Hematology Flashcards
What is blood?
Liquid Connective tissue that consists of cells surrounded by extracellular matrix
What are the blood three general functions
Transportation, Regulation, and protection
What binds oxygen in the red blood cell
Hemoglobin which contains iron
What do the Hematological System carry throughout the body?
Nutrients from the gastrointestinal tract
Head and waste products
Hormones
Oxygen and Carbon Dioxide
What do the Hematological System cell regulate?
The pH of the body fluids
Heat absorbing and coolant properties
Blood osmotic pressure
How do the Hematological System protect the body
- Blood Clots protects aggressive loss of blood
- White blood cells protect against disease by phagocytosis and producing antibodies
- contain additional proteins called interferons and complements to help protect against disease
How much blood is in a average adult male and female
Male: 5-6 liters
Women: 4-5 liters
What are the two components of whole blood and the percentage
Blood Plasma: 55%
Formed Elements: 45%
What type of components make the formed elements of blood
99% Red blood cells
> 1% pale colorless WBC and platelets
What is Hematocrit
The percentage of RBC that occupies in the total blood volume
What is the normal range of HCT for males and females
Males: 42%-52%
Females: 37%-47%
Is made up of the WBCs and platelets which are <1% of total blood volume
Buffy Coat
What is in the blood plasma and the percentage of each
Water: 91.5%
Proteins: 7%
Solutes: 1.5%
Which protein is most plentiful plasma protein, which account 54% of all plasma protein?
Albumins
What organ is responsible for proteins to be synthesized?
Liver
What are the normal ranges for RBC in males and females?
- 3 million RBC/uL Men
4. 8 million RBC/ul Females
How long do RBC live?
120 days/4 months
Normal Range for WBC and how long do they live
5,000-10,000uL
Few hours to a few days
The function of a WBC
Combat pathogens and other foreign substances that enter the body
What are the granular leukocytes cells?
Neutrophils
Eosinophils
Basophils
What are the percentage of Neutrophils in WBC and their function?
50-70% most plentiful
Destroys bacteria with lysozymes, defensins and strong oxidants
What are the percentage of Eosinophils in WBC and their function?
1-5%
Destroys certain parasitic worms
What are the percentage of Basophils in WBC and their function?
- 0-1%
- Heparin, histamine, and serotonin that intensifies the inflammatory response in allergic reactions
What are Agranular Leukocytes in WBC?
Lymphocytes (T cells, B cells and Natural killer cells)
Monocytes
Platelets
What are the percentage of Lymphocytes in WBC and their function?
20-40% of all WBC (2nd most abundant)
Big responses to viruses (in general)
What are the percentage of Monocytes in WBC and their function?
1-6%
Phagocytic (transform into a fixed histiocyte or a wandering macrophage)
What are the normal ranges for Platelets and their function
150,000-400,00/uL
- Live for 5-9 days
- Form platelet plug during hemostasis, release chemicals that promote vascular spasm and blood clotting
The process by which the formed elements of blood develop is called?
Hemopoiesis or Hematopoiesis
The primary site of hemopoiesis?
Red bone marrow
Which cell has the capacity to develop into different cell types
Pluripotent Stem Cells
With stimulation by specific hormones these stem cells will further differentiate into 2 cell lines:
Myeloid and lymphoid
Cells that differentiate further into several specific types of cells which mature in the bone marrow and the types that fall under this classification
Myeloid stem cells
Red cells Platelets Eosinophils Mast Cells Basophils Neutrophils Monocytes
What cells begin development in the bone marrow but mature in the lymphatic tissues and what are the cells
Lymphoid cells
T Cells
B Cells
Natural Killer Cells
What are immature neutrophils. Before they are mature into the adult cell
Bands
What is usually considered a poor prognosis and >10% bands considered abnormal
A left shift
Associated with myelodysplastic disorders. Most immature cells of myeloid process associated with certain cancers
Blast cells
What is a sequence of responses that stops bleeding when blood vessels are injured and is a quick, localized to the region of damage, and carefully controlled
Hemostasis
The three mechanism can reduce loss of blood from vessels
Vascular Spasm
Platelet plug formation
Blood clotting (coagulation)
When blood vessel is damaged, the smooth muscle in its wall contracts immediately, a response called
Vascular Spasm
When platelets come into contact with parts of a damaged blood vessel, their characteristics changed drastically and they quickly come together to form (what) to help fill the gap in the injured blood vessel wall
Platelet plug formation
What is a straw-colored liquid plasma minus the clotting proteins
Serum
Clotting (coagulation) factors include
- Calcium ions (CA2+)
- Several enzymes that are made by liver cells and released into the blood
- Various molecules associated with platelets or released by damaged tissues
What are the three stages when clotting occurs
- Prothrombinase is formed
- Prothrombinase converts prothrombin (with the help of Vitamin K) into thrombin
- Thrombin converts soluble fibrinogen into insoluble fibrin
What can inhibit step 3 in the clotting stages?
Cigarette smoke
What is fibrinolysis
- When a blood clot is formed and inactive plasma called plasminogen is incorporated into the clot
- Blood and body tissues contain substances that activate plasminogen into plasmin. Once activated, plasmin begins digesting and dissolving fibrin threads thus removing the clot.
Clotting in an unbroken blood vessels is called
Thrombosis
A blood clot, bubble of air, fat from broken bones, or a piece of debris transported by the bloodstream is called
Embolus
Where do emboli form
Often in veins where blood flows is slower
The surface of RBC contain a genetically determined assortment of antigens composed of
glycolipids and glycoproteins
What are antigens that occur in characteristics combinations
Agglutinogens
What are the two major blood groups
ABO and Rh
What do plasma usually contain that react with the A or B antigens if the two are mixed
Antibodies or Agglutinins
What do plasma usually contain that react with the A or B antigens if the two are mixed
Antibodies or Agglutinins
Which method of blood transfusion has the advantages of simulating presence of red blood, plasma, and fresh platelets in the perfect 1-1-1 ratio.
Fresh Whole blood
What are the indications for Fresh Whole Blood
- Massive hemorrhage when more than 10 units are expected to be required
- Cardiac Surgery
Which transfusion Commonly used to raise hemoglobin. Each unit is about 300mL and of which 200mL consist of RBC. One unit will usually bring up the hemoglobin by about 1g/dL
Packed Red Blood Cells
What are the current guidelines when giving packed RBC
Hemoglobin falls below 7-8g/dL threshold for critically ill patients
What is the ratio for transfusion for Packed RBC
For every unit if packed RBCs given, you should give a unit of FFP and unit of platelets for a 1-1-1 ratio
What are the characteristics of Leukocyte poor blood transfusion
- Reduce incidence of leucoagglutination reactions, platelets alloimmunization, transfusion related acute lung injury and CMV exposure
What are some of the characteristics of Autologous Packed RBCs for blood transfusion
- Patients donate their blood if necessary for elective surgery
- Units can be refrigerated up to 35 days or longer depending on anticoagulant used
What are characteristics of Frozen RBC
- Allow units to be glycerolized and frozen for up to 10 years
- One ACP215 can deglycerolize one unit in 1 hour
- After deglycerolize, units can be ready for transfer or refrigerated for additional 14 days
What should happen before a transfusion to occur
The recipient and the donor’s blood need to be typed and cross matched to avoid hemolytic transfusion reaction
What happens if a mother of O negative blood (Rh negative) is impregnated with a second child having a Rh positive baby.
Provide rho-gram after deliver Rh positive offspring. (4 months before delivery)
Treatment for Leukoagglutinin reaction
- Acetaminophen 500-600mg PO
- Diphenhydramine 25mg PO or IV
- Hydrocortisone 1mg/kg IV
Treatment for Hypersensitivity Reactions
Provide these types of patients with washed or frozen RBC to avoid future severe reactions
These reactions are almost always due to exposure to allogeneic plasma proteins rather than to leukocytes
Hypersensitivity reactions
