test 2 Flashcards

1
Q

what is hematology

A

the study of blood and blood-forming tissues. This includes the bone marrow, blood, spleen, and lymph system.

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2
Q

what is hematopoiesis

A

Blood cell production (hematopoiesis) occurs within the bone marrow. Bone marrow is the soft material that fills the central core of bones.

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3
Q

what are two types of bone marrow

A

yellow (adipose) and red (hematopoietic), and it is the red marrow that actively produces blood cells.

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4
Q

blood and its function

A

transportation, regulation, and protection. There are two major components to blood: plasma and blood cells.

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5
Q

plasma

A

is composed primarily of water, but it also contains proteins, electrolytes, gases, nutrients, and waste.

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6
Q

3 types of blood cells

A

rythrocytes (RBCs), leukocytes (WBCs), and thrombocytes (platelets)

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7
Q

where do the blood cells develop from?

A

All three types of blood cells develop from a common hematopoietic stem cell within the bone marrow, best described as an immature blood cell that is able to self-renew and to differentiate into hematopoietic progenitor cells.

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8
Q

Erythrocytes

A

are primarily composed of a large molecule called hemoglobin, which is a complex compound composed of heme (an iron compound) and globin (a simple protein) and binds with oxygen and carbon dioxide.

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9
Q

Erythropoiesis

A

is the process of RBC production

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10
Q

Hemolysis

A

destruction of RBCs) by monocytes and macrophages removes abnormal, defective, damaged, and old RBCs from circulation.

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11
Q

Leukocytes

A

WBCs) appear white when separated from blood. There are five different types of leukocytes, each of which has a different function.

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12
Q

Leukocytes: granulocytes

A

Granulocytes (neutrophils, eosinophils, basophils): the primary function of the
granulocytes is phagocytosis, a process by which WBCs ingest or engulf any unwanted organism and then digest and kill it. The neutrophil is the most common type of granulocyte.

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13
Q

leukocytes: lymphocytes

A

Lymphocytes constitute 20% to 25% of WBCs, and originate form stem cells in bone marrow. They form the basis of the cellular and humoral immune responses.

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14
Q

leukocytes: Monocytes

A

Monocytes constitute 3% to 8% of all WBCs, and are phagocytic cells. They can ingest small or large masses of matter, such as bacteria, dead cells, tissue debris, and old or defective RBCs.

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15
Q

The primary function of thrombocytes

A

is to initiate the clotting process by producing an initial “platelet plug” in the early phases of the clotting process.

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16
Q

Hemostasis

A

is a term used to describe the blood clotting process. This process is important in minimizing blood loss when various body structures are injured.

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17
Q

Four components contribute to normal hemostasis

A

(1) vascular response, (2) platelet plug formation, (3) fibrin clot development of the blood, and (4) clot dissolution.

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18
Q

Fibrinolysis

A

a method of maintaining blood in its fluid form, is a continual process resulting in the dissolution of fibrin and thus clots.

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19
Q

spleen and role in hematological system

A

which is located in the upper left quadrant of the abdomen. The role of the spleen can be classified into four general functions: hematopoiesis, filtration, immunological support, and storage.

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20
Q

The lymph system

A

onsisting of lymph fluid,
lymphatic capillaries,
lymphatic ducts,
and lymph nodes—carries fluid from the interstitial spaces to the blood.

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21
Q

physical exam for hematological system

A

including an assessment of lymph nodes, liver, spleen, and skin.

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22
Q

The most direct means of evaluating the hematological system

A

is through laboratory analysis and other diagnostic studies.

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23
Q

The complete blood count (CBC)

A

involves several laboratory tests, each of which serves to assess the three major blood cells formed in the bone marrow.

24
Q

pancytopenia

A

Suppression of the entire CBC, (marked decrease in the number of RBCs, WBCs, and platelets).

25
Q

Erythrocyte sedimentation rate (ESR or “sed rate”)

A

measures the sedimentation, or settling, of RBCs and is used as a nonspecific measure of many diseases, especially inflammatory conditions.

26
Q

when is the hemoglobin value reduced

A

in cases of anemia, hemorrhage, and states of hemodilution, such as those that occur when the fluid volume is excessive.

27
Q

when are RBCs increased

A

in polycythemia or in states of hemoconcentration, which can develop from volume depletion (dehydration).

28
Q

The hematocrit value

A

is determined by spinning blood in a centrifuge, which causes erythrocytes (RBCs) and plasma to separate. The RBCs are heavier, and settle to the bottom. The hematocrit value represents the percentage of RBCs in comparison with the total blood volume. The hematocrit value is reduced and elevated in the same conditions that raise and lower the hemoglobin value.

29
Q

laboratory tests

A

The laboratory tests used in evaluating iron metabolism include serum iron, total iron- binding capacity (TIBC), serum ferritin, and transferrin saturation.

30
Q

Radiological studies for the hematology system involve

A

primarily the use of computed tomography (CT) or magnetic resonance imaging (MRI) for evaluating the spleen, liver, and lymph nodes.

31
Q

Bone marrow examination is important in the evaluation of

A

many hematological disorders. The examination of the marrow may involve aspiration alone or aspiration with biopsy.

32
Q

Lymph node biopsy

A

involves obtaining lymph tissue for histological examination to determine the diagnosis and to help for planning therapy

33
Q

tests

A

Testing for specific genetic or chromosomal variations in hematological conditions is often helpful in assisting in diagnosis. These results also help to determine the treatment options and prognosis.

34
Q

iron deficiency anemia

A

develop from inadequate dietary intake, malabsorption,
blood loss, or hemolysis.

35
Q

why is iron deficiency common in pregnancy

A

Also, pregnancy contributes to iron deficiency because of the diversion of iron to the fetus for erythropoiesis, blood loss at delivery, and lactation.

36
Q

main goal of iron deficiency anemia

A

to treat the underlying disease causing reduced intake (e.g., malnutrition, alcoholism) or absorption of iron. In addition, efforts are directed toward replacing iron with dietary changes or supplementation.

37
Q

who is at increased risk for developing iron deficiency anemia

A

These include premenopausal and pregnant women, people from disadvantaged socioeconomic backgrounds, older adults, and individuals experiencing blood loss.

38
Q

clinical manifestations of Fe def anemia

A

pallor
glossitis (tongue inflammation)
cheilitis ( inflammation of lips)

headache,, parenthesis, burning sensation of tongue all from lack of iron in tissues

39
Q

iron def diagnostic studies

A

low levels of everything except high levels of TIBC

40
Q

iron def anemia therapy

A

treat underlying cause
med therapy, ferrous sulphate or ferrous gluconate, nutritional therapy and transfusion of packed RBC

41
Q

Thalassemia

A

is a group of diseases that involve inadequate production of normal
hemoglobin and therefore decreased erythrocyte production.

42
Q

thalassemia and genetics

A

It has an autosomal recessive genetic basis. An individual with thalassemia may have a heterozygous or homozygous form of the disease, based on the number of thalassemic genes the individual has.

43
Q

Thalassemia minor

A

requires no treatment because the body adapts to the reduced level of normal hemoglobin.

44
Q

The symptoms of thalassemia

A

major are managed with life-long blood transfusions in conjunction with IV deferoxamine (Desferal) to reduce the iron overloading (hemochromatosis) that occurs with chronic transfusion therapy.

45
Q

Megaloblastic anemias

A

are a group of disorders caused by impaired DNA synthesis
and characterized by the presence of large RBCs.

46
Q

why are microcytic RBC easily destroyed

A

Macrocytic (large) RBCs are easily destroyed because they have fragile cell membranes.

47
Q

what are 2 common forms of megaloblastic anemias

A

cobalamin deficiency and folic acid deficiency.

48
Q

Cobalamin (vitamin B12) deficiency

A

is most commonly caused by pernicious anemia, which results in poor cobalamin absorption through the GI tract.

Treatment: Parenteral or intranasal administration of cobalamin (cyanocobalamin or hydroxocobalamin) is the treatment of choice.

49
Q

Folic acid (folate)

A

is required for DNA synthesis leading to RBC formation and maturation and therefore can lead to megaloblastic anemia.

Treatment: Folic acid deficiency is treated by replacement therapy.

50
Q

ANEMIA OF CHRONIC DISEASE

A

Chronic inflammatory, autoimmune, infectious, or malignant diseases can lead to an underproduction of RBCs and mild shortening of RBC survival

51
Q

treatment of anemia of chronic disease

A

The best treatment of anemia of chronic disease is correction of the underlying disorder.

52
Q

Aplastic anemia

A

is a disease in which the patient has peripheral blood pancytopenia (decrease of all blood cell types) and hypocellular bone marrow.

53
Q

Management of aplastic anemia

A

is based on identifying and removing the causative agent (when possible) and providing supportive care until the pancytopenia reverses.

54
Q

SICKLE CELL DISEASE

A

Sickle cell disease (SCD) is a group of inherited, autosomal recessive disorders characterized by the presence of an abnormal form of hemoglobin in the erythrocyte.

55
Q

sickle cell disease pathophysiology

A

The major pathophysiological event of this disease is the sickling of RBCs. Sickling episodes are most commonly triggered by low oxygen tension in the blood.
* With repeated episodes of sickling there is gradual involvement of all body systems, especially the spleen, lungs, kidneys, and brain.

56
Q

Collaborative care for a client with sickle cell disease is directed toward

A

(a) preventing sequelae from the disease,
(b) alleviating the symptoms of the disease,
(c) minimizing end–target organ damage,
(d) promptly treating serious sequelae, such as acute chest syndrome. There is no specific treatment for the disease.