Quiz 4 Study Guide: Blood Flashcards
What composes Primary Hemostasis?
Platelets
What composes Secondary Hemostasis?
Factors to cause adhesion for Platelets (Coagulation)
What are the features of platelets?
Anucleated
Lifespan of about 10 days
Circulating platelets do not adhere during stasis, adhesion occurs.
What are the features of Primary Hemostasis?
- Typically initiated by injury
- Adherence to subendothelium by interacting with Von Willebrand Factor
- aggregate with other platelets and form surface for coagulation cascade
What are the features of Secondary Hemostasis?
- Coagulation Cascade ( Factors from Liver)
- Series of activating enzymatic conversions
- Fibrin and platelet aggregates form stable clot
What factors are Vitamin K dependent necessary for calcium binding sites activation coagulation cascade?
Factors II, VII, IX, and X.
What are Checks and balances of Hemostasis?
Natural Anticoagulants (Protein C: prevent growth of clot) Fibrinolysis (breaks down clot)
What factors allow us to assess hemostasis?
- Platelet Count (part of CBC)
- Coagulation Cascade (PT and PTT)
- Fibrinolysis
- Prolonged coagulation tests may be due to deficiency or inhibitor of a coagulation factor.
What are features of Thrombotic Disorders?
Pathologic Counterpart of Hemostasis
Virchow’s Triad
Acquired Hypercoagulable States
What is Virchow’s Triad?
Endothelial Injury
Abnormal Blood Flow
Hypercoagulability (acquired/inherited factors)
What are Acquired Hypercoagulable States?
Surgery/Trauma Limb Immobilization Bedridden Long distance air travel Pregnancy Oral Contraceptives
Causes of Bleeding Disorders?
Abnormal Vessels
Decreased Platelets/Dysfunction
Abnormal Factors
What is Platelet-type bleeding?
-Mucocutaneous bleeding (e.g. Petechiae on Mucosal Surfaces)
* Caused by thrombocytopenia and Von Willebrand disease*
What causes Thrombocytopenia?
- Decreased bone marrow production
- Hemodilution due to multiple transfusions
- Immune reaction due to platelet autoantibodies directed at platelet surface proteins.
What is the Clinical Presentation of Thrombocytopenia?
Platelet counts
What are the abnormalities in coagulation factors in Thrombocytopenia?
Inherited: von Willebrand disease (factor VIII), Hemophilia A and B
Acquired: Liver disease, Vitamin K deficiency
What is a Complete Blood Count (CBC) and what does it include?
It is an automated hematological evaluation
It includes red and white blood cells and platelets.
What Factors can alter a CBC?
Iron Deficiency Medications Alcohol Infections Gender Pregnancy
Leukocyte counts include…
All nucleated hematopoietic cells except red blood cells.
Why are White Blood Cell Counts important?
To evaluate infections, some drug effects (Cytotoxic and antimicrobial), and radiation therapy.
What is a normal WBC count?
3500 - 10000 cells/microliter
Neutrophils =55%
Eosinophils = 3%
Lymphocytes =35%
What is important to pay attention to in a WBC count.
Both TOTALS and PERCENTS
What is Leukocytosis?
WBC >10,000
*** Caused by chronic infection/inflammation, Exercise, and some Leukemias
What are the different types of Anemias?
Microcytic (too few cells)
Macrocytic Too many cells)
Examples of Microcytic Anemias…
Iron deficiency -caused by hemorrhaging (glossitis)
Lead Poisoning
Examples of Macrocytic Anemias…
Liver Disease
Drugs
Vitamin B12 or folate deficiency (includes neurologic findings)
What are Leukemias?
Systemically distributed neoplasms of white cells.
Characteristics of Acute myeloid or lymphatic Leukemias?
No evidence of maturation in blood or marrow
> 20% Blast (immature) cells
Can have skin and gum infiltration
What two types of Leukemias are there?
Acute Myeloid or Lymphatic
Chronic Myeloid or Lymphatic
What are Lymphomas?
Solid tumors of hematopoietic system/neoplasms of lymphoid tissue lymphadenopathy.
What two types of Lymphomas are there?
Non-Hodgkin Lymphoma
Hodgkin Lymphoma
*** Both are clonal expansions at various developmental stages.
What is Non-Hodgkin Lymphoma?
Indolent to very aggressive
Survival is years to weeks depending on type
What is Hodgkin Lymphoma
All types - Curable in most
Lymphomas usually have…
Enlarged, painless, lymphadenopathy
