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Oral Surgery I > EXAM I Hematology > Flashcards

EXAM I Hematology Flashcards

1
Q

___ is the study of blood and blood-forming tissues (bone marrow, spleen, lymph system)

A

hematology

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2
Q

what are the components of blood?

A
  • plasma - 55%
  • blood cells - 45%
    • three types - erythrocytes, leukocytes, thrombocytes/platelets
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3
Q

erythrocytes are composed of ___

A

hemoglobin

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4
Q

___ = erythrocyte production, is stimulated by ___, and is controlled by what hormone?

A
  • erythropoiesis
  • hypoxia
  • erythropoietin synthesized in the kidney
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5
Q

___ = destruction of erythrocytes

A

hemolysis

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6
Q

during hemolysis, ___ is released into the blood stream

A

bilirubin

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7
Q

what is the normal life span of a erythrocyte?

A

120 days

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8
Q

what are the 5 types of leukocytes?

A

basophils, eosinophils, neutrophils, monocytes, lymphocytes

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9
Q

which type of granulocyte functions in phagocytosis and early phase of inflammation?

A

neutrophil

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10
Q

which type of granulocyte functions in phagocytosis and parasitic infecitons?

A

eosinophil

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11
Q

which type of granulocyte functions in the inflammatory response and allergic response?

A

basophil

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12
Q

which type of leukocyte functions in cellular and humoral immune response?

A

lymphocyte

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13
Q

which type of leukocyte functions in phagocytosis and cellular immune response?

A

monocyte

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14
Q

___ must be present for clotting to occur

A

thrombocytes/platelets

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15
Q

in order for clotting to occur, platelet count must be >___/mm3

A

50,000

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16
Q

the goal of clotting is to minimize blood loss when injured. what is the vascular response, platelet response, and what are the plasma clotting factors involved?

A
  • vascular response - vasoconstriction
  • platelet response - activated during injury, forms clumps (agglutination)
  • plasma clotting factors - I-XII, intrinsic and extrinsic pathways
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17
Q

what is a normal WBC blood count?

A

4,000-11,000 u/l

associated with infection, inflammation, tissue injury, or death

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18
Q

___ is the term for low WBC count

A

leukopenia

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19
Q

___ is the term for low neutrophil count

A

neutropenia

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20
Q

what is a normal RBC count for males? what about females?

A
  • males - 4.5-5.5 x 106 u/l
  • females - 4.0-5.0 x 106 u/l
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21
Q

___ is the percent of whole blood that is composed of red blood cells; it is a measure of both the number of red blood cells and the size of red blood cells

A

hematocrit

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22
Q

what is a normal platelet count?

A

150,000-400,000

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23
Q

___ = low platelet count

A

thrombocytopenia

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24
Q

what can happen if platelet count is below 20,000?

A

spontaneous hemorrhage

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25
Q

___ is the term for a decrease in number of RBCs, WBCs, and platelets

A

pancytopenia

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26
Q

___ is a reduction in the number of RBCs, the quantity of hemoglobin, or the volume of RBCs

A

anemia

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27
Q

anemia results in varying degrees of ___

A

hypoxia

because the main function of RBCs is oxygenation

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28
Q

what are 3 prevalent conditions of anemia?

A
  • blood loss
  • decreased production of erythrocytes
  • increased destruction of erythrocytes
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29
Q

what are the 7 clinical manifestations of anemia?

A
  • pallor
  • fatigue, weakness
  • dyspnea
  • palpitations, tachycardia
  • headache, dizziness, restlessness
  • slowing of thought
  • parasthesia
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30
Q

what is the etiology of hypochromic microcytic iron-deficiency anemia?

A
  • inadequate dietary intake
    • found in 30% of the world’s population
  • malabsorption
    • absorbed in duodenum
    • GI surgery
  • blood loss
    • 2 ml blood contain 1mg iron
    • GI, GU losses
  • hemolysis
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31
Q

what do the cells look like in hypochromic microcytic iron-deficiency anemia?

A

small cells, light in color

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32
Q

the most common clinical manifestation of iron-deficiency anemia is ___, and the second most common is ___

A
  • pallow
  • inflammation of the tongue (glossitis)
  • also common is cheilitis, sensitivity to cold, and weakness and fatigue
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33
Q

what are some diagnostic studies that can test for iron-deficiency anemia?

A
  • CBC; endoscopy/colonoscopy
  • iron levels: total iron-binding capacity (TIBC), serum ferritin
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34
Q

what is the treatment for iron-deficiency anemia?

A
  • treatment of the underlying disease/problem
  • replace iron
    • oral iron - feosol, dexferrum; absorbed best in acidic environment; GI effects - constipation
    • parenteral iron - IM or IV; less desirable than PO
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35
Q

___ is an autosomal recessive geentic disorder of inadequate production of normal hemoglobin

A

thalassemia

36
Q

thalassemia is common in ___ groups

A

mediterranean ethnic

37
Q

what are the clinical manifestations of thalassemia?

A
  • asymptomatic -> major retardation -> life threatening
  • splenomegaly, hepatomegaly
38
Q

which thalassemia requires blood transfusions with IV deferoxamine (used to remove excess iron from the body)?

A

thalassemia major

39
Q

which thalassemia involves the body adapting to low hemoglobin levels?

A

thalassemia minor

40
Q

what type of anemia is characterized by large RBCs which are fragile and easily destroyed (so there are fewer)?

A

megaloblastic macrocytic type

41
Q

what are the common forms of megaloblastic anemia?

A
  • cobalamin deficiency (pernicious anemia)
  • folic acid deficiency
    • alcoholics
    • pregnancy evaluation is important - neural tube defects, clefting/syndromic sysceptibility
42
Q

folic acid deficiency can cause ___

A

megaloblastic anemia

43
Q

___ is required for RBC formation and maturation

A

folic acid

44
Q

what are some causes of folic acid deficiency?

A
  • poor dietary intake
  • malabsorption syndromes
  • drugs that inhibit absorption
  • alcohol abuse
  • hemodialysis
45
Q

in folic acid deficiency, what do the cells look like?

A

large and fragile

46
Q

how is folic acid deficiency treated?

A
  • folate replacement therapy
  • encourage patients to eat foods with large amounts of folic acid
    • leafy green vegetables, liver, mushrooms, oatmeal, peanut butter, red beans
47
Q

cobalamin deficiency is a deficiency in ___

A

vitamin B12

48
Q

___ is an important water-soluble vitamin

A

vitamin B12

49
Q

___ is required for cobalamin absorption

A

intrinsic factor

50
Q

what are some causes of cobalamin deficiency?

A
  • gastric mucosa not secreting intrinsic factor
  • GI surgery - loss of intrinsic factor secreting gastric mucosal cells
  • long-term use of H2-histamine receptor blockers
  • atrophy and loss of mucosa
  • nutritional deficiency
  • hereditary defects of cobalamin utilization
51
Q

what are the clinical manifestations of cobalamin deficiency?

A
  • general symptoms of anemia
  • sore tongue
  • anorexia
  • weakness
  • parasthesia of the feet and hands
  • altered thought processes: confusion -> dementia
52
Q

you should evaluate your patient frequently for gastric carcinoma if they have a ___ deficiency

A

cobalamin

53
Q

a schilling test is a medical investigation used for patients with ___ deficiency, and is used to determine if the patient has ___

A
  • cobalamin
  • pernicious anemia
  • intranasal form of cyanocobalamin (nascobal) is available
54
Q

___ is an underproduction of RBCs and shortening of RBC survival, is the 2nd most common cause of anemia after iron deficiency anemia, and generally develops after 1-2 months of sustained disease

A

normochromic normocytic anemia (chronic disease)

55
Q

the following are causes of which type of anemia?

impaired renal function

chronic, inflammatory, infectious or malignant disease

chronic liver disease

folic acid deficiencies

splenomegaly

hepatitis

A

normochromic normocytic anemia (chronic disease)

56
Q

aplastic anemia is characterized by ___

A

pancytopenia (reduction of all blood cell types)

57
Q

aplastic anemia affect ___ out of every 1 million people

A

4

58
Q

aplastic anemia is manageable with ___ or ___

A

erythropoietin or blood transfusion

59
Q

in what ways can aplastic anemia be a critical condition?

A

risk of hemorrhage and/or sepsis

60
Q

what does acquired aplastic anemia result from?

A

exposure to ionizing radiation, chemical agents, viral and bacterial infections

61
Q

anemia is caused by ___

A

blood loss

62
Q

describe anemia caused by acute blood loss

A
  • result of suddne hemorrhage
    • trauma, surgery, vascular disruption
    • replacing blood volume
    • identifying source of hemorrhage
    • stopping blood loss
63
Q

describe anemia caused by chronic blood loss

A
  • sources/symptoms
  • similar to iron deficiency anemia
  • GI bleeding, hemorrhoids, menstrual blood loss
  • diagnostic studies - identify source, stop bleeding, supplemental iron administration
64
Q

what are 3 types of hemolytic anemia?

A
  • sickle cell disease
  • acquired hemolytic anemia
  • hemochromatosis
65
Q

___ is caused by destruction or hemolysis of RBCs at a rate that exceeds production

A

hemolytic anemia

66
Q

hemolytic anemia is the ___ major cause of anemia

A

third

67
Q

which type of anemia (intrinsic or extrinsic) is characterized as abnormal hemoglobin, enzyme deficiencies, and RBC membrane abnormalities?

A

intrinsic hemolytic anemia

68
Q

which type of anemia (intrinsic or extrinsic) is characterized as normal RBCs that are damaged by external factors (liver, spleen, toxins, and mechanical injury [heart valves])?

A

extrinsic

69
Q

___ is an overproduction of red blood cells

A

polycythemia

70
Q

what is polycythemia a result of?

A
  • a primary process in the bone marrow (a myeloproliferative syndrome)
  • or it may be a reaction to chronically low oxygen levels or malignancy
71
Q

what are complications of polycythemia?

A

increased viscosity of blood, can lead to hemorrhage and thrombosis

72
Q

what is the treatment for polycythemia?

A
  • phlebotomy
  • myelosuppressive agents
    • interferon alpha-2b (intron A) therapy
    • agents that target platelet number (anagrelide Iagrylin) and platelet function (aspirin)
73
Q

platelet count in thrombocytopenia is <___

A

150,000

74
Q

what are causes of thrombocytopenia?

A
  • low production of platelets
  • increased breakdown of platelets
75
Q

what are symptoms of thrombocytopenia?

A
  • bruising
  • nosebleeds
  • petechiae
76
Q

describe immune thrombocytopenic purpura

A
  • abnormal destruction of circulating platelets
  • autoimmune disorder
  • destroyed in hosts spleen by macrophages
77
Q

describe thrombotic thrombocytopenic purpura

A
  • increased agglutination of platelets that form microthrombi
78
Q

what are diagnostic studies that can be performed to diagnose thrombocytopenia?

A
  • platelet count
  • prothrombin time (PT)
  • activated partial thromboplastin time (aPTT)
  • Hgb/Hct (hemoglobin/hematocrit)
79
Q

what is the treatment for thrombocytopenia?

A
  • based on cause
  • corticosteroids
  • plasmaphoresis
  • splenectomy
  • platelet transfusion
80
Q

what is bleeding dyscrasia?

A

another term for bleeding abnormality

81
Q

what things might you look for when determining if a patient has a history of bleeding?

A
  • epistaxis (nose bleeds)
  • easy bruising
  • hematuria (bloody urine)
  • heavy menstrual
  • spontaneous bleeding
  • medications - anticoagulants or antiplatelet agents
82
Q

what would be included in the workup of a patient with a bleeding disorder?

A
  • CBC; differential
  • extrinsic vs intrinsic pathways (PT vs PTT); liver profile
  • INR
  • hemoglobin types: A, B, C, von willebrands disease (factor 8 c)
  • are platelet problems qualitative or quantitative; numbers or other issues?
83
Q

what are some local hemostatis measures can be taken with patients with bleeding disorders?

A

gelfoam, surgicel, thrombin/flowseal

84
Q

what are the treatment options for a patient with a bleeding disorder whose INR is >3?

A

may need bridging with lovenox (low dose heparin); 2-3 ok to either stop coumadin or proceed with concern for hemostasis

INR will vary depending on reason for coumadin therapy

85
Q

what is the protocol for treatment of patients receiving antiplatelet therapy like plavix?

A

anti-platelet therapy should not be stopped depending upon amount of surgery needed

ie a quadrant of extractions does not require stopping of plavix

Oral Surgery I (13 decks)

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