Exam 2 Hematology Flashcards
1
Q
- *Hematopoiesis**
a) What is this?
b) Where does it happen?
c) What is the hormone involved?
d) What factor can be trigger?
A
a) Blood production
b) Bone marrow
Formed from stem cells in bone marrow
c) Specific to RBCs(erythropoietin)
Released from the kidneys
d) Blood loss, injury, low oxygen
2
Q
Component of blood
Function?
A
Erythrocytes(RBCs)-Carrying oxygen
Leukocytes(WBCs)-Immune system
Thrombocytes(platelet)-Clotting blood
3
Q
What is the anemia?
Definition
A
A lack of red blood cells or dysfunctional red blood cells in the body
This leads to reduced oxygen flow to the body’s organs
Acute or chronic blood loss
4
Q
What is the iron deficiency?
A
Most common anemia
Nutrition issue
Easy to prevent
Pregnancy, Acute blood loss
5
Q
Iron deficiency
Patho factors
A
- Microcytic hypochromic
- Increased iron demand
- Increased iron loss
- Decreased iron intake
- Decreased iron absorption
6
Q
Iron deficiency
Manifestations
A
Fatigue, cold, pallor, headache
Glossitis: smooth tongue, swollen
Cheilitis: irritated, swollen, lips
Koilonychia: spooning of the fingernails
7
Q
a) Cytic means?
Microcytic/Macrocytic
b) Chromic means?
Normochromic
A
a) Size
Micro=small
Macro=big
b) Number
8
Q
What is the main alteration of anemia?
A
Reduced oxygen carrying capacity
Result in tissue hypoxia
9
Q
What is the pernicious anemia?
Patho factors
A
Macrocytic-normochromic
Defective DNA synthesis caused by lack of B12
Vegan
10
Q
Pernicious anemia
Manifestations
A
Glossitis
Smooth togue, swollen(BEEFY)
11
Q
What is normocytic-normochromic anemias?
A
Post-hemorrhagic
Hemolytic anemia
Aplastic anemia
12
Q
What is the Aplastic anemia?
A
A condition that occurs when your body stops producing enough new blood cells
Issue with bone marrow
13
Q
What is the Hemolytic anemia?
A
A disorder in which red blood cells are destroyed faster than they can be made
14
Q
What is the folate deficiency?
A
There isn’t enough folic acid in the body
- *Folic acid**
- Helps make healthy red blood cells, which carry oxygen around the body
15
Q
What does decreased oxygen to skin lead to?
A
- delayed wound healing
- loss of elasticity
- thin gray hair
16
Q
What does decreased oxygen to the gastrointestinal tract lead to?
A
- abdominal pain
- nausea and vomiting
- anorexia
- constipation
- stomatitis
17
Q
What is B12 needed for?
A
DNA synthesis
18
Q
How do you treat pernicious anemia?
A
- B12 injections or supplements
- blood transfusions
19
Q
What is the Polycythemia vera?
A
- The bone marrow makes too many RBCs
- A stem cell disorder
- Increase blood viscosity(sticky and thick)
- Itchiness/Pruritus
- Ruddy red color
20
Q
What causes polycythemia vera?
A
a change in the JAK2 gene, which causes the bone marrow cells to produce too many red blood cells.
21
Q
When a nurse is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the nurse calls these erythrocytes:
- *a. Hyperchromic**
- *b. Hypochromic**
- *c. Macrocytic**
- *d. Microcytic**
A
b
22
Q
A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias does the nurse suspect the patient has?
- *a. Sideroblastic anemia**
- *b. Hemolytic anemia**
- *c. Pernicious anemia**
- *d. Iron deficiency anemia**
A
B
23
Q
A patient wants to know about risk factors for acute leukemia. Which of the following should the nurse include? (Select all that apply.)
- *a. Cytomegalovirus (CMV) infection**
- *b. Eating genetically modified food**
- *c. Chemotherapy treatment for other cancers**
- *d. Excessive ultraviolet radiation exposure**
- *e. Ovarian cancer**
A
C, D, E
24
Q
A patient has microcytic hypochromic anemia. Which of the following pathogenic mechanisms may cause anemia in this patient? (Select all that apply.)
- *a. Decreased erythrocyte life span**
- *b. Failure of mechanisms of compensatory erythropoiesis**
- *c. Disturbances of the iron cycle**
- *d. Increased basal metabolic rate**
- *e. Swelling in the tissues**
A
A, B, C
25
A nurse checks individuals with liver disease for clotting problems because:
* *a. The liver is often the site of platelet pooling.**
* *b. Clotting factors are produced in the liver.**
* *c. High levels of bilirubin interfere with the clotting system.**
* *d. Treatment medications for liver failure cause fibrinolysis.**
B
26
A staff member asks what leukocytosis means. How should the nurse respond? Leukocytosis can be defined as:
* *a. A normal leukocyte count**
* *b. A high leukocyte count**
* *c. A low leukocyte count**
* *d. Another term for leukopen**
B
27
What is the leukemia?
A cancer of blood-forming tissues
Bone marrow makes large numbers of abnormal cells
28
What is ALL (Leukemia)?
Acute Lymphocytic Leukemia-ALL
- Most common in children
- 20% of cases are in adults
29
What is ALL (Leukemia)
a) Patho
b) Symptoms
a) Marked by \> 30% of lymphoblasts(gotten bigger) in the blood or bone marrow
Survival rate decreases with age
b) Fever, bleeding, fatigue,
infection, joint pain, night sweats, weight loss, anemia,
30
What is the Leukocytosis?
- Increase in leukocytes
- A normal, protective, physiologic response to physiologic stressors (like infection)
31
What is the Leukopenia?
- Decrease in leukocytes
- Not normal and not beneficial
- low WBC count predisposes a patient to infections
32
What will happen to most people with acute leukemias without treatment?
They would only live a few months
People will get sick quickly and die
33
What is characteristic of chronic leukemias?
More mature blood cells, but still abnormal
Will crowd out the normal mature cells
Progresses over time- most patients can live for many years with chronic leukemias
34
What is characteristic of acute leukemias?
Immature blood cells
Fast growing
Crowd out the normal mature cells
35
What is harder to treat, acute or chronic leukemia?
Chronic leukemias are harder to treat
36
What causes the fatigue in ALL and AML?
Anemia
37
What causes the low-grade fever in ALL and AML?
Lack of functioning WBC- cannot produce a high-grade fever
38
What is leukocytosis?
So many WBC that they clots
Increases blood viscosity
Clots in the lungs and brain (seizures, coma, dyspnea)
39
What WBC problem will indicate ALL or AML?
Leukopenia
40
What is treatment for leukemias?
Chemotherapy
Bone marrow transplant
Stem cell transplant
Radiation
41
a) What is the ALL (leukemia)?
b) What causes?
a) Acute lymphoblastic leukemia
Most common in children
b) bone marrow failure
-anemia, neutropenia
organ infiltration
-tender bones, lymphadenopathy
**30% of lymphoblasts(growing bigger) in t he blood or bone marrow.**
42
a) What is the AML(leukemia)?
b) What causes?
a) Acute Myelogenous Leukemia
Most common in adult
b) Marked by proliferation of immature myeloid cells.
fecreased apoptosis
lack of cellular differentiation
Chromosomal abnormalities associated
43
a) What is the CLL(leukemia)?
b) What causes?
a) Chronic Lymphocytic Leukemia
increased in persons \> 40
b) Malignant transformation of B-lymphocytes
B-cells have decreased apoptosis
44
In a Complete Blood Count (CBC), the normal white blood cell count range is:
* *a) 4.2-6.2mill/mm3**
* *b) 13-17g/dL**
* *c) 0.5-1.0%**
* *d) 5,000-10,000 mm3**
D
Abnormal means-infection,inflammation
45
In a Complete Blood Count (CBC), the normal red blood cell range is:
a) 13-17d/dL
b) 4.2-6.2mill/mm3
c) 5,000-10,000 mm3
d) 80-97
b
46
a) When RBCs increase?
b) When RBCs decrease?
a) Dehydration
Heart disease
Polycythemia vera
b) fatigue
dizziness
from of anemia
47
Your patient has a platelet count of 20,000. This finding is:
a) Low indicating thrombocytopenia
b) High indicating thrombocytosis
c) Within the normal range
d) High indicating risk for increased clotting
a
150,000 to 450,000
48
What is Thrombocytopenia?
A low number of platelets in the blood
## Footnote
**can be fatal, especially if the bleeding is severe or occurs in the brain**
49
What happen when high platelet count?
**Clotting could happen spontaneously** Blood clots may occur anywhere in the body, Most common in the hands, feet and brain.
50
Your patient has a WBC count of 17,000. This value is considered:
* *a) High indicating leukocytosis**
* *b) Low indicating leukopenia**
* *c) Within normal limits**
* *d) Low indicating anemia**
A
51
Your patient has an absolute neutrophil count of less than 500/mm3. This predisposes him to:
a) Increased risk of blood clotting
b) Increased risk of bleeding
c) Increased risk of bruising
d) Increased risk of infection
D
52
Your patient has a WBC level of 3,000/mm3. You are concerned that your patient may have:
a) Elevated white blood cells
b) Increased risk for bleeding
c) Low white blood cells and risk for infection
d) This is not concerning; this in within normal limits
C
53
Plasma contains what?
Protein
Antibodies
Globulin
54
What are these for?
a) Fibrinogen
b) Prothrombin
a) Sticky/ hard-blood is going to stick together
b) Stop bleeding
55
What are the reasons that leukocytes might be high? 4
- Infection/illness
- Inflammation
- Injury
- Stress
56
Clotting process 1-4
Bleeding
1) Platelets gather and become sticky
Covered hole=plug
2) Clotting factors=reinforce platelets
3) Fibrin act as glue
4) RBCs and WBCs make the site stronger
57
What is the Neutrophil?
* Make up about 50% of leukocyte count
* Only live for 4 days
* Granulocyte, Phagocyte
58
In adults hematopoiesis occurs mostly where?
Red marrow of **flat bones**/proximal humerus/femur
not as much: liver and spleen
59
In children where does hematopoiesis occur?
Red marrow in **long bones**/flat bones/proximal humerus/femur
60
leukopoiesis creates what kind of cells?
WBCs:
neutrophil
eosinophil
basophil
monocyte
lymphocyte
61
Thrombopoiesis creates?
platelets
62
What is produced when kidneys sense a decrease in blood flow or O2?
EPO
63
This WBC produced early in infections moves to site of infection and phagocytose bacteria and debris
Neutrophil
64
what element is required for RBC proliferation and Hgb synthesis?
Iron
65
What is the erythropoiesis?
a) Where is erythropoietin made?
b) What is main stimulus?
The formation of red blood cell
a)the kidneys
b)Decreased RBCs
Decreased hemoglobin
Decreased blood flow
Bleeding
66
Bone marrow is also called what tissue??
Myeloid
67
What is the sickle cell anemia?
Caused by a change in the gen(child)
- Abnormal shape of red blood cells
- Rigid and sticky, which can slow or block blood flow
- Die in 10 to 20 days,
There's no cure
Treatments can relieve pain
68
What is the Thalassemia?
- Less than normal amounts of an oxygen-carrying protein
- The body to not make enough hemoglobin, leading to **anemia that causes pallor, fatigue and stunted growth**.
69
What is the hemophilia?
- Blood doesn't clot normally.
- Uncontrollable bleeding
-Cause a mutation or change, in one of the genes
70
This is the term described for when stem cells can't grow and divide therefore you see a decrease in ALL cell types
Aplastic anemia
71
Type of WBC that is the primary pathogen fighting cell
Neutrophils
40-60%
72
Type of WBC that helps control allergic responses and fight parasites
Eosinophils
2-4%
73
Type of WBC that releases histamine or other inflammatory mediators
Basophils
0.5-1%
74
Type of WBC that is a antigen presenting cell and creates inflammatory mediators
Monocytes
2-8%
75
Type of WBC that deals with immune response two types T and B
Lymphocytes
20-40%
76
**Erythrocytes**:
## Footnote
when the supply of _________ in the tissues are decreased, the ________ are signaled to secrete the hormone _______________ which stimulates the bone marrow to secrete more pro erythroblasts from pluripotent stem cells to becomes erythrocytes and with an increase in erythrocytes there will be an increase in oxygen delivery
Oxygen
Kidneys
Erythropoietin
77
**Leukocytes**:
incases of acute \_\_\_\_\_\_\_\_\_, a shift to the left is from an increased number of _________ because cells from the bone marrow are being recruited to become __________ so fast that there is a build up of those
Infection
Bands
Neutrophils
78
Leukemia initiates in the _______________ while lymphoma primarily initiates in the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Bone marrow
Lymph nodes
79
Which of the following is not part of the triad of Virchow and a contributor to thrombus formation?
* *A. Arthrosclerosis**
* *B. Hypervolemia**
* *C. Polycythemia Vera**
* *D. Hypercalcemia**
* *E. Iron-Deficiency Anemia**
E. Iron-Deficiency Anemia
80
What are the three factors that make up the triad of Virchow?
1. loss of vessel wall integrity
2. change in blood constituents
3. abnormalities of blood flow
81
If someone has anemia how would our body respond?
- Increased need for O2
- Increase release of EPO by the kidney,
- Increase RBC production by the bone marrow
