Heme/Onc basics Flashcards
1
Q
RBCs
- nuclei +/-
- shape
- filled with what
- life span
A
no nuclei
biconcave– filled with hemoglobin
life span=120 days
2
Q
Neutrophils
- Nucleus +/-
- contain?
- function
- life span
A
- 3-5 nuclear lobes
- cytoplasm with pale, lilac colored granules
- phagocytes
- provide protection from acute infections
- life span 5 hours-few days
3
Q
Basophils
- nucleus +/-
- role
A
lack nuclear segmentation–dots everywhere
role=similar to eosinophils
- phagocytic
- help fight acute infections
4
Q
eosinophils
- nucleus +/-
- role?
A
two nuclear lobes
roles
-chronic immune responses–>helminth worm infections, asthma and allergies
5
Q
Monocytes
- nucleus +/-
- roles
- life span
A
kidney shaped nucleus in light blue cytoplasm
- highly phagocytic
- life span is long
- keep “watch” detecting danger signals produced by infection or tissue injury
6
Q
Lymphocytes
- key role in?
- structure
- types
A
key role in adaptive immunity
- condensed nuclei and scant cytoplasm
- B cells
- t cells
- NK cells
7
Q
where are B cells made
where are T cells made
A
B cells–>bone marrow
T cells–>thymus (transformed in thymus)
8
Q
A
eosinophil
9
Q
A
monocyte
10
Q
A
lymphocyte
11
Q
A
neutrophil
12
Q
A
basophil
13
Q
bone marrow produces how much:
- rbc
- platlets
- neutrophils
A
RBC= 200 billion
platelets=100 billion
neutrophils=60 billion
14
Q
define hematopoiesis
A
production of RBCs and platelets in the bone marrow
15
Q
cytopenia
A
too few blood cells
16
Q
cytoses
A
too many blood cells
17
Q
what maintains hematopoeisis
A
hematopoietic stem cells (HSCs)
18
Q
what is technically transplanted
A
hematopoietic stem cells
19
Q
define hemostasis
A
stopping of blood flow
20
Q
clot formation starts with
A
platelet plug at the site of vessel injury–> PRIMARY PLAT PLUG
21
Q
steps in hemostasis
A
- primary platelet plug
- once platelets adhere to vessel wall—triggers platelet activation–>changes plat shape from circle to a spiky sea urching shape–>incrs surface area of platelet + changes platelet membrane glycoproteins—->allows it to bind to fibrinogne
- plat activation results in release of arachidonic acid–>converted to thromboxane A2 (protent inducer of platelets via series of enzymes Cyclooxygenase)
22
Q
what happens after platelets are activated during hemostasis
A
- shape changes from circle–>spiky sea urchin
- surface area incrs with shape change
- shape change also changes plats membrane glycoproteins–lets them bind to fibrinogen
- arachidonic acid released–>converted to Thromboxane A2–>inducer of platelets via series of enzymes including Cyclooxygenase
23
Q
cyclooxygenase
- what is it
- what activates it
A
enzyme that activates platelets
**thromboxane A2 activates platelets thru this enzyme
24
Q
ASA contains what
A
cyclooxygenase inhibitors
-why ASA is used to suppress platelet activation
25
coagulation cascade
| -three pathways and their factors invovled + lab work to test for the pathway
1. INTRINSIC PATHWAY
TEST=aPartial Thromboplastin Time (aPTT)
*FACTORS: XII, XI, IX, VIII, X
12, 11, 9, 8, 10
2. EXTRINSIC
TEST= prothrombin time (PT)
FACTORS: VII, X
7 and 10
3. COMMON PATHWAY
X from extrinsic and intrinsic
X--> Xa-->prothrombin (II) + thrombin-->Fibrinogen (I)--> FIBRIN CLOT
26
Lab assessments of the coagulation cascade
| -what are the initial tests of blood coagulation cascade
INITIAL TESTS
* Plat count
* prothrombin time (PT)
* partial thromboplastin Time (PTT) aka aPTT
27
Platelet Count
- normal?
- below normal means? s/s?
>100,000 per microliter
BELOW= takes LONGER time to clot
s/s: purpura + mucosal bleeding
28
Prothrombin Time (PT)
- normal?
- this is testing what?
- abnormal time?
* testing of the extrinsic pathway
* Normal 10-13 seconds--- time it takes for blood to clot
* LONGER=deficiency in one or more of the clotting factors in extrinsic pathway-->aka FACTORS VII******, X,
29
INR
- stands for
- dervied from?
international normalized ratio
- derived from PT
- same as PT--- but it is "standardized" by taking into account the potency of the tissue factor-----whifh is what is added to the plasma to perform the PT used
30
aPTT
- stands for
- normal?
- what is added
- which pathway
Activated PARTIAL thromboplastin TIME
* normal (time takes for blood to clot) is 25-35 secs
* Kaolin is added to plasma-->activates factor XII-->starts INTRINSIC cascade (factors XII, XI, IX, VIII, X, prothrombin and fibrinogen)
31
Thrombin TIme
- when is this done
- tests?
* extra test--- only done if there is a coagulation problem
| * THROMBIN TIME (TT)-->tests functionality of fibrinogen and presence of thrombin inhibitors (heparin, etc)
32
patients with inherited bleeding disorders usually have ____ deficiencies present
only a single
33
patients with an acquired bleeding problem, they will have _____ deficiencies
multiple
| ***acquired problems like vit K deficiency or liver dz
34
list the common anticoag drugs
1. VIT K ANTAGONISTS--warfarin
2. HEPARIN
3. LOW MOLECULAR WEIGHT HEPARIN
35
vitamin K anatagonist
- what do they do
- MC ? route?
- what is monitored when pt on this
**block or slow down clotting by affecting VII, IX and X and prothrombin-->bc they all need vit K for carboxylation
MC=warfarin--PO
-pt must be monitored closely--PT/INR testing-->make sure anti-coagulation is within therapeutic range
36
Heparin
- moa
- route
activates anithrombin
- inhibits several steps in cascade
- IV***
37
low molecular weight heparin
- route
- moa
sc
| *doesnt require intensive monitoring---but also doesnt work as fast
38
direct inhibitor drugs
- what are they
- general moa
new oral anticoags that directly inhibit activated coagulation factors------ INDIRECTLY affects many parts of the coag cascade
39
# define sequestration
- where is it done
| - can cause?
* spleen
* spleen takes 1/3 of body's platelets to store them
* pt with splenomegaly have higher proportion of their platelets entrapped along with RBCs and WBCs
* significant reduction in one or more of peripheral blood counts due to sequsetration is called-->HYPERSPLENISMh
40
hypersplenism
- what is it
- what happens to plat count
sig reduction in one or more of the peripheral blood counts by splenic sequestration
**PTs with it generally have plat counts of 50,000-120,000 per microliter---- not really low enough to pose a serious risk of hemorrhage
