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Pathology Exam 1 > Hematology Pathology > Flashcards

Hematology Pathology Flashcards

1
Q

Functions of Blood

A
  1. delivery and transport of substances for cell metabolism (o2, CO2, electrolytes)
  2. defense against microorganisms and injury (clotting and immune elements)
  3. maintain acid-base balance (7.4)
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2
Q

Component definition

A

55%- plasma (clotting factors, albumin/proteins, electrolytes)

45% cellular component- RBC, WBC, platelets (not real cell)

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3
Q

What is a CBC?

A

complete blood count

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4
Q

What is crow’s foot?

A

left- WBC

middle- hemoglobin and hemotacrit

right- platelets

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5
Q

Function of RBC?

A

carries hemoglobin, biconcave shape for ability to fold onself and move through small spaces

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6
Q

lifespan of RBC?

A

about 120 days, removed by spleen

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7
Q

RBC count

A

number of RBC in PCV( packed cell volume)

normal count- male- 4.7-6.1 million/ml
female- 4.2-5.4

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8
Q

Hematocrit

A

the percent of RBC given in a given volume of whole blood

normal values- male 37-49%
female 36-46%

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9
Q

What is MCV?

A

mean corpuscular volume, average volume of 1 RBC

reference range- 80-100 fl

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10
Q

Reticulocytes

A

slightly immature form of RBC, most likely result of bone marrow failure, BM pumping out RBC at higher rate than normal

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11
Q

Function of hemoglobin

A

transports O2 and CO2

Hgb and Hct rise or fall together, Hgb is 1/3 of HCT

normal values- male 14-18 g/dl
female 12-16g/dl

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12
Q

Effects of low hemoglobin?

A

pt feels tired, dizzy, low aerobic capacity or endurance

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13
Q

What is MCH?

A

mean corpuscular hemoglobin, amount of Hgb carried on 1 RBC

27-33 picograms/cell

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14
Q

What is MCHC?

A

mean corpuscular hemoglobin concentration

percentage of Hgb carried on 1 RBC

range 33-36 g/dl

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15
Q

What is ESR?

A

erythrocyte sedimentation rate, measure of how fast the RBC sink to bottom of a solution

non-specific test for inflammation and inflammatory response

male 0-17 mm/hr
female- 1-25 mm/hr

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16
Q

What is anemia?

A

reduction in the oxygen carrying capacity of the blood

decreased Hct and RBC

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17
Q

What are the three ways to describe anemia?

A
  1. etiology- decreased RBC production, maturation or destruction
  2. color- hypochromatic- less red
    normochromatic- normal
  3. size (most common way to describe)- microcytic, normacytic, macrocytic
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18
Q

Hemorrhagic Anemia

A

rapid loss of blood flow due to- surgery, trauma, rupture

normocytic and normochromatic
- decreased RBC/Hgb and MCV

symptoms- dizzy, hypotension, tachycardia, possible death

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19
Q

Aplastic Anemia

A

decreased RBC production due to bone marrow dysfunction or damage

normalcytic and normochromatic
- decreased RBC/Hgb and normal MCV

symptoms- easy bruising, bleeding and fatigue etc.

treatment- treat bone marrow dysfunction

20
Q

Hemolytic Anemia

A

normalcytic and normochromatic

RBC are being broken down too quickly

RBC can be destroyed intravascular by immune system, enzymes or oxidation

extravascular- removed by spleen or liver prematurely

can be inherited or acquired

symptoms- fatigue, weakness, ictaris (jaundice)

21
Q

Other causes of normalcytic anemia?

A

chronic blood loss (slow GI bleed)

renal failure- low EPO level, EPO stimulates bone marrow to make RBC

22
Q

Iron Deficient Anemia

A

microcytic, hypochromic anemia, most common in world

loss or lack of iron decreases amount available for RBC/ Hgb production

symptoms- pica (craving dirt for iron), fatigue etc.

23
Q

Thallasemenia

A

associated with ethnicity- greeks, italians, AA, ameican indians, Asian

decreased Hgb production, usually mild

24
Q

Vitamin B12 Anemia

A

decreased level of VB12 leads to production of larger RBC

classified as macrocytic and normachromatic
- increased MCV decreased RBC/Hgb

most commonly from poor absorption of B12 in gut, genetics, vegans

symptoms- anorexia, loss of proprioception/vibration, ataxia

25
Folic Acid Anemia
same as B12 with no neurological symptoms
26
Sickle Cell Anemia
abnormal form of Hgb produced cresent shaped cells unable to pass through smaller vessels leads to clogged vessels, hypoxia distally, pain, tissue organ damage
27
PT implications for anemia
generally a yellow flag, will affect aerobic capacity/endurance
28
Polycythemia
body is naturally producing more RBC, caused by normal reaction to hypoxia, abnormally elevated EPO, or abnormal stem cells PMH: high altitude living, smoking, cyanotic heart disease apparent polycythemia is caused by dehydration
29
Leukocytes
aka White blood cells defender against organism that cause infection phagocytosis- eat of pathogen normal level- 5000-10000 leukocytes "left shift of CBC"
30
Neutrophils
most numerous of WBC (55% of WBC) responsible for management of bacterial infection, chief phagocytes in early inflammation
31
Eosinophils
less common WBC 1-4% mainly for parasitic management increased in allergy/asthma
32
Agranulocytes
powerful phagocytes, three major groups 1. monocytes- initiators of the inflammatory repsonse 2. lymphocytes- large part of WBC 36%, major ones at Tcells and BCells 3. NK cells (natural killer cells)- attack cells infected by virus w/o prior exposure 5-10% WBC
33
Causes of low WBC production
Drugs, infection (overwhelming), bone marrow failure, nutritional deficiency
34
Leukopenia
decrease in total WBC count leads to neutropenia- decrease in bacterial infection fighting cells- less than 1000 neutrophils less than 500- pt cant control growth of own bacterial flora less than 200- essentially no inflammatory process
35
What things suppress bone marrow
Drugs- chemo, chloramphenicol, siezure meds infections- parovirus, EBV (mono), HIV, Hepatitis other- radiation, nutrition
36
Causes of neutrophilia
high neutrophil count - bacterial infection, inflammation, tissue necrosis
37
Causes of lymphocytosis
viral infections, pertussis, hep, TB
38
PT implications of WBC disorders
yellow flag for pts who are leukopenic try to avoid patients who neutrophil count is less than 1000 bc these patients are immunocompromised
39
Function of platelets
disc shaped fragments- not cell bc they have no nucleus or DNA responsible for clotting cascade, made in BM 1/3 to spleen, 2/3 to circulatory system
40
Values to know for Platelets
normal 150,000-400,000 life span 7-10 days less than 50,000 increased risk of bleeding with trauma less than 10-20000 increases risk of spontaneous bleeding
41
What is thrombocytopenia?
too few platelets usually immune mediated other causes:infection, drugs, alcohol, nutrition, BM
42
What is thrombocytosis?
too many platelets, value greater than 500,000 caused by chronic inflammation or infection, solid tumors, splenectomy (removal or natural ability to remove platelets) pts are at risk for increased clotting or DVT
43
Clotting Factor tests
1. Phrothrombin time (PT) how long does it take for blood to clot in normal solution RR: 12-15 seconds 2. Partial Prothromboplastin time (PTT)- another measure of how long blood clots RR: 30-40 sec 3. International Normalized Ration (INR)- test for pts on anticoagulants RR: 0.9-1.1
44
What is most common cause of platelet dysfunction?
acetacylic acid aka aspirin, irreversibly inhibits platelet pool for 10 days w/ single dose
45
Iatrongenic acquired
too much anticoagulant Warfarin or heparin
46
Indications for anti platelet therapy
TIA, CVA prevention angina, MI prevention peripehral vascular disease
47
PT Implications
be cautious with pts w/ DVT avoid pulmonary embolism platelet count less than 50000 enlarged spleen- painful to palpation and during trasnfers on anticoagulants

Pathology Exam 1 (7 decks)

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