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Pathophysiology > Disorders of Blood Cells > Flashcards

Disorders of Blood Cells Flashcards

1
Q

Characteristics of Blood

A
  • Blood is a liquid tissue

* Blood is 45% cells and 55% plasma

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2
Q

Contents and characteristics of plasma

A

• The liquid part of blood
o Dissolved solutes such as sodium, potassium, bicarbonate, electrolytes, hormones, cytokines and other particles
• 93% of plasma is water, and 7% of plasma is protein, mainly albumin, immunoglobulins (gammaglobulins)

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3
Q

Characteristics of serum

A
  • The fluid remaining after blood clots
  • Analyzed for most blood lab tests
  • Since it doesn’t contain fibrinogen (a coagulation protein) so it doesn’t clog the lab equipment
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4
Q

What are the formed elements

A

• Erythrocytes (RBC), leukocytes (WBC), and thrombocytes/platelets

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5
Q

Characteristics of RBC

A
  • intact whole cells

- are most abundant (they need to transport oxygen)

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6
Q

Characteristics of platelets

A

are the fragments of the cytoplasm of a bone marrow cell (megakaryocyte)

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7
Q

Where do formed elements reside in?

A

Bone Marrow

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8
Q

Characteristics of Red Marrow

A

 In central cavity of bones of the spine, pelvis, ribs, cranium, and the proximal ends of long bones
 25% develops RBC
 75% develops WBC (because they have a shorter life span)

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9
Q

Characteristics of yellow marrow

A

stores fat and can become red marrow if necessary

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10
Q

Where do blood cells also exist

A

Spleen, lymph nodes, thymus

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11
Q

What does the quantity of cells depend on?

A

o Life span

o Rate of production

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12
Q

The generation of blood cells

A

Hematopoiesis

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13
Q

What do all cells arise from?

A

Pluripotent hematopoietic stem cell

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14
Q

What does the pluripotent stem cell give rise to?

A

2 multipotent stem cells

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15
Q

What is another name for the multipotent stem cells

A

Progenitor cells

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16
Q

What do progenitor cells give rise to?

A
  • Lymphoid Progenitor Cells

- Myeloid Progenitor Cells

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17
Q

What do lymphoid progenitor cells give rise to

A

-Lymphocytes 
(T cells (mature in thymus) B cells (mature in bone marrow and turn into plasma cells))
-Leukocytes
-WBC

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18
Q

What do myeloid progenitor cells give rise to?

A
  • Granulocytes (Neutrophils, basophils, eosinophils)
  • Monocytes
  • Erythrocytes
  • Megakaryocytes
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19
Q

Do white blood cells contain a nucleus?

A

Yes

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20
Q

What is the role of granulocytes?

A

(Neutrophils, basophils, eosinophils)

-Part of inflammatory reactions, have digestive enzymes, in allergic reactions

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21
Q

What is the role of megakayocytes

A
  • Precussor cells to platelets

- Stop bleeding, role in coagulation

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22
Q

Where are blood cells made in a fetus?

A

Liver and Spleen

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23
Q

Where are blood cells made from birth on?

A

-Shifts to the red marrow

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24
Q

Do the liver and spleen retain their ability to produce cellular elements?

A

Yes

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25
Q

-Blood cell production by the liver and spleen

-Occur when the bone marrow if wiped out

A

Extramedullary Hematopoiesis

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26
Q

Where are bone marrow biopsies taken from?

A

Iliac crest and sternum

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27
Q

Characteristics of RBC (origination, life ex. components)

A

• Originate from myeloid progenitor cells in the marrow
• Begin nucleated, but the nucleus is ejected before the cell enters the bloodstream so there is more room for hemoglobin
• Live 120 days and iron and hemoglobin are recycled
o Hemoglobin AIC is a great test for diabetics because it tests the past 3 months glucose levels

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28
Q

What is usually the problem if you have low reticulocytes?

A

Problem with bone marrow

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29
Q

What is the problem if you have too high reticulocytes?

A

Anemia

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30
Q

Characteristics of hemoglobin

A
  • Compound in RBC to which oxygen attaches to
  • Functions to transport oxygen from lungs to tissues
  • Synthesis requires iron, vitamin B12, vitamin B6, and folic acid
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31
Q

Where is erythropoietin made and what is its function?

A

Made in the kidney and it stimulates RBC production

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32
Q

How is EPO stimulated?

A

By the amount of oxygen delivered to the kidneys via RBC

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33
Q

Low oxygen, increases/decreases EPO and RBC

A

Increases

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34
Q

How many heme units are on a RBC?

A

4

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35
Q

What problems occur if you have problems with your heme state?

A
  • Genetic defect that can cause disease
  • Lacking iron- can lead to iron deficiency
  • You wont have effective iron transport
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36
Q

What stimulates WBC production

A
  • Hormones
  • Inflammatory molecules
  • Immune molecules
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37
Q

3 characteristics of WBC

A
  • Nucleated phagocytic cells
  • Fight microbes and non-self-invaders
  • Promote repair process
38
Q

What are the number of neutrophils high in?

A

Bacterial infection

39
Q

What are the number of lymphocytes high in?

A

Viral infections

40
Q

How long do RBC live?

A

120 days

41
Q

How long do neutrophils, basophils, and eosinophils live?

A

4 days

42
Q

How long do lymphocytes and monocytes live?

A

1 or 2 weeks

43
Q

How long do platelets live?

A

1 week

44
Q

How long does aspirin inhibit platelet activity

A

For the life of the platelet (so 1 week)

45
Q

How are old RBC removed?

A

The spleen

46
Q

What is the premature destruction of RBC called?

A

Hemolysis

47
Q

What is a sign of hemolysis?

A

Jaundice- bc bilirubin increases in the blood and causes jaundice

48
Q

Describe the laboratory assessment of formed elements

A
  • Blood samples are taken from peripheral blood

* Anticoagulants are used to keep the sample clot free

49
Q

What is included on a CBC

A

• RBC, WBC, White blood cell differential, hemoglobin, hematocrit, platelets

50
Q

What are elevated/depressed numbers seen on a CBC if your patient has an infection

A

o Infection= high neutrophils and left shift (high in bacterial inflammatory responses)

51
Q

This varies between men and women and it is often used

A

Hemoglobin

52
Q

This is a percentage of the amount of blood that is RBC

A

hematocrit

53
Q

What are examples of Red Cell indicies

A
  • MCV
  • MCH
  • MCHC
54
Q

Average cell size

A

MCV

55
Q

o Average amount of hemoglobin in an average RBC

A

MCH

56
Q

o Average concentration of hemoglobin per unit of volume in an average RBC

A

MCHC

57
Q

What are 2 things that are important for the diagnosis of disease

A
  • Size of RBC

- Hemoglobin concentration

58
Q

Hypochromic=

A

too little hemoglobin

59
Q

Hyperchromic

A

too much hemoglobin

60
Q

 Elevated when RBC production increases as the bone marrow increases production

A

Reticulocytes

61
Q

• Abnormally low hemoglobin in the blood

o Decreased numbers of RBC, decreased hemoglobin, or both

A

Anemia

62
Q

Is anemia usually a sign for an underlying condition

A

Yes

63
Q

What is the first lab test you run to diagnoses someone with anemia

A

CBC and red cell indicies

64
Q

What are 2 causes of anemia

A
  • Failed bone marrow production

- RBC loss due to hemorrhage or destruction

65
Q

What are symptoms of anemia

A 
•	SOB
•	Tired
•	Weak
•	Pale
•	Tachycardia
o	Body is demanding more O2
•	Palpitations
•	Ticitnic 
•	Angina 
o	Not enough oxygen in the heart
•	Kidneys are going to secrete erythropoietin to increase RBC production
66
Q

What is the goal of anemia

A

• Goal is to reestablish oxygen to tissues

o Increase SV and HR

67
Q

What are 2 problems that hemorrhage creates?

A

-Loss of oxygen carrying capacity
-Loss of iron
(If you lose blood its hard to restore nutrients)

68
Q

What are some dangers of acute blood loss?

A

o Lose the O2 carrying capacity
o Lose Iron
o Danger- shock and death

69
Q

What type of shock can be caused by blood loss

A

Hypovolemic Shock

70
Q

Where is chronic blood loss usually seen?

A

Through the GI tract (from colon, or uterus usually)

71
Q

Is blood loss fast or slow in chronic blood loss?

A

Slow, trickling blood loss

72
Q

If you are over 50 and you present with anemia, what is probably your diagnosis?

A

• GI/Colon carcinoma until proven otherwise

73
Q

What can cause chronic blood loss in a young female?

A

Menstrual periods

74
Q

What are 4 main features of anemia?

A
  • Short RBC life span
  • Active hypercellular bone marrow
  • Increased blood erythropoietin
  • Blood that contains high amounts of reticulocytes or new RBC
75
Q

Why is the bone marrow hypercellular?

A

because the bone marrow works overtime to try to replace dying cells

76
Q

Why is EPO high?

A

secreted by the kidney to stimulate more RBC production

77
Q

How are most anemias caused?

A

Genetic defects

78
Q

What are 4 kinds of genetic anemias?

A
  • Sickle cell
  • Hereditary Spherocytosis
  • Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD)
  • Thalassemia
79
Q

What is the mutation that causes Sickle cell?

A
  • Point mutation of chromosome 11

* Substitution of valine (hydrophobic) instead of glutamine acid (hydrophilic)

80
Q

How does this mutation effect the cell?

A

Changes the 3D shape

81
Q

What type of anemia do patients with Sickle cell present with?

A

Normocytic Normochromic

82
Q

What triggers Sickle Cell anemia?

A
  • Mostly in hypoxic situation
  • Lose hemoglobin F
  • Hypoxic injury that decreases oxygen and changes the ability for O2 to be traveled on cells
83
Q

Can Sickle cell be reversed?

A

Yes- if you remove the cause of hypoxia

-At some point it’s not reversible and it can occlude vessels

84
Q

What can Sickle cell cause?

A

• Infections caused by loss of splenic immune function
o Accumulated infarcts destroy the spleen
o Strep pneumonia, salmonella

85
Q

What is treatment for Sickle cell?

A

o Increase hemoglobin F (fetal hemoglobin)
o Pain control
o Hydration
o Make sure they have vaccines (meningitis, pneumonia, influenza)

86
Q

Describe hereditary Spherocytosis

A

• Spectrin mutation, in cell membrane and allows it to be flexible
• When mutation, it can cause destruction cause it can’t move and deform easily
o Mild anemia, jaundice, splenomegaly

87
Q

Describe G6PD

A
  • X linked recessive genetic disorder that causes deficiency of G6PD in RBC
  • G6PD is important in the in the supply of energy to stabilize the RBC membrane
  • Mutation causes the RBC to be fragile and susceptible to destruction
88
Q

Describe Thalassemia

A
  • A group of microcytic (low MCV) hemolytic diseases that tend to occur in people of Mediterranean decent
  • Impairs synthesis of the alpha or beta peptide chains of the globin protein of hemoglobin
89
Q

What does thalassemia impair?

A

• The genetic defect effects the amount of hemoglobin synthesized

90
Q

Describe the cells in thalassemia

A
  • Rendered the RBC fragile and susceptible to hemolysis

* RBC are pale and normal and lack the amount of hemoglobin in the cytoplasm

91
Q

Describe the RBC in thalassemia

A

• Causes microcytic hypochromic RBC

92
Q

What are examples of non-genetic hemolytic anemias

A
  • Iron defieciency
  • Megaloblastic (Macrocytic)
  • Perniciuos
  • Anemia of chronic disease
  • Aplastic anemia

Pathophysiology (18 decks)

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