Heme And Immunity Flashcards
What is DIC?
Overactivation of coagulation factors
What is thrombotic thrombocytopenia purpura (TTP)?
Clotting and bleeding at the same time.
Blood disorder where the platelets abnormally clump together causing blood clots which will reduce # of platelets b/c they are being used to form clots.
What does it mean to have a hypersensitivity?
When the immune system is reacting in a way that damages the body instead of protecting it.
What antibodies are associated with type 2 hypersensitivities?
IgM and IgG
Which hypersensitivity has an environmental antigen IgE?
Type 1
What is a type 3 hypersensitivity?
When antigen-antibody complexes deposit in blood vessel walls leading to inflammation and tissue damage.
What is a type 4 hypersensitivity?
When inflammation and tissue damage is caused by T cells.
What are the 3 different types of anemia?
Blood loss, hemolytic, and deficient RBC production
What will labs look like in a patient with anemia?
decreased Hbg/Hct and RBC count.
What does microcytic and hypochromic RBC mean?
Cell is too small and too pale
What happens to the RBCs in sickle cell disease?
RBC’s sickle to a crescent shape when the hemoglobin is deoxygenated
What is the characteristic of the RBCs in iron deficiency anemia?
FAST
microcytic and hypochromic
F= iron deficiency
A= anemia of chronic disease
S= seroblastic anemia
T=thalassemia
What are megaloplastic anemias?
B12 and folic acid deficiency
What is B12 deficiency anemia called?
Pernicious anemia
What is the cell shape and color of cells in pernicious anemia?
Big Fat Pig
macrocytic and normochromic (big w/ normal color)
B= B-12 F= folate P= pernicious
What is aplastic anemia?
When there is a reduction in RBC, WBC, and platelets.
impaired bone marrow can cause what type of anemia?
Aplastic anemia
What is the normal lifespan of RBCs?
120 days
Why is erythropoietin important?
It is required to stimulate the bone marrow to create RBCs
What is (primary) polycythemia vera?
Increased in all 3 blood cells (RBC, WBC, platelets) caused by overproduction of the bone marrow d/t neoplastic disease.
What is a hematocrit level?
The % of total blood volume occupied by RBCs.
I.e : 45% of blood volume is made up of erythrocytes
Where is erythropoietin produced?
in the kidneys
What are the 3 types of polycythemia?
primary or polycythemia vera, secondary , and relative.
What is polycythemia?
Increased RBCs with a hematocrit level greater than 50% which increases blood viscosity.
What is secondary polycythemia?
Increase in erythropoietin as a compensatory response to hypoxia. Only RBC levels will be high and WBC and platelets will be normal.
What is relative polycythemia?
Only blood volume has been lost, but no cells. There is less of the water component of plasma, concentrating the RBCs.
Hypercoagulability can be caused by what 2 factors?
increased platelet function or clotting activity
How does endothelial damage increase risk for blood clots?
greater chance for platelets to adhere and aggregate on damaged walls releasing growth factors
*think atherosclerosis
What is thrombocytosis?
Increased platelet #
How does polycythemia increase the risk of blood clots?
high hematocrit increases blood viscosity
Where are clotting factors produced?
In the liver
Where are clotting/coagulation factors produced?
In the liver
What are the 4 causes of thrombocytopenia?
ITP, TTP, splenic sequestration, and dilution
What is a splenic sequestration?
When the spleen is enlarged, platelets will get trapped inside and the # of platelets in the serum will decrease.
How can ASA and NSAIDs cause a decrease in platelets?
they impair synthesis of thromboxane needed for platelet aggregation.
How do ASA and NSAIDs affect platelets differently?
ASA permanently alters the platelets and NSAIDs only affect platelets as long as the life cycle of the drug
Why is vitamin K important for coagulation factors?
it is required for activation of factors II, VII, IX, X, and prothrombin.
Which clotting factors is calcium required for?
All of them except the first 2
How can DIC lead to thrombocytopenia?
Too much clotting uses a lot of the platelets so there will be a reduced amount. This will cause excessive bleeding because there will be less clotting in other areas of the body where platelets can’t be found.
What labs confirm DIC?
↑ PT, PTT, and D dimer
What activates the intrinsic pathway of DIC?
Endothelial injury
What activates the extrinsic pathway of DIC?
Tissue injury
What does a high PTT mean?
The higher it is the slower it is for the blood to clot
What lab values will be abnormal if the extrinsic pathway is affected?
PT and INR
Does heparin affect the intrinsic or extrinsic pathway?
Intrinsic
Does coumadin/warfarin affect the intrinsic or extrinsic pathway?
Extrinsic
Hemophilia A has a deficiency in which coagulation factor?
Factor VIII
What is ITP?
When life cycle of platelets is shortened d/t an autoimmune disorder where the body produces anti-bodies that destroys it’s own platelets.
May seen easy bruising in patients
What causes infectious mononucleosis?
Epstein Barr virus infecting B lymphocytes
What are the s/sx of infectious mononucleosis?
Swollen lymph nodes, fever, malaise, and enlarged liver and spleen.
What causes the enlarged lymph nodes in infectious mononucleosis?
B cells mature in the lymph nodes so if they are infected they will cluster in the area
lymphocytic and myelogenous are acute or chronic leukemias?
both
Which cells does Acute lymphocytic leukemia (ALL) affect?
Natural killer, B, and T cells
Which cells does Acute myelogenous leukemia (AML) affect?
myeloid precursor cells in the bone marrow such as neutrophils, basophils, eosinophils, and monocytes
Which acute leukemia primarily occurs in children?
ALL
What is pancytopenia?
Reduction or absence of all three blood cell types
What are the 2 types of chronic leukemias?
CLL and CML
CLL affects which cells primarily?
B cells
Presence of Reed-Sternberg cells indicates what type of lymphoma?
Hodgkin’s
What is multiple myeloma?
proliferation of malignant plasma cells in the bone marrow and osteolytic bone lesions throughout the skeletal system
What are the manifestations of multiple myeloma?
pathologic fx, hypercalcemia, hyperviscosity of blood, osteolytic lesions, compression fx
A blood type has what kind of antibodies?
B antibodies
B blood type has what kind of antibodies?
A antibodies
AB blood type has what type of antibodies?
None
O blood type has what type of antibodies?
A and B
Can type A blood donate to type AB?
yes
Can AB blood donate to type B?
No
Who is the universal blood type donor?
Type O
Who is the universal blood type receiver?
AB
Does AML mostly occur in children or adults?
Older adults
Which cells are involved in CML?
Pluripotent hematopoietic progenitor cell such as bone marrow granulocytes, erythroid precursors, and megakaryocytes.
