Ch. 3 Blood Flashcards
Blood Cell Counts
RBC= 3.5-5.5 x 10^6 per mm2 WBC= 5,000-10,000 Plt= 150,000-350,000
RBC
- biconcave, 120 lifespan, circulate in 20 sec
- produced in long bone marrow
erythropoietin
stimulates RBC production in bone marrow
- produced in kidney, liver
- Needs Vit. B12 and Folic acid***
RBC increase with what?
high altitudes, pulm disease
Normal HCT on bypass
22-30%
WBC Granulocytes and Agranulocytes
Granulocytes:
1) Neutrophils- engulf bacteria, foreign, phagocytes
-produced by bone marrow
2) Eosinophils- allergies/parasites
-2 lobes
3) Basophils- release heparin, histamine= open vessels
-nucleus
Agranulocytes:
1) Lymphocytes- produce antibodies- B and T cells
-B cell=moves to spleen/lymph to create memory** and plasma cells** (creates antibodies)
-T cell= killer, helper cells
2) Monocytes- engulf, become macrophages in tissue
WBC Percentages
Neutrophils= 60% Lymphocytes= 30 Monocytes= 6 Eosinophils= 3 Basophils= 1
Occlusion
30 inches above, 1 cm drop per minute
Thrombocytes (platelets)
- negative charge, no nucleus, bone fragments by megakarocyes
- 3 properties= adhesion, aggregate, angulation
- release TXA2 (constrictor), factors, and contains platelet factor 3**
anemia
low RBC
aplastic anemia
low RBC cuz bone marrow doesn’t produce enough
pernicious anemia
low RBC cuz low Vit. B12 and folic acid (erythropoietin needs these to make RBC)
polycthemia
high HCT
-cytosis, -philia, -penia, -pheresis
- cytosis/philia= high
- penia= low
- pheresis= remove then give back
hemolysis
RBC break down= plasma free Hgb
Reynolds number
> 2,000 = turbulent flow, hemolysis
diapedesis
able to move through vessel walls without damage
leukocytosis
high WBC with infection
leukopenia
low WBC < 5,000
neutrophilia
high neutrophil >7500
neutropenia
low neutrophil < 1500
eosinophilia
high eosinophil > 500
basophilia
high basophil > 100
monocytosis
high monocytes > 100
lymphoctyosis
high lymphocytes > 4500
lymphoctyopenia
low lymphocytes < 1500
thrombocytopenia
low platelets < 50,000
plasmapheresis
remove plasma and add back
plateletpheresis
remove platelets and add back
hyperkalemia
high K=
- if high gluc= add insulin
- if low gluc- give lasix, hemoconcentration
Blood Clotting Steps and 3 Phases
1) platelet agg
2) prothrombin, thromboplastin, Ca
3) thrombin, fibrin
4) fibrin mesh
1) vascular constriction
2) platelet plug
3) coagulation cascade- fibrin mesh
Vit K dependent Factors
II, VII, IX, X
Antithrombin III
stops fibrinogen from turning into fibrin AND prothrombin into thrombin
Heparin (and 3 effects)
1) potentiates ATIII
2) inactivates thrombin by cofactor II***
3) affects platelets
- half life= 60-120 min (hypothermia increases)
- eliminated by kidney **and reticule-endethelial system (liver)
- decreases BP and SVR by 10-20%
- strong anion
Protamine
- heparin antagonist
- 1-1.3 mg per 100 units heparin
- don’t give faster than 5 mg per minute
- half life 5 min
- weak cation
Protamine Reaction
= lower BP, bradycardia, circle collapse, increase CVP
= give inotropes, pulm artery dilators (nitroglycerin** and isoproterenol)
-more likely if pre-exposed to protamine, allergic to seafood, DMII, men with vasectomy
Storage: RBC, WBC, WBC + Hep, Plt, FFP
RBC= 35 days WBC= 35 days , 48 hrs with hep Plt= 3 days FFP= 1 year
Reaction to PRBC
-acute hemolytic (incompatibility), allergic/antigen, delayed hemolytic, fibrile/fever, pulm edema
Give if low HCT
PRBC
Give if High blood loss
whole blood
give if thrombocytopenia
platelets
give if clotting deficiency
FFP
give if hemophilia (high bleeding, cuz clotting factors), vWF low, low fibrin
cryoprecipitate
give if low COP
albumin
give if organ tx
leukocytes poor RBC
