Ch. 3 Blood

Question 1

Blood Cell Counts

Answer 1

RBC= 3.5-5.5 x 10^6 per mm2
WBC= 5,000-10,000
Plt= 150,000-350,000

Question 2

RBC

Answer 2

• biconcave, 120 lifespan, circulate in 20 sec

- produced in long bone marrow

Question 3

erythropoietin

Answer 3

stimulates RBC production in bone marrow

• produced in kidney, liver
• Needs Vit. B12 and Folic acid***

Question 4

RBC increase with what?

Answer 4

high altitudes, pulm disease

Question 5

Normal HCT on bypass

Answer 5

22-30%

Question 6

WBC Granulocytes and Agranulocytes

Answer 6

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

Question 7

WBC Percentages

Answer 7

Neutrophils= 60%
Lymphocytes= 30
Monocytes= 6
Eosinophils= 3
Basophils= 1

Question 8

Occlusion

Answer 8

30 inches above, 1 cm drop per minute

Question 9

Thrombocytes (platelets)

Answer 9

• negative charge, no nucleus, bone fragments by megakarocyes
• 3 properties= adhesion, aggregate, angulation
• release TXA2 (constrictor), factors, and contains platelet factor 3**

Question 10

anemia

Answer 10

low RBC

Question 11

aplastic anemia

Answer 11

low RBC cuz bone marrow doesn’t produce enough

Question 12

pernicious anemia

Answer 12

low RBC cuz low Vit. B12 and folic acid (erythropoietin needs these to make RBC)

Question 13

polycthemia

Answer 13

high HCT

Question 14

-cytosis, -philia, -penia, -pheresis

Answer 14

• cytosis/philia= high
• penia= low
• pheresis= remove then give back

Question 15

hemolysis

Answer 15

RBC break down= plasma free Hgb

Question 16

Reynolds number

Answer 16

> 2,000 = turbulent flow, hemolysis

Question 17

diapedesis

Answer 17

able to move through vessel walls without damage

Question 18

leukocytosis

Answer 18

high WBC with infection

Question 19

leukopenia

Answer 19

low WBC < 5,000

Question 20

neutrophilia

Answer 20

high neutrophil >7500

Question 21

neutropenia

Answer 21

low neutrophil < 1500

Question 22

eosinophilia

Answer 22

high eosinophil > 500

Question 23

basophilia

Answer 23

high basophil > 100

Question 24

monocytosis

Answer 24

high monocytes > 100

Question 25

lymphoctyosis

Answer 25

high lymphocytes > 4500

Question 26

lymphoctyopenia

Answer 26

low lymphocytes < 1500

Question 27

thrombocytopenia

Answer 27

low platelets < 50,000

Question 28

plasmapheresis

Answer 28

remove plasma and add back

Question 29

plateletpheresis

Answer 29

remove platelets and add back

Question 30

hyperkalemia

Answer 30

high K= - if high gluc= add insulin - if low gluc- give lasix, hemoconcentration

Question 31

Blood Clotting Steps and 3 Phases

Answer 31

1) platelet agg 2) prothrombin, thromboplastin, Ca 3) thrombin, fibrin 4) fibrin mesh 1) vascular constriction 2) platelet plug 3) coagulation cascade- fibrin mesh

Question 32

Vit K dependent Factors

Answer 32

II, VII, IX, X

Question 33

Antithrombin III

Answer 33

stops fibrinogen from turning into fibrin AND prothrombin into thrombin

Question 34

Heparin (and 3 effects)

Answer 34

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

Question 35

Protamine

Answer 35

- 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

Question 36

Protamine Reaction

Answer 36

= 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

Question 37

Storage: RBC, WBC, WBC + Hep, Plt, FFP

Answer 37

``` RBC= 35 days WBC= 35 days , 48 hrs with hep Plt= 3 days FFP= 1 year ```

Question 38

Reaction to PRBC

Answer 38

-acute hemolytic (incompatibility), allergic/antigen, delayed hemolytic, fibrile/fever, pulm edema

Question 39

Give if low HCT

Answer 39

PRBC

Question 40

Give if High blood loss

Answer 40

whole blood

Question 41

give if thrombocytopenia

Answer 41

platelets

Question 42

give if clotting deficiency

Answer 42

FFP

Question 43

give if hemophilia (high bleeding, cuz clotting factors), vWF low, low fibrin

Answer 43

cryoprecipitate

Question 44

give if low COP

Answer 44

albumin

Question 45

give if organ tx

Answer 45

leukocytes poor RBC