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Blue Book 1 > Chapter 3: Blood > Flashcards

Chapter 3: Blood Flashcards

1
Q

Proerythroblast

A

precursor for erythrocyte (with large nucleus)- produced in long bone marrow?

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2
Q

Erythropoietin

A

hormone (found in kidney/liver) that stimulates RBC production in bone marrow. Vit. B12 and folic acid are important in producing mature RBC

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3
Q

Aplastic Anemia

A

if bone marrow does not produce enough RBC

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4
Q

Pernicious Anemia

A

lack of Vit. B12 and folic acid in diet or poor absorption= low RBC

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5
Q

Hemoglobin

A

in RBC, function to transport oxygen/CO2

  • iron and protein compound
  • each heme molecule carries 1 O2
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6
Q

Polycythemia

A

elevated hematocrit (could be caused by living in high elevation, pulmonary disease, etc)

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7
Q

Anemia

A

low RBC count (could be caused by blood loss, RBC production failure, or RBC destruction)

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8
Q

Hematocrit on Bypass

A

22-30% considered normal on bypass (lowers because of dilution- which provides better capillary perfusion)

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9
Q

Hemolysis

A

destruction of RBC membrane- release hemoglobin

  • creates plasma free hemoglobin and releases the intracellular K
  • if occlusion is too loose= turbulence (Reynolds Number > 2,000)
  • they want laminar flow
  • best way to set occlusion- column of arterial fluid 30 inches above roller head, tighten until it drops 1 cm per minute
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10
Q

Diapedesis

A

passage of WBC through the walls of blood vessels

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11
Q

WBCs are characterized by:

A

presence or lack of granules in cytoplasm
1) granulocytes contain granules (neutrophils 60%, basophils 1%, eosinophils 3%)
2)agranulocytes lack granules ( lymphocytes 30%, monocytes 6%)
Order: N L M E B

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12
Q

Leukocytosis

A

increased WBC count (normally with infection)

-above 5,000-10,000 per cubic millimeter

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13
Q

Leukopenia

A

abnormal decrease in WBC count (could be caused by drug reaction, radiation, etc)
-below 5,000-10,000 per cubic millimeter

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14
Q

Neutrophils

A
  • granulocytes, produced by bone marrow
  • engulf (phagocytosis) foreign bodies
  • remove bacteria, cell debris, solid particles
  • can move from capillary to tissue
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15
Q

Neutrophilia

A

increase in neutorphils (above 7500 per cubic millimeter)

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16
Q

Neutropenia

A

low neutrophil count (below 1,500 per cubic mm)

  • linked to leukemia, infections, low b12, chemotherapy)
  • also more likely to contract infections
17
Q

Eosinophils

A
  • granulocytes, 2 lobed WBC

- increase with allergies and parasites

18
Q

Eosinophilia

A

increase in eosinophils (> 500 per cubic mm)

-Hyperesoinophilia- increase due to no apparent cause

19
Q

Basophils

A
  • granulocytes, contain nucleus and granules
  • release heparin and histamines to keep vessels open at sites of pathogens
  • only 1% of WBC!
20
Q

Basophilia

A

increase number in basophils (>100 per cubic mm)

-numbers increase with bone marrow disease and decrease with severe allergic reactions

21
Q

Monocytes

A
  • become macrophages when leave blood stream and enter tissue- engulf pathogens and foreign particles
  • they arrive second to site after neutrophils
  • largest WBC
22
Q

Lymphocytes

A

production of antibodies (B and T cells)

23
Q

Lymphocytosis

A

increase in lymphocytes >4,500 per cubic mm

24
Q

Lymphocytopenia

A

decrease in lymphocytes < 1500 per cubic mm

25
Q

B Cells and T Cells

A

lymphocytes

  • B cells- exposed to antigen/allergen, moves to spleen/lymph nodes and produces plasma/memory cells
  • T cells- killer cells, assist B cells and secrete chemicals
26
Q

Platelets/thrombocytes

A
  • no nucleus or hemoglobin, surface negatively charged, produced in bone marrow (megakaryocytes) as broken fragments of cytoplasm
  • necessary for clotting
  • –phospholipid membrane aids in clotting factors= platelet factor 3
  • –releases vasoconstrictor= thromboxane A2
  • -DO NOT give platelets on bypass
  • normal count is 150,000-350,000 per cubic mm
  • count decreases 20-65% after CPB
27
Q

Thrombocytopenia

A

-low platelet count (<50,000)

28
Q

Cell suffix (number wise)

  • philia
  • cytosis
  • penia
A

philia- increase
cytosis- increase
penia- decrease

29
Q

Plasma

A
  • 91.5% water and comprises 55% of blood
  • mostly comprised of albumin and plasma proteins
  • function is to transport blood cells, platelets
  • contains electrolytes, clotting factors, proteins glucose, fats, bilirubin, globulins, and gases
  • very important for protein balance between interstitial space (colloid osmotic pressure)
30
Q

Plasmapheresis and Plateletpheresis

A

separation of plasma or platelets from blood and returned to body

31
Q

Potassium

A
  • intracellular (98% of total K is intracellular)
  • needed for cardiac muscle contractions
  • insulin brings K and glucose into the cell (insulin levels are low during hypothermic bypass, so blood glucose/K increases)
  • if K is high AND not peeing, consider giving insulin
  • hyperkalemia will cause irregular heart contractions
  • Normal K levels are 3.5-5 mEq/L
32
Q

Calcium

A
  • contractility, clotting, neurotransmission

- blood calcium is regulated by parathyroid hormone and Vit D

33
Q

Magnesium

A
  • intracellular
  • competes with calcium
  • controlled by kidney
34
Q

3 Phases to Forming a Clot

A

1) vascular- constriction of vessels at injury
2) platelet aggregate and release factors to aid in vasoconstriction
3) clotting factors/cascade

35
Q

Intrinsic vs. Extrinsic Pathway

A
  • intrinsic= initiated by foreign substance
  • extrinsic= initiated by tissue injury
  • both combine into the common pathway with Factor X
36
Q

Heparin

A
  • increases antithrombin 3 (which inactive- stops production of thrombin)
  • –stops fibrinogen from becoming fibrin and prothrombin from becoming thrombin
  • also binds to cofactor 2 to inactivate thrombin
  • half-life= 1-2 hours (increased during hypothermia, decreased during rewarming)
  • elimination by kidneys (so impaired renal function can prolong heparin function)
  • bolusing heparin at beginning of case can decrease SVR and BP by 10-20%
  • bovine or porcine
37
Q

Anti-thrombin III Deficienc

A
  • if no response to initial heparin dose, redoes

- if no response, give 2 units of FFP or ATIII

38
Q

Protamine

A
  • binds to heparin to inhibit and allows clotting
  • from salmon sperm
  • 1-1.3 mg per 100 units of heparin given
  • given slowly to prevent reactions (5 /min): hypotension, bradycardia, increase CVP/PAP (increase chance of reaction if DMI, seafood allergy, or past protamine exposure)
  • shorter halflife than heparin- 5 min?

Blue Book 1 (3 decks)

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