Ch 27 Heme Lymph System PPT Flashcards
1
Q
What are the main components of the hematologic system?
A
Bone marrow, blood, and blood components
2
Q
What structures make up the lymphatic system?
A
Lymph nodes, nodules, lymph vessels
3
Q
What are the functions of blood?
A
Transport substances/cells, regulate body temp, pH, fluid balance
4
Q
What percentage of blood is plasma?
A
About 55%
5
Q
What produces the formed elements in blood?
A
Stem cells in red bone marrow
6
Q
What is plasma mostly made of?
A
91% water
7
Q
Where are plasma proteins synthesized?
A
In the liver
8
Q
Name 3 important plasma proteins.
A
Prothrombin, fibrinogen, albumin
9
Q
What is the normal blood pH range?
A
7.35 – 7.45
10
Q
What is the main function of red blood cells?
A
Carry oxygen bonded to iron in hemoglobin
11
Q
What hormone increases RBC production?
A
Erythropoietin
12
Q
Where is erythropoietin secreted from?
A
The kidneys during hypoxia
13
Q
What does the presence of many reticulocytes indicate?
A
Insufficient mature RBCs to meet oxygen demand
14
Q
What nutrients are essential for RBC production?
A
Protein, iron, folic acid, Vitamin B12
15
Q
What is required for Vitamin B12 absorption?
A
Intrinsic factor from stomach parietal cells
16
Q
How long do RBCs live?
A
About 120 days
17
Q
What causes hemolysis?
A
Diseases like malaria and sickle cell anemia
18
Q
What does excess hemoglobin in the blood cause?
A
Elevated bilirubin and jaundice
19
Q
What determines ABO blood type?
A
Antigens on RBCs (A or B)
20
Q
What determines Rh factor?
A
Presence of D antigen
21
Q
How are WBCs different from RBCs?
A
Larger, have nuclei, involved in immune/inflammatory responses
22
Q
Where are T lymphocytes matured?
A
Thymus
23
Q
Where do lymphocytes become activated?
A
Lymph nodes, spleen, lymphatic nodules
24
Q
What do monocytes become in tissue?
A
Macrophages
25
What is the main function of neutrophils?
Phagocytosis of foreign material
26
What role do eosinophils play?
Combat histamine, allergic reactions, parasitic infections
27
What do basophils release?
Heparin and histamine
28
What are the types of T cells?
Helper, suppressor, killer, memory
29
What are the types of B cells?
Memory and plasma cells (produce antibodies)
30
How are platelets formed?
Fragments of megakaryocytes in red bone marrow
31
What is the lifespan of platelets?
About 10 days
32
What prevents platelets from sticking to vessels?
Smooth endothelial lining, heparin, antithrombin
33
What is the role of the spleen in immunity?
Stores lymphocytes, filters pathogens and worn-out cells
34
Why is the spleen not vital?
Other organs compensate if it's removed
35
Where is the spleen located?
LUQ below diaphragm, behind stomach
36
What does the thymus do?
Matures and proliferates T cells
37
What happens to the thymus with age?
It atrophies
38
What is "lymph"?
Tissue fluid that enters lymph capillaries
39
Why must lymph return to blood?
To maintain blood volume and pressure
40
Which vein receives lymph from thoracic duct?
Left subclavian vein
41
What vein receives lymph from right lymphatic duct?
Right subclavian vein
42
What is the function of lymph nodes?
Filter pathogens, house macrophages and lymphocytes
43
Where are lymph nodes commonly found?
Cervical, axillary, inguinal regions
44
What is the difference between lymph nodes and nodules?
Nodes are deeper and larger; nodules are just under mucous membranes
45
What are tonsils an example of?
Lymphatic nodules
46
What happens with aging in the lymphatic system?
Decreased immunity due to atrophied thymus and reduced function
47
What ancestry is associated with sickle cell anemia?
Black, Mediterranean, or Asian
48
What ancestry is linked to pernicious anemia?
Northern European
49
What conditions might indicate vitamin B12 deficiency?
Poor diet, alcohol abuse
50
What are petechiae?
Small hemorrhagic spots under the skin
51
What are ecchymoses?
Larger areas of hemorrhage (bruises)
52
What is purpura?
Hemorrhage into skin, mucous membranes, organs
53
What may pallor, cyanosis, or jaundice indicate?
Blood disorders, oxygenation issues, or hemolysis
54
What is clubbing of the fingernails a sign of?
Chronic hypoxia or anemia
55
What may sternal tenderness suggest?
Packed bone marrow
56
What does a CBC test include?
RBC, WBC, Hgb, Hct, Platelets
57
What does PT test for?
Activity of clotting factors, liver function
58
What is INR used to monitor?
Warfarin therapy
59
What does aPTT assess?
Clotting factors, heparin therapy
60
What does a Coombs test detect?
Antibodies against RBCs
61
What is a bone marrow biopsy used for?
Diagnosing cancers, infections, or evaluating treatment
62
What are common biopsy sites?
Sternum, iliac crest, vertebrae
63
What is lymphangiography?
Imaging test for lymph blockages or cancers using dye
64
Why is patient education important after lymphangiography?
Dye may cause skin, urine, stool discoloration
65
What is a lymph node biopsy for?
Checking if lymph enlargement is due to cancer or infection
66
What is autologous transfusion?
Patient’s own blood is transfused
67
What is allogeneic transfusion?
Donated blood from someone else
68
What are PRBCs used for?
Anemia or blood loss
69
What is FFP used for?
Clotting factor replacement
70
What is albumin used for?
Hypovolemia from low albumin
71
What are cryoprecipitates?
Used for missing clotting factors
72
How soon must transfusions be started after receiving blood?
Within 30 minutes
73
How long can a transfusion last?
No longer than 4 hours
74
What type of tubing is needed for transfusion?
Y tubing with a filter
75
Who verifies blood before transfusion?
Two nurses
76
What is a febrile reaction?
Fever, chills, back pain — usually mild, common
77
How to prevent febrile reactions?
Use leukocyte-depleted blood if there's history
78
What is a urticarial reaction?
Hives from plasma antigens, mild allergic response
79
What should be done if a hive reaction occurs?
Stop transfusion, notify HCP, may restart if stable
80
What is a hemolytic reaction?
Destruction of RBCs from incompatible blood
81
What are signs of hemolytic reaction?
Chest/back pain, chills, fever, nausea, shock
82
What is the first step for a hemolytic reaction?
Stop transfusion immediately
83
What organ is most at risk in hemolytic reactions?
Kidneys
84
What is an anaphylactic reaction to transfusion?
Severe allergy to donor immunoglobulins
85
What are signs of anaphylactic reaction?
GI cramping, respiratory failure, vomiting
86
What is TRALI?
Transfusion-related acute lung injury
87
What are signs of TRALI?
Hypoxia, crackles, fever, hypotension
88
What is TACO?
Transfusion-associated circulatory overload
89
Who is most at risk for TACO?
Elderly or debilitated patients
90
What are signs of TACO?
Cough, chest pain, crackles, frothy sputum
91
What is the volume range of blood in the human body?
4–6 liters
92
What are the two main categories of blood components?
Plasma and formed elements
93
What are the three formed elements in blood?
RBCs, WBCs, Platelets
94
What is the function of albumin in plasma?
Maintains oncotic pressure and fluid balance
95
What is the role of globulins?
Include antibodies and transport proteins
96
What is the purpose of clotting factors in plasma?
Facilitate blood coagulation
97
What happens to plasma temperature as it circulates?
It is warmed in the liver and skeletal muscle, then distributes heat
98
What structure in the stomach produces intrinsic factor?
Parietal cells
99
What is a reticulocyte?
An immature red blood cell
100
What condition triggers erythropoietin secretion?
Hypoxia
101
What happens when there is excess destruction of RBCs?
Hemolysis → elevated bilirubin → jaundice
102
What are macrophages responsible for in blood breakdown?
Phagocytize old RBCs and recycle hemoglobin
103
What is bilirubin a byproduct of?
Hemoglobin breakdown
104
Which antigen determines the Rh factor?
D antigen
105
What is the function of leukocytes?
Defense against infection and injury
106
Which WBCs respond first to bacterial infection?
Neutrophils
107
Which WBCs are elevated in parasitic infection?
Eosinophils
108
Which cells are involved in allergic response?
Basophils and eosinophils
109
What type of immunity involves T and B lymphocytes?
Adaptive immunity
110
Where do B cells mature?
Bone marrow
111
What is the primary immune organ during childhood?
Thymus
112
What are memory cells?
Long-lived lymphocytes that respond to previously encountered antigens
113
What structure prevents spontaneous platelet activation?
Smooth endothelial lining of blood vessels
114
What substances inhibit platelet aggregation?
Heparin and antithrombin
115
What are petechiae often associated with?
Thrombocytopenia or capillary fragility
116
What is a clinical sign of anemia visible on skin or nails?
Pallor or spoon-shaped nails
117
What are signs of blood-related disorders in vital signs?
Tachycardia, fever, hypotension
118
What does jaundice suggest in a hematologic disorder?
Hemolysis or liver dysfunction
119
What is indicated by sternal tenderness?
Overactive bone marrow
120
What does elevated HR suggest in a blood disorder?
Compensation for anemia or hypoxia
121
What are common lymph node regions assessed?
Cervical, axillary, inguinal
122
What size of lymph node enlargement is clinically significant?
Greater than 1 cm
123
What does lymphadenopathy potentially indicate?
Inflammation, cancer, infection
124
What might be found in a lymph node biopsy?
Infection, malignancy, granulomas
125
What lab test measures RBC volume percentage?
Hematocrit (Hct)
126
What does a low hemoglobin (Hgb) indicate?
Anemia
127
What does platelet count evaluate?
Clotting ability and bleeding risk
128
What coagulation test assesses intrinsic pathway?
aPTT
129
What does bleeding time measure?
Time it takes small puncture to stop bleeding
130
What is capillary fragility testing for?
Susceptibility of capillaries to rupture
131
What is type and screen used for?
Blood compatibility before transfusion
132
What does a positive Coombs test indicate?
Autoimmune hemolytic anemia
133
What is the main risk of bone marrow aspiration?
Bleeding or infection at the site
134
What type of dye is used in lymphangiography?
Blue dye (e.g., isosulfan blue)
135
What symptom should be monitored after lymphangiography?
Limb swelling or sensory changes
136
What can discoloration of skin/urine after lymphangiography indicate?
Dye excretion (normal)
137
What is standard transfusion blood compatibility matched by?
ABO and Rh factor
138
What is the most common transfusion product?
PRBCs (packed red blood cells)
139
What condition is treated with platelet transfusion?
Thrombocytopenia
140
What should be done if transfusion is delayed?
Return blood to bank if not used within 30 minutes
141
Why is a 20G or larger IV needed for transfusion?
To prevent hemolysis and allow proper flow rate
142
How often are vitals checked during transfusion?
Before, at 15 min, hourly, and at the end
143
Why is leukocyte-reduced blood used?
To reduce febrile non-hemolytic reactions
144
What does washed blood help prevent?
Severe allergic transfusion reactions
145
What does warming transfusion blood help prevent?
Hypothermia and arrhythmias during massive transfusions
146
What are early symptoms of febrile transfusion reaction?
Chills, fever, backache, headache
147
How should a febrile transfusion reaction be managed?
Stop transfusion, give antipyretics, notify HCP
148
What characterizes a urticarial transfusion reaction?
Hives, itching, sometimes mild fever
149
What is the treatment for a mild urticarial reaction?
Benadryl, possibly restart transfusion
150
What is the hallmark sign of hemolytic reaction?
Sudden back/chest pain with fever/chills
151
What test is used after suspected hemolytic reaction?
Direct Coombs and crossmatching
152
What happens to BP in hemolytic reaction?
It drops (hypotension)
153
What is the role of diuretics in hemolytic reaction?
Prevent kidney damage from hemoglobin
154
What immune product triggers anaphylaxis in transfusions?
Donor immunoglobulins
155
Who is most at risk for anaphylactic transfusion reactions?
Patients with multiple transfusions or pregnancies
156
What are signs of anaphylactic reaction?
Respiratory distress, GI symptoms, cardiovascular collapse
157
What is the emergency response to anaphylactic reaction?
Stop transfusion, start CPR if needed
158
What respiratory disorder is linked to donor antibodies?
TRALI
159
What are early signs of TRALI?
Shortness of breath, low oxygen, crackles
160
What does TRALI look like on a chest X-ray?
Bilateral pulmonary infiltrates
161
What population is at highest TRALI risk?
Critically ill or ventilated patients
162
How is TRALI managed?
Stop transfusion, ICU care, oxygen or ventilation
163
What causes TACO?
Fluid overload from too rapid transfusion
164
What are signs of TACO?
Frothy sputum, JVD, crackles, HTN, tachycardia
165
How is TACO treated?
Diuretics, stop transfusion, slow rate if resumed
166
Why is older age a risk for TACO?
Reduced cardiac and renal reserve
167
What distinguishes TACO from TRALI?
TACO = fluid overload, TRALI = immune response
168
What is the most serious transfusion complication?
Hemolytic reaction
169
Why is staying with the patient the first 15 min crucial?
Most severe reactions happen early
170
When do delayed transfusion reactions typically occur?
Hours to days after transfusion
171
What is alloimmunization?
Immune response to foreign antigens from transfused blood
172
What are symptoms of a delayed hemolytic reaction?
Mild fever, low Hgb, jaundice
173
What does washed PRBCs remove?
Plasma proteins
174
What does leukoreduction remove?
White blood cells
175
Why might immunocompromised patients need irradiated blood?
To prevent graft-versus-host disease
176
What is GVHD in transfusions?
Donor T cells attack recipient tissues
177
What is the lifespan of a transfused RBC?
About 120 days (same as natural RBCs)
178
What does MCV measure?
Average volume of RBCs
179
What is MCH?
Mean corpuscular hemoglobin (average Hgb per RBC)
180
What condition shows low MCV and MCH?
Iron-deficiency anemia
181
What shows elevated MCV?
Vitamin B12 or folate deficiency
182
What test screens for iron stores?
Ferritin
183
What is transferrin?
Iron transport protein
184
What does high TIBC suggest?
Iron-deficiency anemia
185
What causes low reticulocyte count in anemia?
Bone marrow suppression
