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Paige: Heme/Onc Module! > Red Blood Cell Disorders: Background > Flashcards

Red Blood Cell Disorders: Background Flashcards

1
Q

What do RBCs do?

A

Transport oxygen, CO2, CO, and HN03 (nitric acid) gases for exchange

Via the protein hemoglobin

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2
Q

Anemia definition

A

Low hemoglobin, RBC count, or hematocrit

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3
Q

Hematocrit definition

A

the % of RBCs

total blood volume

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4
Q

Polycythemia definition

A

elevated Hbg, RBC count, or hematocrit

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5
Q

What tests do you first use to assess for RBC disorders?

A

CBC

peripheral smear

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6
Q

What does a peripheral smear test?

A

morphology of RBCs

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7
Q

Where are RBCs made?

A

bone marrow stem cells

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8
Q

what hormone drives RBC production?

A

erythropoeitin (epo)

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9
Q

What organ secretes epo?

A

kidney

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10
Q

What items in our diet are needed to supply the bone marrow?

A

iron

folic acid

vitamin B12

protein

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11
Q

Life cycle of a RBC

A
  1. In bone marrow w/ nuclei
  2. Nuclei get extruded after all the Hgb is made
  3. RBC leaves the bone marrow w/ some RNA (this RNA stains as a reticulocyte)
  4. The reticulocyte matures into an RBC in 2 days
  5. This RBC circulates in the blood for 120 days
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12
Q

What does the reticulocyte count measure?

A

how the bone marrow is responding to a decrease in RBCs

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13
Q

How is reticulocyte count measured? (fraction)

A

raw reticulocyte count x patient Hgb

normal Hgb

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14
Q

What percentage of reticulocyte count indicates the bone marrow is working?

A

greater than 3%

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15
Q

What happens to RBCs after 120 days?

A

They are hemolyzed in the spleen, and Hgb is degraded into heme and globin.

Heme –> indirect bilirubin; transported to liver to become direct bilirubin

This gets stored in the gall bladder

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16
Q

What could high levels of indirect bilirubin indicate?

A

hemolysis or hereditary Gilbert syndrome

17
Q

What could high indirect bilirubin PLUS high corrected reticulocyte, high LDH, and hemoglobinuria point to?

A

hemolysis

18
Q

Hemoglobin definition

A

protein composed of different amino acid chains (alpha, beta, delta, gamma)

has 4 iron-containing heme groups

19
Q

What types of Hgb are in everyone’s RBCs?

A

Hgb A, F, and A2

20
Q

What Hgb is predominant in utero?

A

F

21
Q

What Hgb is most dominant after birth?

A

A

22
Q

What can decreased alpha- or beta-chain production cause?

A

thalassemia (alpha and beta types)

23
Q

What is the most common hemoglobinopathy?

A

sickle hemoglobin (Hgb S)

24
Q

What lab tests can be used to identify hemoglobinopathies?

A

hemoglobin electrophoresis

isoelectric focusing (IEF)

high-performance liquid chromatography (HPLC)

capillary zone electrophoresis (CZE)

25
Q

What causes a hypocoagulable state?

A

platelet deficiency

factor deficiency (clotting factors, vWF, Vit K)

26
Q

What causes a hypercoagulable state?

A

excess platelets

deficiency of anti-thrombotic proteins (protein C, protein S)

27
Q

How do platelet problems usually manifest?

A

excessive/repetitive bleeding, bruising, or bleeding @ unusual sites

28
Q

How do platelet problems & vWD present?

A

skin petechiae, bruising, increased mucosal bleeding (epistaxis, gums, menorrhagia)

29
Q

How do coagulation defects typically present?

A

(e.g. hemophilia)

hemarthroses and deep tissue hematomas

30
Q

What diagnostic studies are usually used for coagulation disorders?

A

CBC with platelet count, peripheral smear, and PFA (for ID and quantifying cellular changes)

PT (extrinsic clotting pathway) or INR

PTT (intrinsic clotting pathway)

TT (if either PT or PTT is prolonged)

metabolic profile (liver and kidney fn)

D-dimer (detects thrombosis)

31
Q

What is the intrinsic clotting pathway?

A

indicates when there is damage inside a blood vessel

feeds into the common pathway (factors X, V, II)

32
Q

What is the extrinsic clotting pathway?

A

indicates there is a tissue injury (outside the blood vessel)

feeds into the common pathway (X, V, II)

33
Q

What does PT tell?

A

examines how long clotting takes in the extrinsic pathway, or common pathway

(Factors VII, X, V, II)

34
Q

What does PTT tell?

A

examines how long clotting takes in the intrinsic pathway, or common pathway

(Factors XII, XI, IX, VIII, X, V II)

35
Q

Which clotting factors work with Vitamin K?

A

II, VII, IX, X

36
Q

Which lab value measures the effect of Coumadin? (which affects the Vit. K dependent factors)

A

PT

37
Q

Which lab values tell you about Heparin’s effect? (which increases antithrombin III activity)

A

PPT

Paige: Heme/Onc Module! (8 decks)

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