Hem Pathology Flashcards

1
Q

What are the two main causes of Vit B12 anemia

A

Inadequate intake & Impaired Absorption

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2
Q

What is pernicious anemia

A

Type of Impaired Absoprtion Vit B12 anemia, due to intrinsic factor deficiency

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3
Q

What are lab values found with vit B12 anemia

A

low B12, high MCV, low Hgb

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4
Q

What are two MACROphagic anemias?

A

Vit B12, Folate

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5
Q

What is another name for Anemia of Chronic Disease (ACD)

A

Anemia of inflammation (AI)

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6
Q

What is the cause of ACD?

A

decreased erythropoiesis and impaired iron utilizations as a result of chronic disease

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7
Q

What is the cause of sickle cell anemia

A

decreased life span of sickle cells (10-20 days instead of 90-120)

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8
Q

What are the causes of IDA

A

dietary deficiency, impaired absorption, increased requirement, chronic blood loss

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9
Q

what lab values are expected with IDA

A

Low Fe, microcytic-hypochromic RBCs on blood smear

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10
Q

How does anemia affect the cardiac system

A

1.decreased RBCs = decreased viscosity and volume of blood so interstitial fluid moves into intravascular space to expand plasma volume further decreasing viscosity, creating a hyperdynamic circulatory state as thin blood flows faster = INCREASED STROKE VOLUME AND HR
2.hypoxia leads to dilation of arterioles/capillaries, further contributes to hyperdynamic circulatory state and increased sv&hr - leads to heart failure

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11
Q

how does anemia affect the respiratory system

A

tissue hypoxia increases rate and depth of breathing - dyspnia, palpitations, fatigue

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12
Q

What is the intrinsic pathway in the coagulation cascade?

A

XII –> XI –> IX –> VIII (12,11,9,8)
then common pathway

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13
Q

What lab test is used to measure intrinsic pathway?

A

aPTT

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14
Q

What is the extrinsic pathway in the coagulation cascade

A

TF(tissue factor/F3) and VII (7) lead to common pathway

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15
Q

What lab test is used to measure the extrinsic pathway

A

PT

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16
Q

What is the common pathway?

A

1.Factor X interacts with FV, Ca & lipids to convert prothrombin (F2) to thrombin (F2a)
2.thrombin turns soluble fibrinogen (F1) into insoluble fibrin by linking particles together into chains
3.Factor XIII then takes insoluble fibrin and cross-links it to stabilize it into fibrin mesh which holds platelet plug in place

17
Q

What is factor 2?

A

inactive = prothrombin
active = thrombin

18
Q

What are the two ways coagulation is inhibited

A

inhibition of thrombin formation & fibrinolysis

19
Q

How is thrombin formation inhibited

A
  1. thrombin activates protein c (APC)
  2. APC combines with Protein S to slow down F5a and 8a
  3. Thrombin becomes inactive
  4. antithrombin inhibits further thrombin
20
Q

How does fibrinolysis occur

A

Tissue plasminogen activatory (T-PA) converts plasminogen to plasmin, which breaks down fibrin
(shows up as Ddimer)

21
Q

what is antithrombin

A

glycoprotein synthesized in the liver that inhibits factor 2a (thrombin), factor Xa, and to a lesser extent F11a adn 9a.
(half life 2-3 days)

22
Q

what is d-dimer and what does it indicate?

A

d-dimer is a biproduct of fibrinolysis - high levels indicative there may be a blood clotting condition

23
Q

what is C-reactive protein (CRP) and what does it indicate

A

CRP becomes active when contacts thrombin, helps to slow down coagulatin process
HIGH LEVEL = INFLAMMATION

24
Q

what percentage do erythrocytes/plasma/buffy layer make up in blood

A

RBC=45%
plasma = 55
BL=<1%

25
Q

What makes up the buffy layer of blood (2 things)

A

leukocytes (WBC), platelets (thrombocytes)

26
Q

What plasma proteins are present in blood (5 things)

A

albumin (most common), globulins, fibrinogen, additional immune mediators, clotting factors

27
Q

What are the functions of blood (6 things)

A
  1. respiratory gas exchange
28
Q

What are the functions of blood (6 things)

A
  1. respiratory gas exchange
    2.transport of nutrients
    3.thermoregulation
    4.hemostasis
    5.immunity
    6.regulate cell function, osmotic pressure & pH
29
Q

what makes up plasma

A

water (90%), elecrolytes, gases, plasma proteins

30
Q

What cells results from the myloid stem cell?

A

RBC (from erythroblasts), platelets (from megakaryocytes), myoblasts–> granulocytes: neutrophils, eosinophils, basophils & monocytes (turn into macrophage)

31
Q

What cells result from the lymphoid stem cell

A

agranular B&T lymphocytes & NK cells

32
Q

What does an eosinophil look like?

A

two piece nucleus, red granules

33
Q

what does a basophil look like

A

bright blue granules

34
Q

what does a neutrophil look like

A

multilobed nucleous

35
Q

what does a monocyte look like

A

kidney bean shaped nucleous, no granules

36
Q

what occurs in coagulation initiation

A

TF&F7 activate 9, 10, 11 and small amount of thrombin

37
Q

what occurs in coagulation amplification

A

thrombin activates F5, F8, platelets, and F11