Hematologic Emergencies Flashcards
Hematology
The study of blood
Hematopoietic System
Organs and tissues involved in the production of blood components (bone marrow, spleen, lymph nodes)
Hematologic disorder
Any disorder of the blood
Hemolytic disorder
Disease process that cause the breakdown of RBC
Hemostatic disorder
Bleeding and clotting abnormalities
Blood and plasma
Blood is a connective tissue.
Plasma is the liquid portion of the blood.
Blood accounts for 8% of total body weight of approx. 5-6 L.
Blood consist of two main components: plasma and formed elements
-plasma is 92% water and the remaining 8% is made up of proteins, electrolytes, clotting factors and glucose.
-plasma accounts for 55% of the total blood volume and the formed elements account for the remaining 45%.
Erythrocytes
Red blood cells
Leukocytes
White blood cells
Thrombocytes
Platelets
Stem Cells
- Cells that develop into other types of cells in the body, this production is stimulated by erythropoietin that is secreted by the kidneys in response to a circulatory need.
- RBC take 5 days to mature and have a lifespan of 120 days.
Hemoglobin
Carries oxygen to the tissues
Bohr Effect
When oxygen rich RBC encounter the environment that contains higher concentrations of carbon dioxide they release oxygen there
Hematocrit
Gives the overall proportion of RBC in the blood
Neutropenia
Abnormally low number of neutrophils which make up the majority of circulating WBC.
Humoral Immunity
Secretion of antibodies called immunoglobulins, which recognize and specific antigen.
Cell-mediated immunity
Macrophages and T-cells attack and destroy pathogens or foreign substances
Platelets
Platelets are responsible for the clotting of blood
-Approximately 2/3 of platelets are circulating in the blood the rest are stored in the spleen.
Thrombocytosis
Body produces too many platelets
Thrombosis
Clotting or coagulation of blood inside of blood vessel
Hemostasis
- Complex process that allows the body to stop bleeding through vascular spasm, coagulation, and platelet plugging.
- The opposite of hemostasis is hemorrhage.
- Clots are made of fibrin, when injury is detected thrombin converts fibrinogen to fibrin and the clotting process begins.
Clotting Cascade
Process by which clotting factors work together to ultimately form fibrin, also called the coagulation cascade, can be initiated through either intrinsic or extrinsic pathways.
Coagulopathy
Any process that interferes with the activation or continuation of the clotting cascade or hemostasis.
Von Williebrand Disease
The bloods ability to clot is decrease bc of the absence of vin williebrand factor that is necessary for platelet adhesion.
Blood forming organs and RBC production
- Major players are bone marrow, liver and spleen.
- Bone marrow is primary site for cell production.
- Liver produces clotting factor found in the blood
- Liver filters the blood, removes toxins, and essential to normal metabolism and homeostasis.
- Old RBC are broken down into bile in the liver, liver also stores blood.
Spleen
Involved in the filtering and breakdown of RBC, assist with the production of lymphocytes, and has a role in providing homeostasis and infection control
-Stores about 1/3 of platelets.
Sickle cell Disease
Disease that causes RBC to be misshapen, resulting in poor oxygen carrying capability and potentially resulting in lodging of the RBC in a blood vessel or the spleen
Hemophillia
Bleeding disorder that is primarily hereditary, in which clotting does not occur or occurs insufficiently
Sickle cell crisis
Condition in which a patient with sickle cell disease experiences a significant pain due to insufficient passage of oxygen and nutrients into tissues and joints because of vessel congestion.
Polycythemia
Overproduction of RBC, WBC and platelets.
Aplastic Crisis
Hemolytic Crisis
(Sickle cell disease) The body temporarily stops making RBC, causing the patient to become easily tired, anemic, pale, and short of breath.
Hemolytic crisis occurs when RBC destruction causes jaundice.
Leukocytosis
Increase in the total number of WBC
Vasoocclusive Crisis
Blood flow to an organ becomes restricted, causing pain, ischemia, and often organ damage.
-circulation to the spleen becomes obstructed as a result of this organs narrow vessels and function if removing damaged RBC. Spleen will swell and rupture.
Splenic sequestration crisis
Caused by sickle cells within the spleen blocking blood from leaving the spleen, which results in painful, acute enlargement if the spleen and hard and bloated abdomen.
Acute Splenic sequestration syndrome
LiFe threatening complication. RBC become trapped in the spleen causing a dramatic decline in the amount of hemoglobin available in the circulation. (Usually occurs in infants and toddlers)
Anemia
Hemoglobin or RBC levels that is lower than normal.
- Iron deficiency anemia is the most common type, causes include GI blood loss, menstrual bleeding, frequent donations or diagnostic test, low birth weight or premie.
Thalassemia
Type of anemia in which either not enough hemoglobin is produced or the hemoglobin is defective
Leukopenia
Reduction in WBC
-often lead to fever and infection
Thrombocytopenia
Reduction in platelets
-cutaneous bleeding (including petechiae) and bleeding from mucous membranes (nose bleed, rectal bleeding)
Leukemia
-Disease that develops in the lymphoid system.
- Cancer, WBC develop abnormally or excessively.
-Can cause anemia, thrombocytopenia and leukocytosis.
-Acute, bone marrow is replaced with abnormal lymphoblast
Chronic, abnormal mature lymphoid cells accumulate in the bone marrow, lymph nodes, spleen and peripheral blood. (Found during routine blood test)
Lymphoblast
Lymphocytes that have been transformed because the stimulation by an antigen
Lymphomas
Group of malignant diseases that arise within the lymphoid system.
-two categories, non Hodgkin and Hodgkin lymphoma.
Non-Hodgkin- can occur at any age in any person and can be hereditary, categorized by progression of disease: indolent (very slow), aggressive, or highly aggressive.
Hodgkin- painless, progressive enlargement of the lymphoid glands, most commonly affecting the spleen and lymph nodes.
-first peak ages 10-35 and later in life.
-may not show symptoms for years, night sweat, chills, persistent cough, swelling of lymph nodes (neck).
Disseminated Intravascular Coagulation (DIC)
May result from any life threatening condition, massive injury, hypotension due to trauma, sepsis, OB complication.
- Free thrombin and fibrin deposits in the blood increase, and platelets begin to aggregate. Breakdown of fibrin clots, occurs leading to excessive bleeding, massive blood loss, or tissue injury. Second uncontrolled hemorrhage results from severe reduction in clotting factors.
- High mortality rate 60-65%
Multiple Myeloma
The number of plasma cells (B cells that form antibodies) in the bone marrow increases abnormally, leading to formation of tumors in the bone.
Transfusion reactions
-occur in 0.2%-10% of transfusions.
Permissible blood types ————————————— A+ > A-, O+, O- A- > O- AB+ > All (universal recipient) AB- > A-, B-, O- B+> B-, O+, O- B- > O- O+> O- (Universal donor) O-> None
Transfusion related lung injury
Non-cariogenic pulmonary edema caused by increased capillary permeability post transfusion.
