Hematocrit Flashcards
1
Q
plasma
A
fluid component of blood (clear yellow)
2
Q
albumin
A
maintains osmotic pressure so plasma doesn’t leak into tissues
3
Q
globulin
A
helps to transport antibodies
4
Q
fibrinogen
A
involved in blood clotting
5
Q
plasma components x3
A
albumin, globulin, fibrinogen
6
Q
blood cell types x3
A
white blood cellsred blood cellsplatelets
7
Q
white blood cells function
A
protection through inflammation and infection
8
Q
red blood cells function
A
oxygen and carbon dioxide transport
9
Q
platelets function
A
important in blood clotting
10
Q
- RBC lifespan
A
120 days
11
Q
immature RBC
A
reticulocyte
12
Q
mature RBC
A
erythrocyte
13
Q
RBC production regulated by…
A
erythropoietin (released by kidneys)
14
Q
erythropoeitin function
A
released by kidneys in response to decreased SpaO2 (hypoxemia)
15
Q
hemoglobin
A
protein for O2 transporteach heme carries 4 molecules of O2
16
Q
major Hgb in adult
A
Hgb A
17
Q
Hgb in fetus
A
Hgb F
18
Q
what is needed for Hgb to pick up oxygen?
A
heme and iron- also folic acid and vitamin B12
19
Q
elderly lifespan considerations (blood cells)
A
decreased blood volume, hemoglobinaging bone marrow = lower RBC, WBCaging liver = less protein production, plasma proteins
20
Q
universal recipient
A
AB
21
Q
universal donor
A
O negative
22
Q
blood type classified…
A
according to antigens on cell membrane
23
Q
anemia
A
NOT A DISEASE (a sign)- low Hct, RBC, hgb- increased reticulocyte count
24
Q
*anemia s/s
A
- fatigue: most common complaint (due to decrease O2 delivery to cells = decrease in cellular work = fatigue)- CVS: increased HR & palpitations, orthostatic hypertension- resp: dyspnea on exertion (decreased O2 sat)
25
*anemia in toddlers/young
90% due to iron deficiency (nutritional intake)
26
*anemia in adolescents
typically low nutrition period of rapid growth
27
*anemia in pregnancy
due to decreased blood volume
28
*anemia in adults
GI bleeding most common reason (any adult with iron deficiency anemia should be evaluated for abnormal bleeding)
29
*anemia in elderly
chronic diseaseGI bleedingnutritional
30
*anemia: iron deficiency causes
most common anemia worldwide- blood loss (GI, menstrual)- dietary insufficiency- poor GI absorption/malabsorption, post-gastrectomy
31
*iron deficiency treatment
increase dietary intake of ironsupplement: ferrous sulfate
32
ferrous sulfate supplement...
for iron deficiency anemiacan cause nausea, constipation (dark, tarry stool)
33
anemia: decreased RBC production due to...
- lack of iron, B12, folic acid (prevents DNA synthesis, so RBC production goes down)- dysfunctional bone marrow -> aplastic anemia (decrease in circulating RBC) / acquired from exposure to toxins- low levels of erythropoetin, thyroid hormone
34
*aplastic anemia
condition in which the bone marrow does not make enough new blood cells; leads to pancytopenia
35
pancytopenia
condition with reduction in number of all blood cells- requires bone marrow to diagnose- 50% idiopathic- 50% radiation, chemo, infection, toxin, drug reaction
36
anemia: increased RBC destruction
hemolytic anemia
37
anemia types
decreased productionincreased destructionblood lossgenetic disorders
38
hemolytic anemia
classified according to how hemolysis occursacquired vs inherited
39
acquired hemolytic anemia
autoimmune, malaria, lead poisoning
40
inherited hemolytic anemia
- defects of RBC membrane production: hereditary spherocytosis (RBC are sphere shaped)- defects in hgb production: sickle cell disease, thalassemia- defective RBC metabolism: G6PD deficiency (glucose-6-phosphate dehydrogenase)
41
hereditary spherocytosis
RBC = sphere shaped
42
*sickle cell disease
RBC typically pliable (aged = fragile)- genetic disorder: fragile, easily broken, sickle resulting in chronic anemia (pain, disability, organ damage, increased risk for infection, early death)- autosomal recessive- African American 1:5000 disease, 1:12-15 trait- early diagnosis critical: optimum treatment- newborn screening mandatory in US
43
*sickle cell disease pathophysiology
abnormal hgb chains with HGB S instead of HGB A- RBC w/ hgb S lives ~12-15 days- hgb S sensitive to changes in O2 leading to sickling, rigidity, clumping- vasoocclusive event (VOE)- sickle cell crisis
44
*vasooclusive event (VOE)
hgb s makes cells fragile, sticky, can block blood flow - characteristic of sickle cell disease
45
*sickle cell crisis
extensive sickling
46
*sickle cell trait
often asymptomatic, maybe mild symptoms
47
*causes of sickling
- hypoxia- dehydration- infection- venous stasis- pregnancy- alcohol consumption- low/high environmental of body temp- strenuous exercise- emotional stress- acidosis- anesthesia- high altitude
48
sickle cell disease lab values
low hematocrit (shorter RBC life)reticulolyte count increaseWBC high due to chronic inflammation (hypoxia, ischemia)
49
sickle cell disease presentation
PAIN - most common problem due to obstructed blood flow from hypoxia (mild to severe, requiring hospitalization)- acute pain episode: sudden onset. chest, back, abdomen, extremities- chronic pain: common, can require high doses of opioids (addiction rare with SCD)
50
sickle cell crisis treatment
EARLY TREATMENT- oxygen (even if oxygen is normal)- pain: likely IV opioids- hydration: IV- rest: decrease stress, promote venous return- treat infection- close monitoring- possible blood transfusion
51
prevention of sickle crisis
- risk for infection higher due to spleen damage during anoxic events (contact provider at first sign!)- genetic counseling- hydration, avoid EtOH, tobacco, temp extremes, strenuous physical activity, high altitudes
52
thalassemia
genetic defect in hgb synthesis (Asians, Middle Eastern, Mediterranean, African)- asymptomatic to incompatible with life
53
thalassemia diagnosis
blood smear shows microcytic hypochromic anemia with misshapen RBC
54
thalassemia treatment
only for severe: frequent blood transfusion, possible bone marrow transplant
55
hemolytic anemia
hereditary spherocytosis: N European ancestry (autosomal dominant)- mild to severe- treatment: severe = frequent transfusions
56
platelet disorders causes
- inherited (autoimmune disorder)- acquired (viral)- temporarily induced by drugs
57
platelet disorders tests
- lab test for coagulation: measures ability to clot and time taken- platelet count- prothrombin time (PT)
58
thrombocytopenia
platelet # below that which is needed for clotting
59
thrombocytosis
elevated platelet count- risk for deep vein thrombosis, pulmonary embolism
60
idiopathic thrombocytopenia purpura (ITP)
autoimmune disorder with high platelet destruction by spleen- pre-existing immune disorder such as lupus- can be triggered by viral infection- seen most often in 2-5yo, women 20-40- prognosis: excellent with 75% spontaneous recovery within 3 months
61
ITP presentation
mucosal bleedinglarge bruising (ecchymosis)petechial rash
62
ITP treatment
protection from trauma, maintain safe environmentplatelet transfusion if < 20k
63
clotting factor disorders
genetic or acquired from liver damage
64
hemophilia
hereditary clotting factor disorder- 80% have deficiency in factor VIII- recessive X linked (women are carriers, sons affected)
65
hemophilia presentation
abnormal bleeding in response to trauma- excessive, bruise easily, joint pain/edema
66
hemophilia treatment
replacement of missing factor (EXPENSIVE)prevention with safe environmentcoordinated care: physical + psychosocial support
67
leukemia
cancer (WBC disorder) uncontrolled production of immature WBC
68
bone marrow disease or autoimmune disorder
(WBC disorders)
69
neutropenia
abnormally few neutrophils in blood leading to increased susceptibility to infection
70
* typical RBC count
4.2 - 6.1 million/ul
71
* typical hgb
female: 12 - 16 g/dlmale: 14 - 18 g/dl
72
* typical hct
female: 37 - 47%male: 42 - 52%
73
* typical WBC count
5000 - 10000 /mm^3
74
* typical platelet
150k - 400k /mm^3
75
typical mean corpuscular volume
80 - 95 fL
76
low MCV
microcytic
77
high MCV
macrocytic
78
mean corpuscular hemoglobin
27 - 31(not as important in real world practice)
79
mean corpuscular hemoglobin concentration
32 - 36 g/dlit's all about the color!
80
low MCHC
hypochromic
81
high MCHC
hyperchromic
82
* typical reticulocyte count
0.5% - 2.0%bone marrow functioning
83
most common complaint of anemia (+ due to)
fatigue
