Hematology Flashcards
hematopoiesis
-formation of blood
erythropoiesis
-formation of RBC
most blood matures in the _____
-bone marrow
Blood Components
- plasma
- cellular components
Plasma
- 55-60% of blood
- fluid component
Organic and inorganic componenets of arterial plasma include:
- water
- electrolytes
- proteins
- gases
- nutrients
- waste products
- hormones
Blood Proteins
- albumin
- gamma globulins/antibodies
- alpha/beta globulins
- fibrinogen
Albumin
- regulate passage of water and solutes through capillaries
- binding protein for all lipid-soluble blood constituents, hormones and drugs
Concentration of Albumin
- 4 g/dl
- reduced suggests hepatocellular injury
Gamma Globulins
- antibodies
- synthesized by lymphocytes
- defend against micro-organisms
Alpha/Beta Globulins
-transport Proteins
Fibrinogen
- promotes coagulation
- stops bleeding from blood vessels
Serum
-plasma with removed fibrinogen (clotting factor)
Composition of Plasma:
Water
92%
Composition of Plasma:
Protein
6-8%
Composition of Plasma:
Salts
0.8%
Composition of Plasma:
Lipids
0.6%
Composition of Plasma:
Glucose
0.1%
cellular components of blood
- thrombocytes (platelets)
- Erythrocytes (RBC)
- Leukocytes (WBC)–5 types
5 types of leukocytes
- neutrophils
- eosinophils
- basophils
- lymphocytes
- monocytes
Granulocytes
- neutrophils
- eosinophils
- basophils
Agranulocytes
- lymphocytes
- monocytes
RBC Function
-transport gas to and from tissue cells and lungs
Normal RBC Count
-4.4-5.3 million/mm3 of circulating blood
Hematocrit Levels
Male: 37-49%
Female: 36-46%
Hemoglobin Levels
Male: 14-18 gm/100ml
Female: 13-16 gm/100ml
WBC
-body’s defense mechanism
WBC Count
- 4,500-11,000/mm3 of circulating blood
- high=infection
- low=immunocompromised
Platelets
- thrombocytes
- irreg shaped cytoplasmic fragments that provide hemostasis after vascular injury
- normal coag and clot formation
Platelet Counts
-150,000-400,000 platelets/mm3 of circulating blood
Stem Cell System
- multipotential stem cells form in bone marrow
- some formed in blood, umbilical cord and placenta
Stem cells formed in the ____
-bone marrow
Stem cells migrate to ______to mature
-bone marrow or blood stream
During maturation blood cells differentiate into ______
- granulocytes, thrombocytes, erythrocytes
- and they proliferate
2 mechanisms for maturation
- proliferation (multiplication)
- differentiation (specialization)
Blood Granulocyte Levels
-4000-6000 cells/microliter
Prone to infection if blood granulocytes levels are below _____
-1000 cells/microliter
Erythropoietin
- (glycoprotein)
- hormone from kidney that stimulates uncommited stem cells to differentiate into proerythroblasts (precursor of RBC)
Oxyhemoglobin
- O2 carrying hemoglobin
- 4 sites full=saturated
Reduced hemoglobin
- hemoglobin without oxygen
- (deoxyhemoglobin)
as Hb relseases its O2 into tissue it also sheds small amounts of ____
- nitric oxide
- dilates the blood vessels to help O2 get into tissues
Each RBC can carry ____ Hb molecules
-300 molecules
Hb synthesis requires:
- formation of protoporphyrin
- availability of iron (heme)
- production of proteinaceous globulin
Leukocytes develop from____
-stem cells in bone marrow
granulocytes mature in ____
bone marrow
agranulocytes mature in _____
blood stream
Growth factors control _____
-cell growth and differentiation
Platelet formation
- involves endomitosis w/o cytoplasm division
- daughter cells break off in fragments
endomitosis
- mitosis of nucleus
- (doubling of DNA)
Platelets live ____ days
10 days
Normal Coagulation and Lysis depends on
-balance between thrombin and plasmin
Clinical exam
- physical appearance (color)
- level of energy
- blood tests
- bone marrow aspiration
- serologic studies for antibodies
- tests for vitamins
- schilling test (measure Vitamin B12)
Bone marrow componenets
- blood cells
- adipose tissue
blood tests give info about:
- absolute and relative # of blood cells
- shape of cells
- functional characteristics of blood cells
CBC
- complete blood count
- calc percentage of WBC , RBC, platelets, hematocrit, Hb
Low RBC indicate:
- leukemia
- bone marrow failure
- hemorrhage
High RBC indicate
- polycythemia vera
- pulmonary fibrosis
- cor pulmonale
- renal disease
Mean Corpuscle Volume
- size RBC
100: macrocytic
Blood Tests Related to RBC
- RBC count
- mean corpuscle volume
- mean corpuscular Hb concentration
- Hb determination
- hematocrit determination
- sedimentation rate (ESR)
- reticulocyte count
- Hb electrophoresis
- Sickle Cell test
- glucose-6phosphate dehydrogenase deficiency
Hematocrit tells you:
- fraction of blood occupied by RBC
- % RBC per dL
Blood Tests Related to Hb metabolism
- Serum ferritin determination
- total iron-binding capacity
- transferrin saturation
- direct antiglobulin test
- antibody screen
Ferritin
- iron in storage
- stored in liver
- some in muscles
Blood tests related to leukocytes
- neutrophil count
- lymphocyte count
- plasma cell count
- monocyte count
- eosinophil count
- basophil count
transferrin
-iron transport protein
Transferrin Saturation
-normal level is around 30
Blood Tests related to platelets/clotting factors
- platelet count
- bleeding time
- clot retraction time
- platelet adhesion studies
- platelet aggregation studies
- whole blood clotting time
- circulating anticoagulants
- PTT
- PT
- INR
- fibrinogen assay
- fibrin-fibrinogen degradation product
PTT Normal
30-40 sec
PT Normal
12-15 sec
INR Normal
0.9-1.1
Sodium Levels
-136-145
Potassium Levels
-3.5-5
Chloride Levels
100-106
CO2 Levels
26-28
Calcium Levels
8.5-10.5
Normal O2 Sat
> 90%
Common S/Sx of Circulatory Disorders
- edema/lymphedema
- congestion
- infarction
- thrombus
- embolus
- bleeding/bruising
- shock
- lymphadenopathy
- splenomegaly
Aging
- marrow size decreases
- dereased total serum iron
- decreased total binding capacity
- decreased intestinal iron absorption
- increase platelet adhesiveness
- increased red cell rigidity
- early activation of coag system
- decreased hemoglobin and hematocrit
- decreased # and function of lymphocytes
Universal donor
-O neg
Universal receiver
- AB+
Blood Transfusion Reactions
-