Hematology and fetal circulation Flashcards by Sophia Timm

What is hematocrit and what percentage of blood is this

Hematocrit are red blood cells (erythrocytes)
47% in males, 42% in females

How well did you know this?

Not at all

Perfectly

Describe reasons that a patient might present with high or low hematocrit

High: High iron, blood doping
Low: Anemia, blood loss

How well did you know this?

Not at all

Perfectly

What is 55% of the blood made of

Plasma- whole blood

How well did you know this?

Not at all

Perfectly

What is 1% of whole blood made of

buffy coat- leukocytes, platelets

How well did you know this?

Not at all

Perfectly

Which cells make all of the blood cells

HSC’s- hematopoietic stem cells

How well did you know this?

Not at all

Perfectly

What are the 2 pools of progenitor cells

Myeloid- RBC’s, megakaryocytes (make platelets), eosinophils, basophils, neutrophils, monocytes
Lymphoid- make lymphocytes

How well did you know this?

Not at all

Perfectly

What is the makeup (in percent) of RBC to WBC in the bone marrow

75% WBC (progenitor or maturing)
25% maturing RBCs (Progenitors or maturing)

How well did you know this?

Not at all

Perfectly

What is the makeup of RBCs vs WBCs in circulation

500x as many RBCs in circulation vs WBCs

How well did you know this?

Not at all

Perfectly

Where does extramedullary hematopoiesis occur

liver and spleen

How well did you know this?

Not at all

Perfectly

Where do we find bone marrow in bones in kids vs adults

kids- all through cavities of bones
adults- only ends of long bones and in flat bones

How well did you know this?

Not at all

Perfectly

What are platelets

fragments of megakaryocytes

How well did you know this?

Not at all

Perfectly

What cell is the most abundant in the blood

RBC’s

How well did you know this?

Not at all

Perfectly

What leukocyte is the most abundent in the blood

neutrophils

How well did you know this?

Not at all

Perfectly

How much of plasma is made of plasma proteins

How well did you know this?

Not at all

Perfectly

Life span of RBCs/erythryocyes

120 days

How well did you know this?

Not at all

Perfectly

How do RBCs make ATP

anaerobically

How well did you know this?

Not at all

Perfectly

Function of erythryocytes bi-concave shape

Allow for swelling, flexibility to push through capilaries, increased surface area

How well did you know this?

Not at all

Perfectly

structure of adult hemoglobin

2 alpha, 2 beta polypeptide chains (4 total)
an iron (heme) group on each chain (4 total)

How well did you know this?

Not at all

Perfectly

What is the test that measures the terminal valine on each beta chain of hemoglobin to measure the 1-2 month average glucose level?

Hemoglobin A1c

How well did you know this?

Not at all

Perfectly

What is the biggest factor to determine how much oxygen binds to hemoglobin

the amount of oxygen present that is creating the diffusion gradient

How well did you know this?

Not at all

Perfectly

What are the 2 factors that make it harder for oxygen to bind to hemoglobin

high levels of 2,3, BPG or Hydrogen ions
- These both compete w oxygen

How well did you know this?

Not at all

Perfectly

What is the significance of carbon monoxide and hemoglobin

Carbon monoxide competes with oxygen to bind on hemoglobin, and binds 200x stronger than oxygen(greater affinity)

How well did you know this?

Not at all

Perfectly

Structure of fetal hemoglobin

Hemoglobin F: 2 alpha chains, 2 gamma hemoglobin chans
Stronger affinity for oxygen than hemoglobin A

How well did you know this?

Not at all

Perfectly

Does hemoglobin A or hemoglobin F have a stronger affinity?

Hemoglobin F has a stronger affinity for oxygen

How well did you know this?

Not at all

Perfectly

What are RBCs produced in response to

Blood loss, high altitude, aerobic exercise training, low o2 levels

List the pathway for RBC production

Chemoreceptors in kidneys sense low 02 levels--> release EPO--> stimulate production

Where is iron stored after RBC distruction

Liver

What is the heme group used to make after RBC destruction

Bilirubin which is stored in the gallbladder for digestion use

What is jaundice pathologically

buildup of biliruben in the blood

What is the treatment for jaundice

phototherapy- convert biliruben to lumiruben to get rid of it from the blood

If you have stem cell damage, what is the resulting anemia

aplastic anemia

What anemia is common after chemotherapy

aplastic anemia

If you have the distruction of RBCs or loss from bleeding, what type of anemia is this

hemolytic anemia (can be an autoimmune disorder

What occurs when a glutamine is exchanged for a valine in terms of anemia?

sickle cell anemia- changes shape of hemoglobin

What occurs in hemoglobin with sickle cell anemia

hemoglobin clumps more, higher prevalence in black and hispanic people

If you have a lack of hemoglibin due to an inherited blood disorder, what is this

thalassemias

What is on the tail of an A antigen

N-acetylgalactososomine

What is on the tail of the B antigen

glactose

What is on the tail of the antigen on O blood

It does not have anything in addition to the H antigen (every type has H antigen, but nothing extra)

What antigen is Rh factor

Antigen D

What is universal recipient

AB+ (no antibodies)

What is universal donor

O- (no antigens)

What do endothelial cells release when they are injured

5-HT

What causes the vascular spasm?

Direct injury to smooth muscle, disrupted endothelial cells, local pain receptors stimulated

What activates platelets

When platelets contact collagen they activate (swell and become sticky)

What do platelets release when activated

ADP, Serotonin, Thromboxane A2

End goal of phase 1 of coagulation

Prothrombin activator (Xa) (10a)

End goal of phase 2 of coagulation

Thrombin

End goal of phase 3 of coagulation

Fibrin

End goal of stabilization of coagulation

13a

What are the 2 pathways in phase 1, and what do both lead to the formation of?

intrinsic and extrinsic (both lead to the formation of factor X, which forms Xa)

What occurs in phase 2 of coagulation

Factor Xa (prothrombin activator) converts prothrombin into thrombin

What occurs in phase 3 of coagulation

thrombin converts fibrinogin ( soluble) into fibrin (insoluble)

Which phase of coagulation requires Ca

stabilization

What is the clot buster, and what activates it?

Plasmin is clot buster (remove clot), activated form of plasminogen, activated by Tissue Plasminogin Activator (TPA)

Describe DIC

Uncontrolled clotting in all vessels, followed by bleeding due to the rest of the blood not being able to clot

What causes DIC

sepsis, incompatable blood transfusions, pregnancy

What does DIC lead to

multiple organ failure, death

Describe thrombocytopenia

low platelet count leads to bleeding in small vessels all over the body (petechiae) Platelet count under 50,000/ul blood

Treatment of thrombocytopenia

platelet infusion

Causes of imparied liver function related to blood disorders

Vitamin K deficiency (common in newborns) Hepatitis or cirrhosis --> reduction of bile to absorb vitamin K, reduction in plasma proteins

Hemophilias description and treatment

Hereditary bleeding disorder, missing one or more clotting factor Treated with clotting factor transfusion ( most are x-linked recessive)

Describe blood volume restoration when not in a hospital

Severe bleeding causes a low blood volume and in an emergency no time for blood typing or matching. Need to replace immediately, so use normal saline or electrolytes

Describe the uterine blood flow in pregnancy

No pregnancy- arteries connect to capillaries and veins, no shuts Preegnant- trophoblast invasion- bore holes in endometrium into maternal sinuses post-partum- return to non-pregnant state

Describe the fetal circulation of oxygenated blood

Placenta-->umbilical vein-->through the liver-->IVC-->R atrium-->Foramen ovale-->L atrium-->L ventrical-->Aorta-->Head

Describe the fetal circulation of deoxygenated blood

Upper body/head-->SVC-->R atrium-->R ventricle-->Pulm artery-->Ductaus arteriosus-->Aorta-->feet and umbilical arteries