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Hematology Oncology > Pathophysiology and introduction > Flashcards

Pathophysiology and introduction Flashcards

1
Q

How much blood do you donate when you donate blood?

A

Around 1 pint (450-550ml)

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2
Q

What is the general composition of blood

A

90% water, 10% solutes
6 quarts in our body

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3
Q

Chief function of blood

A

deliver substances needed for cell metabolism
remove wastes
defense
acid base balance

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4
Q

What percent of blood is plasma

A

55% to 60%

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5
Q

How long do RBCs live

A

120 days

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6
Q

What percent of whole blood are RBCs

A

45%

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7
Q

What is the most abundent cell in the body

A

RBC

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8
Q

What percent of blood are WBCs/Platelets

A

1%

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9
Q

What makes 55% of blood

A

Plasma component- acellular
Albumin and antibodies, clotting factors

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10
Q

What is the carrier protein in blood

A

albumin

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11
Q

If blood plasma with clotting factors is removed, what is it

A

serum

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12
Q

If someone is asking for serum, what are they asking for

A

blood plasma with clotting factors

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13
Q

Where is blood made

A

Red bone marrow

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14
Q

What is red marrow replaced by with age

A

Yellow marrow (made of fat cells)

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15
Q

Where is red bone marrow found after age 18?

A

Vertebrae, ribs, skull, pelvis, femur and humerus proximal ephphyses

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16
Q

If you want to get red bone marrow from someone over the age of 18, where should you take it from?

A

Vertebrae, ribs, skull, pelvis, femur and humerus proximal ephphyses

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17
Q

What does hematopoiesis mean

A

hemato- blood
poiesis- to make

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18
Q

When will you see major reticulocytes in the blood

A

When someone has a large trauma or looses a lot of blood, the body will push out many reticulocytes quickly

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19
Q

If you see a RBC in peripheral, do they typically have a nucleus or not?

A

No– as RBC gets more hemoglobin, nucleus gets smaller. By blood, no nucleus.
If has nucleus, does not have a lot of hemoglobin

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20
Q

What does the kidney release to secrete more RBCs

A

Erythropoietin (EPO) - Stimulated by low O2 levels detected by kidneys
Stimulate more RBC profliforation

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21
Q

Trace the path of erythryopoesis

A

Erythrocyte precursor–> nucleated RBC–> nucleus expelled–> reticulocyte–>mature RBC–> Peripheral circulation

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22
Q

What is the average lifetime of a RBC

A

120 days

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23
Q

What is the general makeup of a RBC

A

NO nucleus or organelles

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24
Q

What are the 2 chains in hemoglobin in an adult vs fetus

A

Adult– 4 chains, 2 alpha, 2 beta
Fetus- 4 chains, 2 alpha, 2 gamma (higher O2 affinity)

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25
Q

How many hemoglobin molecules does one RBC contain

A

300 million

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26
Q

What are the key necessities for RBC production

A

Proteins, Vitamins, Minerals (IRON), Folate

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27
Q

Where is the body iron found and how is it lost

A

bound to heme or stored in liver
lost in urine, sweat, epithelial cells, or from gut

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28
Q

Where is iron absorbed

A

Jejunum and duodenum
Stored in bone marrow and liver by ferritin

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29
Q

What are 3 common ways someone has an iron deficiency because of gut abnormalities

A
  1. Surgeries where they no longer have the duodenum or jejunum
  2. Medications (acid suppressors for GERD ex.) that lower the acididty and absorbtion
  3. Celiac disease
30
Q

Porphyrin from RBCs goes where in RBC distruction

A

Reduced to bilirubin, transported to liver, secreted in bile

31
Q

What 2 factors maintain platelets

A

TPO and IL-11(both inflammatory markers)

32
Q

How long do platelets circulate for

33
Q

What factor is made in the liver that helps maintain Platelet function?

34
Q

What is the most common WBC

A

Neutrophils

35
Q

Which WBC fights parasites

A

eosinophils

36
Q

Which WBCs fight Allergic reactions

A

Mast cells and Basophils

37
Q

Your patient has elevated eosinophils. What is a possible infection cause?

38
Q

Your patient has elevated neutrophils. What is a possible infection cause?

39
Q

Your patient has elevated mast cells and basophils. What is a possible infection cause?

40
Q

What stimulates the production of WBCs

A
  • G-CSF (graulocyte colony stimulating factor)
  • GM-CSF ( Granulocyte macrophage colony stimulating factor)
41
Q

Where do B cells mature

A

Lymph nodes and spleen

42
Q

Where are T cells exposed to antigens

43
Q

What cell makes antibodies

A

B cells (Lymphocytes, do not contain granules)

44
Q

What percent of WBCs are Lymphocytes

A

35%
Do not contain granules
B cells, T cells, NK cells

45
Q

What percent of WBC are macrophages

A

5% of all WBCs, Monocytes in circulation

46
Q

What occurs in DiGeorge syndrome

A

Chromosome 22 deletion
Underdeveloped thymus
Patients do not develop T cells which causes severe immune deficiency

47
Q

Which type of immunity does the spleen play a role in

A

Innate and adaptive
Trains B cells and T cells, Antigen presentation
Regulates blood volume

48
Q

If your patient comes to you complaining of RUQ pain and feelings of fulness, what is the organ that is possibly implicated?

A

The Spleen, full feeling because when inflammed it presses on stomach, when we have imperfect RBCs, they sequester here and cause pooling in the spleen, causing splenomegaly

Common in hemolytic anemia, sickle cell anemia, maleria, mononucleosis

49
Q

What are some common disorders causing an enlarged spleen

A

Common in hemolytic anemia, sickle cell anemia, maleria, mononucleosis

50
Q

Function of lymph nodes

A

Lymphocytes and macrophages interact to generate immune response
Antigen presentation to T cells, B cell maturation
Abnormal cells trapped here

51
Q

What does an issue with primary hemeostasis look like for patients

A

patients in surgery can’t stop bleeding, can’t actually form the platelet plug.
Patients often have gum or vaginal bleeding, too.

52
Q

Describe primary homeostasis

A

Platelet plug
Platelest are activated, adhesion, aggregation, secretion

53
Q

What drives secondary homeostasis

A

coagulation cascade/factors
Fibrin clot

54
Q

If you hear “fibrin clot” what type of homeostasis are you thinking

A

secondary homeostasis

55
Q

Blood vessel injury releases what factor

A

vWF (Von willebrand factor)

56
Q

When platelets are activated, which surface protein do they express

A

Glycoprotein 2b/3a (targetted by plavix to prevent platelet plug)

57
Q

What does GPIIb/IIIa bind to to form the platelet plug

A

fibrinogen

58
Q

What are the 5 steps to platelet plug formation

A
  1. Blood vessil injury
  2. Platelet adhesion to vWF from endothelium
  3. Platelet activation
  4. Platelet aggregation
  5. Platelet plug formed
59
Q

What are intrensic vs extrensic pathways measured by

A

PTT= intrensic (Table Tennis is played inside)
PT= extrensic (Tennis is played outside)

60
Q

Factor 8 deficiency leads to what

A

Hemophilia A

61
Q

Factor 9 deficiency leads to what

A

Hemophilia B

62
Q

Warfarin inhibits what

A

PT (extrensic pathway) Vitamin K antagonist

63
Q

Hemophilia B is caused by what deficiency

A

Factor 9 deficiency

64
Q

Hemophilia A is caused by what

A

Factor 8 deficiency

65
Q

What are the vitamin K dependent factors

A

2, 7, 9, 10
1972 ( War of Vietnam was 1972, and Warfarin inhibits Vitamin K),

66
Q

What does heparin inhibit

A

Intrensic pathway (PTT)

67
Q

What drug inhibits the intrensic pathway

68
Q

If you want to inhibit factor 12, which drug should you give

A

Heparin (inhibits intrensic pathway)

69
Q

If you want to inhibit factor 7, which drug should you give?

A

Warfarin (vitamin K antagonist)

70
Q

Where are most coagulation factors made

71
Q

Which factor starts the extrensic pathway

72
Q

Which factor helps with both clot formation and breakdown

A

12a turns plasminogen to plasmin

Hematology Oncology (12 decks)

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