bruising; petechiae, nosebleeds and bleeding gums may occur if the platelet count is below 20,000, compared with a normal range of 150,000-400,000/mm

25
Q

The most common specific factor inhibitors are

A

FVIII and FIX

26
Q

antiphospholipid antibodies proIong PPT but are associated with:

A

increase in thrombosis
rather than bleeding

27
Q

Plasma comprises ____ of total
volume of whole blood

A

~55%

28
Q

what is serum?

A

If whole blood is allowed to contact glass, it will clot.
After centrifugation, the fluid portion is SERUM.
SO essentially same as plasma
BUT NO clotting factors

29
Q

Pre-analytical variables account for what percent of Iab errors?

A

Account for up to 75% of laboratory errors

30
Q

what is lipemia?

A

milky plasma after fight fat meal

31
Q

what is hemolysis?

A

rupture of pure RBC
-could happen due to poor collection
-releases cellular contents into blood (significant inc in K, Mg, Ph)

32
Q

lipid panes can show:

A

-total cholesterol
-HDL-C
-LDL-C
Triglycerides (VLDL)

33
Q

what is a basic metabolic panel?

A

Multiple chemistry tests are grouped and reported as
a single profile for ease of ordering. Includes electrolytes and tests of kidney function
Na, K, C, CO2, BUN, Cr, Glu

34
Q

what is the main determinant of plasma osmolality?

A

Na

35
Q

what can too high of Na cause?

A

hypernatremia
dehydration

36
Q

what can decreased serum sodium cause?

A

hyponatremia
increased fud retention

37
Q

what is the main intracellular cation?

A

Potassium

38
Q

what can elevated K cause?

A

hyperkalemia
renal insuffiencey
cardiac conduction issues
poor phlebotomy

39
Q

what can decreased K cause?

A

hypokalemia
diarrhea, diuretics

40
Q

What is the major extracellular anion?

A

Chloride

41
Q

how is chloride level usually changed?

A

usually in shift in Na or bicarb to maintain electrical neutrality

42
Q

Serum Creatinine is excreted by the kidneys and so blood levels are therefore proportional to:

A

renal excretory function

43
Q

why is blood glucose level important to monitor?

A

diabetes mellitus

44
Q

What does hemoglobin A1c measure?

A

what percentage of hemoglobin is non-enzymatically glycated
– correlates with average glucose level in the blood over lifespan of RBCs analyzed (2-3 months)

45
Q

what does the total protein level reflect?

A

nutritional status liver disease and kidney function

46
Q

What is albumin?

A

major protein in the extracellular portion of blood

47
Q

what is albumin level important for?

A

maintains colloid osmotic pressure

48
Q

what is the difference of indirect and direct bilirubin?

A

–Direct: Water-soluble conjugated bilirubin secreted into bile
–Indirect: Insoluble Unconjugated circulating from RE system bound to albumin

49
Q

what is total Ca?

A

The total serum calcium is a measure of both
– Free (ionized) calcium
– Protein bound (usually to albumin) calcium

50
Q

what is alkaline phosphate?

A

increased when bile duct is blocked or cancer spreads to bones

51
Q

what is the Alanine Aminotransferase (ALT) test?

A

An ALT blood test measures the amount of ALT in the blood to help diagnose or monitor liver disease
α-ketoglutarate + alanine ⇌ glutamate + pyruvate

52
Q

what is the Asparate Aminotransferase (AST) test?

A

shows Liver injury or irritation, heart attack or heart failure, kidney or lung damage, mononucleosis, or some types of cancer

53
Q

what does the pancreatic serum amylase and lipase test show?

A

When the pancreas is damaged, these digestive enzymes can be found in the blood at higher levels than normal

54
Q

what is the most abundant WBC?

A

neutrophils
lymphocytes
monocytes
eosinophils
basophils

55
Q

what is average RBC count in male and female?

A

M: 4.7-6.1
F: 4.2-5.4

56
Q

what is normal hemoglobin count in m and f?

A

m: 13.5-17.5
f: 12-15.5

57
Q

what condition is marked by decreased WBC?

A

leukopenia

58
Q

what condition is marked by increased WBC?

A

leukocytosis

59
Q

what condition is marked by decreased platelets?

A

thrombocytopenia

60
Q

what condition is marked by raised platelets?

A

thrombocytosis

Biochem Final (6 decks)

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