Hematologic part 1 Flashcards
Name the main four components of blood?
Plasma
RBCs
WBCs
Platelets
What are the different functions of blood? (5)
- Transports oxygen and nutrients
- Forms clots
- Carry cells and antibodies to fight infections
- Bring waste products to kidneys and liver
- Regulates body temperature
Stem cell categories
Myeloid Stem Cells
Lymphoid Stem Cells
What are the different types of Myeloid Stem Cells
Erythrocytes (RBC)
Leukocytes (WBC)
Platelets
What are the types of Lymphoid Stem cells
T lymphocytes
B lymphatocytes
Where does blood transport oxygen and nutrients to?
The lungs and tissues of the body
Why does blood form clots?
To prevent excess blood loss
Why are cells and antibodies carried in the blood?
Prevents and fights infection
Why is blood taken to the kidneys and liver?
Waste is filtered out of the blood and cleaned
How does blood regulate body temp?
Perfusion and blood circulation creates warmth
What are RBC’s responsible for?
(Extra: What type of stem cell is this again?)
Carrying oxygen to tissues and remove carbon dioxide from tissues
(RBCS are considered to be myeloid stem cells)
What do WBC’s do? And how many of them are there?
WBC’s or leukocytes fight infection.
There are 5 different types of WBCs.
Romaneschi asks you a question about Erythrocytes. What do you refer to those as?
RBC’s
You know all the information about wbcs. If Romaneschi asks you a question, what else might she refer to them as?
Leukocytes
What is the role of our platelets?
To stop bleeding from happening.
What may Romaneschi refer to platelets as?
Thrombocytes
Platelets/Thrombocytes have a nucleus.
True or False? Explain.
False. They do not have a nucleus because they are fragments of cytoplasm belonging to megakaryocytes of bone marrow.
Which Lymphoid stem cells create antibodies? And what part of the body are they created in?
B lymphocytes
They create them in the Bone marrow.
Which Lymphoid stem cells control immune response? Where are these made and found?
T lymphocytes.
They are made in the bone marrow but can be found maturing in the Thymus.
You get your lab panel back. Which lymphoid stem cell can be used to evaluate immune function?
T lymphocytes
- especially in those with HIV
What are the 5 types of WBCs?
Neutrophils
Eosinophils
Basophils
Monocytes
Lymphocytes (that are myeloid)
Which wbcs are responsible for fighting off pathogens?
Neutrophils
You go to the doctor after feeling a little off. Your lab shows a high amount of eosinophil wbcs. What does this mean?
Allergies or parasite
You went to the doctor and found out you have a parasitic organism. Which wbc should’ve fought them off & therefore be high?
Eosinophils will be high
Which wbc fights off bacteria, fungi, and viruses &&& is the largest wbc in the body?
(Where are they produced?)
Monocytes
They are formed in the bone marrow.
Which wbc will determine the specificity of the immune response when dealing with infectious organisms?
Lymphocytes
How big is the lymphocyte population compared to other wbcs?
20-40% of wbcs are lymphocytes
What do Basophil wbcs release?
Heparin, Histamine, and other mediators
What is a simple way to describe Leukemia?
Neoplastic proliferation or replication of one cell
What is a common indicator of Leukemia?
Unregulated proliferation or replication of WBC in bone marrow (sort of like popcorn).
What happens to the other cells, besides wbcs, when a person has leukemia?
Other cells don’t have enough room for cell production
How is leukemia classified?
They draw labs and try to distinguish if its lymphoid or myeloid. And then they decide if its acute or chronic.
- these things will determine the type of tx someone gets
What determines treatment for leukemia?
The classifications of the leukemia
What are acute leukemias characterized by?
Abrupt onset of a blast phase
What are chronic leukemias?
Where symptoms evolve over months to years with a majority of mature leukocytes
What is common lab trend for leukemia?
Elevated wbcs (since there is unregulated proliferation)
What is the Blast phase of Leukemia?
Acute onset when there are more than 30% of blast cells from samples from invading tissue and organs outside of the bone marrow home.
What word would you use to describe the blast phase of leukemia ?
Acute phase
Blast crisis
Aggressive leukemia
What is Acute Myeloid Leukemia?
Type of leukemia that affects myeloid cells such as rbcs, platelets, and monocytes
What is Acute Myeloid Leukemia related to?
Previous cancer treatment from Hodgkins Lymphoma. So, it is a secondary cancer.
Explain the relationship between Hodgkins Lymphoma and AML ?
A lot of times those who are “cured” of Hodgkins lymphoma develop Acute Myeloid Leukemia after cancer treatment
What will Acute Myeloid Leukemia appear as at first?
What impact does this have?
The flu
It means the AML can be ignored.
What condition do those with AML end up with?
What symptoms will there be?
Pantocytopenia which means all their labs are low across the board.
Fever, infection, weakness, fatigue, bleeding - all ties into the flu.
Patient with a history of Hodgkins Lymphoma comes into the doctor complaining of pain in the abdomen, bleeding gums, and bone pain. Why is this concerning?
They could have Acute Myeloid Leukemia as evidence by cell growth in organs like the liver and spleen, hyperplasia of gums, and bone expansion.
What labs would you expect to be decreased for AML?
RBCs, Platelets, and normal leukocytes
In AML, what will the blast cell percentage be?
Only greater than 20% due to it progressive towards aggressive - but it’s not there yet.
With AML, what are the major causes of death?
Infection & Bleeding
- bc pantocytopenia , decrease in the other wbc, rbc, and platelets
What skin issues will we present with AML and why?
Ecchymosis
Petechiae
Which is due to the pancytopenia.
What clue indicates imminent bleeding risk in AML?
What bleeds are we talking about?
The platelet count being less than 10,000.
GI, pulmonary, intracranial
What is a clue that the AMl patient is at risk for systemic infection?
A neutrophil count less than 100.
What risk increases if the neutrophil count being decreased is prolonged?
What should we assess for?
What is treatment?
Fungal infections
Assess for oral thrush.
- tx with antifungals like flagels
If your patient has AML and is therefore at risk for neutropenia or low neutrophils, how do we typically protect them?
Neutropenia precautions
- no plants
- no fresh fruits or veggies
- wash hands
- private room
- PPE!!!
Goal of treatment for patients with AML?
Complete remission
What are the steps of chemo used for Acute Myeloid Leukemia?
- Induction therapy
- Consolidation
- BMT
- Could consider supportive care if they don’t wanna go through all this.
What is induction therapy?
What does this lead to in addition?
First step of therapy for acute myeloid leukemia which is an aggressive chemo to destroy leukemic & normal cells to try to make sure they get it all.
Makes them definitely be in pancytopenia & they’ll need supportive care.
What is consolidation?
When do we start it?
Second step for AML where you have lower doses of chemo to get rid of any remaining leukemia cells.
Start it when they recover from induction.
What is the usual form of chemo for consolidation?
What type of care will those undergoing consolidation need?
Cytarabine
Need supportive care especially for nausea so Zofran.
What is BMT?
Bone marrow transplant for AML. Replacing bad bone marrow hematopoietic function with donor stem cells that are healthy.
- so they can build up a good immune system without all the issues
What is complication of AML treatment?
Tumor lysis syndrome
What is tumor lysis syndrome?
Intracellular electrolytes and fluids entering the systemic circulation.
What does an increased uric acid and phosphorus due to tumor lysis syndrome cause?
Gout
Renal stone & Colic
Acute Renal Failure
What does an increase in potassium but decrease in calcium due to the tumor lysis syndrome cause?
Dysrhythmias
Hypotension
Neuromuscular effects
Confusion
Seizures
What can we use to treat complications of tumor lysis syndrome?
Allopurinol for gout
High fluid intake
Kayexalate to bind potassium so it leaves the body
Hemodialysis to remove toxins
