Module 2 - Leukocytes Flashcards

1
Q

Leukocytosis

A

WBC count is high
*Normal protective response to physiological stress

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2
Q

Leukopenia

A

WBC count is low

Lack of neutorphils

*this is never normal

Absolute WBC count below 4 x 10^9/L

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3
Q

List causes of LEUKOPENIA

A

Radiation
Chemotherapy
anaphylaxis
auto-immune disorders
Immune deficiencies

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4
Q

List the causes of LEUKOCYTOSIS

A

Normal response to infection/inflammation
Malignancies
surgery
pregnancy
injury
exercise
emotional stress
Medicaitons, hormones, toxins

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5
Q

Define Neutrophilia

A

Early stage of infection or inflammation

Absolute count exceeds 7.5 x 10^9/L

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6
Q

What is “Shift to the left”

A

Release of immature neutrophils

Occurs when demand > supply (severe infection)

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7
Q

Define Neutropenia

A

Decrease in circulating neutrophils

Defined a a count less than 2 x 10^9/L

Can result from prolonged infection

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8
Q

Define Eosinophilia

A

> 4.5 x 10^9/L
Allergic disorders type I (asthma) and dermatological disorders

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9
Q

Define Basophilia

A

increase in circulating basophils
response to inflammation and hypersensitivity reactions
release histamines

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10
Q

Define Monocytosis

A

increase in number of circulating monocytes (macrophages)

Usually occurs in later stage of infection, with chronic infection, when phagocytosis is needed and neutropenia

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11
Q

Define Thrombocytopenia

A

Decrease in number of platelets
< 150 x 10^9/L

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12
Q

What are the CAUSES of thrombocytopenia

A

Increase consumption of platelets

decrease in production of platelets

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13
Q

What is HIT

A

Heparin Induced Thrombocytopenia

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14
Q

What is the pathophysiology of HIT

A

Immune mediated adverse drug reaction

IgG antibodies against heparin-patlet factor 4 complex leading to platelet activation

Results in increased clotting, decreased platelet count

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15
Q

When does HIT occur

A

5-10 days after starting heparin treatment

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16
Q

What are the SYMPTOMS of HIT

A

Platelet consumption and clots

decrease in platelet count 5-10 days after initiation of heparin

Bleeding is rare

17
Q

What does DIC stand for

A

Disseminated Intravascular Coagulation

18
Q

What is DIC

A

Acquired clinical syndrome characterized by wide spread activation of coagulation resulting in fibrin clots to medium and small vessels throughout the body. Can lead to multi-system organ failure and bleeding

19
Q

Causes of DIC

A

Retaining pregnancy tissues

Sepsis

Widespread trauma

Cancer

20
Q

What is the PATHOPHYSIOLOGY of Disseminated Intravascular coagulation

A

Excessive widespread exposure to TF (tissue factor)

Tissue factor binds and activates VII which activates the extrinsic clotting pathway leading to fibrin and thrombin

21
Q

Why does haemorrhage occur in DIC

A

consumption of platelets for clotting exceeds production

22
Q

What laboratory test can be used to diagnose DIC

A

Clinical symptoms

D-Dimers
Produced in the degredation of fibrin clots by plasmin

23
Q

What is the TREATMENT of DIC

A

(1) end the underlying pathology
(2) Support organ function
(3)control thrombosis

  • heparin?
  • replace clotting factors?
  • fluids (restore BP, UO, CO)
24
Q

What is a Thrombus

A

A clot that is attached to the vessel wall

25
What is the difference between VENOUS thrombi and ARTERIAL thrombi
Venous thrombi - RBC and fibrin, low flow Arterial thrombi - platelets and firbin, high flow
26
What is the TREATMENT for Thrombi
(1) Anticoagulant therapy - Venous thrombus only (2) Remove the clot
27
What medications activate fibrinolysis And what is the risk of these medications
Urokinase streptokinase alteplase *risk of hemorrhage
28
What is the PATHOPHYSIOLOGY of arterial thrombus formation
- atheroscelerosis plaque - turbulent blood flow - exposure of basal lamina (collagen) - slowing of blood flow - activation of platelets
29
What is the PATHOPHYSIOLOGY of venous thrombus formation
- stasis of blood flow - slows down, platelets contact with endothelium for long periods
30
What are the most common clinical conditions that predispose someone to venous stasis
- surgery - bed rest > 1 week - paralysis - malignancy - MI, heart surgery - age