Patho Unit 3 Flashcards

Question

Hematopoiesis

Answer 1

Formed element production - Cells are formed in red bone marrow from pluripotent stem cells and mature in the bone marrow or lymphoid tissue - Active red marrow in adults in pelvis, sternum, vertebrae

Answer 2

Cellular production in the bone marrow

Answer 3

Disease conditions can cause production of cells outside of the bone marrow

Answer 4

The production of red blood cells - Hypoxia stimulates the kidneys to release erythropoietin (EPO) which circulates to the red marrow and speeds up the maturation of immature RBCs

Answer 5

Measures the rate of Erythropoiesis

Answer 6

Immature RBC | - Contains hemoglobin, RNA, and mitochondrial remnants

Answer 7

Platelets - Cell fragments - Aid in clotting by clumping and the release of biochemical mediators

Answer 8

Low platelet count - < 50,000 hemorrhage from minor trauma - < 15,000 spontaneous bleeding - < 10,000 severe bleeding

Answer 9

Increased platelet count

Answer 10

Forming a blood clot 1. Vascular spasm 2. Platelet plug formation 3. Activation of the coagulation cascade

Answer 11

- Originates in Macrophage/Fibroblast | - Stimulates Granulocytes

Answer 12

- Originates in T cell | - Stimulates Neutrophil, Macrophage

Answer 13

- Originates in kidney cells and Kupffer cells | - Stimulates Erythrocytes

Answer 14

CYTOKINES that act as hormones to stimulate the proliferation of progenitor (early) cells - Originate from one cell to stimulate the proliferation of another - G-CSF, GM-CSF, Erythropoietin

Answer 15

- Positive feedback system - Begins with activation of several soluble, inactive clotting factors (cascading) - 2 pathways (Extrinsic and Intrinsic) - Merge at Factor X forming common pathway - Coagulation is usually fast and localized

Answer 16

Activated by tissue factor (tissue thromboplastin)

Answer 17

Activated by contact with the injured vessel

Answer 18

- Extrinsic and Intrinsic activation - The common pathway begins with the formation of Prothrombinase - Prothrombinase activates Prothrombin into Thrombin - Thrombin induces the formation of fibrin from fibrinogen

Answer 19

- After 30-60 min. platelets contract (actin and myosin proteins squeeze them out into the serum) - The clot becomes impacted and the edges of the blood vessel are brought closer together - Endothelial cells begin to restore endothelial lining - Clot needs to be removed (Fibrinolysis)

Answer 20

Removes blood clots - Large amounts of plasminogen are incorporated into clots - Endothelial cells produce Tissue Plasminogen Activator (TPA), causing Plasminogen to become its active form Plasmin - Factor XII and Thrombin in the coagulation cascade also change Plasminogen into Plasmin - Plasmin digests clots

Answer 21

Prothrombin Time/International Normalized Ratio - Measures the EXTRINSIC pathway - Usually used to check status after anticoagulant administration

Answer 22

Activated Partial Thromboplastin Time | - Measures the INTRINSIC pathway

Answer 23

- Measures PLATELET FUNCTION, not number | - New instrumentation is replacing this test

Answer 24

Insufficient RBCs or a decrease in the quality or quantity of hemoglobin - Typical symptoms: fatigue, weakness, dyspnea (breathing problems) and pallor (paleness) - Classified according to ETIOLOGY (origin) and/or MORPHOLOGY

Answer 25

- Fe deficiency anemia - Folate/B12 deficiency anemia - Hermorrhagic anemia - Anemia of chronic disease (ACD) - Hemolytic anemia

Answer 26

``` Volume - Microcytic - Macrocytic - Normocytic Chromasia (color) - Hypochromic - Normochromic ```

Answer 27

- Pale, small RBCs | - Usually Fe deficiency anemia

Answer 28

- Large RBCs | - Usually Folic Acid or vitamin B12 deficiency anemia

Answer 29

- RBCs are normal size and hemoglobin content | - Usually caused by hemorrhage or hemolysis

Answer 30

- Normocytic-Normochromic - Due to red cell lysis - Fragile cells, infection drugs, autoimmunity, circulating antibodies - Symptoms: enlarged spleen and jaundice

Answer 31

- Normocytic-Normochromic - Due to blood loss - Surgery or Trauma - Symptoms: shock and acidosis

Answer 32

ACD - Normocytic-Normochromic - Bacterial toxins, cytokines from WBCs, supression of progenitor cells - usually mild

Answer 33

- Normocytic-Normochromic - Bone marrow hypo- or aplasia - Causes: acquired due to drugs, viruses, genetics, and neoplasia - Symptoms: petechiae, bleeding, infections, pancytopenia

Answer 34

- Macrocytic-Normochromic - Intrinsic factor deficiency leas to insufficient absorption ofB12 - Autoimmunity - autoantibody to gastric parietal cells - Symptoms: digestive symptoms, glossitis, peripheral neuropathy - Treatment: replace B12

Answer 35

- Macrocytic-Normochromic - Inhibits DNA synthesis - Alcoholics and malnourished are at risk - Symptoms: digestive symptoms, glossitis (similar to Pernicious Anemia but no neurological symptoms) - Treatment: replace Folic Acid

Answer 36

- Microcytic-Hypochromic - Most commonly caused by excessive bleeding or poor diet - High risk: pregnant women, adolescents, children, elderly, anyone with chronic blood loss - Symptoms: fatigue, weakness, shortness of breath, paleness, spoon-shaped nails, sore tongue, dry corners of mouth

Answer 37

- Microcytic-Hypochromic - Dysfunctional iron uptake by erythroblasts producing sideroblasts and resulting in decreased synthesis of heme - Causes: lead, ethanol, other drugs - heptosplenomegaly, hemochromatosis

Answer 38

Role: DNA synthesis Deficiency: Macrocytic Anemia

Answer 39

Role: DNA and RNA synthesis Deficiency: Macrocytic Anemia

Answer 40

Role: Hgb synthesis Deficiency: Microcytic Hypochromic Anemia

Answer 41

Diseases or conditions that cause excessively large numbers of RBCs in the blood - Pathology: increased blood viscosity promotes clotting, and poor oxygenation in distal tissues - Symptoms: red color of face, hands, feet, ears, and mucous membranes, high blood pressure, engorgement of retinal and sublingual veins, and hepatosplenomegaly

Answer 42

An increase of RBCs due to loss of plasma

Answer 43

Primary - Polycythemia Vera (not caused by another diagnosis) Secondary - Physiologic response to hypoxia

Answer 44

- Primary (not due to another diagnosis) - Rare, non-malignant proliferative abnormality of bone marrow - Thought to be caused by hypersensitive bone marrow - Hct as high as 70-80% - Tends to occur in men between 40-60

Answer 45

Common because it is a physiologic response to hypoxia - COPD - High altitude - Smoking - Sleep apnea

Answer 46

- Reduction of cells and blood volume achieved by therapeutic phlebotomy (bloodletting), which helps prevent the hyperviscosity and thrombus formation - Treat the cause of the hypoxia and the number of red blood cells will decrease

Answer 47

Too few Neutrophils - Prolonged severe infection (depletes cellular numbers) - Decreased production (starvation, aplastic bone marrow, chemo) - Reduced survival (autoimmune diseases: lupus and rheumatoid arthritis)

Answer 48

Too many Eosinophils | - Increased in allergic disorders and parasitic invasions

Answer 49

Too many Neutrophils - Evident in the first stages of an infection or inflammation - Immature Neutrophils (bands) are released into the blood - Premature release is called a "shift to the left"

Answer 50

Too few Lymphocytes | - Immune deficiencies, drug destruction, viral destruction

Answer 51

- Characterized by fever, sore throat, lymphadenopathy and hepatosplenomegaly - Transmitted by saliva - Caused by Epstein-Barr Virus - Bcells have EBV receptor sites making them a primary site of the infection - Monospot test

Answer 52

Too many Monocytes - Measurement in blood has poor correlation with disease - Usually occurs with Neutropenia in later stages of infections

Answer 53

Too many Lymphocytes - Acute viral infections - Malignancies

Answer 54

- Well differentiated cells that don't function normally - Gradual onset - Chronic Myeloid (CML) and Chronic Lymphoid (CLL)

Answer 55

- Asymptomatic (19%) - Splenomegaly - Infections - Night sweats - Fatigue - Weight loss - Anemia - Bleeding

Answer 56

Malignant disorder of the blood-forming cells, most commonly WBCs and blood forming organs

Answer 57

- Undifferentiated or immature cells, usually "blasts" - Sudden onset - Acute Myeloid (AML) and Acute Lymphoid (ALL)

Answer 58

Acute Myeloid Leukemia - Acute onset - Myeloblasts - Poor survival rate

Answer 59

Chronic Myeloid Leukemia - Gradual onset - Most demonstrate the Philadelphia Chromosome (t9:22)

Answer 60

AML and CLL

Answer 61

B cell cancer of bone marrow - Plasma cells proliferate to predominate the marrow - > 50 years - Involved in the bone marrow and multiple other sites - Destruction of bone (myeloma cells infiltrate bone and stimulate osteoclastic activity) - Abnormal protein production (Bence-Jones)

Answer 62

Proliferation of lymphocytes and lymphoid tissues | - Hodgkin and Non-Hodgkin

Answer 63

Acute Lymphoid Leukemia - Acute - B&T cells - Lymphoblasts

Answer 64

Chronic Lymphoid Leukemia - Chronic and lengthy survival - Primarily a diagnosed in elderly - Usually B cells

Answer 65

- Characterized by presence of Reed-Sternberg cells in lymph nodes, which are usually localized in a single or chain of nodes - Bimodal Age distribution (19-35 & >50) - Signs: fever, weight loss, night sweats, pruritis (itching), lymphadenopathy in neck - Treatment: radiation and chemo

Answer 66

- No Reed-Sternberg cells - Onset usually >50 - Disseminated (multiple node and organ involvement) - Prognosis is worse than Hodgkins

Answer 67

Thrombocythemia & Thrombocytopenia

Answer 68

Adhesion, Aggregation, & Secretion

Answer 69

- > 600,000/mm3 - Myeloproliferative Disorder - More common in ages 50-60

Answer 70

Stem cell disorder in which excess platelets are produced | - Risk of microvascular thrombosis

Answer 71

Platelets aren't functioning normally | - Symptoms: petechiae, mucosal bleeding, and gingival bleeding

Answer 72

- Drugs: Aspirin & NSAIDS - Systemic conditions: renal failure, TTP (Throbotic Thrombocytopenia Purpura) - Hematologic alterations: leukemias

Answer 73

Disorders of platelet adhesion, aggregation secretion and procoagulant activity

Answer 74

- Dependent clotting factors: IX, VII, X, & II | - Warfarin (Coumadin) causes temporary, reversible deficiency

Answer 75

Disorder in which CLOTTING and HEMORRHAGE occur simultaneously - Caused by anything that can activate widespread coagulation - Acquired, deadly and fairly common

Answer 76

- Amount of active thrombin exceeds anti-thrombin, clotting becomes systemic - Widespread thromoses cause widespread ischemia, infarction, and organ hypoperfusion - Fibrinolytic System also activated increasing Fibrin Degradation Products (FDP) resulting in consumptive coagulopathy

Answer 77

- Intrinsic: gram-negative sepsis, hypoxia, low blood flow - Extrinsic: gram-positive toxins, burns, infarctions, surgeries, obstetric accidents, malignancies - Common: activated by substances that enter bloodstream (enzymes, snake venom)

Answer 78

- ABO incompatibility: most common, but usually mild | - Rh factor incompatibility: life threatening

Answer 79

Difference in the fetal and maternal blood types - Occurs in 20% of pregnancies but only 1 in 10 results in HDN - More mild because A and B antigens are poorly developed at birth, and antibodies typically don't cross the placenta

Answer 80

Occurs when and Rh- mother is carrying an Rh+ baby (2nd pregnancy) - Anti-Rh antibodies cross the placenta and attach to fetal erythrocytes - Can lead to severe anemia, edema, CNS damage and fetal death

Answer 81

- Autosomal recessive - Characterized by abnormal Hgb (Hgb S) - Valine replaces Glutamic Acid in Hgb molecule (Valine side chain is hydrophobic, Glutamic Acid is hydrophilic) - Deoxygenation and dehydration cause erythrocytes to stretch and solidify (sickle - Can cause Vasoocclusive Crisis (Sickle Cell Crisis)

Answer 82

Inherited autosomal recessive disorders that casue an impared rate of synthesis of alpha or beta hemoglobin chains

Answer 83

- Defect in beta-chain formation - Results in to many alpha-chains which become unstable and precipitate inside the cells - Most common - Macrophages and spleen destroy these cells

Answer 84

- Heterozygous - Usually asymptomatic - Sometimes an enlarged spleen and small RBCs

Answer 85

- Homozygous - Severe anemia - Regular transfusions required

Answer 86

Hemophilia A & B - The most common of the inherited disorders of the coagulation system - X-linked

Answer 87

- Classic hemophilia - X-linked recessive deficiency of factor VIII - More common

Answer 88

- X-linked recessive deficiency of factor IX | - Less common

Patho Unit 3 Flashcards

Understand: - Structure, and Function of the Hematologic System (Ch 19) - Alterations of Hematologic Function (Ch 20) - Alteration of Hematologic Function in Children (Ch 21)