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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
What is iron in iron studies?
Serum iron bound to transferrin
26
What does low iron indicate?
Iron deficiency anemia, anemia of chronic disease
27
What does high iron indicate?
Hemolytic anemias, iron overload
28
What is transferrin?
Transporter protein for iron
29
What does low trasnferrin indicate?
Iron deficiency, liver disease
30
What is percent transferrin saturation?
% of transferrin bound by iron
31
What does low percent transferrin saturation indicate?
Iron deficiency anemia
32
What does high percent transferrin saturation indicate?
Hemachromatosis, iron overload
33
What is total iron binding capacity (TIBC)?
Indirect measurement of how much iron the patients transferrin CAN hold
34
What does low TIBC indicate?
Anemia of chronic disease, liver disease, renal disease
35
What does high TIBC indicate?
Iron deficiency anemia
36
What is ferritin?
Storage iron | Indicates amount in liver, spleen and bone marrow
37
What does low ferritin indicate?
Iron deficiency
38
What does high ferritin indicate?
Abberant reading during acute inflammation
39
What is the purpose of WBCs (leukocytes)?
Carry out immune system functions | Recognize self from non self
40
What is found on the WBC differential?
``` Neutrophils 50-70% Lymphocytes 25-35% Monocytes 2-6% Eosinophils 0-6% Basophils0-3% ```
41
What are found in granulocytes?
Neutrophils Eosiniphils Basophils
42
What is the purpose of neutrophils?
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
What does increased bands in circulation indicate?
A left shift and infection | Means increased mature cells being pushed out of the marrow.
44
What is the absolute neutrophil count?
``` 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
What are lymphocytes?
Effector cells of immune system, recognize invaders, tag them for removal and kill them. Make antibodies T cells- 80% B cells- 20%
46
What are T helper cells?
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
What are cytotoxic T cells?
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
What is the purpose of B lymphocytes?
- 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
What is the purpose of monocytes?
Serve to replenish tissues with macrophages prior to and during immune response
50
When monocytes are released into circulation and travel to tissues what do they mature into?
``` 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
What is the purpose of eosinophils?
- Responsible for immune processes against helminths and parasites - Also involved in allergic reactions - Contain granules of toxins, released after activation
52
What is the purpose of basophils?
Mediates inflammatory reactions - -Releases heparin, histamine, and cytokines - -Chemotactic for eosinophils - -Involved in allergic reactions
53
What is the purpose of platelets?
Facilitate blood coagulation by: Adhering to exposed endothelial tissue Aggregation with other platelets Secretion of platelet coagulants
54
What can low platelets indicate?
``` Bleeding Heparin Induced Thrombocytopenia (HIT) Infection Chemotherapy Radiation Marrow failure Alcohol abuse Autoimmune destruction Spelinic sequestration ```
55
What can high platelets indicate?
Myeloproliferative disease | Polycythemia
56
What are the antigens on the surface of RBCs?
A or B or neither (O) Rhesus factor (D antigen) Positive or Negative
57
What are the blood types?
A+, A-, B+, B-, AB+ (universal receiver), AB-, O+, O-
58
What are the antibodies to other blood types?
A has antibodies to B B has antibodies to A O has antibodies to A and B - has antibodies to +
59
What is the most important thing when looking at labs for a patient?
Most important to compare a change in patient’s own values, even within normal range
60
Do women or men tend to have lower RBC values and high platelet counts?
Women

Pharmacology III (19 decks)

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