Hematology Flashcards
What is hematology?
The study of blood and blood forming tissues, which includes the bone marrow, blood, spleen. and lymph system
A basic knowledge of hematology is useful in clinical settings to evaluate these 4 things
the patients ability to transport O2 and CO2, maintain intravascular volume. coagulate blood, combat infections
_____________ play a role in allergic responses/reactions and parasitic infections.
Eosinophils
Which result in the complete blood count (CBC) reflects the protein found on the red blood cell that helps carry oxygen throughout the body
Hgb (Hemoglobin)
Low Platelet count
Thrombocytopenia
Low White Blood cell count
Leukopenia
represents the average size of red blood cells on the CBC result.
MCV (Mean Corpuscular Volume)
You’re assessing the red blood cell indices on the complete blood count (CBC). What part of the indices represents the concentration of Hgb on the RBC?
MCHC (mean corpuscular hemoglobin concentration)
Plasma is ______________ water
92%
Blood is composed of _______________ & ____________
plasma; formed elements
What does plasma consist of ?
protein (albumin, globulin, fibrinogen)
water
other solutes (ions, nutrients, waste products (BUN, uric acid, lactic acid)
, gases (O2, CO2)
regulatory substances (hormones- cortisol, aldosterone, ADH, erythroepoetin)
All of the components of blood are essential to maintaining _______________-
homeostasis
What is the first step in fibrin clot formation ?
The formation of a platelet plug
we know when the neutrophils are high, we suspect an
acute infection
Where are all the formed elements of the blood manufactured ?
The bone marrow
When you have a suppressed bone marrow, you have
pancytopenia
One erythrocyte carries how many hemoglobin molecules ?
300
When you administer a patient PRBC, what is the underlying reason behind it ?
To restore the oxygen carrying capacity of the blood
Spleen’s importance
very important for immunity
is a filter for blood
stores old components of RBC, platelets
Liver’s importance
Prothrombin, Albumin, makes bile (w/o bile you are not able to absorb fats and fat soluble vitamin (ADEK)
without absorption of vitamin K, you get bleeding
Who is the first responder in clot formation ?
Platelets - activated by the extrinsic or intrinsic factor (from the endothelial lining itself, can be damaged by toxins. ischemia)
ADP helps the platelet to
aggregate
This medication blocks binding of ADP to PLT-ADP receptor site
Plavix
What does Thromboxane do ?
induces aggregation
this medication inhibits enzymes needed (by PLT) to make thromboxane
Aspirin
Antiplatelet drugs act on the __________ system so the ___________never form
arterial; platelet plugs
extrinsic means some source of trauma thats ___________-to the endothelial system
external
This medication prevents the synthesis of the Vitamin K clotting dependent factors ……………
Coumadin (Warfarin)
Vitamin K is the ____________ activator
prothrombin
This medication disrupts the conversion of fibrinogen to fibrin so that that the fibrin clot can never form
Heparin
This is the ratio of patients prothrombin time to the normal mean
INR
International Normalized Ratio
It helps to standarize the way we interpret the prothrombin time
Both Heparin & Warfarin are interrupting the common clotting pathway in different places. TRUE OR FALSE
TRUE
does heparin or warfarin have the longer half life
Warfarin does
Heparin has short half life - once you turn the heparin drip off, normal clotting time will return within 30-60 minutes
Immune system - we have _________ and __________ ways to protect us against invaders
specific; nonspecific
The specific protection in our immune system involves these 2 types of cells
T cell & B cell
What are the 5 types of B cells (immunoglobulins/antibodies)?
Why does this matter clinically?
IgA IgD IgG IgE IgM
Hypersensitivity diseases - these B cell types have a role
Both the B cell and the T cell have ____________ and take “notes.”
memory
Is the primary immune response or the secondary immune response more dramatic ?
The secondary immune response is more dramatic
- this is when the body amounts an immune response after being exposed to something it has already been exposed to. Clinically, this is when you would start seeing clinical manifestations of an allergic response
it is important to note when giving a drug whether this is the first time a patient has received it, and if so to pay especially special attention to the second time they receive it because that is likely when the clinical manifestations of an allergic response will occur
Ig___ are antibodies located on the surface of red blood cells
IgD
most relevant antibody types to pay attention to
IgG
IgE
IgM
which antibodies are mostly involved in the primary & secondary immune response ?
IgG
IgM
this is the antibody type involved in allergies
IgE
a very severe allergic response to something that can be life endangering
anaphylaxis
Different types of hypersensitivity reactions
Type 1 - mediated by IgE to allergens
Type 2 - mediated by IgG & IgM (called a cytotoxic response)
Type 3 - an antigen-antibody immune complex is formed
Type 4 - only one that is T cell mediated , it is a delayed response. (Latex allergies & contact dermatitis fall within this category of hypersensitivity response)
Type ______hypersensitivity is associated with an extreme ___anaphylactic_____________ response
1
these are WBC that releases histamine during an allergic reaction
Basophils & Mast cells
with histamine comes an inflammatory response, change in capillary permeability and all the reactions we think of with inflammation
swelling of the tissue just beneath the skins surface
angioedema
Anaphylaxis manifestations
angioedema (Dangerous b/c of airway closure potential)
Urticaria (rash on skin)
Widening of the blood vessels - patient could lost BP and go into shock
Steroids are ___________ stabilizers, which are the ones that release ___________
mast cell; histamine
__________ stimulates the bone marrow to increase erythrocyte production
Erythropoietin
normal life span of a erythrocyte (RBC)
120 days
What is erythropoiesis regulated by ?
Cellular 02 requirements and general metabolic activity
Erythropoiesis is stimulated by ___________ and controlled by _____________
hypoxia; erythropoietin ( a glycoprotein growth factor synthesized and released primarily by the kidney- it stimulates the bone marrow to increase RBC production)
Erythropoiesis is also influenced by the availability of ___________ such as
nutrients; protein, iron, folate (folic acid), cobalamin (vitamin B12), riboflavin (vitamin B2), pyridoxine (vitamin B6), pantothenic acid, niacin, ascorbic acid (vitamin C) and Vitamin E
ERythrocyte production is also affected by endocrine hormones, such as thyroxine, corticosteroids, and testosterone
this is the immature erythrocyte and assessing their number is a useful means of evaluating the rate and adequacy of erythrocyte production
Reticulocyte - can develop into mature RBCs within 48 hours of release into circulation
the primary function of granulocytes (leukocytes containing granules within the cytoplasm)
phagocytosis
granulocytes can migrate through vessel walls and to the sites where they are needed most
_____ are the primary phagocytic cells involved in acute inflammatory responses
Neutrophils
this is a mature neutrophil
segmented neutrophil
mature because the nucleus is segmented into 2-5 lobes connected by strands
this is a immature neutrophil
band (for the band appearance of the nucleus)
the mature neutrophil is much more effective at phagocytosis
an increase in __________ in the blood is a common diagnostic indicator of infection and tissue injury
neutrophils
___________ cells are similar to basophils, but they reside in connective tissues and play a central role in inflammation, permeability of blood vessels and smooth muscle contraction
Mast
____________ cells are lymphocytes that do not require prior exposure to antigens to kill virus infected cells and activate T cells and phagocytes
Natural Killer
most lymphocytes transiently circulate in the blood and also reside in lymphoid tissues
their primary function is to initiate the clotting process by producing an initial platelet plug at the site of injury
platelets
at the site of any capillary damage, platelet activation is initiated
increasing number of platelets accumulate to form an initial platelet plug that is stabilized with clotting factors
platelet production is partly regulated by _____________ a growth factor that acts on the bone marrow to stimulate platelet production. Where is this produced ?
thrombopoietin
It is produced in the liver, kidneys, smooth muscle and bone marrow
About 2/3 of total body iron is bound to ______________ in erythrocytes and ______________ in muscle cells
What is the other 1/3 stored as ?
hemoglobin; myoglobin
The other 1/3 is stored as ferritin and hemosiderin (degraded form of ferritin) in the bone marrow, spleen, liver & macrophages
When the stored iron is not replaced, hemoglobin production is reduced
_____________, synthesized in the liver, serves as a carrier plasma protein for iron.
Transferrin
The degree to which ____________ is saturated with iron is a reliable indicator of the iron supply for developing RBCs
Transferrin
There is normally very little iron loss except from blood loss. TRUE OR FALSE
TRUE
As part of normal iron metabolism, iron is recycled after macrophages in the liver and spleen phagocytize old & damaged RBCs. Iron binds to transferrin in the plasma or is stored as ferritin or hemosiderin. Only about 3% is lost daily in sweat, urine, bile and epithelial cells in the GI tract.
