Hematologic Flashcards
Whole blood functions
- delivery of substances needed for cellular metabolism
- defense against microorganisms and injury
- removal of wastes
- maintenance of acid-base balance
Erythrocytes (RBC’s)
- most abundant cell in body
- responsible for tissue oxygenation.
- normal value is 4.2-6.2 million
Hemoglobin
- oxygen-carrying protein of the erythrocyte (rbc)
- a single erythrocyte contains as many as 300 hemoglobin molecules
- 97% of oxygen in blood is combined with hemoglobin and carried on the RBCs
Leukocytes (WBCs)
- defend the body against infection and remove debris (phagocytosis)
- normal value is 4,500 to 10,000 mcL
Thrombocytes (platelets)
- disk shaped cytoplasmic fragments
- essential for blood coagulation and control of bleeding
- normal value is 150-400,000 mm
Hemostasis
means arrest of bleeding
Requirements of Hemostasis is ..
-platelets, clotting factors and vasculature
Lymphoid Organs - SPLEEN
- largest lymphoid tissue
- located in the abdominal LUQ
- has sinuses filled with blood
What 2 tissue types does the Spleen have
- White pulp (lymphocytes)
- Red pulp (rbcs, lymphocytes, macrophages)
Lymphoid organs - LYMPH NODES
- small bean shaped lymph tissue
- filters lymph fluid in the lymph vessels
- clusters of lymph nodes throughout the body
Anemia
reduction in the total number of erythrocytes (RBCs) in the circulating blood or in the quality or quantity of hemoglobin
Etiology of Anemia
- impaired erythrocyte production
- acute of chronic blood loss
- increased erythrocyte destruction
- combination of the above
What do you need to look at on the CBC for anemia
rbc, Hgb, Hct, MCV, MCH
Anemia physiologic manifestation
reduced oxygen carrying capacity– hypoxemia
Classic Anemia symptoms
- fatigue
- weakness
- dyspnea
- pallor
- palpitations
Macrocytic-Normochronic Anemias
Pemicious anemia AKA Vitamin B12 deficiency
Pemicious anemia
anemia caused by lack of intrinsic factor from the gastric parietal cells
Etiology of Premicious anemia
- severe gastric disease
- genetic
- autoimmune
- chronic alcholism
- dietary
- PPI use
CM when hemoglobin at 7-8 gm/dl for Premicious anemia
- fatigue
- weakness
- loss of appetite
- weight loss
- arthralgia
- paresthesia
- tachycardia
- glossitis
Folate deficiency anemia
folate deficiency
Etiology of Folate deficiency anemia
- dietary
- alcohol abuse
- pregnancy
- celiac disease
- inflammatory bowel disease
- crohns disease
- medications
CM Folate deficiency anemia
- stomatitis
- SOB
- dysphagia
- flatulence
- watery diarrhea
- palpitations
- weakness
Iron deficiency anemia
disorder or iron metabolism
Etiology of Iron deficiency anemia
- inadequate intake
- excessive menses
- GI loss
- frequent use of antacids
CM of iron deficiency anemia
pale weak, fatigue new heart murmur heart palpitations dyspnea pica (eat weird things) cold intolerance
Polycythemia
myeloproliferative RBC disorder
-overproduction of red blood cells
Relative ploycthemia
- results from dehydration
- fluid loss results in relative increases of red cell counts and Hgb and Hct values
Absolute polycythemia - Primary absolute
polycythemia vera (pv)
Absolute polycythemia - secondary absolute
Increase in erythropoietin as a normal response to chronic hypoxia or erythropoietin-secreting tumors
CM of polycythemia
Increased blood viscosity and hypercoagulopathy Spleen enlargement Heart murmurs Thrombosis formation Plethora Headache
Alterations of Leukocyte Function- Quantitative disorders:
- Increases or decreases in cell numbers
- Bone marrow disorders or premature destruction of cells
- Response to infectious microorganism invasion
Leukocytosis
- Leukocytosis is a normal protective physiologic response to physiologic stressors, such as infectious microorganisms
- A high white cell count
Leukopenia
- Leukopenia is not normal and not beneficial
- A low white cell count predisposes a patient to infections
Leukemia
- A malignant disorder in which the blood-forming organs lose control over cell division, causing an accumulation of dysfunctional blood cells.
- Uncontrolled proliferation of non-functional leukocytes crowds out normal cells from the bone marrow and decreases production of normal cells.
Leukemia Cause appears to be a genetic predisposition plus exposure to risk factors such as:
- Some disorders of the bone marrow and other organs that can progress to acute leukemias
- Some viruses
- Ionizing radiation in large doses
- Drugs
- Down syndrome and other congenital disorders
Classic leukemia symptoms:
Fatigue/Weakness Loss of appetite Bleeding Fever SOB Weight loss
Acute lymphocytic leukemia (ALL)
- Too many lymphoblasts
- Mostly occurs in children
Abrupt onset/Rapid progression
Acute myelogenous leukemia (AML)
- Too many myeloblasts
- Most common adult leukemia
Abrupt onset/Rapid progression
Chronic myelogenous leukemia (CML)
Too many blood cells made in bone marrow
Gradual onset/Slow progression
Chronic lymphocytic leukemia (CLL)
- Too many immature lymphocytes
- Most common adult leukemia in western world
Gradual onset/Slow progression
Lymphadenopathy
Enlarged lymph nodes that become palpable and tender
Local lymphadenopathy
Drainage of an inflammatory lesion located near the enlarged node
General lymphadenopathy
Occurs in the presence of malignant or nonmalignant disease
Hodgkin Lymphoma
The presence of reed-sternberg cells in the lymph nodes
Etiology of Hodgkin Lymphoma
unknown
EB virus
CM of Hodgkin Lymphoma
Painless lymphadenopathy Mediastinal mass Splenomegly Abdominal mass Fever Weight loss Night sweats Pruritus Anemia
Non-Hodgkin Lymphoma
Generic term for a diverse group of lymphomas
Etiology of Non-Hodgkin Lymphoma
Genetic Viral infections Immunosuppresion Radiation H. Pylori
CM of Non-Hodgkin Lymphoma
Localized/generalized painless lymphadenopathy Splenomegaly Fever Weight loss Night sweats Fatigue
Disorders of Platelets
Thrombocytopenia
Thrombocytopenia
Platelet count <150,000/mm3
Causes of Thrombocytopenia
- Hypersplenism
- Autoimmune disease Idiopathic thrombocytopenic purpura (ITP)
- Viral or bacterial infections that cause Disseminated Intravascular Coagulation (DIC)
- Heparin-induced thrombocytopenia (HIT)
CM of Thrombocytopenia
Petechiae Purpura Mucosal bleeding Gingival bleeding Enlarged spleen or liver Internal bleeding Hemorrhage
Essential (primary) thrombocythemia (thrombocytosis)
Thrombocythemia is characterized by platelet counts >400,000/mm3
Causes of (primary) thrombocythemia (thrombocytosis)
ESSENTIAL= Myeloproliferative disorder of platelet precursor cells REACTIVE= Secondary reaction
CM of (primary) thrombocythemia (thrombocytosis)
Thrombosis of arteries or veins
Hemorrhage
Neurological manifestations
H/A most common
Alterations of Coagulation
-Vitamin K deficiency
Vitamin K is necessary for synthesis and regulation of prothrombin, the procoagulant factors (VII, XI, X), and proteins C and S (anticoagulants).
-Liver disease
Liver disease causes a broad range of hemostasis disorders:
1. Defects in coagulation
2. Fibrinolysis
3. Platelet number and function
-Hemophilia A
-Von Willebrand Disease *MOST COMMON
-Disseminated Intravascular Coagulation (DIC)
