Hematology and Coagulation Flashcards
components of blood
plasma, RBCs, WBCs, platelets
what makes up liquid portion of blood
plasma (55% of blood overall)
what percentage of plasma is water
91
percentage of plasma is proteins
7 (57% of proteins are albumin, 30% are globulins for immune defense, rest is clotting factors)
2 clotting factors found in plasma
fibrinogen, prothrombin
where plasma proteins are made
most in liver except for Ig made by plasma cells in lymph tissue
percentage of blood that are cells
45%
percentage of cells in blood that are RBCs (erythrocytes)
99%
what do CBC differentials tells us
can breakdown percentages of blood components
what kind of cells make up leukocytes (WBCs)
neutrophils, lymphocytes, monocytes, eosinophils, basophils (Never Let My Engine Blow)
serum vs plasma
serum: liquid remains after blood clots (clotting factors not present)
plasma: liquids remains when clotting is prevented with anticoagulant
normal percentage ranges for types of WBCs
neutrophils –> 60-70%
lymphocytes –> 20-25%
monocytes –> 3-8%
eosinophils –> 2-4%
basophils –> 0.5-1%
where blood cells made in fetus
liver, spleen
2 pathways for blood cell differentiation
myeloid (RBCs, WBCs, platelets)
lymphoid (immune B and T cells)
types of lymphocytes
plasma cells and T cells
define GM-CSF
stimulating factor that triggers initial myeloid differentiation pathways
role of granulocyte progenitors
myeloid cells with granules in them (monocytes and neutrophils)
role of megakaryocyte
turns myeloid cells into platelets
role of erythropoietin (EPO)
turns pro-erythroblast into mature RBC in bone marrow
components of hemoglobin protein
4 heme rings (2 alpha, 2 beta) with an iron atom in each that carries oxygen
O2 capacity of RBC
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
nutrients needed for heme production
iron –> vitamin c and copper
heme ring –> B6 (pyridoxine), pantothenic acid
cells –> folate, B12, B2, protein
B3 (niacin) and Vitamin E needed
meaning of PaO2
partial pressure of O2 in arterial blood, how well O2 can move from lungs to blood stream
why can high affinity of O2 in Hgb be bad
less willing to release O2 to tissues
how does alkalosis shift O2-Hgb dissociation curce
shifts to left meaning higher affinity
definition of anemia
shortage of RBCs
define normocytic normochronic
normal size and color, comes from low RBC production or high RBC consumption
causes for low RBC production
bone marrow defects, bone marrow mass crowding, leukemia prevention production, chronic disease (leads to chronic inflammation which down regulates production)
causes of high consumption of RBCs
hemorrhage, hemolysis, malignancy
define microcytic hypochromic anemia
smalls cells and low color, not enough heme which results in defects in Hgb
causes of microcytic hypochromic anemia
chronic blood loss, iron deficiency (most common form of anemia), Hgb defects
define macrocytic normochromic anemia
big cells and normal color, heme is fine
causes of macrocytic normochromic
folate and B12 deficiency
normal Hgb range
men –> 13.5 - 17.5 g/dl
women –> 12.0 - 15.5 g/dl
functions of platelets
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
define fibrinolysis
clot breakdown
importance of vitamin K
makes coagulation factors functional, Protein C and S (natural anti-coagulants) also dependent on Vitamin K
relationship between factor 8 and vWF (von Willebrand Factor)
vWF circulates blood carrying factor 8 and the 2 combined promote platelet adhesion and aggregation
deficiencies/defects in factor 8/vWF results in what common bleeding disorders
hemophilia A/von Willebrand Disease
define “classic” hemophilia A
deficiency in factor 8
define “christmas disease” hemophilia B
deficiency in factor 9
explain clot breakdown
T-PA activates plasminogen to make it into plasmin, plasmin breaks down fibrin clot into fibrin degradation products
define d-dimer
present in blood when mature clot as been formed and degraded
define FDPs
fibrinogen degradation products found when plasmin degrades less mature clot (fibrinogen)
anticoagulants on endothelium surface
prostaglandins –> inhibits platelet aggregation
nitric oxide –> inhibits platelet adhesion and aggregation
anticoagulants from liver
proteins C & S –> inactivate some clotting factors
anticoagulation meds that work on platelet level
aspirin –> inhibits platelet activation by inhibiting thromboxane
plavix –> binds to receptor on platelets inhibiting binding of fibrinogen and activation
what does PTT and Anti-Xa testing look for
factors 8, 9, 11, 12; efficacy of heparin as anticoagulant, examines clot amplification and propagation (should be 25-35s)
what does PT/INR test look for
factors 1, 2, 3, 5, 7, 10; efficacy of warfarin as anticoagulant, examines clot initiation (should be 10-13s)
what is INR
normalized ratio of PT across lab (0.8 - 1.1)
define leukemia
uncontrolled growth of malignant WBCs causing overcrowding of bone marrow and decreased production and function of normal hematopoietic cells
