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308 > Hematologic > Flashcards

Hematologic Flashcards

1
Q

Most common constituents of blood plasma

A

Proteins: albumin (major carrier molecule), globulin, fibrinogen, prothrombin
Water
Other solutes: Ions, nutrients, waste products, gases, regulatory substances

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2
Q

What unique properties does an erythrocyte have that make it ideal as a gas carrier?

A

biconcave disk shape and able to be reversibly deformed.

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3
Q

How does a neutrophil mature?

A

matures in bone marrow, released as bands if needed. first responders to inflammation, phagocytize.

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4
Q

Nutritional requirements for erythropoiesis

A

B12 : need intrinsic factor that is excreted from stomach cells for transport, defects in IF lead to decreased absorption of B12 and pernicious anemia
Folate : DNA synthesis
B6, Vit E, pantothenic acid

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5
Q

How does body use and store iron as related to erythropoiesis?

A

continually recycled. Iron binds to transferrin in the blood, is transported to macrophages of the MPS, and is stored in the cytoplasm as ferritin.

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6
Q

Hgb

A

Hemoglobin: amount of hemoglobin by weight per dL of blood.

Anemias

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7
Q

Hct

A

Hematocrit: measure of percentage of RBC’s in total blood volume (3xhgb)

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8
Q

RBC

A

Red cell count: number (in millions) RBC’s circulating in blood

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9
Q

MCV

A

Mean corpuscular volume: measure of the

average volume or size of a single RBC

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10
Q

MCH

A

Mean Corpuscular Hemoglobin: measure of the

total amount of hgb in a RBC

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11
Q

MCHC

A

Mean Corpuscular Hemoglobin Concentration:
measure of the average concentration or
percentage of Hgb in a single RBC

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12
Q

RDW

A

Red Cell Distribution Width: provides an estimate of RBC size

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13
Q

Reticulocyte count

A

immature RBC - reflects bone marrow function

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14
Q

Anemia

A

reduction in the total number of erythrocytes in the circulating blood or a decrease in the quality or quantity of hemoglobin

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15
Q

Common classification of anemia

A

based on changes that affect the erythrocytes size or hemoglobin content.

cytic: cell size
chromic: hemoglobin content

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16
Q

Normochromic-macrocytic anemia

A

PERNICIOUS ANEMIA AND FOLIC ACID DEFICIENCY
Unusually large RBC’s
DNA and RNA synthesis

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17
Q

Pernicious anemia

A

Cause: Lack of intrinsic factor causing deficiency in B12

Clinical manifestations
• Weakness, fatigue
• Paresthesias of the feet and fingers, difficulty walking
• Loss of appetite, abdominal pains, weight loss
• Sore tongue that is smooth and beefy red, secondary to
atrophic glossitis
• “Lemon yellow” (sallow) skin as a result of a combination of pallor and icterus
• Neurologic symptoms from nerve demyelination
• Not reversible, even with treatment
• Often unrecognized in older adults due to subtle, slow onset and presentation

18
Q

Folate deficiency anemia

A

Cause: lack of folate absorption in upper small intestine

Clinical manifestations
• Severe cheilosis: Scales and fissures of the lips and corners of the mouth
• Stomatitis: Mouth inflammation
• Painful ulcerations of the buccal mucosa and tongue:
Characteristic of burning mouth syndrome
• Dysphagia (difficulty swallowing), flatulence, and watery
diarrhea
• Neurologic symptoms: Usually not seen

19
Q

Microcytic-hypochromis anemia

A

abnormally small RBC’s in abnormally reduced amount of hemoglobin.
IRON DEFICIENCY ANEMIA, SIDEROBLASTIC ANEMIA

20
Q

Iron-deficiency anemia

A

Causes:
• Inadequate dietary intake
• Excessive blood loss
• Chronic parasite infestations
• Metabolic or functional iron deficiency
• Menorrhagia (excessive bleeding during menstruation)
• Iron deficiency anemia and folate deficiency anemia are
two leading causes of anemia in pregnancy
Use of medications that cause gastrointestinal bleeding
(aspirin, nonsteroidal antiinflammatory drugs [NSAIDs])
• Surgical procedures that decrease stomach acidity,
intestinal transit time, and absorption (e.g., gastric bypass)
• Insufficient dietary intake of iron
• Eating disorders, such as pica (craving and eating
nonnutritional substances such as dirt, chalk, and paper)

Clinical manifestations
• Fatigue, weakness, shortness of breath
• Pale earlobes, palms and conjunctivae
• Brittle, thin, coarsely ridged, and spoon-shaped (concave or koilonychia) nails
• Red, sore, painful tongue
• Angular stomatitis: Dryness and soreness in the corners of the mouth
• Become symptomatic: When hemoglobin (Hgb) 7 to 8 g/dl

21
Q

Sideroblastic anemia

A

Cause: a defect in mitochondrial heme synthesis.

Clinical manifestations:
Iron overload (hemochromatosis)
Enlarged spleen (splenomegaly) and liver (hepatomegaly)
22
Q

Normochromic-normoblastic anemia

A 
relatively normal in size and hgb content but insufficient in number. No common cause
APLASTIC ANEMIA
POST HEMORRHAGIC ANEMIA
HEMOLYTIC ANEMIA
ANEMIA OF CHRONIC DISEASE
23
Q

Aplastic anemia

A

Pathophysiology
• Characteristic lesion is a hypocellular bone marrow that has
been replaced with fat

Clinical manifestations
• Hypoxemia, pallor (occasionally with a brownish pigmentation
of the skin)
• Weakness along with fever and dyspnea with rapidly
developing signs of hemorrhaging if platelets are affected

24
Q

Post hemorrhagic anemia

A

Cause: acute blood loss
Manifestations: depends on severity of blood lost

25
Q

Hemolytic anemia

A

Accelerated destruction of RBC’s

Manifestations:
depend on severity of hemolysis and success of compensatory erythropoiesis

26
Q

Anemia of Chronic disease

A

Inflammation
Cause: decreased erythropoiesis seen
in AIDS, rheumatoid arthritis, lupus erythematosus, hepatitis, renal, failure, and malignancies.
Failure to increase erythropoiesis in response to decreased
numbers of erythrocytes
• Kidney damage, affecting erythropoietin (hormone for
production of erythrocytes)

27
Q

Neutropenia causes

A

Prolonged severe infection
Decreased production
Reduced neutrophil survival
Abnormal neutrophil distribution and sequestration

28
Q

Neutrophilia causes

A

Early stages of infection or inflammation.

29
Q

Eosinophilia causes

A

allergic disorders, parasitic invasion

30
Q

Eosinopenia

A

Usually caused by migration of cells to
inflammatory sites
Other causes
• Surgery, shock, trauma, burns, or mental distress

31
Q

Pathophysiology of infectious mononucleosis

A

Caused by Epstein Barr virus. Infection of B lymphocytes that spread through lymph tissue and into the blood

32
Q

Clinical manifestations of leukemia

A

Fatigue caused by anemia
Bleeding resulting from thrombocytopenia (reduced
numbers of circulating platelets)
Fever caused by infection
Anorexia, weight loss, diminished sensitivity to sour and
sweet tastes, wasting away of muscle, and difficulty
swallowing

33
Q

Differences of acute and chronic leukemia

A

Acute: immature cells, rapid onset
Chronic: mature cells do not function properly, slow progression

34
Q

Acute lymphocytic leukemia

A

common in children; philadelphia chromosome

35
Q

Actue myelogenous leukemia

A

Most common adult leukemia; increased risk with down syndrome. Exposure to radiation, chemo, hereditary conditions

36
Q

chronic myelogenous leukemia

A

arise from hematopoeitic stem cell

37
Q

Chronic lymphocytic leukemia

A

affects monoclonal B lymphocytes

38
Q

pathophysiology of hodgkin’s lymphoma

A

REED-STERNBERG CELLS (RS); B cell in the germinal center has unsuccessful immunoglobulin gene rearrangement; should undergo apoptosis but survives.

39
Q

Thrombocytopenia

A

Petechiae and purpura, frank bleeding from mucous
membranes (epistaxis (nose), hematuria, menorrhagia,
bleeding gums)

40
Q

ITP

A

IgG targets platelet glycoproteins, are sequestered and removed from circulation.
viral infections, allergies, SLE
manifestations: petechiae, purpura, to major hemorrhage

41
Q

Sickle cell vasoocclusive crisis

A

Sickling is in microcirculation, extremely painful, and symmetric
Hands and feet exhibit painful swelling (hand-foot syndrome).

42
Q

Sickle cell manifestations

A

Infection: Most common cause of death
• Glomerular disease: Hyposthenuria—the inability of the tubules of the kidneys to concentrate urine, bed wetting, proteinuria
• Gallstones or cholecystitis

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