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A&P II > Chapter 17 - Blood Pt. 2 > Flashcards

Chapter 17 - Blood Pt. 2 Flashcards

1
Q

Characteristics of clot retraction:

A
  1. stabilises clot
  2. actin and myosin in platelets contract within 30-60 minutes
  3. contraction pulls on fibrin strands, squeezing serum from clot
  4. draws ruptured blood vessel edges together
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2
Q

In vessel repair, the vessel is healing as ____ occurs.

A

clot retraction

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3
Q

Two factors involved in vessel repair:

A
  1. platelet-derived growth factor (PDGF)

2. vascular endothelial growth factor (VEGF)

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4
Q

Platelet-derived growth factor stimulates:

A

division of smooth muscle cells and fibroblasts to rebuild blood vessel wall

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5
Q

Vascular endothelial growth factor stimulates:

A

endothelial cells to multiply and restore endothelial lining

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6
Q

Characteristics of fibrinolysis:

A
  1. removes unneeded clots after healing

2. begins within two days; continues for several

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7
Q

In fibrinolysis, plasminogen in the clot is converted to plasmin by:

A
  1. tissue plasminogen activator (tPA)
  2. factor XII
  3. thrombin
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8
Q

What is plasmin?

A

a fibrin-digesting enzyme

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9
Q

The two mechanisms that limit clot size:

A
  1. swift removal and dilution of clotting factors

2. inhibition of activated clotting factors

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10
Q

Thrombin is bound onto ____.

A

fibrin threads

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11
Q

____ inactivates unbound thrombin.

A

antithrombin III

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12
Q

Heparin in basophil and mast cells inhibits thrombin by:

A

enhancing antithrombin III

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13
Q

Factors preventing undesirable clotting–platelet adhesion is prevented by:

A
  1. Smooth endothelium of blood vessels prevents platelets from clinging
  2. Antithrombic substances nitric oxide and prostacyclin secreted by endothelial cells
  3. Vitamin E quinine acts as potent anticoagulant
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14
Q

Disorders of hemostasis:

A
  1. Thromboembolic disorders
  2. Bleeding disorders
  3. Disseminated intravascular coagulation (DIC)
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15
Q

undesirable clot formation

A

thromboembolic disorder

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16
Q

abnormalities that prevent normal clot formation

A

bleeding disorder

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17
Q

involves both undesirable clot formation and abnormalities that prevent normal clot formation

A

disseminated intravascular coagulation (DIC)

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18
Q

The different thromboembolic conditions are:

A
  1. Thrombus
  2. Embolus
  3. Embolism
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19
Q

What is thrombus?

A

a clot that develops and persists in an unbroken blood vessel; may block circulation leading to tissue death

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20
Q

What is embolus?

A

A thrombus freely floating in the bloodstream

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21
Q

What is embolism?

A

Embolus obstructing a vessel; e.g. pulmonary and cerebral emboli

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22
Q

What are the risk factors of thromboembolic conditions?

A
  1. atherosclerosis
  2. inflammation
  3. slowly flowing blood
  4. blood stasis from immobility
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23
Q

The different anticoagulant drugs are:

A
  1. aspirin
  2. heparin
  3. warfarin
  4. dabigatran
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24
Q

What is aspirin?

A

An antiprostaglandin that inhibits thromboxane A2

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25
Q

What is heparin?

A

An anticoagulant used clinically for pre- and post-operative cardiac care.

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26
Q

What is warfarin also known as?

A

Coumadin

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27
Q

What is warfarin used for?

A

those prone to atrial fibrillation

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28
Q

How does warfarin work?

A

interferes with action of vitamin K

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29
Q

How does dabigatran work?

A

directly inhibits thrombin

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30
Q

Different bleeding disorders are:

A
  1. thrombocytopenia
  2. impaired liver function
  3. hemophilia
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31
Q

What is thrombocytopenia?

A

deficient number of circulating platelets

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32
Q

In thrombocytopenia, ____ appear due to spontaneous, widespread hemorrhage.

A

petechiae

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33
Q

Thrombocytopenia is due to:

A

suppression or destruction of red bone marrow (e.g. malignancy, radiation, drugs)

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34
Q

In thrombocytopenia, the platelet count is:

A

<50,000/microl is diagnostic

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35
Q

How is thrombocytopenia treated?

A

with transfusion of concentrated platelets

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36
Q

With impaired liver function, there is an inability to synthesise _____.

A

procoagulants

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37
Q

Impaired liver function is caused by:

A
  1. vitamin K deficiency
  2. hepatitis
  3. cirrhosis
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38
Q

Impaired fat absorption and liver disease can also prevent the liver from:

A

producing bile

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39
Q

Without bile production in the liver, what happens?

A

impaired fat and vitamin K absorption

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40
Q

Hemophilia A is due to:

A

factor VIII deficiency

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41
Q

Hemophilia B is due to:

A

factor IX deficiency

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42
Q

Hemophilia C is due to:

A

factor XI deficiency

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43
Q

Which hemophilia is the most common type?

A

hemophilia A (77% of all cases)

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44
Q

Symptoms of hemophilia include:

A

prolonged bleeding, especially into joint cavities

45
Q

Hemophilia is treated with:

A

plasma transfusions and injection of missing factors

46
Q

Treatment for hemophilia leads to increased risk for:

A

hepatitis and HIV

47
Q

In DIC, clotting causes:

A

bleeding

48
Q

Characteristics of clotting causing bleeding in DIC:

A
  1. widespread clotting blocks intact blood vessels

2. severe bleeding occurs because residual blood is unable to clot

49
Q

When can DIC occur?

A
  1. as a pregnancy complication
  2. in septicemia
  3. incompatible blood transfusions
50
Q

Whole-blood transfusions are used when:

A

blood loss is rapid and substantial

51
Q

In blood transfusion, ___ is removed.

A

plasma and WBCs

52
Q

Packed red blood cells are transfused to restore:

A

oxygen-carrying capacity

53
Q

Transfusion of incompatible blood can be:

A

fatal

54
Q

RBC membranes bear 30 types of:

A

glycoprotein antigens

55
Q

What is the function of antigens?

A
  1. generate an immune response against anything perceived as foreign
  2. promoters of agglutination
56
Q

promoters of agglutination are called:

A

agglutinogens

57
Q

Mismatched transfused blood perceived as foreign may be:

A

agglutinated or destroyed; can be fatal

58
Q

Presence or absence of each antigen is used to classify:

A

blood cells into different groups

59
Q

Antigens of ___ and ___ blood groups cause vigorous transfusion reactions.

A

ABO; Rh

60
Q

Other blood groups that usually have weak agglutinogens are:

A
  1. MNS
  2. Duffy
  3. Kell
  4. Lewis
61
Q

The different types of ABO blood groups are:

A
  1. A
  2. B
  3. AB
  4. O
62
Q

ABO blood group classification is based on:

A

the presence or absence of two agglutinogens (A and B) on the surface of RBCs

63
Q

Blood may contain agglutinins. What are agglutinins?

A

preformed anti-A or anti-B antibodies

64
Q

What do agglutinins do?

A

act against transfused RBCs with ABO antigens not present on recipient’s RBCs

65
Q

Anti-A or anti-B antibodies form in blood at about what age?

A

2 months

66
Q

Adult levels of anti-A or anti-B antibodies are reached by:

A

8-10 months

67
Q

How many named Rh agglutinogens (Rh factors) are there?

A

52

68
Q

What are the most common Rh agglutinogens?

A
  1. C
  2. D
  3. E
69
Q

Rh+ indicates presence of:

A

D antigen

70
Q

How many of Americans are Rh+?

A

85%

71
Q

How are Rh- individuals different?

A

anti-Rh antibodies are not spontaneously formed in Rh- individuals

72
Q

Anti-Rh antibodies form if Rh- individual:

A
  1. receives Rh+ blood

2. Rh- mom is carrying Rh+ fetus

73
Q

In Rh- individuals, a second exposure to Rh+ blood will result in:

A

a typical transfusion reaction

74
Q

Hemolytic disease of the newborn is also called:

A

erythroblastosis fetalis

75
Q

Erythroblastosis fetalis only occurs in:

A

Rh- mom with Rh+ fetus

76
Q

What happens in erythroblastosis fetalis?

A
  1. Rh- mom is exposed to Rh+ blood of fetus during delivery of first baby–the baby is healthy
  2. Mother synthesises anti-Rh antibodies
  3. In second pregnancy, mom’s anti-Rh antibodies cross the placenta and destroy RBCs of Rh+ baby
77
Q

The second child of erythroblastosis fetalis can be treated with:

A

prebirth transfusions and exchange transfusions after birth

78
Q

What is the function of RhoGAM?

A

a serum containing anti-Rh which can prevent Rh- mother from becoming sensitised

79
Q

Transfusion reactions occur if:

A

mismatched blood is infused

80
Q

In transfusion reactions, a donor’s cells:

A
  1. are attacked by recipient’s plasma agglutinins
  2. agglutinate and clog small vessels
  3. rupture and release hemoglobin into bloodstream
81
Q

A transfusion reaction between donor and recipient’s cells can result in:

A
  1. diminished oxygen-carrying capacity
  2. diminished blood flow beyond blocked vessels
  3. hemoglobin in kidney tubules —> renal failure
82
Q

Symptoms of transfusion reaction are:

A
  1. fever
  2. chills
  3. low blood pressure
  4. rapid heartbeat
  5. nausea
  6. vomiting
83
Q

Mismatched blood transfusion can be treated by:

A

preventing kidney damage–fluids and diuretics are used to wash out hemoglobin

84
Q

Type O:

A
  1. universal donor

2. no A or B antigens

85
Q

Type AB:

A
  1. universal recipient

2. no anti-A or anti-B antibodies

86
Q

Titles for Type O and AB are misleading because:

A

other agglutinogens can cause transfusion reactions

87
Q

Autologous transfusions are where:

A

a patient pre-donates

88
Q

Before transfusion, what is done?

A
  1. blood typing

2. cross matching

89
Q

What are the characteristics of blood typing?

A
  1. RBCs with antibodies are mixed against their agglutinogen(s) which causes clumping of RBCs.
  2. Blood typing is done for ABO and for Rh factor.
90
Q

What are the characteristics of cross matching?

A
  1. Recipient’s serum is mixed with donor’s RBCs.

2. Recipient’s RBCs is mixed with donor’s serum.

91
Q

Death from shock may result from:

A

low blood volume

92
Q

What is blood volume restored/replaced with?

A
  1. Normal saline or multiple-electrolyte solution that mimics plasma electrolyte composition
  2. Plasma expanders
93
Q

multiple-electrolyte solution is also known as

A

Ringer’s solution

94
Q

What are examples of plasma expanders?

A
  1. purified human serum albumin
  2. hetastarch
  3. dextran
95
Q

What do plasma expanders do?

A

mimic osmotic properties of albumin

96
Q

The different diagnostic blood tests are:

A
  1. hematocrit
  2. blood glucose tests
  3. microscopic examination
  4. differential WBC count
  5. prothrombin time and platelet counts
  6. SMAC (blood chemistry profile)
  7. complete blood count (CBC)
97
Q

hematocrit tests for

A

anemia

98
Q

blood glucose tests for

A

diabetes

99
Q

microscopic examination reveals

A

variations in size and shapes of RBCs, which is an indication of anemia

100
Q

prothrombin time and platelet counts assess

A

hemostasis

101
Q

SMAC (a blood chemistry profile) tests for

A

liver and kidney disorders

102
Q

complete blood count (CBC) checks:

A

formed elements, hematocrit, hemoglobin

103
Q

Fetal blood cells form in:

A
  1. fetal yolk sac
  2. liver
  3. spleen
104
Q

The primary hematopoietic area by 7th month is:

A

red bone marrow

105
Q

blood cells develop from

A

mesenchymal cells called blood islands

106
Q

The fetus forms:

A

Hemoglobin F

107
Q

What does Hemoglobin F do?

A

It has a higher affinity for O2 than hemoglobin A formed after birth.

108
Q

Blood diseases of aging are:

A
  1. chronic leukemias
  2. anemias
  3. clotting disorders
109
Q

Blood diseases of aging are usually precipitated by:

A
  1. disorders of the heart
  2. disorders of blood vessels
  3. disorders of immune system

A&P II (8 decks)

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