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PATH 375 > Hematolymphoid > Flashcards

Hematolymphoid Flashcards

1
Q

Lymphoid tissue

Location; role

A
  • Located in the lymphoid tissue and blood (lymphocytes)
  • Primary (BM & thymus) vs secondary (lymph node, spleen, MALT)
  • Role: Adaptive immunity
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2
Q

Myeloid tissue

Location; role

A

Location:
- Bone marrow (blood cell precursors)
- Blood (erythrocytes, platelets, granulocytes, monocytes)

Role: transport oxygen (RBCs), clotting (platelets), fight infection (WBCs)

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3
Q

Hematopoiesis

A

Different cell lines, each undergo differentiation into a committed cell type

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4
Q

Lymphopoeisis

Location and types of cells

A
  • B cells mature in BM
  • T cells mature in thymus
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5
Q

Hematopoiesis (Fetal, infant, adult)

A
  • Fetal: HSCs in yolk sac migrate to liver, BM, spleen, LNs and thymus
  • Infant: Extramedullary hematopoiesis stops
  • Adult: Hematopoiesis occurs in flat bones, ribs, vertebrae, and end of long bones (If BM destroyed, extramedullary hematopoiesis in spleen, liver and lymph nodes)
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6
Q

Components and composition of blood

Blood quantity; components; blood measurements

A

Quantity: 5L of blood

Components:
- Plasma (water, plasma proteins, solutes)
- RBCs

Measurements:
- Complete blood count (CBC): tests whether components are within normal range
- Hematocrit: ratio of packed RBC to total volume (~40-45%)

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7
Q

Serum

A

Plasma without coagulation proteins (blood clotting factors: fibrinogen, prothrombin, coagulation factors)

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8
Q

RBC morphology

Normal

A

Normal: biconcave disk (no nucleus) (abnormal: sickle cell, etc.)

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9
Q

Hemoglobin

Function; structure

A

Function: carries oxygen

Structure: Consists of 4 globin chains (each globulin chain has a heme containing Fe to carry oxygen; 4 polypeptide chains designatied alpha, beta, delta and gamma - normal adults mostly HbA)

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10
Q

RBC life cycle

A
  • Circulation for 120 days
  • Erythropoietin (growth factor) released by kidneys promotes erythropoiesis in BM and release
  • Spleen sequesters old RBCs (components reutilized or excreted)
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11
Q
A
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12
Q

Anemia

Definition; assessment; etiological classification

A

Definition: Reduction of total circulating red cell mass below normal limits
Assessment: Hemoglobin levels (Hb < 130 males; < 115 females)
Etiological classification: Increased loss, increased destruction, decreased production

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13
Q

Anemia

A

Morphological classification: RBC size (microcytic, normocytic, macrocytic) and hemoglobin content (hypochromic (pale), normochromic (normal))

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14
Q

Anemia
1) Iron deficiency
2) Massive blood loss
3) Vitamin B12 and/or folic acid deficiency
4) Sickle cell

A

1) Hypochromic microcytic
2) Normochromic normocytic
3) Macrocytic
4) Abnormal shape

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15
Q

Anemia Etiological Classification

Increased factors

A

Increased loss (bleeding): acute vs chronic

Increased destruction (hemolytic anemia):
Destruction of abnormal RBCs:
- Inherited: red cell membrane disorders, anzyme deficiencies, abnormal Hb)
- Acquired: PNH

Destruction of normal RBCs:
- Immune mediated
- Mechanical (repetitive trauma)
- Infections
- Chemical/toxic injury

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16
Q

Anemia Etiological Classification

Decreased factors

A

Decreased RBC production

Nutritional deficiences:
- Deficiency in Hb synthesis (iron deficiency anemia)
- Deficiency affecting DNA synthesis (vitamin B12 or folic acid deficiency)

Bone Marrow failue:
- Aplastic anemia
- Infiltration of BM by malignant cells
Inherited genetic defects:
- Thalassemoa syndromes

17
Q

Anemia signs and symptoms

Why; signs; symptoms

A

Due to decreased ability to carry oxygen

Signs: Pale skin, pale mucosa, brittle nails, tachycardia
Symptoms: fatigue, weakness, short of breatj, drowsiness, chest pain, unusual cravings

18
Q

Important:

Iron deficiency anemia

Where is it absorbed? incorporated? how is it stored? lost?

A
  • Iron is absorbed in SI and tansported to other sites bound to transferrin
  • Iron incorporated into hemoglobin in BM
  • Iron is stored as ferritin (aggregates form hemosiderin)
  • Iron lost primarily in cell loss
  • Aging RBCs destroyed in spleen and iron is reutilized
19
Q

Iron deficiency anemia causes, lab results, treatment

A

Causes: Decreased intake, decreased absorption, increased loss, increased requirements
Lab results: blood smear, hemoglobin and hematocrit low, serum iron and ferritin low
Treatement: determine/treat underlyinh cause, iron replacement

20
Q

Important

Aplastic anemia

What? Causes? Diagnosis?

A

Characterized by loss of multipotent stem cell, resulting in pancytopenia (decreased RBCs, WBC, and platelets)

Causes:
- Primary (idiopathic)
- Secondary (related to BM supression): chemical agents, radiation, viral infection, inhereted

Diagnosis:
- CBC: Pancytopenia
- BM biopsy: few forming blood cells

21
Q

Important

Megaloblastic anemia

Pathogenesis; diagnosis

A

Caused by deficiency of B12 vitamin or folic acid

Pathogenesis:
- Deficiencies delay normal maturation of RBCs
- RBC precursors do not mature (for megaloblasts)
- Megaloblasts destroyed in BM or spleen

Diagnosis:
- Peripheral blood smear: oval macrocytes, large segmented neutrophils
- BM biopsy: hypercellular with megaloblasts

22
Q

Megaloblastic anemia

Vitamin B12 general, absorption, deficiency

A

Vitmain B12:
- Essential nutrient
- Co-enzyme required for synthesis of DNA

Absorption:
- Dietary B12 achieved from food > binds to intrinsic factor from gastric parietal cells > B12-IF complex transferred to BM

Deficiency:
- Decreased intake
- Impaired absorption (Pernicious anemia)

23
Q

Megaloblastic anemia

Pernicious anemia pathogenesis; clinical manifestations

A

Pernicious anemia pathogenesis:
- Atrophic gastritis > results in decrease in gastric parietal cells > insufficient IF > B12 deficiency > megaloblastic anemia

Clinical manifestations:
- Spinal cord lesions > loss of vibration, relfexes

24
Q

Megaloblastic anemia

Folate deficiency

A

Folate deficiency:
- Results in megaloblastic anemia similar characteristics to B12 deficiency

Causes folate deficiency:
- Impaired absorption
- Decreased intake
- Increased requirement

25
Q

Thalassemias

A
  • Genetic defect in synthesis of normal Hb (no abnormal Hb produced or defect in quantity)
  • HbA has 4 chains: 2a, 2B (genes affected)
  • Thalassemoa classified on basis of type of chain affected (E.x. a thalassemia > defective a chain synthesis)
26
Q

Thalassemias

A

a thalassemia (4 genes code):
- Single gene deletion (asymptomatic)
- 2 gene deletion (a thalassemia trait > mild anemia)
- 3 gene deletion (Hemoglobin H disease > moderate to severe anemia)
- 4 gene deletion (Hydrops fetalis > most severe

PATH 375 (4 decks)

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