exam 2: heme Flashcards
What is the dominant element of blood?
erythrocyte (RBC)
What does the RBC do?
transports gas to and from tissue cells and lungs
How long do RBC last?
80-120 days
How much does the erythrocyte make up the blood component?
45%
What is a buffy coat?
it is a component of blood that covers leukocytes (WBC) and platelets
how much does the buffy coat make up the blood component?
<1%
what is contained in blood plasma?
water (91%), proteins and other solutes
how much does blood plasma make up the blood component?
55%
how do kidneys help with RBCs?
it stimulates RBC production when kidneys sense reduction in O2; or when the body experiences hypoxia or hemorrhage
what are clotting factors?
promotes coagulation and stops bleeding from damaged blood vessels through platelet formation
what are Fibrin Degradation Products (FDP)s ?
plasmin as enzyme that dissolves clot—works as fibrinolysis—by degrading fibrin and fibrinogen into FDPs
what causes thrombus (clot) formation?
decreased circulation, platelet aggregation on vessel wall and blood coagulation
what are risk factors for thrombus (clot) formation?
sedentary activities and post operations
what is an embolus?
a clot that dislodges and circulates in the blood which can obstruct vessel and organs
what happens when an arterial clot is formed?
platelets initiate the process
fibrin formation occurs
RBCs are trapped inside the fibrin mesh
what are assessment cues related to arterial clot formation
secondary to:
MI- chest/upper body pain, SOB, extreme fatigue
CVA- numbness/sensation loss of extremity/side, confusion, inability to speak
what happens when a venous clot is formed?
platelet aggregation with fibrin that attaches to RBCs
venous stasis and valves worsen circulation
what are assessment cues related to venous clot formation
secondary to:
DVT- extremity is red, warm, inflamed, tender
PE- lethal with sudden/extreme SOB, chest pain while breathing, collapse, shock
what is a pernicious anemia?
lack of vitamin B12
abnormal DNA and RNA synthesis in erythroblast
premature cell death
what type of anemia is pernicious and what is it caused by?
macro-cytic anemia
caused by: congenital or acquired deficiency of intrinsic factor and genetic disorder of DNA synthesis
what is a folate deficiency anemia
lack of folate
premature cell death
what type of anemia is a folate deficiency and what is it caused by?
microcytic-hypochromic anemia
caused by: dietary folate deficiency
what is an iron deficiency anemia?
a lack of iron for hemoglobin
insufficient hemoglobin
what type of anemia is an iron deficiency and what is it caused by?
microcytic-hypochromic anemia
caused by: chronic blood loss, dietary iron deficiency, disruption of iron metabolism or iron cycle
what is a posthemorrhagic anemia?
blood loss
what type of anemia is a posthemorrhagic anemia and what is it caused by?
normocytic-normochromic anemia
caused by: increased erythropoiesis and iron depletion
what is a sickle cell anemia?
abnormal hemoglobin synthesis
abnormal cell shape with susceptibility to damage, lysis and phagocytosis
what type of anemia is sickle cell and what is it caused by?
normocytic-normochromic anemia
caused by: congenital dysfunction of hemoglobin synthesis
what are common clinical manifestations to anemia?
weakness, fatigue, paresthesias, difficulty walking, loss of appetite, cheilosis (scales and fissures of mouth), stomatitis, painful ulcerations
what is hemophilia?
a group of inherited bleeding disorders resulting from mutation in coagulation factors
common: joint bleeding
what is an Immune Thrombocytopenic Purpura (ITP)
destruction of platelets or antibody-mediated inflammatory reactions to allergens damage blood vessels and cause seepage into tissues
what is a thrombocytopenia
platelet count of less than 150k
what causes thrombocytopenia
decreased platelet productions:
viral infections, drugs/radiation therapy, chronic renal failure, bone marrow hypoplasia or cancer
increased platelet consumption:
HIT, I (idiopathic) TP, thrombotic thrombocytopenic purpura (TTP), and disseminated intravascular coagulation (DIC)
what is a general of clonal diversity?
a colonal phase of the immune response that produces large numbers of T and B lymphocytes with maximum delivery of antigen receptors
what is a colonal selection?
a colonal phase of the immune response that selects, expands, and differentiates the clones of T and B cells against specific antigens
what is the role of antigens
molecular targets of antibodies
what are lymphocytes
T cells: Thymus derived
B cells: Bone marrow derived
what is humoral immunity
antibodies circulating in blood (fight bacteria or viruses)
what is cellular immunity
T cells (fight intracellular pathogens and abnormal cells)
what is an active immunity
develops after exposure to antigen; long-lived
what is an example of active immunization and what is it
vaccines: biologic preparations of antigens that induce long-lasting protective immune response (through boosters)
what is a passive immunity
pre-formed antibodies or T cells are administered; temporary
what are examples of passive immunizations
Hep A and Hep B
Monoclonal Antibody against RSV for ebola virus infection
what is an IgG antibody?
is the most abundant class (80-85%) which accounts for most of the protective activity against infections
what is the role of IgG
it is transported across the placenta to protect the newborn child during the first 6mos
what is an IgM antibody
largest and the first antibody that the body makes when encountering an antigen
what is the role of IgM
to synthesize in early neonatal life but may be increased as a response to infection in utero
what is an IgA antibody
found in blood and bodily secretions as secretary IgA
what is an IgD
a part of the BCR antigen receptor on the surface of early B cells
what is an IgE
low concentrations in the circulation
what is the role of IgE
a mediator of many common allergic responses and as a defense against parasitic injection
what are clinical cues found in secondary (acquired) immune deficiencies
complications of other physiologic or pathophysiologic conditions
MANY: pregnancy, trauma, stress, malnutrition, acquired infections, malignancy, burns, stress
what is the role of IgE
a mediator of many common allergic responses and as a defense against parasitic injection
what is a direct function of antibodies
through the action of antibody alone in affecting infectious agents or toxic products by neutralization-inactivating or blocking the binding of antigens to receptors
what is an indirect function of antibodies
requires activation of other components of the innate immune response
what is a type 1 hypersensitivity
IgE-Mediated Hypersensitivity Reactions
common allergic reactions against environmental antigens
IgE
what is a type 2 hypersensitivity
Tissue Specific Hypersensitivity Reactions
immune reactions against a specific cell or tissue
IgG
what is a type 3 hypersensitivity
Immune Complex-Mediated Hypersensitivity
antigen-antibody(immune) complexes formed in circulation and deposited in vessel walls
IgG
IgM
what is a serum sickness
type reactions that are caused by formation of immune complexes in the blood and their subsequent generalized deposition in target tissues
what is a Raynaud phenomenon
conditions caused by temperature-dependent deposition of immune complexes in the capillary beds of the peripheral circulation
what is an arthus reaction
repeated local exposure to antigen that reacts with performed antibody and forms immune complexes in walls of local blood vessels
what is a type 4 hypersensitivity
Cell-Mediated Hypersensitivity Reactions
mediated by T lymphocytes and do not involve antibodies
what is a systemic lupus erythrematosis (SLE)
production of large variety of autoantibodies against self-antigens
what are common clinical findings of SLE
rash, photosensitivity, arthritis, serositis, renal dysfunction, neurologic disorders, hematologic manifestations
what is an alloimmune disease in transplant rejection in acute
cell mediated response that occurs within days to months after transplantation
what is an autoimmune disease in transplant rejection in chronic
slow, progressive organ failure from chronic inflammation and weak-cell mediated type 4 reaction
what are clinical cues found in primary (congenital) immune deficiencies
result of single gene defects
Predominantly antibody deficiencies; defects in phagocte number or function; defects in innate immunity; and complement defects
what does hemostasis depend on
adaptive immunity’s defense system to promote health and prevent illness
what are alloimmunity conditions
organ/blood transplant rejection
what are autoimmunity conditions
SLE and sickle cell disease
what do anticoagulants do
prevent formation of clots than inhibit circulation
what do antiplatelets do
prevent platelet aggregation
what do thrombolytics do
promotes fibrinolytic mechanism (converting plasminogen to plasmin; destroying the fibrin in the blood clots)
attack and dissolve blood clots that have already formed
what is an anti XA Unfractionated Heparin Level
measurement of antithrombin (AT)
-which is a catalyzed inhibitor of factors 10A by unfractionated heparin
what is an induction therapy in immunosuppressant drugs
provides intense immunosuppression with drugs designed to diminish presentation and T-cell response
-reduces risk of acute rejection during initial transplant period
what are traditional virus
whole or components of inactivated (killed) microorganisms
can be live or dead
what are attenuated virus
live, weakened microorganisms
what are toxoids
inactivated toxins that stimulate antitoxin formation but can’t produce disease
what are conjugate vaccines
requires protein or toxoid from unrelated microorganism to link outer coating of disease-causing microorganism
what are recombinant subunit vaccines
involve some genetic material of pathogen into another cell or organism where antigen is produced
