Exam 1 (general info) Flashcards
What is hematology?
study of the anatomy, physiology, and pathology of blood-forming elements
What is plasma?
fluid collected from blood in the presence of anti-coagulant (contains antibodies)
What does plasma consist of?
90% water | proteins | inorganic salts (NaCl, bicarbonate) | organic substances (glucose, urea) | gases (O2, CO2) | miscellaneous
What proteins are in plasma?
albumins and antibodies
What are albumins?
insoluble proteins that are able to reduce toxicity in the body
What are the formed elements in blood?
all of the leukocytes and erythrocytes
What are the 3 granulocytes?
neutrophils (PMN) | basophil | eosinophil
What do agranulocytes consist of?
monocytes and lymphocytes
What are the 2 things that one needs to look at during a disease process? Which aspect is more important and why?
cell number count within normal range | function is normal = more important aspect because normal numbers don’t always indicate patient is good
Where do all blood cells come from?
hematopoietic stem cells in the bone marrow
Which cells have lobulated nuclei?
granulocytes
What does a blood cell with fine chromatin and nucleoli indicate?
cell is young/mature
What happens to the chromatin as the blood cell ages?
will be thicker and more condensed
What are 4 diseases that are associated with levels of WBCs?
HIV/AIDS | leukemia | lymphoma | immunodeficiency
What does the suffix “-penia” mean?
lower than normal value
What does the suffix “-cytosis” mean?
higher than normal value
What is lymphoma? What is an example of a lymphoma disease?
increase number in WBCs (lymphocytes) | Hodgkin’s
What is the tendency of blood to coagulate due to?
absence of anticoagulants
What does serum contain?
anything not part of the coagulation process
What is coagulation?
same thing as clotting
What does VPRC stand for?
volume packed RBCs
What does VPRC (crit) tell you?
how many RBCs patient has in their blood compared to total volume
What does a low VPRC indicate?
low RBC count = may be anemic
What does pink plasma indicate?
RBC lysis
What atom is important for the clotting process?
Ca2+
What are the 3 anti-coagulants that bind and sequester Ca2+?
ammonium or potassium oxalate | EDTA | sodium citrate
What is heparin?
anti-thrombin = stops coagulation
What is serum?
fluid collected after blood coagulation
What are “relative” numbers?
percentage of a cell type present against the total number of all WBCs |
What are “absolute” numbers?
exact quantity of a cell type in the body that is actually circulating
Which one is more important: relative or absolute?
absolute
What is the largest blood cell type?
monocytes
What “age” must all cells in the circulation must be?
mature
What are the 4 characteristics that one must look out when distinguishing between WBCs?
size compared to RBC | nucleus | granules | staining
What is hepatomegaly?
enlarged liver
What is splenomegaly?
enlarged spleen
What is lymphadenopathy?
enlarged lymph node
What is a responsive bone marrow?
when it produces more WBCs or RBCs (depending on case) due to cytosis and those produced cells actually come out of the bone marrow and are functional
What cells are not commonly detected in the bone marrow?
lymphocytes - they leave somewhat mature from BM and reach full maturity in the lymph nodes
What does the reticulo-endothelial system contain?
bone marrow | lymph node | spleen | peyer’s patches | cells in circulation
What are the 2 parts of the bone marrow?
red and white marrow
What is the red marrow?
active synthesis of RBCs
What is the white marrow?
“reserve” not active in synthesis of RBC
What are the 5 things that is contained in the bone marrow?
connective tissue | RBC + precursors | WBC + precursors | platelets + precursors | lymphocytes
Where does the pathogen first go to once it has penetrated our skin?
lymph to the lymph nodes
What does the pathogen stimulate once it is in the lymph nodes?
lymphocyte maturation
When do pathogens enter the circulation?
via blood transfusion
What organ is the primary site of lymphocyte maturation?
lymph nodes
What cell types are in the lymph nodes?
lymphocytes and monocytes (macrophage cells)
What do lymph nodes function as?
filters lymph checking for pathogens and antigens
What does the spleen function as?
filtering organ containing lymphocytes and monocytes (macrophages)
What does splenomegaly indicate?
increase of cell proliferation in response to microbial infection and etc.
What are Peyer’s patches?
lymphoid aggregates lining the intestines - lymphocyte stimulation site
What is function of Peyer’s patches?
filters pathogenic bacteria | very active after consumption of uncooked food
What do Peyer’s patches produce?
IgA = can stop bacteria from overgrowth
What is hematopoiesis?
production of blood cell elements
What is myelopoiesis?
production of granulocytes and platelets in the BM
What is lymphopoiesis?
production of lymphocytes = occurs in lymph nodes, spleen, Peyer’s patches
What is embryonic antigen? What does it indicate if found in adults?
antigen that only embryos should have (stem cells) | can indicate malignancy
What is the H and E stain used for?
tissue biopsy
What is the Prussian Blue stain used for?
determines iron content
What is the Giemsa stain used for?
detects pathogens
What is the Wright stain used for?
normal staining of blood cells to see cell type
What is Myeloid:Erythroid (M:E) ratio?
indicates if activity in BM is normal
What is the normal M:E range?
3.5-5 : 1
What can a high M:E ratio be due to?
increase Myeloid production = indicates infection
What can a low M:E ratio be due to?
increase in RBC production = bleeding problem such as anemia (loss of blood)
What symptoms will one have when malignant cells produce in the BM?
decrease production of WBC, RBC, and platelet | leads to anemia, bleeding problem, infection problem
What is the Cells:Fat (C:F) ratio?
measures bone marrow activity
What do “cells” refer to in the C:F ratio?
any cell type that is actively undergoing proliferation in the BM
What does “fat” refer to in the C:F ratio?
cells in reserve (white marrow) = does not stain
What does a C:F ratio > 1 indicate?
BM is active and red portion is actively producing cells
What does a C:F ratio < 1 indicate?
BM is unresponsive = cannot or is not producing cells
What does a C:F ratio of > 1 indicate with a patient who has a low M:E ratio?
patient is currently anemic and BM is compensating for the RBC shortage
What is hyperplasia in terms of BM activity?
overproduction of cells = highly active
What are 4 characteristics of hyperplastic BM?
C.F > 1 | more hematopoietic cells than fat cells | more red marrow | more BM cells produced than normal
What is hypoplasia in terms of BM activity?
decreased production of cells = under-active
What are the 4 characteristics of hypoplastic BM?
C.F < 1 | more fat cells, less hematopoietic cells | more white marrow | less BM cells produced than normal
What are 3 characteristics of the BM when the patient has Acute L Leukemia?
No M.E ratio = all cells look the same | hyperplastic BM | C.F > 1
What do immune cells require in order to proliferate and differentiate?
immature nucleus (fine chromatin)
Which immune cells will continue to proliferate after maturity?
lymphocytes and monocytes
Which cell types are transfusable?
RBC | platelets | granulocytes
Why is it not safe to transfuse lymphocytes directly to someone?
donor immune system will reject it as it sees it as foreign
Due to immuno-rejection, what must transplant patients take in order to introduce their body to the transplanted organ?
immunosuppressant drugs
What are the 5 things hematopoietic cell maturation changes in?
cell size | cell shape | chromatin | nucleus shape | presence/absence granules
What does the Wright stain contain?
methylene blue and eosin
What does the H and E stain contain?
hematoxylin and eosin
What must cells need to maintain in order to remain viable?
metabolic processes needed for energy
How can you guess the cell type if the cells look degenerated?
use of normal differential values = guess neutrophils (most abundant)
What are characteristics of monocytes?
horse-shoe large nucleus | vacuoles present
What is diagnosis?
the symptoms and what caused it
What are differential diagnoses?
all of the diagnoses (the causes) of that symptom | possible causes of that symptom (symptom ie: neutrophilic leukocytosis)
What is leukocytosis?
over normal value in WBC count
What is leukopenia?
under normal value in WBC count
What are the 5 differential diagnoses for monocytosis?
increase in monocytes | pulmonary tuberculosis | Rickettsia infections | typhoid fever | lymphoma
What are the 2 types of leukopenia?
balanced | leukopenia in selected cells
What is balanced leukopenia?
reduction in all leukocytes
Which 2 cell types are most important?
neutropenia and lymphopenia
Why are eosinopenia, basopenia, and monocytopenia will not likely be detected?
normal value is very small to begin with
Why should diagnosis include family history?
genetic diseases commonly appear early on in childhood (parents might have it too)
What are monocytes called in tissues?
macrophages
What are 3 functions of monocytes?
chemotaxis, phagocytosis, intracellular killing
What are monocytes also involved in?
immune response, process antigens and targets malignant cells
What is desensitization of allergy?
administer Ag to induce production of more IgG »_space;> so Ag won’t bind to IgE on mast/basophils = no histamine secretion
What are the 3 things that the level of each type of antibody production is dependent on?
antigen | how often antigen is inoculated and the route | dosage of Ab
What is “measurement of immunity”?
measure/detect antibody titer
What test is an example of measurement of immunity?
skin test (PPD)