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Human Pathophysiology > Diseases of Blood Cells > Flashcards

Diseases of Blood Cells Flashcards

1
Q

Blood Components

plasma percentage

A

55%

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2
Q

Blood Components

WBCs and platelets percentage

A

less than 1%

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3
Q

Blood Components

RBCs percentage

A

45%

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4
Q

Erythrocytes

Lifespan?
Production?
Removal?

A
  • 120 days
  • hematopoeitic cells
  • spleen, liver
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5
Q

erythropoeitin

A

controls the activates the erythrocyte production

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6
Q

hemoglobin

in a normal healthy person

A

HbA

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7
Q

hemoglobin

structure

A
  • 2 alpha clobin chain
  • 2 beta globin chain
  • heme-mineral (binding site of oxygen)
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8
Q

T/F: Heme-mineral makes up only 10% of body iron.

A

FALSE – heme-mineral makes up 80% body iron in RBC

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9
Q

WBCs

WBCs types

A
  • granulocytes
  • monocytes
  • lymphocytes
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10
Q

laboratory assessment of blood cells

RBCs Indices

A
  • size: mean cell volume
  • Hgb content
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11
Q

RBC indices: size

A

Mean Cell Volume (MCV)

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12
Q

RBC indices: hgb content

A
  • Mean Cell Hemoglobin (MCH)
  • Mean cell hemglobin concentration (MCHC)
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13
Q

anemia

microcytic

A

small cells

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14
Q

anemia

normocytic

A

normal cell size

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15
Q

anemia

macrocytic

A

large cell size

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16
Q

anemia

hypochromic

A

less color = less hemoglobin

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17
Q

anemia

normochromic

A

normal color = normal hemoglobin

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18
Q

anemia

hyperchromic

A

more color = more hemoglobin

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19
Q

causes of anemia

A
  • hemorrhage
  • hemolytic anemia
  • insufficient RBC production
  • chronic disease
  • aplastic anemia
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20
Q

hemorrhagic anemia leads to:

A
  • loss of oxygen carrying capacity
  • loss of iron
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21
Q

Main threat of acute hemorrhagic anemia?

A
  • hypovolemic shock
  • tissue hypoxia
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22
Q

Examples of chronic hemorrhagic anemia?

A
  • menstrual bleeding
  • intestinal bleeding
  • presents as iron-deficiency anemia
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23
Q

hemolytic anemia

A

premature destruction of RBC

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24
Q

RBC hemolytic characteristics

A
  • active bone marrow
  • increased EPO
  • increase reticulocytes
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25
Q

Causes of hemolytic anemia

A
  • genetic defects
  • non-genetic
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26
Q

Genetic hemolytic anemia

A
  • glucose-6-phosphate dehydrogenase deficiency
  • X linked recessive
  • increase prevalance african-americans
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27
Q

more about Genetic hemolytic anemia

A

Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme that plays a crucial role in the red blood cells (RBCs) by generating nicotinamide adenine dinucleotide phosphate (NADPH). NADPH is essential for protecting RBCs from oxidative damage and maintaining the cellular redox balance. Here’s how G6PD functions in RBCs to generate NADPH:

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28
Q

sickle cell disease

A
  • HbS
  • autosomal recessive
  • missense mutation in beta globin chain
  • at low oxygen RBC sickel
  • microinfarcts
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29
Q

Sickle cell disease signs and symptoms

A
  • obstruction of small vessels = lack of organ function
  • microcytic anemia
  • pain
  • infections (hyposplennism)
  • reduced life expectancy
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30
Q

thallasemia pathophysiology

A
  • impairment of synthesis of alpha or beta globuin chain of hemoglobin
  • leads to aggregation of RBC
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31
Q

signs and symptoms thallasemia

A
  • codocyte “target cells’
  • microcytic, hypochromic anemia
  • splenomegaly
  • hyperactive bone marrow (bone deformities)
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32
Q

treatment for hemolytic anemia

hydroxyurea

A

stimulate production of fetal hemoglobin

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33
Q

treatment for hemolytic anemia

sickle cell disease

A
  • cure-bone marrow transplant
  • blood transfusion (supportive)
  • prophylactic penicillin (supportive)
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34
Q

treatment for hemolytic anemia

thallassemia

A
  • transfusion (issues with iron)
  • splenectomy
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35
Q

warm autoimmune hemolytic anemia

A
  • mediated by IgG
  • symptoms of anemia
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36
Q

Cold autoimmune hemolytic anemia

A
  • IgM mediated
  • onset of symptoms sudden
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37
Q

non-genetic hemolytic anemia

A
  • mechanical hemolysis
  • malaria (transmitted by mosquitos)
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38
Q

Benefits of being a sickle cell trait carrier?

A
  • heterozygous advantage
  • carrier = immune to malaria
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39
Q

Cause of Anemia: Insufficient RBC Production

Why does kidney failure cause low RBC production?

A
  • low EPO production (triggered by hypoxia)
  • RBC may have shorter lifespan
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40
Q

Cause of Anemia: Insufficient RBC Production

What nutritional deficiencies can cause decreased RBC production?

A
  • iron
  • folate
  • vitamin B12
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41
Q

What is the most common nutrient deficiency in the world?

A

iron-deficiency anemia

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42
Q

Iron-Deficiency Anemia

Etiology is typically due to an underlying condition, what are two common examples?

A
  • chronic blood loss: menstrual abnormalities; GI bleeding
  • intestinal disease: parasites
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43
Q

Iron-Deficiency Anemia

What is the pathphysiology of Iron-Deficiency Anemia? What causes this?

A
  • a decreased ability to make hemoglobin
  • the gradual depletion of iron stores (anemia is last indication)
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44
Q

Iron-Deficiency Anemia

What are two examples of iron storage in the human body?

A
  • ferritin is found in the liver
  • transferrin is found in blood
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45
Q

Iron-Deficiency Anemia

What are cellular charateristics of Iron-Deficiency Anemia?

A
  • microcytic hypochromic
  • low reticulocyte count
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46
Q

Nutritional Deficiency Anemia

Nutritional Deficiency Anemia is typically folate or B12 based, what are these two things important for?

A

DNA synthesis

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47
Q

Nutritional Deficiency Anemia

What are cellular characteristics of Nutritional Deficiency Anemia?

A
  • macrocytic anemia
  • ^^ this is a type of megaloblastic
48
Q

Nutritional Deficiency Anemia

What are the main causes of Nutritional Deficiency Anemia?

A
  • diet
  • lack of intrinsic factor: pernicious anemia lacks receptor that triggers absorption of B12 within the ileum
49
Q

Anemia of Chronic Disease

What are causes of this kind of anemia?

A
  • RBC survival shortened
  • Erythropoiesis impaired
  • underlying chronic diease
50
Q

Anemia of Chronic Disease

What are cellular characteristics of Anemia of Chronic Disease?

A
  • normocytic
  • normochromic
51
Q

Aplastic Anemia

Primary bone marrow failure can cause panytopenia, what does this mean?

A

deficiency of all cells from bone marrow

52
Q

Aplastic Anemia

What are the typical causes of Aplastic anemia?

A
  • idiopathic
  • radiation
  • autoimunne
  • genetic
  • infection (HIV)
53
Q

Myelophthisic Anemia

Myelophthisic Anemia is caused by infiltration of bone marrow by non-hematopoietic cells or abnormal cells, what are some examples?

A
  • lipid storage diseases
  • metastatic cancer
54
Q

Myelophthisic Anemia

What are cellular characteristics of Myelophthisic Anemia?

A
  • normochromic
  • normocytic
55
Q

Polycythemia

A

too many RBC

56
Q

Polycythemia

Primary Polycythemia is caused by?

A

bone marrow malignancy

57
Q

Polycythemia

Secondary Polycythemia is caused by?

A
  • lung cancer
  • life at altitude
  • increase in EPO
58
Q

Polycythemia

What are complications with having too many RBCs?

A
  • increased viscosity (clot risk)
  • heart failure due to pumping thick blood
59
Q

Alterations of Leukocytes

What are general ways leukocytes can be altered?

A
  • deficiencies in quality and quantity of leukocytes
  • increased numbers of leukocytes
  • malignancies
60
Q

Alterations of Leukocytes

Define leukocytosis.

A

cell counts higher than normal

61
Q

Alterations of Leukocytes

Leukocytosis is a normal protective physiological response to what?

A

stressors

62
Q

Alterations of Leukocytes

Is leukocytosis benign or malignant?

A

it can be both

63
Q

Alterations of Leukocytes

Define leukopenia.

A

counts lower than normal

64
Q

Alterations of Leukocytes

Is leukopenia always abnormal?

A

yes

65
Q

Alterations of Leukocytes

Leukopenia, low WBC count, predisposes people to what?

A

infections

66
Q

Leukopenia

Define granulocytopenia

A

low granulocyte count
- neutrophils, basophils, eosinophils

67
Q

Leukopenia

What does agranulocytosis mean?

A

very low granulocyte count

68
Q

Leukopenia

What are possible resulting clinical problems?

A

it depends on what granulocyte is affected
- neutrophils = increased bacterial infections
- eosinophils = increased parasitic infections

69
Q

Leukopenia

Define Lymphopenia

A

decreased lymphocyte count

70
Q

Leukopenia

Is granulocytopenia or lymphopenia more common?

A

granulocytopenia; lymphopenia is uncommon

71
Q

Leukocytosis

Define leukocytosis.

A

high white cell count

72
Q

Leukocytosis

Granulocytosis is the most common type, give a specific example.

A

neutrophilia

73
Q

Leukocytosis

What causes lymphocytosis?

A

viral infections

74
Q

Infection of Lymphocytes

What is infectious mononucleosis?

A

an acute, self-limiting infection of B lymphocytes transmitted by saliva through personal contact

75
Q

Infection of Lymphocytes

What are symptoms of mono?

A

enlarged, tender lymph nodes

76
Q

Infection of Lymphocytes

What typically causes mono?

A

Epstein-Barr virus
- b cells have an EBV receptor site

77
Q

Infection of Lymphocytes

How is mono treated?

A

rest, no medicine

78
Q

Infection of Lymphocytes

What could a person with a compromised immune system develop from mono?

A

B cell lymphoma

79
Q

Hematological Malignancies

Define leukemias

A

malignant disease involving WBC precursors in bone marrow and peripheral blood
- myeloid
- lymphoid

80
Q

Hematological Malignancies

Define lymphomas

A

malignant dieases involving lymphocytes
- non-hodgkins lymphoma
- hodgkins lymphoma

81
Q

Hematological Malignancies

Define Myeloma

A

malignant disease of plasma cells

82
Q

Hematological Malignancies

Describe the pathgenesis of WBC malignancies.

A
  • most are acquired mutations
  • some are inherited
  • normal cell maturation is blocked so immature cells accumulate
83
Q

Leukemias

What can uncontrolled proliferation of malignant leukocytes cause?

A
  • overcrowding of bone marrow
  • decreased production and function of normal hematopoietic cells
84
Q

Leukemias

What are the four kinds of leukemias?

A
  • acute lymphoid leukemia
  • acute myeloid leukemia
  • chronic lymphoid leukemia
  • chronic myeloid leukemia
85
Q

Types of Leukemias

ALL

A

acute lymphocytic leukemia

86
Q

Types of Leukemias

AML

A

Acute myelogenous leukemia

87
Q

Types of Leukemias

CML

A

chronic myelogenous leukemia

88
Q

Types of Leukemias

CLL

A

chronic lymphocytic leukemia (CLL)

89
Q

Types of Leukemias

What is the most common leukemia of childhood?

A

acute lymphocytic leukemia

90
Q

Myeloid Malignancies arise from myeloid progenitor cells. Give some examples.

A

AML, CML, Myelopdysplasia (pre-cancer), Myeloproliferative syndromes

91
Q

What is a myeloproliferative syndrome?

A

a syndrome where bone marrow makes too many RBC, platelets, WBC

92
Q

What are examples of myeloproliferative syndromes?

A
  • CML
  • polycythemia vera
  • essential thrombocythemia
  • myelofibrosis
93
Q

What is the distinguishing feature of AML?

A

appearance of abnormal immature WBC

94
Q

What is the most common form of acute leukemias in adults?

A
  • AML
  • can also affect children
95
Q

AML Prevelance in regards to gender and age?

A
  • incidence increases with age
  • more common in men
96
Q

How would you describe the onset of AML?

A

typically sudden

97
Q

AML presents as bone marrow failure, what are some common symptoms?

A
  • bone pain
  • anemia
  • infection
  • fever
  • thrombocytopenia (low platelet count)
98
Q

Myeloid Dysplastic Syndrome (MDS) is characterized by hematologic neoplasms, these can lead to what?

A

ineffective hematopoiesis

99
Q

MDS is more common in adults over 70 and is known to be a what?

A

pre-leukemia syndrome

100
Q

Does CML occur in adults or children?

A
  • mainly in adults, rarely in children
101
Q

Lymphoid Malignancies

Lymphoid Leukemias location?

A
  • malignant lymphocytes in bone marrow
  • can spill into blood
102
Q

Lymphoid Malignancies

Lymphomas location?

A

typically found in lymph nodes

103
Q

Lymphoid Malignancies

ALL demographic? Onset?

A
  • most common form of leukemia in children; leading cause of cancer deaths in children
  • sudden
104
Q

Lymphoid Malignancies

How is ALL characterized?

A

too many immature lymphoid cells (blasts) that are poorly functioning
- blasts spill into the blood
- mostly B cells

105
Q

Lymphoid Malignancies

What are the symptoms of ALL?

A
  • recurrent infections
  • lethargy
  • generalized weakness
  • bleeding
  • enlarged lymph nodes
  • pathological leukocytosis
106
Q

Lymphoid Malignancies

How is ALL treated?

A

chemotherapy – highly curable (85% rate)

107
Q

Lymphoid Malignancies

CLL demographic? Onset?

A
  • occurs most often in adults; incidence increases with age
  • slow growing
108
Q

Lymphoid Malignancies

What are symptoms of CLL?

A
  • asymptomatic for years
  • malaise
  • weight loss
  • loss of appetite
  • predisposed to developing infections
  • overall survival rate is about 10 years
109
Q

Lymphoma

What is lymphoma?

A

generic term for diverse group of cancers affecting B, T, or NK lymphocytes
- most have B cell phenotype
- usually malignant cells not present in blood

110
Q

Lymphoma

Are lymphomas beningn?

A

no, never

111
Q

Lymphomas

What age group does it affect?

A

any age

112
Q

Lymphomas

What are the 2 main categories of lymphoma? How are these differentiated?

A
  • non-hodgkins lymphomas
  • hodgkins lymphoma

a biopsy is required

113
Q

NHL

Describe NHL

A
  • risk increases with age
  • can spill into blood and present as leukemia
114
Q

What age group is most affected by Hodgkin’s Lymphoma?

A

10 - 30 yrs in america

115
Q
A

Human Pathophysiology (4 decks)

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