Hematology

Question 1

What is DIC?

Answer 1

Disseminated Intravascular Coagulopathy involves widespread clotting, reduction of clotting factors, then bleeding.
50% of cases are associated with pregnancy.

Question 2

What are some risk factors and signs/symptoms of DIC?

Answer 2

Risks include obstetric complications, sepsis, cancers and intravascular hemolysis/

s/s: hypovolemia, mucosal bleeding, ALOC, hypotension, MI and seizures.

Question 3

Describe anemia

Answer 3

Anemia is a reduction of O2 carrying capacity in red blood cells. Usually a dysfunction of hemoglobin from reduced RBC production, early destruction of RBC’s or a problem with the cell function and shape.

Question 4

What are some risk factors and signs/symptoms of anemia?

Answer 4

Risk factors include congenital defects, diet, bleeding, travel (parasitic infections - eek!), cancers, kidney or liver disease.

s/s: air hunger, fatigue, bleeding, dizziness, chest pain, headaches, cold hands and feet, resting tachycardia.

Question 5

What is the normal RBC count for men and women?

BONUS POINTS: what is the RBC count threshold for blood transfusion?

Answer 5

Men: 135-145
Women: 125-130

Threshold for transfusion: less than 70

Question 6

Describe hemophilia, and its signs/symptoms

Answer 6

Hemophilia is a bleeding disorder due to clotting factor deficiencies on Factor VII + IX genes on the X chromosome. Females can be carriers, but are usually asymptomatic. Most commonly bleeds occur in hinged joints, soft tissues, mucous membranes and in the CNS (most common cause of death)

s/s: multiple bruises, bleeding, anemia

Question 7

Describe sickle cell disease, and its signs/symptoms

Answer 7

A group of hereditary diesases causing malformation of RBC’s, rendering them unable to carry O2 effectively. Usually appears in early childhood, and most common in regions where malaria is prevelant.

s/s: fatigue, dyspnea, pallor, tachycardia, chronic hyperbilirubinemia with GI/GU upset and jaundice, pain in joints and chest can be severe

Question 8

Describe lukemia, and its signs/symptoms

Answer 8

Lukemia is cancer of blood forming organs, particularly affecting WBC’s. It’s the most common childhood cancer.

s/s: fever, fatigue, anemia, weight loss, swollen lymph nodes, night sweats, bone pain or tenderness.

Question 9

Describe multiple myeloma and its signs/symptoms

Answer 9

B-cell cancer in bone marrow most common in males over 60, and carries a hereditary component.

s/s: bone pain, neuropathy, SOB, fatigue, infections, significant weight loss, fractures, hypercalcemia.

Question 10

Where do RBC’s mature?

Answer 10

In the liver

Question 11

What are the components of blood?

Answer 11

Plasma (water, salt, antibodies)
Proteins (mainly albumin)
Platelets (thrombocytes)
White blood cells
Erethrocytes (RBC's make up 40% of blood volume)

Question 12

What is the difference between intrinsic and extrinsic pathways of the coagulation cascade?

Answer 12

Intrinsic pathway involves factors found within blood.

Extrinsic pathway involves tissue factor in smooth muscle and Ca+

Question 13

Describe the common pathway of the coagulation cascade

Answer 13

1) Factor X (which requires vitamin K), works on prothrombin
2) Prothrombin with Ca+ converts to thrombin (aka Factor II)
3) Thrombin acts on fibrinogen
4) Fibrinogen with Ca+ converts to fibrin (aka Factor I) to form a clot

Question 14

Describe the plasminogen system

Answer 14

Thrombin also creates plasmin from plasminogin and anti-thrombin to prevent unregulated clotting and aid in fibrinolysis.