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Physiology Module 1 > Module 1: Hematology Physiology > Flashcards

Module 1: Hematology Physiology Flashcards

0
Q

T or F: All individuals produce antibodies to the AB carbohydrate antigen that they lack.

A

T

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1
Q

ABO blood group is based on carbohydrate antigens present on RBC membrane either as _______ or ________.

A

Glycoprotein; Glycosphingolipids

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2
Q 
Predict the blood type of the following:
1. Ag - -
    Ab antiA, antiB
2. Ag A
    Ab antiB
3. Ag B
    Ab antiA
4. Ag A, B
    Ab - -
A
  1. O
  2. A
  3. B
  4. AB
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3
Q

Why are agglutinins produced in people who do not have the respective agglutinogens in their red blood cells?

A

Small amounts of these agglutinogens enter through food and bacteria which initiate the production of agglutinins

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4
Q

Rh blood group has 6 antigens. These are..

A

C, D, E, c, d, e

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5
Q

Most widely prevalent among the 6 Rh antigens

A

D

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6
Q

T or F: Hemolytic disease of the newborn usually manifests i. The second Rh+ baby.

A

T

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7
Q

Two ways of identifying blood types

A

Forward

Reverse

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8
Q

Identify antigen by antisera

A

Forward typing

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9
Q

Identify isoagglutinin in serum

A

Reverse typing

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10
Q

Matches donor blood unit to recipient’s blood

A

Cross-matching

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11
Q

T or F: Cross-matching should always be done even in mergency cases.

A

F, may not be done in emergency cases (give type-specific)

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12
Q

Blood transfusion products

A 
Whole blood
Packed red blood cells
Platelet concentrate
Fresh frozen plasma
Cryosupernate
Cryoprecipitate
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13
Q

Increases oxygen-carrying capacity

A

Whole blood; Packed red blood cells

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14
Q

T or F: Whole blood is ideal for cases of acute hemorrhage of more than 25% of blood volume.

A

T

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15
Q

T or F: Packed red blood is given to patients with anemia but without symptoms.

A

F, should be given to those with anemia and symptoms (dizziness, inc heart rate, difficulty breathing)

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16
Q

Reduces risk of mucosal bleeding

A

Platelet concentrates

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17
Q

Thresholds for transfusion:
Patient w/o fever or infection
Patient w/ fever or infection
Undergoing invasive procedure

A

5,000
10,000
50,000

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18
Q

Contains stable coagulation factors and plasma proteins

A

Fresh frozen plasma

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19
Q

These inactivate factors V and VIII

A

Protein C

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20
Q

Used for correction of coagulopathies including rapid reversal of warfarin, supplying deficient plasma proteins, treatment of TTP

A

Fresh frozen plasma

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21
Q

Supplies fibrinogen, factor VIII and von Willebrand factor

A

Cryoprecipitate

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22
Q

Each unit of cryoprecipitate contains ____ units of factor VIII

A

80

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23
Q

Contains factor IX

A

Cryosupernate

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24
Q

Adverse reactions to transfusion can be..

A

Immunologic
Non immunologic
Infections

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25
Q

Immunologic reactions to transfusion?

A 
Febrile nonhemolytic transfusion reactions
Allergic reactions
Anaphylaxis
Graft versus host disease
Transfusion-related acute lung injury
Posttransfusion purpura
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26
Q

Non immunologic reactions to transfusion:

A 
Fluid overload
Hypothermia
Electrolyte imbalances
Iron overload
Hypotensive reactions
Immunomodulation
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27
Q

Infections related to transfusion?

A

Viral (hepB/C, HIV, CMV etc)

Bacterial contamination

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28
Q

Aids in prevention of bloodloss

A

Hemostasis

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29
Q

Stages of hemostasis

A

Reflex vasoconstriction
Primary hemostasis
Secondary hemostasis
Clot retraction or Clot dissolution

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30
Q

Results in immediate reduction in bleeding

A

Reflex vasoconstriction

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31
Q

Mechanisms of reflex vasoconstriction

A

Local myogenic spasm-strongest contributor
Local autocoid factors from platelets and injured tissues
Nervous reflexes

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32
Q

Formation of platelet plug

A

Primary hemostasis

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33
Q

Responsible for hemostasis of small vessels

A

Primary hemostasis

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34
Q

Primary hemostasis involves..

A

Platelets (key player)
Blood vessel wall
VWF

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35
Q

Platelets are also called

A

Thrombocytes

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36
Q

Platelets originate from

A

Megakaryocytes

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37
Q

T or F: Platelets can reproduce.

A

F

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38
Q

Normal platelet count

A

150,000 to 450,000

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39
Q

Function in platelets: actin and myosin fibers

A

Contraction (also thrombosthenin)

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40
Q

Function in platelets: ER and golgi

A

Calcium storage

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41
Q

Function in platelets: mitochondria

A

Produces ATP and ADP

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42
Q

Function: Fibrin-stabilizing factor

A

Stabilizes fibrin network

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43
Q

Function in platelets: surface glycoproteins

A

Causes platelet adherence to injured tissue and collagen

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44
Q

Stages in the formation of platelet plug

A

Platelet adhesion
Platelet activation
Platelet aggregation

45
Q

Platelet adhesion

A

Platelets come in contact with exposed subendothelium
Platelets secrete these in their membranes:
Glycoprotein Ib-IX - bind vWF
Glycoprotein Ia/IIb - bind collagen

46
Q

Platelet activation

A

Platelet develops pseudopods
Platelets release thromboxane A2, ADP, PAF and serotonin which activates other platelets
Platelet activate its collagen receptor
Glycoprotein IIb/IIIA after vWF binds to Gp Ib

47
Q

Platelet aggregation

A

Fibrinogen in the blood ( and vWF in the subendothelium) bind to the platelet receptor glycoprotein IIb/IIIA
Formation of loose platelet plug
Fibrin fibers strengthen platelet plug

48
Q

If platelet count <50,000

A

Bleeding

49
Q

If platelet count <10,000

A

May be lethal

50
Q

Formation of fibrin through the coagulation cascade

A

Secondary hemostasis

51
Q

Coagulation cascade is divided into

A

Extrinsic pathway

Intrinsic pathway

52
Q

Factor I

A

Fibrinogen

53
Q

Factor II

A

Prothrombin

54
Q

Factor III

A

Tissue factor

55
Q

Factor IV

A

Calcium

56
Q

Factor V

A

Proaccelerin; labile factor

57
Q

Factor VII

A

Serum prothrombin conversion accelerator; stable factor

58
Q

Factor VIII

A

Antihemophilic factor A

59
Q

Factor IX

A

Antihemophilic factor B; Christmas factor

60
Q

Factor X

A

Stuart factor

61
Q

Factor XI

A

Plasma thromboplastin antecedent; antihemophilic factor C

62
Q

Factor XII

A

Hageman factor

63
Q

Factor XIII

A

Fibrin-stabilizing factor

64
Q

Prekallikrein

A

Fletcher factor

65
Q

High-molecular weight kininogen

A

Fitzgerald factor

66
Q

Initiates coagulation cascade

A

Extrinsic pathway

67
Q

Amplifies the cascade

A

Intrinsic pathway

68
Q

Extrinsic pathway: Clotting can occur in __ sec.

A

15

69
Q

Intrinsic pathway: Clotting occurs in __ min

A

1-6

70
Q

In which part of the coagulation cascade does the intrinsic and extrinsic pathways converge?

A

Factor Xa-mediated generation of thrombin from prothrombin

71
Q

During clot retraction, fibrin clot is invaded by _______ which subsequently form _________ around the clot.

A

Fibroblasts; connective tissue

72
Q

T or F: Calcium from platelet stores also contribute to clot retraction.

A

T

73
Q

Mediated by anticoagulant and thrombolytic mechanisms

A

Clot dissolution

74
Q

What are the factors involved in the coagulation cascade?

A

Calcium
Vit K
Anticoagulant mechanisms

75
Q

T or F: Calcium is involved in ALL steps in the cascade.

A

F, except the first two steps in the intrinsic pathway

76
Q

Required to produce prothrombin in the liver

A

Vit K

77
Q

Anticoagulant mechanisms

A

Endothelium
Intravascular anticoagulants
Lysis of blood clot

78
Q

Binds thrombin thereby reducing free thrombin

A

Thrombomodulin

79
Q

Inactivates thrombin

A

Antithrombin III

80
Q

Increases the activity of antithrombin III hundredfold to thousandfold

A

Heparin

81
Q

T or F: Our body has high concentrations of heparin.

A

F, low

82
Q

Give some causes of severe bleeding

A

Liver diseases
Vit K deficiency
Hemophilia A
Hemophilia B

83
Q

Factor VIII deficiency

A

Hemophilia A

84
Q

Factor IX deficiency

A

Hemophilia B

85
Q

Causes of excess coagulation

A

Protein C and S deficiency

Disseminated intravascular hemolysis

86
Q

Deficiency of hemoglobin in the blood either from too few RBCs or too little hemoglobin

A

Anemia

87
Q

Blood loss anemia: morphology of RBCs?

A

Acute: normal
Chronic: microcytic, hypochromic

88
Q

What time of anemia is caused by Vit B12 deficiency?

A

Megaloblastic anemia

89
Q

Iron deficiency anemia: RBC morohology?

A

Microcytic, hypochromic

90
Q

What type of anemia is caused by failure of the bone marrow activity?

A

Aplastic anemia

91
Q

Rapid destruction of RBCs due to abnormal morphology or from attack of antibodies against RBCs

A

Hemolytic anemia

92
Q

Causes of hemolytic anemia

A

Hereditary spherocytosis
Sickle cell anemia
Erythroblastosis fetalis

93
Q

Excess red blood cells

A

Polycythemia

94
Q

Polycythemia causes increased blood viscosity which leads to

A

Cyanosis/plethora, strokes

95
Q

Types of polycythemia

A

Physiologic: occurs in high altitudes, smokers

Polycythemia vera: genetic abnormality inRBC precursors

96
Q

Hypersensitivity reactions

A

Types I, II, III, IV

97
Q

Most common among the hypersensitivity reactions

A

Type I

98
Q

Immune reactants for each type

A

I- IgE
II and III- IgG
IV- TH1 cells, TH2 cells, CTL

99
Q

Antigen for Type II?

A

Cell or matrix-associated antigen

*other types are soluble antigens, except Type IV ( CTL) - cell associated antigen

100
Q

Mast cell activation

A

Type I

101
Q

Macrophage activation

A

Type IV (TH1 cells)

102
Q

Eosinophil activation

A

Type IV (TH2 cells)

103
Q

Cytotoxicity

A

Type IV (CTL)

104
Q

FcR+ cells

A

Type II and III

105
Q

Type I: Example of hypersensitivity reaction

A

Allergic rhinitis
Asthma
Systemic anaphylaxis

106
Q

Type II: Examples of hypersensitivity reactions

A

Drug allergies (eg. Penicillin)

107
Q

Type III: Examples of hypersensitivity reactions

A

Serum sickness

Arthus reaction

108
Q

Type IV: Examples of hypersensitivity reactions

A

TH1: contact dermatitis, tuberculin reaction
TH2: chronic asthma, chronic allergic rhinitis
CTL: contact dermatitis

109
Q

Immunodeficiency can be

A

Congenital

Acquired

Physiology Module 1 (4 decks)

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