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Pharmacology III > Hematology > Flashcards

Hematology Flashcards

1
Q

What is the blood responsible for?

A

Transport of nutrients and oxygen
Transport of wastes
Transport of cells responsible for immune system regulation
Transport of cells and factors responsible for coagulation and repair

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2
Q

What are the three types of cells in blood?

A

RBC
WBC
Platelets

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3
Q

What is plasma?

A

Liquid portion of blood, contains various enzymes and proteins (such as coag factors and immunoglobulins)

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4
Q

What is hematopoesis?

A

Formation/maturation of blood cells

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5
Q

What are the precursers in bone marrow?

A

Children:
All marrow (all cells are formed here)
Adults:
Marrow of vertebrae, ribs, sternum, clavicle, iliac crest, proximal epiphyses of long bones (are the only places that form marrow)

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6
Q

What is the function of erythrocytes-RBCs?

A

Most abundant cell in blood

Carries oxygen to tissues

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7
Q

What is erythropoesis?

A
  • Formation of reticulocytes stimulated by erythropoetin (EPO) and other factors
  • Reticulocytes released into circulation
  • Loses nucleus and becomes erythrocyte within days
  • 120 day lifespan- important when keeping track of how the meds are being used to create RBC
  • Destruction via lysis or phagocytosis by spleen
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8
Q

Where is erythropoetun produced?

A 
90% produced by kidneys
Reduced levels in renal failure
Mechanism of renal production
Detect hypoxia
Produce and release EPO into circulation
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9
Q

What are the actions of erythropoetin?

A

Stimulate stem cell differenation to RBC precursors
Increase rate of mitosis
Increase release of reticulocytes into circulation
Induce hemoglobin (Hgb) formation

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10
Q

What does hemoglobin do?

A 
Binds oxygen
Oxygen binds to iron atoms in HgB protein in RBC
Reduced affinity for oxygen with:
Reduced pH (acidity)
CO2
Increased temp
High elevation

Synthesis requires pyridoxine (Vit B6)
Made of 2 alpha and 2 beta chains
Each linked to heme group (polyphorin ring with iron chelated at center)

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11
Q

What does hemoglobin require for formation?

A

Vitamin B6 pyroxidine

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12
Q

What is hematocrit?

A

Defines % of blood volume occupied by RBC

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13
Q

What does low hematocrit indicate?

A

Anemia

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14
Q

What does high hematocrit indicate?

A

Polycythemia

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15
Q

What is found on the RBC indices?

A

Mean Corpuscular volume
Mean Corpuscular hemoglobin concentration
Red Cell Distribution Width

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16
Q

What is the mean corpuscular volume (MCV)?

A

Average volume of RBC

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17
Q

What does a low MCV indicate?

A

Microcytic anemia

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18
Q

What does a high MCV indicate?

A

Macrocytic anemia

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19
Q

What is the corpuscular hemoglobin concetration (MCHC)?

A

Volume of RBC occupied by Hgb (%)

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20
Q

What does a low MCHC indicate?

A

Microcytosis, reduced Hgb production

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21
Q

What does a high MCHC indicate?

A

Macrocytic anemia

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22
Q

What is red cell distribution width (RDW)?

A

Variability of RBC size

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23
Q

What does low or high RDW indicate?

A

Low or high: various anemias, liver disease

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24
Q

What is found on iron studies?

A 
Iron
Transferrin
Percent transferrin saturation
Total iron binding capacity (TIBC)
Ferritin
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25
Q

What is iron in iron studies?

A

Serum iron bound to transferrin

26
Q

What does low iron indicate?

A

Iron deficiency anemia, anemia of chronic disease

27
Q

What does high iron indicate?

A

Hemolytic anemias, iron overload

28
Q

What is transferrin?

A

Transporter protein for iron

29
Q

What does low trasnferrin indicate?

A

Iron deficiency, liver disease

30
Q

What is percent transferrin saturation?

A

% of transferrin bound by iron

31
Q

What does low percent transferrin saturation indicate?

A

Iron deficiency anemia

32
Q

What does high percent transferrin saturation indicate?

A

Hemachromatosis, iron overload

33
Q

What is total iron binding capacity (TIBC)?

A

Indirect measurement of how much iron the patients transferrin CAN hold

34
Q

What does low TIBC indicate?

A

Anemia of chronic disease, liver disease, renal disease

35
Q

What does high TIBC indicate?

A

Iron deficiency anemia

36
Q

What is ferritin?

A

Storage iron

Indicates amount in liver, spleen and bone marrow

37
Q

What does low ferritin indicate?

A

Iron deficiency

38
Q

What does high ferritin indicate?

A

Abberant reading during acute inflammation

39
Q

What is the purpose of WBCs (leukocytes)?

A

Carry out immune system functions

Recognize self from non self

40
Q

What is found on the WBC differential?

A 
Neutrophils 50-70%
Lymphocytes 25-35%
Monocytes 2-6%
Eosinophils 0-6%
Basophils0-3%
41
Q

What are found in granulocytes?

A

Neutrophils
Eosiniphils
Basophils

42
Q

What is the purpose of neutrophils?

A

Prevent microorganism invasion, kill invading organisms
Attracted to site of infection by chemotactic factors
Phagocytize microorganisms
Release toxic substances from granules within cell into vacuole containing organism

43
Q

What does increased bands in circulation indicate?

A

A left shift and infection

Means increased mature cells being pushed out of the marrow.

44
Q

What is the absolute neutrophil count?

A 
WBC # x (% segs+ %bands)
Lower = higher risk for infection
Neutropenia
Mild = ANC 1000-1500/mm3
Moderate= ANC 500-1000/mm3
Severe= ANC < 500/mm3
45
Q

What are lymphocytes?

A

Effector cells of immune system, recognize invaders, tag them for removal and kill them.
Make antibodies
T cells- 80%
B cells- 20%

46
Q

What are T helper cells?

A

2/3 T helper cells
Express CD4 as T cell receptor (TCR)
Binds to antigen on antigen presenting cells with major histocompatability complex (MHC) 2
Cascade of signal results in:
Proliferation of T cells, B cells, Natural killer (NK) cells
Production of chemotactic cytokines

47
Q

What are cytotoxic T cells?

A

1/3 are cytotoxic T cells
Express CD8 as TCR
Binds to antigen on antigen presenting cells with MHC 1
If recognizes antigen as non-self, inserts perforins into effector cell and inserts granzymes (proteases) to kill

48
Q

What is the purpose of B lymphocytes?

A
  • Bind soluble antigen, then display on MHC 2 receptors
  • If T helper cell sensitized to that antigen binds and recognizes it. T cell releases cytokines to signal B cell to proliferate and mature
  • B cells can mature into plasma cells, which secrete antibodies
  • Some B cells become “Memory” B cells, which persist in body and contribute to immunity
49
Q

What is the purpose of monocytes?

A

Serve to replenish tissues with macrophages prior to and during immune response

50
Q

When monocytes are released into circulation and travel to tissues what do they mature into?

A 
Macrophages
Liver- Kupffer cells
CNS- microglial cells
Skin- Langerhans cells
Bone- osteoclasts
Macrophages phagocytize foreign antigen and cells containing foreign antigen

Dendritic cells
Antigen presenting cells

51
Q

What is the purpose of eosinophils?

A
  • Responsible for immune processes against helminths and parasites
  • Also involved in allergic reactions
  • Contain granules of toxins, released after activation
52
Q

What is the purpose of basophils?

A

Mediates inflammatory reactions

  • -Releases heparin, histamine, and cytokines
  • -Chemotactic for eosinophils
  • -Involved in allergic reactions
53
Q

What is the purpose of platelets?

A

Facilitate blood coagulation by:
Adhering to exposed endothelial tissue
Aggregation with other platelets
Secretion of platelet coagulants

54
Q

What can low platelets indicate?

A 
Bleeding
Heparin Induced Thrombocytopenia (HIT)
Infection
Chemotherapy
Radiation
Marrow failure
Alcohol abuse
Autoimmune destruction
Spelinic sequestration
55
Q

What can high platelets indicate?

A

Myeloproliferative disease

Polycythemia

56
Q

What are the antigens on the surface of RBCs?

A

A or B or neither (O)
Rhesus factor (D antigen)
Positive or Negative

57
Q

What are the blood types?

A

A+, A-, B+, B-, AB+ (universal receiver), AB-, O+, O-

58
Q

What are the antibodies to other blood types?

A

A has antibodies to B
B has antibodies to A
O has antibodies to A and B
- has antibodies to +

59
Q

What is the most important thing when looking at labs for a patient?

A

Most important to compare a change in patient’s own values, even within normal range

60
Q

Do women or men tend to have lower RBC values and high platelet counts?

A

Women

Pharmacology III (19 decks)

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