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MVP-SBB > Hematology/Coagulation > Flashcards

Hematology/Coagulation Flashcards

1
Q

Antigen negative % frequencies for Rh (D+) antigens

A

C = 20
E = 68
c = 23
e = 3

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2
Q

Antigen negative % frequencies for Rh (D-) antigens

A

C = 97
E = 99
c = 2
e = <1

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3
Q

Antigen negative % frequencies for CAUCASIAN antigens

A

Fya 32
Fyb 20
Jka 24
Jkb 26
M 21
N 30
S 48
s 10

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4
Q

Antigen negative % frequencies for AFRICAN descent antigens

A

Fya 20** verify
Fyb 77
Jka 8
Jkb 52
M 26
N 25
S 68
s 6

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5
Q

3 components of hemoglobin molecule

A
  • Iron
  • Globin protein chains
  • Protoporphyrin
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6
Q

90% of tissue iron (Fe3+) is STORED in these 2 forms

A
  • Ferritin (serum, tissue)
  • Hemosiderin (marrow, other tissue sites)
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7
Q

Globin proteins that transports iron (in serum)

A

Transferrin

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8
Q

Hemoglobin components

A
  • 2 alpha + 2 beta (HgbA) or 2 gamma (Hgb F) globin protein chains
  • 4 heme groups w/protoporphyrin ring and ferrous iron
  • 4 oxygen molecules
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9
Q

Most common cause of hypochromic anemia (and microcytic)

A

Iron deficiency

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10
Q

Heme synthesis disorders present with these cells

A

Sideroblasts (sideroblastic anemia)

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11
Q

Disorders of Globin protein chain synthesis

A

A-thalassemia
B-thalassemia

Alpha or beta chain production disorder - causes excess of complimentary chain

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12
Q

Major integral protein of rbc membrane - 20%

A

Glycophorin

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13
Q

Most abundant peripheral protein of rbc membrane cytoskeleton

A

Spectrin (25-30%) of total membrane; 75% of peripheral protein

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14
Q

RBC membrane is permeable to 2 cations

A

Na+ and K+

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15
Q

25% of rbc membrane is comprised of this lipid

A

Cholesterol

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16
Q

What percentage of total body iron is bound to heme

A

66% (2/3)

Other (1/3) 33% stored in bone marrow

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17
Q

Normal adult hemoglobin contains these types and percentages of hemoglobin

A

Hgb A = 95-97%
Hgb A2 = 2-3%
Hgb F = 1-2%

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18
Q

O2 dissociation LEFT shift

A

Decreased O2 delivery to tissues

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19
Q

O2 dissociation RIGHT shift

A

Increased oxygen delivery to tissue

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20
Q

3 types of abnormal hemoglobin (unable to transport oxygen

A

Carboxyhemoglobin
Methemoglobin
Sulfhemoglobin

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21
Q

Senescence/removal of red cells by these 2 pathways and percentages

A
  • Extravascular - 90% (RES)
  • Intravascular - 5-10% (blood vessels)
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22
Q

Emblem- Meyerhof glycolytic pathway

A

Provides 90% of ATP needed for rbc survival

23
Q

Components of red cell cytoskeleton

A

-Spectrin. (GP-A)
-ankyrin (GP-C)
-protein 4.1
-actin (GP-B)
-adducin

24
Q

Cholesterol accumulation in rbc membrane (liver disease) results in this rbc morphology

A

Target cells

25
Q

Normal P50 value (Oxygen saturation)

A

26-30 mmHg

26
Q

Intravascular hemolysis process steps (5-10% red cell removal)

A

-rbc breakdown in blood vessel
-rbc rupture releases hemoglobin
- Haptoglobin binds free hemoglobin
-hTG/HGB carried to liver
- excess HGB is excreted in urine (hemoglobinuria) or found in plasma as unbound dimers (hemoglobinemia)

27
Q

Extravascular hemolysis process steps (90% red cell removal)

A

-RES (spleen) phagocytize red cells
-iron+transferrin back to bone marrow
-Globin returns to amino acid pool
-biliverdin+albumin back to liver as bilirubin
-bilirubin-glucorondide converted to urobilinogen, excreted to intestines with bile
-protoporphyrn ring disassembled, alpha carbon exhaled as CO (carbon monoxide)

28
Q

Tests used to measure hemolysis

A

Extravascular - direct/indirect bilirubin

Intravascular- haptoglobin (will see hemoglobinemia and hemiglobinuria when haptoglobin is exhausted)

29
Q

Causes of anemia (decreased rbc count, low h/h

A

-nutritional deficiencies
-blood loss
-increased rbc destruction
-decreased production of rbcs
-heredity/acquired defects

30
Q

Reference method for measuring hemoglobin

A

Cyanmethemoglobin

31
Q

Hematocrit (packed cell volume)

A

Determined by centrifugation

= MCV * rbc count

Normal: 47 (m); 42 (f) +/- 5%

32
Q

MCV - estimation of average rbc size

A

Hct *10 / rbc count

Normal: 80-100fL

33
Q

MCH - measuring hemoglobin content

A

Hgb *10 / rbc count

Normal: 27-31 pg

34
Q

MCHC - corpuscular hemoglobin concentration

A

Hgb *100 / HCt

Normal: 32-36%

35
Q

Indices:

MCV(fL)/MCHC(%)

  • Normocytic (80-100)
  • normochromic (32-36)
A

Bone marrow failure, hemolytic anemia, renal disease, leukemia, malignancy

36
Q

MCV(fL)/MCHC(%)

  • Macrocytic (>100)
  • normochromic (32-36)
A

Non/Megaloblastic macrocytic anemias (liver disease, myelodysplasias)

37
Q

Conditions associated with

MCV(fL)/MCHC(%)

  • MICROcytic (<80)
  • Hypochromic (<32)
A
  • Iron deficiency
  • sideroblastic anemia
  • thalassemia
  • lead poisoning
38
Q

RDW - red cell distribution width

A

Size variation in rbc population

Normal: 11.5 - 14.5%

39
Q

Complement:
2 forms of C3 convertase (C3b bound to pathogen surface=opsonization)

A
  • C4b2a (classical)
  • C3bBb (alternative)
40
Q

Anaphylatoxins:
C3a, C4a, C5a

Chemotoxins:
C3a, C5a
recruit phagocytes

A

-recruit phagocytes
-induce contraction of smooth muscle cells
-increase vascular permeability

41
Q

Function of T cells with CD 4

A

Activate B cells, T cells and macrophages

42
Q

Function of T cells with CD 8

A

Destroy foreign cells or body cells with foreign agents

43
Q

Vitamin K dependent clotting factors (Prothrombin group)

A

Factor 2, 7, 9, 10 protein C, protein S

44
Q

INR = patient PT / mean PT ^isi

A
45
Q

Coagulation proteins formed in this organ

A

Liver

46
Q

Common pathway - coagulation factors

A

Factor: 10, 5, 2, 1

47
Q

Extrinsic pathway factors

A

Factor: 7, tissue factor (3)

48
Q

Intrinsic pathway factors

A

Factor: 12, 11, 9, 8

49
Q

PT - time to clot via Extrinsic pathway

A

Normal: 11-14 sec

Factor 7, tissue favor + Common pathway (10, 5, 2, 1)

50
Q

aPTT - time to clot via INTRINSIC

A

Measures activation and contact: factors 12, 11; common pathway; 9, 8

51
Q

Platelet syndrome: adhesion defect, lack of IX-V, giant platelets

A

Bernard-Soulier syndrome

52
Q

Platelet function disorder: gingival bleeding, epitaxis, decreased adhesion and aggregation

A

Glanzmann’s thrombathemia

53
Q

Platelet impaired signaling with small platelets

A

Wiscott-Aldrich syndrome

MVP-SBB (6 decks)

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