Quiz 6 Flashcards
Life span of RBC
120 days
What are the two main cell types of blood?
leukocytes, RBCs
Function of RBCs
transport hemoglobin (and carry carbonic anhydrase)
Where are RBCs formed?
bone marrow
EPO
glycoprotein made in response to arterial hypoxemia from kidneys- stimulates RBC production in bone marrow
platelet lifespan
8-12 days
Normal platelet count
150k-300k
Coagulation cascade provides
thrombin- incorporated into platelet plug
Completion of coagulation process converts…
fibrinogen into fibrin
Which coagulation proteins are NOT synthesized in the liver?
vWF, calcium, factor VIII
Factor I
fibrinogen (forms clot- fibrin)
Factor II
prothromgin- activates I, V, VII, VIII, platelets, protein C, thrombin
Factor III
tissue factor/thromboplastin- cofactor of VII
Factor IV
calcium
vWF
vom Willebrand- mediates adhesion
factor IX
Christmas- activates X
Factor XI
fibrin stabilizing- crosslinks fibrin
What lab value reflects the intrinsic pathway?
aPTT
What lab value reflects the extrinsic pathway?
PT/INR
When does final common pathway occur?
when factor X activated by intrinsic or extrinsic pathway
When is the extrinsic pathway activated?
by release of factor III when injury occurs outside the vessel wall or blood
When is the intrinsic pathway activated?
when injury occurs to vessel itself
Mnemonic for intrinsic pathway
If you can’t buy the intrinsic pathway for $12, you can get it for $11.98 (factors XII, XI, IX, VIII)
Mnemonic for extrinsic pathway
For 37 cents you can purchase the extrinsic pathway (factors III, VII)
Mneumonic for FCP
The FCP can be purchased at the five and dime for 1 or 2 dollars on the 13th of the month (factors V, X, I, II, XIII)
normal PTT
25-32 seconds
normal PT
12-14 seconds
normal INR
1.5-2.5
What is FFP?
fresh frozen plasma- fluid portion of whole blood; contains ALL clotting factors and inhibitors
Should FFP be ABO compatible?
yes, when you can
What is FFP given for?
dilutional coagulopathy (factors consumed or diluted), MTP, warfarin reversal, vWB disease, antithromin III deficiency
What is cryo?
precipitate collected off the top of FFP
What does cryo do?
increases fibrinogen (50 mg/dL with one unit), contains I, VIII, XIII, vWF, protein C
Does cryo need to be ABO compatible?
no
Indications for cryo
microvascular bleeding, vWB disease unresponsive to DDAVP
Indication for pRBCs
bleeding, increase O2 carrying capacity
Indication for platelets
MTP, active bleeding
Immunity
ability of organism to recognize and defend itself against specific pathogens/antigens
Antigen
molecules from a pathogen or foreign organism that provoke a specific immune response
immune response
production of antibodies and generation of specialized lymphocytes against specific antigens
innate/genetic immunity
born with- genetically determined due to lack of receptors or other molecules required for infection
acquired immunity
develops- not genetically determined acquired naturally or artificially
Naturally acquired ACTIVE immunity
antigens or pathogens enter body naturally- immune response generated, either lifelong or temporary ex) chicken pox, mumps
naturally acquired PASSIVE immunity
antibodies pass from mother to fetus via placenta or breast milk (IgG)- no immune response to antigens immunity usually short lived ex) flu or intestinal virus
Artificially acquired ACTIVE immunity
ANTIGENS introduced in vaccines- immune response generated
Artificially acquired PASSIVE immunity
preformed ANTIBODIES (antiserum) given by injection ex) snake antivenom short lived immunity, no response to antigens
Humoral (antibody-mediated) immunity
B cells defends body against bacteria, viruses, toxins BEFORE they enter cells antibodies produced
Cell-mediated immunity
T cells defends against: bacteria and viruses inside host cells and inaccessible to antibodies, fungi, protozoa, helminths, cancer cells, transplanted tissue no antibodies produced
Helper T cells
call “for backup”
Cytotoxic T cells
destroy
Hapten
small foreign molecule that is not antigenic by itself- must be coupled to carrier molecule to be antigenic
Epitope
part of antigen that interacts with antibody
Most common immunoglobulin
IgG (80%)
1st antibody produced during infection
IgM
antibody found in secretions
IgA
What immunoglobin is a small % of serum and has a short half life but is present in allergic reactions?
IgE
Type I Hypersensitivity Reactions
- allergy
- allergen (protein) reacts with IgE antibodies on mast cells
- massive histamine release
- rhinitis, conjunctivitis, urticaria, pruritis, anaphylaxis
Anaphylaxis
severe generalized hypersensitivity reaction
- shocklike state from hypotension secondary to vasodilation and extravasation of protein and fluid
- unpredictable, immediate or delayed
Type II Hypersensitivity Reaction
IgG and IgM antibodies bind to antigens on cell surface or extracellular tissue
- reaction activates complement cascade/membrane attack complex
- transfusion reaction, autoimmune hemolytic anemia, Mg
Type III Hypersensitivity Reactions
immune complex disease in which antigen-antibody complexes deposit in tissues and cause injury
-SLE, RA, glomerulonephritis
Type IV Hypersensitivity Reactions
delayed, 12 hours after exposure
CD4 lymphocytes migrate to site followed by cytokine release and local inflammation
-poison ivy, contact dermatitis
Anaphylactoid reaction caused by mediator from ?
basophils, not mast cells (no histamine) in response to non-IgE mediated triggering event
-less severe, more cutaneous reaction

Antigen antibody complex