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ASDOH Hematology > Test 2 > Flashcards

Test 2 Flashcards

1
Q

The right lymphatic duct drains into?

A

The right subclavian vein.

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2
Q

The thoracic duct carries lymph into?

A

The left subclavian vein

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3
Q

Lymph nodes are most extensive in

A

Crossing joints, the breast, neck, axilla, abdomen, thorax, pelvis & groin

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4
Q

In arterials Pc is?

A

Capillary hydrostatic pressure

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5
Q

In arterials ∏c is?

A

Capillary oncotic pressure

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6
Q

Which arterial pressure is dominant?

A

Capillary hydrostatic pressure going out (Pc)

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7
Q

Which venule pressure is dominant?

A

Capillary oncotic pressure going in (∏c)

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8
Q

Lesser Pi, and ∏i direction of pressure.

A

Pi always into the capillary, ∏i always out of the capillary.

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9
Q

Edema can be caused by:

A
  • excess filtration (typically reflected by ↑P)
  • decreased absorption (typically reflected by ↓π)
  • increased capillary permeability
  • blocked lymphatics
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10
Q

Without normal lymph drainage, fluid can build up in the affected arm or leg, and________ can develop.

A

lymphedema

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11
Q

caused by obstruction of the lymphatic system. Sometimes a parasite.

A

elephantiasis

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12
Q

The there types of tonsils are?

A
  • Pharyngeal (adenoids)
  • Palatine
  • Lingual
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13
Q

is the diffusion system of small concentrations of lymphoid tissue in the GI tract.

A

Mucosa associated lymphoid tissue (MALT)

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14
Q

Stem cell development path to platelet.

A 
Hemocytoblast>>
Megakaryoblast>>
Promegakaryocyte>>
Megakaryocyte>>
Thrombocytes (platelets)
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15
Q

Of our total megakaryocytic where are most “stored”

A

Pooled in spleen 20-30%

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16
Q

Characteristics of a megakaryocytic

A

no nuc, or organelles
many granolas
Average life span 5-20 days
Continually produced by bone marrow.

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17
Q

3 general phases of hemostasis

A 
Vasoconstrictive Phase or Vascular Spasm
Platelet Plug Formation 
----Adhesion
----Aggregation
Coagulation Phase (Blood Clotting)
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18
Q

Platelets stick to the exposed COLLAGEN of damaged endothelium or an artificial surface via…

A

GPIa receptors

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19
Q

via GPIb receptors, it specifically causes platelets to attach firmly to and spread across the damaged endothelial surface…

is a protein found in plasma, platelets and the walls of blood vessels…

A

von Willebrand’s Factor (vWF)

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20
Q

During adhesion, platelets will undergo major structural changes and deformations. Adhesion also triggers the secretion of multiple factors from the platelets.
What are these factors?

A

ADP (adenosine diphosphate)
Thromboxane A2 (TA2; TXA2; a prostaglandin)
Serotonin (5-HT)

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21
Q

What will ADP, TXA2 & to some extent 5-HT do when initial platelets release these factors after the adhesion process.

A

will bind to specific receptors on other platelets. Stimulation of these receptors will activate these platelets by making them more sticky and thus adhere to one another to form.

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22
Q

“Natural” Anticoagulants

A
  • Thrombomodulin
  • Antithrombin III (or just Antithrombin)
  • Heparin cofactor II
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23
Q

What does the thrombomodulin-thrombin complex activate?

A

PROTEIN C

24
Q

What is protein C’s cofactor?

A

Protein S

25
Q

Antithrombin III is…

A

a glycoprotein produced by the liver that binds to and subsequently inhibits factor X and thrombin

26
Q

Heparin cofactor II…

A

is a plasma protein synthesized by the liver and inhibits thrombin

27
Q

What is the Fibrinolytic System?

A

restore normal blood flow in a vessel.
This is initiated by the enzyme PLASMIN which is synthesized from an inactive plasma protein synthesized by the liver called PLASMINOGEN.

28
Q

converts plasminogen to the active plasmin, thus allowing fibrinolysis to occur

A

TISSUE PLASMINOGEN ACTIVATOR (t-PA)

29
Q

Fibrinolysis inhibitors are required in vivo to prevent prolonged or unwanted degradation of fibrinogen. Several natural inhibitors have now been described, including:

A
  • Plasminogen activator inhibitor 1
  • Plasminogen activator inhibitor 2
  • α2-antiplasmin
  • α2-macroglobulin
30
Q

Condition, low platelet count → increased risk for bleeding

A

Thrombocytopenia

31
Q

Often, low platelet levels do not lead to a small red or purple spot caused by bleeding into the skin called…

A

petechia

32
Q

Citrate binds…

A

Calcium

33
Q

the ratio of a patient prothrombin time to a normal (control) sample, raised to the power of the ISI.

A

The INR

34
Q

Clinically, the INR is most often used to…

A

monitor the effectiveness of drugs such as warfarin (Coumadin)

35
Q

Most laboratories report PT results that have been adjusted to the INR for patients on anti-coagulant drugs. These patients should have an INR of ___ to ____for basic “blood-thinning” needs. For some patients who have a high risk of clot formation, the INR needs to be higher - about ___ to ___.

A

2.0-3.0

Higher INR
2.5-3.5

36
Q

In an APTT test, clotting normally takes ______ seconds

A

25-36

37
Q

Coagulation Tests Used to assess the intrinsic pathway

A

ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT)

38
Q

Coagulation Tests Used to assess the extrinsic pathway

A

PROTHROMBIN TIME (PT); PRO-TIME

39
Q

Clinically, the APTT is most often used to monitor..

A

HEPARIN therapy

40
Q

Coagulation Tests Used to assess the common pathway

A

THROMBIN CLOTTING TIME (TT)

41
Q

Used to determine actual deficiencies of specific clotting factors

A

COAGULATION FACTOR ASSAYS

42
Q

Clinically, TT is used when…

A

a PT and/or APTT test is prolonged, particularly if abnormal fibrinogen level or function is considered

43
Q

X-linked disorder; mutations in factor VIII gene

A

Hemophilia A (Factor VIII Deficiency)

44
Q

X-linked disorder; mutations in factor IX gene

A

Hemophilia B (Christmas Disease)

45
Q

are one of the most serious symptoms of hemophilia

A

joint bleeds

46
Q

In cases of hemophilia Joint damage is not a result of blood in the capsule but rather…

A

the healing process

47
Q

Patients with very low factor levels, who experience repeated and painful bleeds into their joints and skeletal muscles, are given

A

IV factor replacement

48
Q

Most common inherited bleeding disorder → affects 125 per million & leads to a mild bleeding disorder affecting males and females equally

A

Von Willebrand’s Disease (vWD)

49
Q

vWF has 2 major roles:

A
  1. Mediating platelet adhesion

2. Stabilizing factor VIII

50
Q

Unlike hemophilia A, patients vWD patients have prolonged PT because of…

A

A failure in platelet-vessel wall interaction.

51
Q

Because of its links to factor VIII, low levels of vWF, like hemophilia A, also result in…

A

a prolonged APTT & reduced factor VIII clotting activity

52
Q

Thrombocytopenia can be caused by:

A

Impaired production of platelets
• Drug induced
• Bone marrow failure

53
Q

autoimmune response to platelets, which are
removed prematurely by the reticuloendothelial
system

A

Idiopathic thrombocytopenic purpura (ITP)

54
Q

Thrombophilias are

A

conditions associated with excessive clotting

55
Q

Examples of inherited thrombophilias include

A

Protein C Deficiency

Protein S Deficiency

56
Q

Examples of inherited thrombophilias include:

A

Activated Protein C Resistance, a poor response by Factor V to protein C occurs.

A mutation in the Factor V gene (Factor V Leiden) was identified as the major cause

ASDOH Hematology (6 decks)

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