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Pathophysiology > Hematology and Coagulation > Flashcards

Hematology and Coagulation Flashcards

1
Q

components of blood

A

plasma, RBCs, WBCs, platelets

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2
Q

what makes up liquid portion of blood

A

plasma (55% of blood overall)

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3
Q

what percentage of plasma is water

A

91

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4
Q

percentage of plasma is proteins

A

7 (57% of proteins are albumin, 30% are globulins for immune defense, rest is clotting factors)

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5
Q

2 clotting factors found in plasma

A

fibrinogen, prothrombin

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6
Q

where plasma proteins are made

A

most in liver except for Ig made by plasma cells in lymph tissue

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7
Q

percentage of blood that are cells

A

45%

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8
Q

percentage of cells in blood that are RBCs (erythrocytes)

A

99%

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9
Q

what do CBC differentials tells us

A

can breakdown percentages of blood components

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10
Q

what kind of cells make up leukocytes (WBCs)

A

neutrophils, lymphocytes, monocytes, eosinophils, basophils (Never Let My Engine Blow)

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11
Q

serum vs plasma

A

serum: liquid remains after blood clots (clotting factors not present)
plasma: liquids remains when clotting is prevented with anticoagulant

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12
Q

normal percentage ranges for types of WBCs

A

neutrophils –> 60-70%
lymphocytes –> 20-25%
monocytes –> 3-8%
eosinophils –> 2-4%
basophils –> 0.5-1%

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13
Q

where blood cells made in fetus

A

liver, spleen

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14
Q

2 pathways for blood cell differentiation

A

myeloid (RBCs, WBCs, platelets)
lymphoid (immune B and T cells)

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15
Q

types of lymphocytes

A

plasma cells and T cells

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16
Q

define GM-CSF

A

stimulating factor that triggers initial myeloid differentiation pathways

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17
Q

role of granulocyte progenitors

A

myeloid cells with granules in them (monocytes and neutrophils)

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18
Q

role of megakaryocyte

A

turns myeloid cells into platelets

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19
Q

role of erythropoietin (EPO)

A

turns pro-erythroblast into mature RBC in bone marrow

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20
Q

components of hemoglobin protein

A

4 heme rings (2 alpha, 2 beta) with an iron atom in each that carries oxygen

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21
Q

O2 capacity of RBC

A

1 heme ring = 1 O2 meaning 1 Hgb = 4 O2 molecules, 1 RBC has MILLIONS of Hgbs so MILLIONS of O2 molecules carried by 1 RBC

22
Q

nutrients needed for heme production

A

iron –> vitamin c and copper
heme ring –> B6 (pyridoxine), pantothenic acid
cells –> folate, B12, B2, protein

B3 (niacin) and Vitamin E needed

23
Q

meaning of PaO2

A

partial pressure of O2 in arterial blood, how well O2 can move from lungs to blood stream

24
Q

why can high affinity of O2 in Hgb be bad

A

less willing to release O2 to tissues

25
Q

how does alkalosis shift O2-Hgb dissociation curce

A

shifts to left meaning higher affinity

26
Q

definition of anemia

A

shortage of RBCs

27
Q

define normocytic normochronic

A

normal size and color, comes from low RBC production or high RBC consumption

28
Q

causes for low RBC production

A

bone marrow defects, bone marrow mass crowding, leukemia prevention production, chronic disease (leads to chronic inflammation which down regulates production)

29
Q

causes of high consumption of RBCs

A

hemorrhage, hemolysis, malignancy

30
Q

define microcytic hypochromic anemia

A

smalls cells and low color, not enough heme which results in defects in Hgb

31
Q

causes of microcytic hypochromic anemia

A

chronic blood loss, iron deficiency (most common form of anemia), Hgb defects

32
Q

define macrocytic normochromic anemia

A

big cells and normal color, heme is fine

33
Q

causes of macrocytic normochromic

A

folate and B12 deficiency

34
Q

normal Hgb range

A

men –> 13.5 - 17.5 g/dl
women –> 12.0 - 15.5 g/dl

35
Q

functions of platelets

A

regulate blood flow to damaged areas of vessels
form platelet plug to stop more bleeding
activate further aspects of clotting cascade
initiate repair processes including clot breakdown

36
Q

define fibrinolysis

A

clot breakdown

37
Q

importance of vitamin K

A

makes coagulation factors functional, Protein C and S (natural anti-coagulants) also dependent on Vitamin K

38
Q

relationship between factor 8 and vWF (von Willebrand Factor)

A

vWF circulates blood carrying factor 8 and the 2 combined promote platelet adhesion and aggregation

39
Q

deficiencies/defects in factor 8/vWF results in what common bleeding disorders

A

hemophilia A/von Willebrand Disease

40
Q

define “classic” hemophilia A

A

deficiency in factor 8

41
Q

define “christmas disease” hemophilia B

A

deficiency in factor 9

42
Q

explain clot breakdown

A

T-PA activates plasminogen to make it into plasmin, plasmin breaks down fibrin clot into fibrin degradation products

43
Q

define d-dimer

A

present in blood when mature clot as been formed and degraded

44
Q

define FDPs

A

fibrinogen degradation products found when plasmin degrades less mature clot (fibrinogen)

45
Q

anticoagulants on endothelium surface

A

prostaglandins –> inhibits platelet aggregation
nitric oxide –> inhibits platelet adhesion and aggregation

46
Q

anticoagulants from liver

A

proteins C & S –> inactivate some clotting factors

47
Q

anticoagulation meds that work on platelet level

A

aspirin –> inhibits platelet activation by inhibiting thromboxane
plavix –> binds to receptor on platelets inhibiting binding of fibrinogen and activation

48
Q

what does PTT and Anti-Xa testing look for

A

factors 8, 9, 11, 12; efficacy of heparin as anticoagulant, examines clot amplification and propagation (should be 25-35s)

49
Q

what does PT/INR test look for

A

factors 1, 2, 3, 5, 7, 10; efficacy of warfarin as anticoagulant, examines clot initiation (should be 10-13s)

50
Q

what is INR

A

normalized ratio of PT across lab (0.8 - 1.1)

51
Q

define leukemia

A

uncontrolled growth of malignant WBCs causing overcrowding of bone marrow and decreased production and function of normal hematopoietic cells

Pathophysiology (11 decks)

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