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Understanding Human Disease Exam 2 > Chapter 9 > Flashcards

Chapter 9 Flashcards

1
Q

blood function

A

carry oxygen, bring WBC to injury, nutrient carrier, platelets for clotting, waste products

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2
Q

blood components

A
  • cells/cell fragments
  • plasma
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3
Q

how much plasma is in the blood

A

55%

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4
Q

how much RBC in the blood?

A

45%

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5
Q

how much WBC and platelets in the blood?

A

<1%

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6
Q

hematocrit

A

% of blood thats RBC

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7
Q

hematopoiesis

A

normal blood production

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8
Q

where does blood production take place?

A

bone marrow

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9
Q

what are the two main lineages of blood production?

A
  • lymphoid: lymphocytes
  • myeloid: everything else (RBC, platelets)
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10
Q

erythrocytes

A

RBC

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11
Q

RBC functions

A

carries oxygen and carbon dioxide to cells

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12
Q

hemoglobin

A
  • normal = HbA
  • structure: alpha globin chain, beta globin chain, heme mineral (in the middle, contains iron)
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13
Q

erythropoiesis

A

formation and development of RBC (don’t divide)

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14
Q

substances needed for erythropoiesis

A
  • protein
  • vitamin B12
  • folic acid (B vitamin)
  • iron
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15
Q

what is red cell production regulated by?

A

osygen content of arterial blood

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16
Q

erythropoietin (EPO)

A
  • released by kidneys - regulate blood volume
  • abused by endurance athletes
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17
Q

how long to RBC live?

A

120 days

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18
Q

how are RBC removed?

A

spleen/liver

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19
Q

leukocytes

A

WBC

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20
Q

types of leukocytes

A
  • granulocytes
  • monocytes
  • lymphocytes
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21
Q

platelets

A
  • cytoplasmic fragments of megakaryocyte (bio cell in bone marrow)
  • not cells (no nucleus and only limited metabolic machinery)
  • contain granules of chemical mediators of clotting and inflammation
  • participate in hemostasis
  • must be replaced continuously
  • only live 10 days
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22
Q

symptoms of anemia

A
  • headache and easy fatiguability
  • loss of appetite and heartburn
  • shortness of breath
  • numbness and tingling sensations
  • pica (craving of nonfood substance)
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23
Q

how does palpation detect anemia?

A

detects enlargement of lymph nodes, spleen and liver

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24
Q

lab tests for hematopoietic disease

A
  • complete blood count (analysis of blood cells (RBC, WBC, hematocrit, hemoglobin)
  • blood smear (look at cells under microscope)
  • biopsy of lymph nodes or bone marrow (look for changes)
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25
Q

disorders of RBCs

A
  • anemia (too little)
  • polycythemia (too many)
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26
Q

disorders of WBC

A
  • too many
  • too little
  • cancer
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27
Q

anemia

A

abnormally low hemoglobin
- low Hgb in RBC
- low RBC

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28
Q

diagnosis of anemia

A
  • CBC (RBC indices, number of RBCs/hematocrit, size of RBC)
  • visual inspection (reticulocyte - immature RBCs, kicked out of bone marrow too early)
  • Hb < 12 g/dl blood
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29
Q

RBC indices

A
  • MCV = mean corpuscle volume (size of RBC)
  • MCHC = mean corpuscle hemoglobin content (measure of hemoglobin per RBC)
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30
Q

anemia: morphologic classification

A

classification based on red cell appearance suggests the etiology of the anemia

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31
Q

normocytic anemia

A

normal size and appearance

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32
Q

macrocytic anemia

A

cells larger than normal (folic acid/B12 deficiency)

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33
Q

microcytic anemia

A

cells smaller than normal

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34
Q

hypochromic anemia

A

reduced hemoglobin content

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35
Q

hypochromic microcytic anemia

A

smaller than normal and reduced hemoglobin content

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36
Q

anemia symptoms

A
  • lightheadedness/fainting
  • pica
  • cold more easily
  • fatigue all the time
37
Q

most common types of anemia

A
  • nutrient deficiencies (starting materials in bone factory)
  • hemolytic anemia (finished products in bone factory, finished too early)
  • disorder of bone marrow (factory)
38
Q

anemia associated with nutrient deficiencies

A
  • iron deficient anemia (most common type)
  • RBC (hypochromic microcytic anemia)
  • pathogenesis = inadequate iron intake in diet, chronic blood loss
  • treatment = administer supplementary iron
39
Q

macrocytic anemia

A
  • deficiency of vitamin B12 (animal products) or folic acid (green leafy)
  • both required for normal hematopoiesis, DNA replication
  • mature red cells formed are larger than normal or macrocytes
40
Q

pernicious anemia

A
  • lack of intrinsic factor results in macrocytic anemia
  • vitamin B12 in food combines with intrinsic factor in stomach
  • vitamin B12 intrinsic factor complex absorbed in ileum
  • receptor in ileum for intrinsic factors = absorbed into blood
41
Q

causes of pernicious anemia

A
  • gastric resection and bypass (vitamin B12 not absorbed)
  • distal bowel resection or disease (impaired absorption of vitamin B12 intrinsic factor complex)
  • may develop among elderly (reduced amount of HCl, cannot free B12 from protein)
  • autoimmune (associated with autoantibodies against gastric mucosal cells and intrinsic factor)
42
Q

conditions that depress bone marrow function

A
  • anemia of chronic disease
  • aplastic anemia
  • myelopthisic anemia
43
Q

anemia of chronic disease

A

mild suppression of bone marrow function

44
Q

aplastic anemia

A

atrophy of bone marrow (injured by chemicals or autoantibodies)

45
Q

myelopthisic anemia

A

bone marrow infiltrated by tumor or replaced by fibrous tissue/cancer cells

46
Q

hemolytic anemia

A

premature destruction of RBC

47
Q

characteristics of hemolytic anemia

A
  • active bone marrow
  • increased EPO
  • increase reticulocytes
48
Q

causes of hemolytic anemia

A
  • genetic defects (sickle cell/thalassemia)
  • non genetic (acquired hemolytic anemia)
49
Q

sickle cell disease (HbS)

A
  • pathogenesis: mutation
  • autosomal recessive
  • missense mutation in beta globin chain
  • RBC sickle
  • microinfarcts
50
Q

thalassemia

A
  • genetic disease affecting synthesis of normal adult hemoglobin (hemoglobin A)
  • autosomal recessive
  • severe complications include overloading the heart
51
Q

acquired hemolytic anemia

A
  • autoimmune (attacked and destroyed by antibodies)
  • destruction of red cells by mechanical trauma (artificial heart valve)
  • passing through enlarged spleen (splenomegaly)
52
Q

diagnostic evaluation of anemia

A
  • history and physical exam
  • CBC to assess degree of anemia, leukopenia, and thrombocytopenia
  • blood smear to determine if normocytic, macrocytic, or hypochromic microcytic
  • reticulocyte count to assess rate of production of new red cells
  • lab tests to determine iron, B12, folic acid levels
  • bone marrow study to see characteristic abnormalities in marrow cells
  • evaluation of blood loss from gastrointestinal tract to localize site of bleeding
53
Q

polycythemia

A

too many RBC

54
Q

types of polycythemia

A
  • primary
  • secondary
55
Q

primary polycythemia

A
  • bone marrow malignancy
  • overproduction of red cells, white cells, and platelets
56
Q

secondary polycythemia

A
  • outside of bone marrow
  • reduced arterial oxygen saturation leads to compensatory increase in RBC (lung cancer, life at altitude, increase in EPO)
57
Q

polycythemia complications

A
  • thick blood (viscous)
  • heart works harder
  • blood clots
  • thrombus
  • increase risk of stroke
58
Q

polycythemia treatment

A
  • primary: drugs that suppress marrow function
  • secondary: periodic removal of excess blood
59
Q

leukopenia

A

deficiencies in the quality and quantity of leukocytes
- always abnormal
- low WBC count predisposes to infections more often

60
Q

leukocytosis

A

increased numbers of leukocytes
- normal protective physiologic response to stressors
- benign or malignant

61
Q

infection of lymphocytes

A
  • infectious mononucleosis
  • acute, self-limiting infection of B lymphocytes transmitted by saliva through personal contact (characterized by enlarged, tender lymph nodes)
  • caused by the epstein-barr virus (EBV)
62
Q

treatment of mononucleosis

A

rest 5-6 weeks

63
Q

leukemias

A

malignant diease involving WBC precursors in bone marrow (myeloid = everything else, lymphoid = T/B cell)

64
Q

lymphomas

A

malignant diseases involving lymphocytes (non/hodgkins lymphoma)

65
Q

myeloma

A

malignant disease of plasma cells (plasma cells in bone marrow making antibodies = bone affected)

66
Q

most common types of leukemias

A
  • granulocytic
  • lymphocytic
  • monocytic
  • uncontrolled proliferations of malignant leukocytes
67
Q

classification of leukemias

A
  • maturity
  • cell types
68
Q

clinical features of leukemia

A
  • manifestations caused by impairment of bone marrow function
  • leukemic cells crowd out normal cells causing -
  • anemia
  • thrombocytopenia: causes bleeding/clots
  • infections from inadequate number of normal white cells
  • usually produce high WBC counts in peripheral blood = blasts (immature WBC)
69
Q

signs and symptoms of leukemia

A
  • recurrent infections
  • generalized weakness
  • anemia
  • bleeding
  • bruising
70
Q

treatment for leukemia

A

chemotherapy (targets rapidly dividing cells)

71
Q

diagnosis of leukemia made by..

A
  • biopsy of bone marrow
  • blood smear (look for blasts)
72
Q

types of leukemia

A
  • acute lymphocytic leukemia (most common iin children, ALL)
  • acute myelogenous leukemia (AML)
  • chronic myelogenous leukemia (CML)
  • chronic lymphocytic leukemia (CLL)
73
Q

lymphomas normally have..

A

B cell phenotype, usually malignant cells not present in blood

74
Q

how does lymphoma present?

A

solid tumor of lymphoid cells

75
Q

does lymphoma affect any age group?

A

yes, all

76
Q

malignant cells often..

A

infiltrate lymph nodes, spleen, thymus, or bone marrow, but may also involve other organs

77
Q

non-hodgkins lymphomas

A
  • risk increases with age
  • 6th most common cancer in U.S
  • cancer cells can spill over into blood; present as leukemia
  • involve lymph nodes, bone marrow, spleen, thymus, cut can be extranodal origin
78
Q

hodgkins lymphoma

A
  • most common malignant neoplasm of Americans 10-30 yrs of age
  • characterized by reed-sternberg cells (B cell gone awry, epstein barr virus)
79
Q

treatment of leukemia/lymphoma

A
  • depends on age, severity, and type
  • chemo and radiation (cancer may become resistant)
  • HSC stem cell transplantation (from bone marrow, need to match HLA, DNA between the two)
80
Q

myeloma

A

B cell that becomes plasma cell

81
Q

myeloma is a malignant disease that only affects..

A

plasma cells

82
Q

myeloma tumors can be..

A

solitary or multifocal, proliferate in bone marrow

83
Q

how old are most myeloma patients?

A

over 45 yrs

84
Q

pathophysiology of myeloma

A
  • functionally useless antibodies (breakdown antibodies and toxic to kidneys)
  • impaired humoral immunity (sick more often, hypogammaglobulinemia)
  • anemia
85
Q

what is the most common cause of death for myeloma patients?

A

infection/renal failure due to kidney toxins

86
Q

thrombocytosis

A

too many platelets

87
Q

thrombocytopenia

A

too little platelets

88
Q

primary thrombocytopenia

A
  • idiopathic thrombocytopenia purpura (ITP)
  • associated with platelet antibodies
  • bone marrow produces platelets, but they are rapidly destroyed
89
Q

secondary thrombocytopenia

A
  • damage to bone marrow from drugs or chemicals (chemo)
  • bone marrow infiltrated by leukemic cells or metastatic carcinoma

Understanding Human Disease Exam 2 (5 decks)

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