Hematology

Question 1

What is hematology?

Answer 1

The study of blood and blood forming tissues, which includes the bone marrow, blood, spleen. and lymph system

Question 2

A basic knowledge of hematology is useful in clinical settings to evaluate these 4 things

Answer 2

the patients ability to transport O2 and CO2, maintain intravascular volume. coagulate blood, combat infections

Question 3

_____________ play a role in allergic responses/reactions and parasitic infections.

Answer 3

Eosinophils

Question 4

Which result in the complete blood count (CBC) reflects the protein found on the red blood cell that helps carry oxygen throughout the body

Answer 4

Hgb (Hemoglobin)

Question 5

Low Platelet count

Answer 5

Thrombocytopenia

Question 6

Low White Blood cell count

Answer 6

Leukopenia

Question 7

represents the average size of red blood cells on the CBC result.

Answer 7

MCV (Mean Corpuscular Volume)

Question 8

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?

Answer 8

MCHC (mean corpuscular hemoglobin concentration)

Question 9

Plasma is ______________ water

Answer 9

92%

Question 10

Blood is composed of _______________ & ____________

Answer 10

plasma; formed elements

Question 11

What does plasma consist of ?

Answer 11

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)

Question 12

All of the components of blood are essential to maintaining _______________-

Answer 12

homeostasis

Question 13

What is the first step in fibrin clot formation ?

Answer 13

The formation of a platelet plug

Question 14

we know when the neutrophils are high, we suspect an

Answer 14

acute infection

Question 15

Where are all the formed elements of the blood manufactured ?

Answer 15

The bone marrow

Question 16

When you have a suppressed bone marrow, you have

Answer 16

pancytopenia

Question 17

One erythrocyte carries how many hemoglobin molecules ?

Answer 17

300

Question 18

When you administer a patient PRBC, what is the underlying reason behind it ?

Answer 18

To restore the oxygen carrying capacity of the blood

Question 19

Spleen’s importance

Answer 19

very important for immunity
is a filter for blood
stores old components of RBC, platelets

Question 20

Liver’s importance

Answer 20

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

Question 21

Who is the first responder in clot formation ?

Answer 21

Platelets - activated by the extrinsic or intrinsic factor (from the endothelial lining itself, can be damaged by toxins. ischemia)

Question 22

ADP helps the platelet to

Answer 22

aggregate

Question 23

This medication blocks binding of ADP to PLT-ADP receptor site

Answer 23

Plavix

Question 24

What does Thromboxane do ?

Answer 24

induces aggregation

Question 25

this medication inhibits enzymes needed (by PLT) to make thromboxane

Answer 25

Aspirin

Question 26

Antiplatelet drugs act on the __________ system so the ___________never form

Answer 26

arterial; platelet plugs

Question 27

extrinsic means some source of trauma thats ___________-to the endothelial system

Answer 27

external

Question 28

This medication prevents the synthesis of the Vitamin K clotting dependent factors ...............

Answer 28

Coumadin (Warfarin)

Question 29

Vitamin K is the ____________ activator

Answer 29

prothrombin

Question 30

This medication disrupts the conversion of fibrinogen to fibrin so that that the fibrin clot can never form

Answer 30

Heparin

Question 31

This is the ratio of patients prothrombin time to the normal mean

Answer 31

INR International Normalized Ratio It helps to standarize the way we interpret the prothrombin time

Question 32

Both Heparin & Warfarin are interrupting the common clotting pathway in different places. TRUE OR FALSE

Answer 32

TRUE

Question 33

does heparin or warfarin have the longer half life

Answer 33

Warfarin does Heparin has short half life - once you turn the heparin drip off, normal clotting time will return within 30-60 minutes

Question 34

Immune system - we have _________ and __________ ways to protect us against invaders

Answer 34

specific; nonspecific

Question 35

The specific protection in our immune system involves these 2 types of cells

Answer 35

T cell & B cell

Question 36

What are the 5 types of B cells (immunoglobulins/antibodies)? Why does this matter clinically?

Answer 36

``` IgA IgD IgG IgE IgM ``` Hypersensitivity diseases - these B cell types have a role

Question 37

Both the B cell and the T cell have ____________ and take "notes."

Answer 37

memory

Question 38

Is the primary immune response or the secondary immune response more dramatic ?

Answer 38

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

Question 39

Ig___ are antibodies located on the surface of red blood cells

Answer 39

IgD

Question 40

most relevant antibody types to pay attention to

Answer 40

IgG IgE IgM

Question 41

which antibodies are mostly involved in the primary & secondary immune response ?

Answer 41

IgG IgM

Question 42

this is the antibody type involved in allergies

Answer 42

IgE

Question 43

a very severe allergic response to something that can be life endangering

Answer 43

anaphylaxis

Question 44

Different types of hypersensitivity reactions

Answer 44

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)

Question 45

Type ______hypersensitivity is associated with an extreme ___anaphylactic_____________ response

Answer 45

1

Question 46

these are WBC that releases histamine during an allergic reaction

Answer 46

Basophils & Mast cells with histamine comes an inflammatory response, change in capillary permeability and all the reactions we think of with inflammation

Question 47

swelling of the tissue just beneath the skins surface

Answer 47

angioedema

Question 48

Anaphylaxis manifestations

Answer 48

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

Question 49

Steroids are ___________ stabilizers, which are the ones that release ___________

Answer 49

mast cell; histamine

Question 50

__________ stimulates the bone marrow to increase erythrocyte production

Answer 50

Erythropoietin

Question 51

normal life span of a erythrocyte (RBC)

Answer 51

120 days

Question 52

What is erythropoiesis regulated by ?

Answer 52

Cellular 02 requirements and general metabolic activity

Question 53

Erythropoiesis is stimulated by ___________ and controlled by _____________

Answer 53

hypoxia; erythropoietin ( a glycoprotein growth factor synthesized and released primarily by the kidney- it stimulates the bone marrow to increase RBC production)

Question 54

Erythropoiesis is also influenced by the availability of ___________ such as

Answer 54

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

Question 55

this is the immature erythrocyte and assessing their number is a useful means of evaluating the rate and adequacy of erythrocyte production

Answer 55

Reticulocyte - can develop into mature RBCs within 48 hours of release into circulation

Question 56

the primary function of granulocytes (leukocytes containing granules within the cytoplasm)

Answer 56

phagocytosis granulocytes can migrate through vessel walls and to the sites where they are needed most

Question 57

_____ are the primary phagocytic cells involved in acute inflammatory responses

Answer 57

Neutrophils

Question 58

this is a mature neutrophil

Answer 58

segmented neutrophil mature because the nucleus is segmented into 2-5 lobes connected by strands

Question 59

this is a immature neutrophil

Answer 59

band (for the band appearance of the nucleus) the mature neutrophil is much more effective at phagocytosis

Question 60

an increase in __________ in the blood is a common diagnostic indicator of infection and tissue injury

Answer 60

neutrophils

Question 61

___________ 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

Answer 61

Mast

Question 62

____________ cells are lymphocytes that do not require prior exposure to antigens to kill virus infected cells and activate T cells and phagocytes

Answer 62

Natural Killer most lymphocytes transiently circulate in the blood and also reside in lymphoid tissues

Question 63

their primary function is to initiate the clotting process by producing an initial platelet plug at the site of injury

Answer 63

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

Question 64

platelet production is partly regulated by _____________ a growth factor that acts on the bone marrow to stimulate platelet production. Where is this produced ?

Answer 64

thrombopoietin It is produced in the liver, kidneys, smooth muscle and bone marrow

Question 65

About 2/3 of total body iron is bound to ______________ in erythrocytes and ______________ in muscle cells What is the other 1/3 stored as ?

Answer 65

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

Question 66

_____________, synthesized in the liver, serves as a carrier plasma protein for iron.

Answer 66

Transferrin

Question 67

The degree to which ____________ is saturated with iron is a reliable indicator of the iron supply for developing RBCs

Answer 67

Transferrin

Question 68

There is normally very little iron loss except from blood loss. TRUE OR FALSE

Answer 68

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.