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Hematology Flashcards

1
Q

Ave no of RBCs per cubic mm

Ave of hemoglobin

A
  1. 2 Men
  2. 7 Women

15g per 100ml

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2
Q

Each gram of hemoglobin is capable of combining with approximatelt

A

1.34 mm of oxygen

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3
Q

Multiple proteins that promote growth

A

Growth inducers

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4
Q

Causes one type of stem cell to differentiate one or more steps toward the final type of adult cell

A

Differentiation inducers

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5
Q

Factors that affect inducer production in Rbc

A

Exposure of body to low level of oxygen in a prolonged period of time
Differentiation
Production of greatly increased erythrocytes

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6
Q

Principal factor that stimulates RBC production

A

EPO

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7
Q

90% of EPO formed in

A

kidneys and the rest liver

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8
Q

Cells that produce EPO

A

Fibroblast like interstitial cells surrounding tubules in renal cortex and outer medulla

Renal epithelial cell

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9
Q

Essential to synthesis of DNA
Lack of both result in maturarion failure

Deficiency -> megaloblast

A

Vitamin B12

Folic acid

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10
Q

Inability to absorb Vitamin B12 from GIT

Because of atrophic gastric mucosa

A

Pernicious anemia

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11
Q

Parietal cell secrete

A

Glycoprotein called IF binding tightly with B12 and protects vitamin from digestion by GI enzymes

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12
Q

Hemoglobin formation starts in

A

proerythroblast stage -> reticulocyte stage

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13
Q

Bind together loosely to form entire Hgb molecule

A

Four hgb molecules

Most important feature ability to bind loosely and reversibly oxygen

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14
Q

total average quantity of iron

A

4-5 grams

65% hgb
4-% myoglobin
1% various heme

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15
Q

Intestinal enterocyte iron absorption

A

1-2mg/day

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16
Q

Iron is stored i

A

Liver parenchyma as iron-ferritin complex

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17
Q

Secretion during infection or inflammation

A

Hepcidin

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18
Q

After significant hemorrhage

Replaces the plasma 1-3 days

3-4 weeks for RBCs to return to normal levels

A

Blood loss anemia

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19
Q

Non functioning bone marrow

Exposure to gamma radiation, toxic chemicals (insecticide, benzene), autoimmune disorders SLE

blood transfusion or bone marrow transplants

A

Aplastic anemia

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20
Q

Lack of B12, folic acid, intrinsic factor

Slow reproduction of erythrocytes in bone marrow

Large odd shaped cells megaloblast

A

Megalobastic anemia

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21
Q

fragile rbc that rupture as they pass capillary

Number is normal but life span is short

Sickle cell anemia by abnormal composition of globin chain of hemoglobin HgbS precipitating in long crystals

A

Hemolytic anemia

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22
Q

Number of RBCs in circulation inc due to hypoxia or genetic aberation

A

Polcythemia

Physiologic - living in high altitude, cardiac failure

Genetic aberration - HCT 60-70 JAK 2 mutation, increased viscosity of blood

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23
Q

Life span of lymphocyte

A

Months to years

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24
Q

Mobile units of protective system of the body
Formed in BM and lymph tissue and transported in the blood to areas of inflammation

Five types in the blood

A

Leukocytes

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25
Q

Protect body via process of phagocytosis

A

Granulocyte

Monocytep

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26
Q

Granulocyte and monocytes are products of

A

Myelocytic lineage

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27
Q

Lymphocytes are products of

A

lymphocytic lineage

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28
Q

Life span of granulocyte

A

4-5 h in circulating blood

4-5d in tissues

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29
Q

Monocyte life span

A

10-12 h before they enter tissues and become macrophages

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30
Q

Enter cells and become tissue mac via

A

Neutrophils
Macrophages

Amoeboid chemotaxis

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31
Q

Factors that inc chance of phagocytosis

A

Rough surface
No protective protein coat
Foreign particle

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32
Q

Phagocytosis is

A

highly selective

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33
Q

First line of defense against invasion

A

Macrophages

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34
Q

Second line of defense in inflamed tissue

A

Neutrophil

neutrophilia

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35
Q

Third wave of inflamed tissue

Third line of defense

A

Second macrophage invasion

Predominant leukocyte

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36
Q

Fourth line of defense

Greatly increased production of

A

Granulocytes and monocytes

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37
Q

Factors involved in feedback control of mac and neutrophil response

Formed by mac and T cells

A 
TNF
IL-1
GMCSF
GCSF
MCSF
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38
Q

Combination of necrotic tissue, dead neutrophils, dead mac and tissue fluid

A

Pus

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39
Q

Produced in large numbers in persons with parasitic infection

A

Eosinophils

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40
Q

Eosinophils release

A 
hydrolytic enzymes
ROS
larvicidal polypeptides called MBP
detoxify some of inflammation inducing substances released by mass cells and basophils and destroy
allergen-antibody complex
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41
Q

Circulating mast cells

IgE antibodies have propensity to become attached to mast and this cell

42
Q

Basophils and mast cells release

A

Histamine
Bradykinin
Serotonin

43
Q

Lymph node or lymphogenous tissue

A

Lymphogenous leukemia

44
Q

Produced by BM and many extramedullary organs

A

Myelogenous

45
Q

Leukemic cells are usually

A

nonfunctional

46
Q

Almost all leukemias spread to

A

Spleen, LN, liver and other regions that have rich blood supply

cause metabolic destruction

47
Q

Antibody-antigen complex activates the

A

Classical pathway

48
Q

Ability to resist organisms or toxins that damage tissues of the body

49
Q

Phagocytosis of bacteria
Destruction of pathogen by acidic secretion
Digestive enzyme of GIT
resistance of skin to invasion
Certain chemicals in blood that attach to foreign org or toxin

A

Innate immunity

50
Q

Ability to develop powerful protective mechanism against specific invading agent

A

Acquired immunity

51
Q

Development of circulating antibodies

A

Humoral

B cell immunity

52
Q

Formation of large numbers of activated lymphocytes specifically designed to destroy foreign agent

A

Cell mediated

T cell immunity

53
Q

Initiates development of immunity at least 8000 kilodaltons

54
Q

Smaller substances that attach to proteins

55
Q

Responsible for acquired immunity
LN, spleen, submucosal areas of GIT and bone marrow

T and B lymphocytes

A

Lymphocytes

56
Q

Where T lymphoctes are preprocessed

57
Q

Removal of thymus eliminates

A

Cell mediated immunity

58
Q

Subsequent exposure to same antigen causes more rapid response due to

A

Memory cell

59
Q

Antibodies are

A

Gamma globulin proteins called immunoglobulin

60
Q

Five general classes of antibodies

A 
IgM
IgA
IgG
IgD
IgE
61
Q

Most numerous

75%

62
Q

Antibodies act by directly attacking the invader

A

Agglutination
Precipitation
Neutralization
Lysis

63
Q

System of about 20 proteins normally present in the plasma that can be activated by antigen-antibody reaction

A

Complement

64
Q

Stimulate phagocytosis both by

A

Neutrophils

Mac

65
Q

Complement:

A

Phagocytosis by neutrophil and mac
Rupture of cell membrane of bacteria and other invading organism
Agglutination
Structure of viruses

66
Q

T helper cells secrete

A

IL 2,3,4,5,6

67
Q

Forms protein mediators called lymphokines

A

T helper cells

68
Q

Secrete hole forming proteins called perforins

A

Cytotoxic t cells by direct attack

69
Q

Regulates activity of other cells so excessive immune reactions do not occur

A

Supressor T cells

70
Q

Failure of tolerance mechanism

A

Autoimmune diseases

71
Q

Develop during processing of T lymphocytes in thymus and B lymphocytes in bone marrow

72
Q

Continuous exposure to self antigen in fetus is thought to cause self reacting t and b lymphocytes to become

73
Q

Caused by activated T cells

Skin eruption, edema or asthmatic attack

A

Allergy and hypersensitivity

74
Q

Caused by IgE antibodies called reagins

75
Q

How many HLA antigens are present over human cell

76
Q

Antigens

Cause blood transfusion reactions

A

Agglutinogen

77
Q

Gamma globulin of IgM and IgG

A

Agglutinins

78
Q

Entry into body of small numbers of group A and B antigens in food and through contact with bacteria

If blood samples are mismatched so that anti A or anti B plasma agglutinins are mixed with RBCs containing A or B agglutinogens -> RBCs agglutinate into clumps

Most lethal effects of transfusion

A

Renal failure

79
Q

Spontaneous occurence of agglutinin almost never happens

Individual must first be expsosed to an Rh antigen usually through transfusion of blood or pregnancy

anti-Rh agglutinin develop and reach maximum concentration within about 2-4 months

A

Rh blood types

80
Q

Progressive agglutination and subsequent phagocytosis of RBCs

A

Erythroblastosis fetalis

81
Q

Transplantation of tissue or whole organ from one part of the body to another

A

Autograft

All cells in transplanted organ contain virtually same antigen

Survive indefinitelt if provided with an adequate blood supply

Identical twin

82
Q

Transplantation of one organ from one identical twin to another

83
Q

One human being to another

Immune reaction almost always occur

Graft die within 1-5 weeks after transplantation unless specific therapy is given to prevent the immune reaction

84
Q

Transplantation of organ from one species to a different species

A

Xenograft

Tx: cyclosphorine, tacrolimus

85
Q

Most impt antigens in graft rejection

More than 150 types of HLA but only 6 are present on cell surface of any one person

Impossible for two individuals with exception of identical twins to have the same six HLA

present on WBC and cells of tissue

A

HLA antigen complex of antigen

86
Q

Prevention of graft rejection

A

Glucocorticoid hormone IL-2
Azathioprine toxic to lymphoid block formation of t cell
Cyclosporine and tacrolimus inhibit formation of T helper and blocks t cell mediated reaction
Immunosupressive antibody therapy anti IL2 receptor antibodies

87
Q

Clotting factor part of extrinsic pathway

88
Q

Precention of blood loss

A

Hemostasis

89
Q

Hemostasis steps

A

Vascular spasm -constriction TXA2
Formation of platelet plug -release ADP and TXA2
Formation of blood clot - 15-20 seconds (severe) and within 1-2 minutes (minor)
Within 3-6 mins: entire opening or broken end of vessel filled with clot
After 20 mins to 1 hourclot retracts
Growth of fibrous or scar tissue

90
Q

Extrinsic pathway

A

Trauma to vascular or extravascular tissue
Release of tissue thromboplastin, phospholipid, lipoprotein complex
Reacts with Factor 7
Activates factor 10 in presence of calcium ions
Common pathway via factor 10

91
Q

Intrinsic pathway

A

After trauma to blood vessel or exposure of blood vessel to collagen
Factor 12 or Hageman factor forms activated factor 12
Then releases phospholipids and platelet factor 3
Activates factor 12 acts on factor 11
Activated factor 11 acts on factor 9
Activated factor 9 works with factor 8, PF3, ca and phospholipid ions activating common pathway

92
Q

Most important factors for prevention of clotting in normal vascular system

A

Smoothness of endothelium
Layer of glycocalyx on endothelium
Thrombomodulin binding thrombin

93
Q

Most important anticoagulants in blood

A

Fibrin thread

Alpha globulin: antithrombin III

94
Q

Removes thrombin from circulation

95
Q

Conditions that cause excessive bleeding in humans

A

Vitamin K deficiency 1972 2-prothrombin, protein C
Hemophilia
Thrombocytopenia

96
Q

Roughened endothelial surface or sluggish blood flow

A

Thromboembolic conditions

97
Q

Virchow’s triad

A

Venous stasis
Activation of blood coagulation
Vein damage

98
Q

Extracted from several animal tissues

Therapeutic dose: 0.5 to 1 mg/kg

Inc clotting time from 6 mins to 30 mins or longer

Antidote

A

Heparin

Protamine sulfate

99
Q

Heparin inc effetiveness of

A

Antithrombin III

100
Q

Competes with Vitamin K for active site

A

Coumarin/warfarin

Physiology (23 decks)

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