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Pathophysiology II > Hematology > Flashcards

Hematology Flashcards

1
Q

what is the process of blood formation called?

A

hematopoiesis or hemopoiesis

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2
Q

what is the whole blood composed of?

A

plasma - amino acids, nutrients, proteins, nitrogenous wastes, electrolytes, gases.
formed elements - WBC, RBC, platelets

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3
Q

blood is specialized __ tissue derived from the __ layer

A

connective; mesodermal/mesenchymal

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4
Q

What are the major bones containing bones marrow generating blood cells?

A

flat bones of axial skeleton: skull, vertebrae, sternum, ribs, pelvic bones

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5
Q

red bone marrow fx to ___ and yellow bone marrow fx to ___

A

generate formed elements of blood; nourish and support red bone marrow

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6
Q

What is myelophthisis? This process is seen in disorders such as ___.

A

the degeneration of red bone marrow w. the substitution of yellow; blood/bone marrow cancers

refers to the displacement of hemopoietic bone-marrow tissue either by fibrosis, tumors

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7
Q

what is myeloid

A

active bone marrow

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8
Q

when pluripotent stem cells develop into WBC colonies, they differentiate into ___ and ___.

A

Myeloid progenitors; lymphoid progenitors

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9
Q

Myeloid stem cells mature into what specific type of WBC?

A

neutrophils, eosinophils, basophils, monocytes

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10
Q

Myeloid progenitors are responsible for which blood cell lines?

A

RBC, platelets, WBC

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11
Q

Lymphoid progenitors are responsible for which blood cell lines?

A

Lymphocytes: T cells, NK cells, B cells,

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12
Q

cancers of WBC are generally termed __ and are characterized as either __ or __

A

leukemia; myeloid/myelogenous/myelocytic; lymphoid/lymphoblastic/ lymphocytic

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13
Q

Which type of leukemia is most common in children? Young adults? Older adults?

A

ALL; AML; CLL

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14
Q

What type of leukemia is characterized by the translocation oh philly chromosome 9-22? It is prevalent in which age group?

A

CML; middle aged adults

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15
Q

Name the major endocrine hormones involved in hematopoiesis and their origins?

A

erythropoietin (KD), thromopoietin (LV), testosterone (testes, ovaries, adrenal glands)

EPO THROMBO TESTO

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16
Q

what is hematocrit and how is it measured?

A

the packed volume of formed elements (primarily RBC) per volume unit of whole blood; measured in percentage

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17
Q

why do males have higher hematocrit levels?

A

testosterone

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18
Q

what is the normal value range of Hct in males? Females?

A

M: 41-53%; F: 37-46%

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19
Q

what is the hemoglobin concentration per vol. of blood (Hb)?

A

measure of the total amt of the O2 carrying protein in the blood

Measure the weight of hemoglobin in the blood

generally reflects the number of RBC in the blood

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20
Q

what is Mean Corpuscular Volume (MCV)?

A

measure of the avg volume of RBCs

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21
Q

what is Mean Corpuscular Hemoglobin (MCH)?

A

measure of the avg volume of hemoglobin in a single RBC

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22
Q

what is Mean Corpuscular Hemoglobin Concentration (MCHC)?

A

measure of the concentration of hemoglobin in a given volume of packed RBCs

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23
Q

what is red cell distribution width (RDW)?

A

a calculation of the variation in the size of RBCs

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24
Q

what is the difference bet. plasma and serum?

A

serum is plasma that has clotting factors removed

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25
Q

name the immediate precursors for the following: erythrocytes, thrombocytes neutrophils

A

reticulocyte; megakaryocyte; band cell

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26
Q

what is leukocytosis? It is an excess of which type of WBC?

A

excess amount to WBCs (neutrophils) in the blood

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27
Q

List the types of excess WBCs

A

neutrophilia, eosinophilia, basophila, lymphocytosis, reticulocytosis, thombrocytosis, bandemia

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28
Q

define leukopenia

A

a reduction in the number of WBCs in the blood

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29
Q

define polycythemia

A

an increase in the number of RBC or decrease in the volume of plasma

Aka polycythemia rubra vera??

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30
Q

erythrocytosis and polycythemia

A

polycythemia refers to increase in formed blood and erythrocytosis is the increase in RBC specifically BUT they are used interchangeably

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31
Q

define anemia

A

a state of diminished count of erythrocytes/hemoglobin

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32
Q

anemia can result from one or more of the 3 basic mechanisms

A
  1. Blood loss,
  2. Deficient erythropoiesis (iron, flolate, copper, chronic illness),
  3. Excessive hemolysis (sickle cell anemia, thalassemia, malaria, auto immune, etc)

Lose, destroying, cant produce,

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33
Q

Describe iron xu anemia

A

microcytic and hypocrhomic: smaller cells size (so decrease in MCV), and poor Hb content (less red, pale cells) AND there is a variaton in size (anisocytosis) and shape (poikilocytosis)

34
Q

the major and most common microcytic anemia is due to ___. The major etiology is?

A

iron xu; chronic (insidious) blood loss

35
Q

describe folate xu anemia

A

lack of folate that leads to large RBC from deficient production of DNA and can lead to macrocytic/megaloblasitc anemia (increase in MCV)

36
Q

floated xu is more common than B12 xu due to the fact that ___

A

folate can not be stored in the body

37
Q

what are the major fx of blood?

A

deliver nutrients, hormones, other chemcical messengers; buffering and enabling metabolic reactions; clotting and prevention of excessive bleeding; elimination of waste; immune defense

38
Q

describe B12 (Cyanocobalamin) xu anemia

A

lack of B12 that leads to large RBC from deficient production of DNA and can lead to macrocytic/megaloblasitc anemia (increase in MCV)

39
Q

describe pernicious anemia

A

special type of B12 deficiency anemia due to deficient absorption of B12 caused by auto-immune injury of gastric mucous (atrophic gastritis) with the atrophy of parietal cells from the inability to produce INTRINSIC FACTOR COMPLEX (a carrier molecule for B12 absorption

40
Q

descripe aplastic anemia

A

Rare disease in which the bone marrow and stem cells are damaged causing pancytopenia (total deficiency of ALL blood cell lines). UNABLE to make blood due to disease of the bone marrow from damaged stem cells

Myelophthisis

41
Q

s/s of iron xu anemia

A

glossy tongue, koilonychia, pagophagia/pica,

42
Q

What tests for iron xu?

A

TIBC
Serum Iron Test
Transferrin and ferritin.

43
Q

TIBC and ferritin in iron xu anemia

A

increase in TIBC indicate iron xu anemia, it measures binding of iron to transferrin (moves iron) and ferritin decreases (stores iron)

44
Q

What are the major nutritional sources for the following: iron, B12, folate

A

iron - liver, shellfish, meat. B12 - liver, shellfish, fish. Folate - liver, legumes, greens

45
Q

What are the 5 Steps for Hemostasis?

A
  1. Brief vasospasm
  2. Temporary platelet plug formation (vWF Factor VIII)
  3. Coagulation cascade(Factor X)
  4. Clot Retraction
  5. Clot Dissolution
46
Q

in temporary platelet plug formation platelet adhesion requires what? Describe

A

von Williebrand Factor (vWF): it is a glycoprotein made in the BV (endothelium) and LV

47
Q

Intrinsic coagulation VS Extrinsic coagulation cascade.

Describe the common pathway

A

Intrinsic coagulation cascade- within an injured blood vessel VS. extrinsic coagulation cascade- trauma,(blood is exposed to injured tissue).

They both intercept at factor X in the common coagulation pathway (activation and production of thrombin)

48
Q

in hemostasis thrombin will activate the production of __ from __ produced by the __

A

Fibrin from Fibrinogen made from the Liver

49
Q

which blood cells are anuclear?

A

platelets and mature RBCs

50
Q

___ initiates the clotting process in the coagulation cascade

A

platelets

51
Q

What is bandemia? what does it suggest?

A

increase in immature neutrophils; initial stage of an acute bacterial infection

52
Q

reticulocytosis is an indication of ___ and ___. What can you suspect?

A

anemia or hypoxia; chronic bleeding, respiratory pathology, smoking, change of altitude, convalescence stage (recovery)

53
Q

define relative polycythemia

A

decrease in plasma volume (dehydration)

54
Q

define absolute polycythemia (primary and secondary)

A

primary- bone marrow malignancy secondary- renal cell carcinoma with excess erythropoietin (made by KD) or hypoxia

55
Q

normocytic and normochromic anemia suggest

A

normal size, normal color : anemia of chronic disease or acute blood loss

56
Q

deficiency of B12 leads to accumulation of what pro-inflammatory amino acid? elevated levels indicate?

A

homocysteine; increase risk for ischemic heart disease and vascular pathological events

57
Q

Vitamin B12 is important for healthy ___ and ___ systems.

A

nervous and cardiovascular

58
Q

Chronic B12 xu has a strong correlation with irreversible ____ deficits due to ____.

A

neurological deficits due to demyelination within the CNS

59
Q

hemolytic anemia can be caused by ___

A

infections, genetic disease

60
Q

define sickle cell anemia

A

a hereditary hemolytic (breaking down heme) which is caused by point mutation (single amino acid: Hemoglobin A)

Glutamic acid is substituted by valine leading to production of Hb S (sickle) instead of Hb A (normal)

autosomal-recessive inheritance (need 2 copies, 1 from mom and 1 from dad).

61
Q

hemoglobin S is prone to ___ under ____ conditions, which in turn leads to sickling of the RBC in ___.

A

crystallization;

Duress: hypoxia, acidosis, stress, dehydration;

peripheral circulation

62
Q

the major pathogenesis of sickle cell anemia is generalized ___ with ___and ____

A

hemolysis - breakdown
thrombosis - excess platelet plugging
ischemia - lack of blood flow (nutrients)

63
Q

list the clinical presentations of sickle cell anemia

A

severe jaundice, icterus, priapism (persistent erection lasting >4 hours), trophic ulcers, neuropathies

64
Q

hemophilia A and B are both ____ genetic disorders of clotting factors __ and __

A

X linked recessive disorders predominantly in males (comes from mom); factors VIII and IX

65
Q

what is more common hemophilia A or B

A

hemophilia A is the most common (deficiency of clotting factor VIII)

66
Q

What is the disease that was named after the 1st patient in 1952, Stephen Christmas, “Christmas Disease”

A

Hemophilia B (deficiency of clotting factor XI)

67
Q

vW disease and hemophilia clinical presentations are very similar, what are they?

How are they different?

What are the difference in hereditary disorders?

A

spontaneous or post-traumatic excessive bleeding, muscle hematoma formation, bleeding in joints (hemarthrosis)

vW disease is more relevant to heavy menses, spontaneous bleeding, thrombosis

vW disease has to do with heredity disorders that are mostly auto-somal (hemophilia A,B are hereditary X recessive disorders)

68
Q

what is the most common bleeding disease?

A

vW disease

69
Q

how are bleeding disorders diagnosed?

A

clinical presentations, prolonged bleeding times and genetic testing

70
Q

reed-sternberg cells are ___ and are a characteristic feature of ___

A

bi-nucleated immature B lymphocytes; Hodgkin’s lymphoma

71
Q

s/s of leukemias and lymphomas

A

painless lymphadenopathy, fatigue, bruising, nose bleeds, profuse sweating, tidal fever, stubborn infections

71
Q

difference between Hodgkins and Non-Hodgkins lymphoma

A

Hodgkins- cancer of lymphatic structure only

Non-Hodgkins- can have a simultaneous component of lymphocytic leukemia as well

72
Q

clinical presentations of multiple myeloma

A

initial onset- bone pain worse at night (dull, gnawing, but fixed), immunodeficiency- chronic infections abnormal in durations

74
Q

describe multiple myeloma

A

is a cancer of monoclonal plasma cells, a type of white blood cell normally responsible for producing antibodies.[1] In multiple myeloma, collections of abnormal plasma cells accumulate in the bone marrow, where they interfere with the production of normal blood cells. Most cases of multiple myeloma also feature the production of a paraprotein—an abnormal antibody which can cause kidney problems. Bone lesions and hypercalcemia (high blood calcium levels) are also often encountered.

75
Q

List the clotting factors that are vita K dependent.

Vita K deficiency can result from the following:

A

Clotting factors: II,VII,IX,X

Fat malabsorption, persistent diarrhea, dietary deficiency, abx use, and some anti-coagulant meds

76
Q

Liver disease may affect the production of clotting factors ___

A

2,5,7,9,10,11

77
Q

Prothrombin time (PT) measures ___

Partial thromboplastin time (PTT) measures ___

A

Extrinsic pathway - PT (play tennis OUTSIDE)

Intrinsic pathway - PTT (play table tennis INSIDE)

78
Q

Reticulocytosis is found is ___ bleeding

A

Chronic

79
Q

Reticulocytosis is found is ___ bleeding

A

Chronic

80
Q

Lymphocytosis is most common in ___ infection

A

Viral infection

81
Q

Bence John’s proteins

A

Multiple myeloma

Pathophysiology II (2 decks)

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