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Hematology > Chapter 1 Organization of Blood > Flashcards

Chapter 1 Organization of Blood Flashcards

1
Q

Liquid connective tissue that consists of cells surrounded by extracellular matrix

A

Blood

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2
Q

Three general functions of blood

A

Transportation

Regulation

Protection

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3
Q

Blood transports ______ from the lungs to cells throughout the body

A

Oxygen

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4
Q

Blood transports ______ from cells to the lungs

A

Carbon dioxide

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5
Q

Carries nutrients from the GI tract to body cells

Heat and waste products away from cells

Transports hormones from endocrine glands to other body cells

A

Blood

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6
Q

Regulates the pH of body fluids

A

Blood

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7
Q

The heat-absorbing and coolant properties of ____ in blood plasma help adjust body temperature

A

Water

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8
Q

Influences the water content of cells

A

Blood osmotic pressure

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9
Q

Protects against excessive loss from the cardiovascular system

A

Blood clots

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10
Q

Protect against disease by carrying on phagocytosis and producing proteins called antibodies

A

WBCs

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11
Q

Additional proteins in blood that helps protect against disease

A

Interferons and complement

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12
Q

Temperature of blood

A

38C (100.4F)

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13
Q

pH of blood

A

7.35 to 7.45

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14
Q

Blood constitutes about __% of the total body weight

A

8%

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15
Q

Blood volume in the average-sized adult male

A

5-6 liters (1.5 gal)

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16
Q

Blood volume in the average-sized female

A

4-5 liters (1.2 gal)

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17
Q

Differences of blood volume is due to:

A

Body Size

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18
Q

Whole blood is composed of two portions

A

Blood Plasma

Formed elements

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19
Q

Liquid extracellular matrix that contains dissolved substances

A

Plasma

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20
Q

Cells and cell fragments

A

Formed elements

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21
Q

Blood is __% formed elements

A

45%

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22
Q

More than __% of formed elements are red blood cells, the rest consist of white blood cells and platelets

A

99%

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23
Q

Plasma makes up what percentage of blood?

A

55%

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24
Q

Percentage of total blood volume occupied by red blood cells

A

Hematocrit

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25
Q

HCT for males

A

42%-52%

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26
Q

HCT in females

A

37%-47%

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27
Q

Buffy coats, <1% of total blood volume, is made up of:

A

WBCs and platelets

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28
Q

Where does the buffy coat lie in centrifuged blood?

A

Between the packed RBCs and blood plasma

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29
Q

Blood plasma is what % of water, proteins, and solutes

A

91.5% water

7% proteins

1.5% solutes

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30
Q

Proteins in the blood (plasma proteins), are synthesized mainly by the:

A

Liver

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31
Q

Most plentiful plasma proteins, make up 54% of all plasma proteins

A

Albumins

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32
Q

Erythrocytes

A

RBCs

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33
Q

Oxygen-carrying protein

A

Hemoglobin

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34
Q

Gives blood the red pigment color

A

Hemoglobin

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35
Q

Hemoglobin transports __% of the carbon dioxide in the blood

A

23%

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36
Q

Adult males RBC volume

A

5.4 million

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37
Q

Adult female RBC volume

A

4.8 million

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38
Q

Red blood cell lifespan

A

120 days

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39
Q

Volume of WBCs

A

5-10k

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40
Q

Lifespan of WBCs

A

Few hours to a few days

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41
Q

Leukocytes

A

WBCs

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42
Q

What do WBCs have that RBCs do not have?

A

Nuclei and organelles

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43
Q

What do RBCs have that WBCs do not?

A

Hemoglobin

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44
Q

WBCs are classified as either:

A

Granular

Agranular

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45
Q

Granular leukocytes

A

Neutrophils

Eosinophils

Basophils

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46
Q

Agranular leukocytes

A

Lymphocytes

Monocytes

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47
Q

50-70% of all WBCs

A

Neutrophils

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48
Q

Nucleus has 2-5 lobes.

Cytoplasm has very fine lilac granules.

Phagocytosis: Destroy bacteria with lysozymes, defensins and strong oxidants.

A

Neutrophils

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49
Q

1-5% of all WBCs

A

Eosinophils

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50
Q

Nucleus usually has 2 lobes, cytoplasm full of large, red-orange granules.

Suppresses effects of histamine in allergic reactions, phagocytizes antigen-antibody complexes and destroys certain parasitic worms

A

Eosinophils

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51
Q

0-1% of all WBCs

A

Basophils

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52
Q

Nucleus has two lobes, has large cytoplasmic granules that appear deep blue purple.

Releases heparin, histamine and serotonin that intensifies the inflammatory response in allergic reaction

A

Basophils

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53
Q

20-40% of all WBCs

A

Lymphocytes

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54
Q

Nucleus is round and slightly indented.

Cytoplasm forms a thin rim around the nucleus that appears sky blue.

Mediates immune responses, including antigen antibody reactions.

  • B Cells secrete antibodies
  • T Cells attack invading viruses, cancer, and transplanted tissue
  • Natural Killer cells attack a wide variety of microbes and tumor cells
A

Lymphocytes

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55
Q

1-6% of all WBCs

A

Monocytes

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56
Q

Nucleus is kidney shaped or horseshoe shaped, cytoplasm is blue-gray and has a foamy appearance

Phagocytic: Will transform into a fixed histiocyte or a wandering macrophage.

A

Monocytes

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57
Q

WBC:

Deep blue-purple

A

Basophil

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58
Q

WBC:

Large, red-orange granules

A

Eosinophils

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59
Q

WBCs:

Very fine lilac granules

A

Neutrophils

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60
Q

WBC:

Thin rim around the nucleus, appears sky blue

A

Lymphocytes

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61
Q

WBC:

Blue gray foamy appearance

A

Monocytes

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62
Q

WBC:

Destroy bacteria

A

Neutrophils

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63
Q

WBC:

Suppresses effects of histamine in allergic reactions

Destroys certain parasitic worms

A

Eosinophils

64
Q

WBC:

Intensifies responses to allergic reactions

A

Basophils

65
Q

WBC:

Mediate immune responses

A

Lymphocytes

66
Q

WBC:

Phagocytic: Will transform into a fixed histiocyte or a wandering macrophage

A

Monocytes

67
Q

Volume of platelets per micro liter

A

150,000-450,000

68
Q

Lifespan of platelets

A

5-9 days

69
Q

The process by which the formed elements of blood develop

A

Hemopoiesis (Hematopoiesis)

70
Q

Primary site of hemopoiesis and continues as the source of blood cells after birth and throughout life

A

Red bone marrow

71
Q

Capacity to develop into different cell types

A

Pluripotent stem cells

72
Q

Pluripotent stem cells are stimulated by specific hormones and will differentiate into 2 cell lines

A

Myeloid

Lymphoid

73
Q

Myeloid stem cells differentiate further into what types of cells?

A

RBCs

Platelets

Eosinophils

Mast cells

Basophils

Neutrophils

Monocytes

74
Q

Lymphoid stem cells begin development in bone but mature in:

A

Lymphatic tissue

75
Q

Immature neutrophils. Nucleus has horseshoe shape and has not developed enough to be a segmented neutrophil

A

Bands

76
Q

Percentage of bands considered abnormal

A

> 10%

77
Q

Associated with myelodysplastic disorders

  • Cytopenias with hyper-cellular bone marrow
  • Morphologic abnormalities in one or more hematopoietic cell lines
A

Blast

78
Q

A sequence of responses that stops bleeding when blood vessels are injured

A

Hemostasis

79
Q

Three mechanisms can reduce loss of blood from vessels

A

Vascular spasm

Platelet plug formation

Blood clotting (coagulation)

80
Q

Loss of a large amount of blood from vessels

A

Hemorrhage

81
Q

Can prevent hemorrhage from smaller blood cells

A

Hemostasis

82
Q

Vascular spasm reduces blood loss for how long?

A

Several minutes to several hours

83
Q

What allows platelets to stick to damaged vessels and form a platelet plug?

A

Stick to collagen fibers and then release chemicals

84
Q

Straw-colored liquid, called serum, is:

A

Plasma minus the clotting proteins

85
Q

Series of chemical reactions that culminates in the formation of fibrin threads

A

Coagulation

86
Q

Clotting factors include:

A

1) Calcium ions (Ca2+)
2) Several enzymes that are made by liver cells and released into the blood
3) Various molecules associated with platelets or released by damaged tissues

87
Q

Many clotting factors are identified by:

A

Roman numerals

88
Q

Three stages of clotting

A

Step 1: Prothrombinase is formed

Step 2: Prothrombinase converts prothrombin (plasma protein formed by the liver with vitamin K) into the enzyme thrombin

Step 3: Thrombin converts soluble fibrinogen (another plasma protein made by the liver) into insoluble fibrin

89
Q

Forms the threads of the clot (Lattice structure like a net)

A

Fibrin

90
Q

Contains substances that interfere with stage 3 of clotting formation; conversion of fibrinogen

A

Cigarette smoke

91
Q

Forms connective tissue in the ruptured area and new endothelial cells repair the vessel lining

A

Fibroblasts

92
Q

Occurs simultaneously as coagulation occurs

  • Site of roughness inside the vessel
  • Plasminogen is incorporated into the clot
  • Plasmin begins digesting and dissolving fibrin threads
A

Fibrinolysis

93
Q

Surfaces of RBCs contain a genetically determined assortment of antigens, agglutinogens, is composed of:

A

Glycolipids and glycoproteins

94
Q

There are at least __ blood groups and more than ___ antigens that can be detected on the surface of RBCs

A

24 blood groups

100 antigens

95
Q

Two major blood groups

A

ABO

Rh

96
Q

ABO blood group is based on what two antigens?

A

A & B

97
Q

People whose RBCs display only antigen A have are type:

A

A

98
Q

People whose RBCs display only antigen B are type:

A

B

99
Q

People whose RBCs display A and B antigens are type:

A

AB

100
Q

People whose RBCs display neither antigen A nor B are type:

A

O

101
Q

Percentage of the population that have ABO type:

A

80%

102
Q

Blood plasma antibodies that react to A or B antigens if the two are mixed

A

Agglutinins

103
Q

If you have type A blood (A antigens on your RBCs), what antibodies would be in your blood plasma?

A

B

104
Q

Rh blood group is named so because the Rh antigen, Rh factor, was first found in the blood of:

A

Rhesus Monkey

105
Q

RBCs who have Rh antigen

A

Rh+

106
Q

RBCs who lack the Rh antigen

A

Rh-

107
Q

Why would blood transfusions be given to patients with anemia?

A

To raise hemoglobin levels

108
Q

RBCs, plasma, platelets in a 1:1:1 ratio

A

Fresh whole blood

109
Q

Indications for use of fresh whole blood

A

Massive hemorrhage when more than 10 units are expected

Cardiac surgery

110
Q

Walking blood bank is what percentage of the crew?

A

10%

111
Q

Form that is filled for walking blood bank

A

DD 572

112
Q

Size of packed RBCs

A

300mL, 200mL consists of RBCs

113
Q

One unit of packed RBCs will usually bring up hemoglobin by:

A

1 g/dL

114
Q

When should you give packed RBCs to critically ill patients?

A

When their hemoglobin falls below 7-8g/dL

115
Q

For every unit of packed RBCs given you should give a unit of:

A

FFP and platelets (1:1:1) ratio

116
Q

Leukocyte reduced blood reduces the incidence of:

A

Leucoagglutination reactions

Platelet alloimmunization

Transfusion related to acute lung injury & CMV exposure

117
Q

Patients scheduled for elective surgery and donate their own blood to transfuse is called:

A

Autologous

118
Q

Units of autologous packed RBCs can be refrigerated up to how many days?

A

35

119
Q

Frozen RBCs:

DoD guidelines allow units to be glycerolized and frozen for up to:

A

10 years

120
Q

Casualty receiving ships and the larger amphibious ships maintain frozen storage of what units while on deployment?

A

O units

121
Q

Can deglycerolize one unit in about 1 hour

A

ACP215 instrument

122
Q

After deglycing a unit of blood, it can be transfused or stored in the refrigerators for an additional __ days.

A

14

123
Q

Before transfusion, the recipient and donor’s blood need to be typed and cross-matched to avoid:

A

Hemolytic transfusion reactions

124
Q

Most important antigens. Everyone who lacks one or both of these antigens has the corresponding IgM antibody in their serum.

Can cause immediate lysis of incompatible red cells.

A

A & B antigens

125
Q

Rh is also known as:

A

D antigen

126
Q

15% of the population lacks this antigen and is not naturally present

A

D antibody

127
Q

O negative mothers are provided what after delivery of Rh positive offspring?

A

Rho-gham

128
Q

Most severe Transfusion reactions involve mismatches in what system?

A

ABO

129
Q

Hemolytic transfusion reactions are mostly due to:

A

Clerical errors and mislabeled specimens

130
Q

When hemolysis occurs it is rapid and intravascular, releasing ______ into the plasma

A

Hemoglobin

131
Q

Death occurs in __ in 1.8 million transfused units.

Most severe reactions are those seen in surgical patients under anesthesia.

A

1

132
Q

Signs and symptoms of hemolytic transfusion reactions:

A

Fever, chills, backache, headache

Apprehension (sense of impending doom)

Dyspnea

Hypotension

Cardiovascular collapse

133
Q

Pts under anesthesia will not manifest typical signs and symptoms of hemolytic transfusion reactions. Their first indication will be:

A

Tachycardia

Generalized bleeding

Oliguria

134
Q

Severe cases of hemolytic transfusion reactions may present with:

A

DIC (Disseminated intravascular coagulation)

Acute kidney injury from tubular necrosis

135
Q

Death occurs in __% of acute hemolytic reactions due to ABO incompatibility

A

4%

136
Q

Hemolytic transfusion reaction:

What lab will be elevated?

A

Hgb, resulting in hemoglobinuria

137
Q

Treatment for hemolytic transfusion reaction:

A

Stop transfusion immediately

Vigorously hydrate patient to prevent acute tubular necrosis

Forced diuresis with mannitol to prevent acute kidney injury

138
Q

Signs and symptoms:

Fever and chills within 12 hours after the transfusion

Cough and dyspnea in severe cases

A

Leucoagglutinin reaction

139
Q

Lab findings for leucoagglutinin reaction

A

Chest radiograph may show transient pulmonary infiltrates

Hgb rises by expected amount despite reaction because there is no hemolysis

140
Q

Treatment for:

Leucoagglutinin reactions

A

Acetaminophen 500-600mg PO

Diphenhydramine 25mg PO/IV

Hydrocortisone 1mg/kg IV

141
Q

Hypersensitivity reactions are mainly due to:

A

Exposure to allogeneic plasma proteins

142
Q

Symptoms of hypersensitivity reactions

A

Urticaria or bronchospasms may develop during or soon after transfusion

143
Q

Transfusion:

Anaphylactic shock may develop in patients who are IgA deficient because:

A

Antibodies to IgA in the patient serum will react against the IgA in the transfused blood product

144
Q

Treatment for hypersensitivity reaction patients

A

Washed or frozen RBCs to avoid future severe reactions

145
Q

RBC donations are contaminated

A

1 out of 30,000

146
Q

Platelet donations are contaminated

A

1 out of 5,000

147
Q

Transfusion of contaminated products with gram positive bacteria symptoms:

A

Fever and bacteremia; Rarely causes sepsis

148
Q

Transfusions contaminated with gram negative with cause:

A

Septic shock

Acute DIC

Acute kidney injury

149
Q

Allogeneic passenger lymphocytes in transfused blood will engraft in some recipients and mount an allo-immune attack against tissues expressing discrepant HLA antigens

A

Graft vs Host Disease

150
Q

Symptoms of Graft vs Host Disease

A

Fever, rash, diarrhea, hepatitis, lymphadenopathy, and severe pancytopenia

Outcome is usually fatal

151
Q

Occurs mostly in patients with immune defects, malignant lymphoproliferative disorders, solid tumors treated with chemotherapy or immunotherapy, treatment with immunosuppressive drugs or older patients undergoing cardiac surgery

A

Graft vs Host Disease

152
Q

Treatment for Graft vs Host Disease

A

Utilizing blood that has been irradiated to prevent lymphocyte proliferation

153
Q

What blood products should be given to those above patients that are at high risk for transfusion associated Graft vs Host disease?

A

Irradiated blood products

154
Q

Transfusion Related Acute Lung Injury (TRALI) occurs in __ out of 5,000 transfusions

A

1

155
Q

Clinically defined as non-cardiogenic pulmonary edema after a blood product transfusion without other explanation

A

Transfusion Related Acute Lung Injury (TRALI)

156
Q

How do you reduce the risk of TRALI?

A

Use male only plasma donors (only 1-5% have antileukocyte antibodies)

Hematology (5 decks)

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