Hematology Flashcards
Blood:
Blood is a unique organ because it is a ______.
Fluid
Blood:
Composed of plasma, various cells, proteins, ______ _____, electrolytes, nutrients, to include ___, and waste products.
Clotting factors;O2
Blood:
Formed by bone marrow in response to ____ ___ level.
low O2
Hematopoiesis:
Occurs in 5 days.
____ O2 level-> stimulates kidney to secrete _______, which increases erythroblast formation, which forms ___________ (immature RBCs)
Low; erythropoitin; reticulocytes
Hematopoiesis:
If rapid erythropoiesis is necessary may release ________ and nucleated _____. After maturity, cells live about ____ days
reticulocytes; RBCs; 120
RBC Function:
95% of cell mass is ________.
Have no nucleus.
Flexible and disk shaped to facilitate ________ and release of gases.
hemoglobin; absorption;
RBC function:
Transport gases through _______. Main function-transport of O2 between ______. Also aids in buffer system
diffusion; lungs
RBC needs:
_____ stores and metabolism.
Vitamin ____ and folic acid metabolism. Destruction.
Iron; B12
WBC:
Total amount = 5,000- 10,000
-60-70% are ________
-30-40% are _________
granulocytes; lymphocytes
WBC function:
Protect against bacterial invasion and other foreign entities. Name the 5 components of WBCs and their function.
- Neutrophils- Fast arrival for short lived phagocytosis
- monocytes- long term phagocytosis
- lymphocytes- produces substances that attack foreign material that kill directly or that enhance phagocytic cells (T). B cells differentiate into plasma cells which produce immunoglobulins
- Eosinophils- allergic reactions (neutralizes histamine) and phagocytosis of parasites
- basophils produce and store histamine which when released provokes an allergic reaction.
Other Components:
Platelets (thrombocytes)- granular Fragments.
Where are they produced?
In the marrow
Other components:
What are platelets regulated by?
the hormone thrombopoitin
Other components:
Platelets control bleeding, how exactly do they do this?
Collect and activate at the site of injury forming a plug. They release substances that activate coagulation factors.
Other components:
Platelets also nurture and maintaining the ______ of the vessels.
lining
Other components: Plasma and plasma proteins 90%=water rest=plasma proteins, \_\_\_\_\_\_ \_\_\_\_\_, nutrient enzymes, waste and \_\_\_\_\_\_\_. -serum -proteins- albumin, globulins
clotting factors; gases
Hemostasis Disorders:
What are the clinical manifestations?
- occasionally none
- Bleeding- mucosa/skin, hemorrhage frank/insidious, prolonged bleeding for venipuncture sites, with TTP, increased range of PCs due to clots in system
Hemostasis disorders:
What diagnostics are used?
Labs: Platelet count, peripheral smears, PT, PTT, RBC morphology, Bone marrow exams.
Acquired coagulation disorders:
Name 4 coagulation disorders.
- liver disease
- Vitamin K deficiency
- Complication of anticoagulant therapy
- Disseminated intravascular coagulation.
Hemostasis Disorders: Thrombocytopenia- platelets below 150,000
What is thrombocytopenia?
- decreased production of platelets within the bone marrow
- increased destruction of platelets
- increased consumption of platelets
Hemostasis Disorders: Etiology
Thrombocytopenia- platelets below 150,000
it can be inherited or acquired name the two acquired etiologies.
- immune- (ITP) Immune thrombocytopenia Purpura- Most common
- Non-immune- due to shortened circulation, turbulent blood flow, decreased production
Hemostasis Disorders: Immune Thrombocytopenia Purpura
Used to be called idiopathic thrombocytopenia. Normal function of platelets- ______ _____.
shortened life
Immune thrombocytopenia Purpura: acquired immune
platelets coated with _______.
platelets recognized by _____ as foreign material and destroyed by macrophages
______ cannot keep supply to demand.
antibodies; spleen; marrow
Thrombotic thrombocytopenia Purpura (TTP): Non-immune (shortened circulation)
What is TTP?
Absence of anti clotting plasma enzyme leads to enhanced agglutination of platelets form MICROclots that deposit in capillaries, decreasing # in system.
What is a medical emergency of TTP?
Clotting and bleeding at the same time
What is Heparin induced thrombocytopenia and thrombosis syndrome (HITTS)?
- Microclotting with reduction of circulating platelets
- immune-mediated response to heparin= antibodies= removal= decreased platelets and platelet/fibrin clots
- heparin neutralized
What contributes to Non-immune thrombocytopenia?
- damage from turbulent blood flow
- decreased production due to:
- drugs
- infections
- alcoholism/marrow suppression
- malignancies
- radiation
- invasive tumors
- fibrosis
Disseminated Intravascular Coagulation:
It begins with small clots in blood stream, blocking vessels. What is it stimulated by?
substances that enter blood-stream as part of a disease (infection), toxin, complication of child birth, dead fetus.
Disseminated Intravascular Coagulation:
It begins with small clots in blood stream, blocking vessels. What else contributes to this problem?
- hemorrhage
- severe injury
Disseminated Intravascular Coagulation (DIC):
It begins with small clots in blood stream, blocking vessels.
Increased clotting _______ platelets and clotting factors needed to ______ ______
depletes; control bleeding
What are DIC clinical manifestations for the following systems: Integumentary Respiratory Cardiovascular GI/GU Neuro M/S
Edit card
What labs would we look at for DIC?
- decreased platelets/clotting factors
- increased clotting time
- increased proteins from clot breakdown
What is the treatment for DIC?
- correct underlying cause
- heparin therapy to slow clotting
- transfuse platelets and clotting factors to replace those depleted.
Hemostasis disorders: treatment
Depends on the type. Name 6 treatments that can be done.
- address underlying cause usually D/C offending med
- temporary fix is steroids or IV immune globulin
- Drugs that suppress the immune system
- Transfusion of platelets
- Splenectomy
- With TTP often treated with plasma transfusions and plasmapheresis (plasma exchange)
