Unit 2 - Chapter 13 - Blood Flashcards
1
Q
expand on blood tissue components
A
- Liquid fraction of whole blood (extracellular
part) called plasma - Cellular components suspended in the
plasma make up the formed elements
2
Q
what are normal volumes of blood/elements/plasma
A
- Plasma: 2.6 L
- Formed elements: 2.4 L
- Whole blood: 4 to 6 L average or 7% to 9%
of total body weight
3
Q
expand on blood pH
A
- Blood is alkaline: pH 7.35 to pH 7.45
- Blood pH decreased toward neutral creates
a condition called acidosis
4
Q
expand on blood donations
A
- Approximately 14 million units donated
annually - Plasma volume expanders (such as
albumin) can only maintain blood volume
after hemorrhage for short periods - Storage of donated blood limited to 6 weeks
5
Q
what is blod plasma
A
Liquid fraction of whole blood minus
formed elements
6
Q
what is the composition of blood plasma
A
Water containing many dissolved
substances, including:
- Nutrients, salts
- About 3% of total O2 transported in blood
- About 5% of total CO2
7
Q
what are the different plasma proteins found in plasma
A
- Albumins
- Globulins
- Fibrinogen
- Prothrombin
8
Q
what is plasma called without the clotting factors
A
serum
9
Q
expand on blood serum
A
- Serum is liquid remaining after whole blood
clots - Serum contains antibodies
10
Q
what are the different formed elements of blood
A
RBCs (erythrocytes)
WBCs (leukocytes)
- Granular leukocytes (Neutrophils, eosinophils, and basophils)
- Agranular leukocytes (Lymphocytes and monocytes)
- Platelets; also called thrombocytes
11
Q
expand on the numbers of formed elements of blood
A
- RBCs: 4.2 to 6.2 million/mm3 of blood
- WBCs: 5000 to 10,000/mm3 of blood
- Platelets: 150,000 to 400,000/mm3 of blood
12
Q
expand on the formation of blood cells
A
- Red bone marrow (myeloid tissue) forms all
blood cells except some lymphocytes and
monocytes - Most other cells formed by lymphoid tissue
in the lymph nodes, thymus, and spleen
13
Q
what does a erythrocyte do
A
oxygen and carbon dioxide tranport
14
Q
what does a neutrophil do
A
immune denfense (phagocytosis)
15
Q
what does a eosinophil do
A
defense against parasites
16
Q
what does a basophil do
A
inflammatory response and heparin secretion
17
Q
what does a b lymphocyte do
A
antibody production precursor of plasma cells
18
Q
what does a t lymphocyte cell do
A
cellular immune response
19
Q
what does a monocyte do
A
immune defenses (phagocytosis)
20
Q
what does a thrombocyte do
A
clots blood
21
Q
what do most blood diseases result from
A
failure of myeloid and lymphoid tissues
22
Q
what are the causes of blood diseases
A
-toxic chemicals
- radiation
- inherited defects
- nutritional deficiencies
- cancers, including leukemia
23
Q
what is aspiration biopsy cytology
A
Aspiration biopsy cytology (ABC)
permits examination of blood-forming
tissues to assist in diagnosis of blood
diseases, if bone marrow failure is
suspected
24
Q
what can be used to replace diseased or destroyed blood-forming tissues
A
Bone marrow, cord blood, and
hematopoietic stem cell transplants
may be used
25
expand on the structural finds of red blood cells
- Tough and flexible plasma membrane
deforms easily, allowing RBCs to pass
through small-diameter capillaries
- Biconcave disk (thin center and thicker
edges) results in large cellular surface area
- Absence of nucleus and cytoplasmic
organelles limits life span to about 120 days
but provides more cellular space for red
pigment called hemoglobin (Hb)
26
what is the function of red blood cells
- transportation of respiratory gases
- homeostasis of acid-base balance
27
what is complete blood cell count
battery of labratory tests used to measure the amounts or levels of many blood constituents
28
what is Hematocrit (also called packed cell
volume, or PCV
the percentage of whole blood that is RBCs
29
what are the 3 red blood cells abnormalities that are names according to size
- Normocytes: Normal size (about 8 to 9 μm in
diameter)
- Microcytic: Small size
- Macrocytic: Large size
30
what are the 3 red blood cell abnormalities that are names according to hemoglobin content of cell
- Normochromic: Normal Hb content
- Hypochromic: Low Hb content
- Hyperchromic: High Hb content
31
what is the composition of type a blood
Type A antigens in RBCs; anti-B type antibodies in plasma
32
what is the compositon of type b blood
Type B antigens in RBCs; anti-A type antibodies in plasma
33
what is the composition of type ab blood
Type A and type B antigens in RBCs; no anti-A or anti-B antibodies in plasma; called universal recipient blood
34
what is the composition of type o blood
No type A or type B antigens in RBCs; both anti-A and anti-B antibodies in plasma; called universal donor blood
35
expand on rh-positive blood
rh factor antigen present in red blood cells
36
expand on rh-negative blood
No Rh factor present in RBCs; no anti-Rh
antibodies present naturally in plasma; anti-Rh
antibodies, however, appear in the plasma of
Rh-negative persons if Rh-positive RBCs have
been introduced into their bodies
37
expand on erythroblastosis fetalis
May occur when Rh-negative mother carries a
second Rh-positive fetus; caused by mother’s
Rh antibodies reacting with baby’s Rh-positive
cells
38
what is polycythemia caused by
cancerous transformation
of red bone marrow
39
what happens to red blood cells in polycythemia
Dramatic increase in RBC numbers: Often in
excess of 10 million/mm3 of blood;
hematocrit may reach 60%
40
what are signs and symptoms of polycythemia
- Increased blood viscosity or thickness
- Slow blood flow and coagulation problems
- Frequent hemorrhages
- Distention of blood vessels and hypertension
41
what are the treatment options for polycythemia
- Blood removal
- Irradiation and chemotherapy to
suppress RBC production
42
what is anemia caused by
-Caused by low numbers or abnormal
RBCs or by low levels or defective types
of hemoglobin
- Normal Hb levels 12 to 14 g/100 mL of
blood
- Low Hb level (below 9 g/100 mL of blood)
classified as anemia
43
what are signs and symptoms of anemia
-Fatigue; skin pallor
- Weakness; faintness; headache
- Compensation results in increased heart
and respiratory rates
44
what is the difference between acute and chronic hemorrhagic anemia
- in acute, blood loss is immediate
- in chronic, blood loss occurs over time
45
what is aplastic anemia characterized by and what is it caused by
- Characterized by low RBC numbers and
destruction of bone marrow
- Often caused by toxic chemicals, irradiation,
or certain drugs
46
what are deficiency anemias caused by
Caused by inadequate supply of some
substance needed for RBC or
hemoglobin production
47
expand on pernicious anemia
- genetic related autoimmune disease
- decreased rbc, ebc and platelet numbers
- rbcs are macrocytic
48
what is pernicious anemia caused by
vitamin b12 deficiency
49
what are symptoms of pernicious anemia
- classic anemia symptoms
- central nervous system impairment
50
what is the treatment for pernicious anemia
- repeated b12 injection
51
expand on folate deficiency anemia
- Caused by folate (vitamin B9) deficiency
- Decreased RBC count
- Common in alcoholism and malnutrition
52
what occurs in iron deficiency anemia
- RBCs are microcytic and hypochromic
- Hematocrit is decreased
53
what is iron deficiency anemia caused by
Caused by deficiency of or inability to
absorb iron needed for Hb synthesis
(dietary iron deficiency is common
worldwide)
54
what is the treatment for iron deficiency anemia
Treatment is oral administration of iron
compounds
55
what is the cause of hemolytic anemias
Caused by decreased RBC life span or
increased RBC rate of destruction
56
what are the symptoms of hemolytic anemias
jaundice, swelling of
spleen, gallstone formation, and tissue
iron deposits, are related to retention of
RBC breakdown products
57
what is sickle cell anemia and what happens to the rbcs
- Genetic disease resulting in formation of
abnormal hemoglobin (HbS); primarily
found in African-Americans
- RBCs become fragile and assume sickled
shape when blood oxygen levels decrease
58
what is the difference in mild sickle cell trait and more severe sickle cell disease
- Mild sickle cell trait—result of one
defective gene
- More severe sickle cell disease—result of
two defective genes; causes blood stasis,
clotting, and episodes called crises that
may be fatal
59
expand on thalassemia
- Group of inherited hemolytic anemias
occurring primarily in people of
Mediterranean descent
- RBCs microcytic and short lived
- Present as mild thalassemia trait and
severe thalassemia major
- Hb levels often fall below 7 g/100 mL of
blood in thalassemia major
60
what are the symptoms of thalassemia
Classic symptoms of anemia coupled
with skeletal deformities and swelling of
spleen and liver
61
what is the treatment for thalassemia
Marrow and stem cell transplantation
needed for long-term treatment success
62
what causes hemolytic disease of newborns and erythroblastosis fetalis
Caused by blood ABO or Rh factor
incompatibility during pregnancy
between developing baby and mother
63
what do the maternal antibodies do in hemolytic disease of newborns and eryhtoblastosis fetalis
Maternal antibodies against “foreign”
fetal RBCs or Rh factor can cross
placenta, enter the fetal circulation, and
destroy the unborn baby’s red cells
64
what are the symptoms in developing hemolytic disease of newborns and eryhtoblastosis fetalis
Symptoms in developing fetus related
to decline in RBC numbers and Hb
levels; jaundice, intravascular
coagulation, and heart and lung
damage are common
65
what is the treatment for hemolytic disease of newborns and eryhtoblastosis fetalis
treatment may include in utero blood transfusions and premature delivery of the baby
66
how can you prevent hemolytic disease of newborns and eryhtoblastosis fetalis
- preventing rh factor incompatibility is now possible by administration of RhoGAM to Rh-negative mothers
67
how are leukocytes categorized
Categorized by presence of granules
(granulocytes) or absence of granules
(agranulocytes)
68
what is the normal wbc count in blood
Normal range is 5000 to 10,000/mm3 of blood
69
what is leukopenia and when may it occur
Leukopenia: Abnormally low WBC count
(below 5000/mm3 of blood)
- Occurs infrequently
- May occur with malfunction of blood-
forming tissues or diseases affecting
immune system, such as AIDS
70
what is leukocytosis, where is it found and what is it a sign of
Leukocytosis: Abnormally high WBC
count (over 10,000/mm3 of blood)
- Frequent finding in bacterial infections
- Classic sign in blood cancers (leukemia)
71
what is differential wbc count
Component test in CBC; measures proportions of each type of WBC in blood sample
72
within leukocytes there are 3 types of granulocytes. what are their names
neutrophils
eosinophils
basophils
73
expand on neutrophils
- Most numerous type of phagocyte
- Numbers increase in bacterial infections
74
expand on eosinophils
- Weak phagocyte
- Active against parasites and parasitic worms
- Involved in allergic reactions
75
expand on basophils
- Related to mast cells in tissue spaces
- Both mast cells and basophils secrete histamine
(related to inflammation)
- Basophils also secrete heparin (an anticoagulant)
76
within leukocytes, there are 2 types of agranulocytes. what are their names
monocytes
lymphocytes
77
expand on monocytes
- Largest leukocytes
- Aggressive phagocytes: Capable of engulfing
larger bacteria and cancer cells
- Develop into much larger cells called
macrophages after leaving blood to enter tissue
spaces
78
expand on lymphocytes
- B lymphocytes involved in immunity against
disease by secretion of antibodies
- Mature B lymphocytes called plasma cells
- T lymphocytes involved in direct attack on
bacteria or cancer cells (not antibody
production)
79
what do lymphoid neoplasms results from
result from B and T
lymphocyte precursor cells or their
descendent cell types
80
what do myeloid neoplasms result from
malignant transformation of precursor cells of
granulocytic WBCs, monocytes, RBCs, and
platelets
81
expand on multiple myeloma
- Cancer of B lymphocytes called plasma
cells
- Most deadly blood cancer in people
older than age 65
- Causes bone marrow dysfunction and
production of defective antibodies
82
what is multiple myeloma charterized by
- Recurrent infections and anemia
- Destruction and fracture of bones
83
what is the treatment for multiple myeloma
chemotherapy, drug
and antibody therapy, and marrow and
stem cell transplantation
84
what is leukemia
WBC-related blood cancers
85
explain the 4 different levels of leukemia
- acute (rapid development of symptoms)
- chronic (slow development of symptoms)
- lymphocytic (affects lymphocytes)
- myeloid (affects granular leukocytes as they develop in the red bone marrow)
86
expand on chronic lymphocytic leukemia
- Average age of onset is 65; rare before age 30
- More common in men than in women
- Often diagnosed unexpectedly in routine physical
exams with discovery of marked B lymphocytic
leukocytosis
- Most patients live many years following diagnosis
87
what are the symptoms of chronic lymphocytic leukemia
anemia, fatigue,
and enlarged—often painless—lymph nodes
88
what is the treatment for chronic lymphocytic leukwmia
chemotherapy and irradiation
89
expand on acute lymphocytic leukemia
- Primarily a disease of children 3 to 7 years of
age; 80% of children who develop leukemia
have this form of the disease
- Highly curable in children but less so in adults
90
what are the symptoms and signs of acute lymphocytic leukemia
- Onset is sudden; marked by fever, leukocytosis,
bone pain, and increases in infections
- Lymph node, spleen, and liver enlargement is
common
91
what is the treatment for acute lymphocytic leukemia
- Treatment includes chemotherapy, irradiation,
and bone marrow or stem cell transplantation
92
expand on chronic myeloid leukemia
- accounts for about 20% of all cases of leukemia
- occurs most often in adults 25 to 60 years of age
- caused by cancerous transformation of granulocytic precursor cells in the bone moaarow
- onset and progression of disease are slow
93
what are symptoms and signs of chronic myeloid leukemia
- fatigue, weight loss and weakness
- marked granulocytic leukocytosis and extreme spleen enlargement
94
what is the treatment for chronic myeloid leukemia
Treatment by new “designer drug”
Gleevec or bone marrow transplants is
curative in over 70% of cases
95
expand on acute myeloid leukemia
- Accounts for 80% of all cases of acute
leukemia in adults and 20% of acute
leukemia in children
- Sudden onset and rapid progression
- Prognosis is poor, with only about 50% of
children and 30% of adults achieving long-
term survival
96
what are the symptoms of acute myeloid leukemia
leukocytosis, fatigue,
bone and joint pain, spongy bleeding
gums, anemia, and recurrent infections
97
what is the treatment for leukemia
Bone marrow and stem cell
transplantation has increased cure rates
98
expand on infectious monocucleosis
- Noncancerous WBC disorder
- Highest incidence between 15 and 25
years of age
- Caused by virus present in saliva of
infected individuals
- Leukocytosis of atypical lymphocytes
with abundant cytoplasm and large
nuclei
99
what are the symptoms of infectious mononucleosis
fever, severe fatigue,
sore throat, rash, and enlargement of
lymph nodes and spleen
100
what does the healing of infectious mononucleosis look like
Generally self-limited and resolves
without complications in about 4 to 6
weeks
101
expand on platelets/blood clotting
- Platelets play essential role in blood
clotting
- Blood vessel damage causes platelets to
become sticky and form a “platelet plug”
- Accumulated platelets release additional
clotting factors that enter into the clotting
mechanism
- Platelets ultimately become a part of the
clot itself
102
expand on the clotting mechanism
- Damaged tissue cells release clotting factors
leading to formation of prothrombin activator,
which combines with platelet-produced
prothrombin activator
- Prothrombin activator and calcium convert
prothrombin to thrombin
- Thrombin reacts with fibrinogen to form fibrin
- Fibrin threads form a tangle to trap RBCs (and
other formed elements) to produce a blood
clot
103
how can you alter the blood clotting mechanism
- Application of gauze (rough surface) to
wound causes platelet aggregation and
release of clotting factors
- Administration of vitamin K increases
synthesis of prothrombin
- Coumadin delays clotting by inhibiting
prothrombin synthesis
- Heparin delays clotting by inhibiting
conversion of prothrombin to thrombin
- Drug called tissue plasminogen
activator (TPA or tPA) used to dissolve
clots that have already formed
104
expand on prothrombin time test
- Used to regulate dosage of anticoagulant
drugs
- Calcium and thromboplastin added to a
tube of patient’s plasma and a tube of
control solution
- Timed to see how long clotting takes and
compared to see if drug dosage needs to
be adjusted
- Highly variable results among labs have
required the use of the INR (International
Normalized Ratio) system, which uses a
calculation to standardize measurements
105
what is a thrombus
staitionary blood clot
106
what is a embolus
Circulating blood clot (TPA
used to dissolve clots that have already
formed)
107
expand on hemophilia
- X-linked inherited disorder that results from
inability to produce factor VIII (a plasma
protein) responsible for blood clotting
- Most serious “bleeding disease” worldwide;
hemophilia A most common form
108
what are the signs and symptoms of hemophilia
Characterized by easy bruising, deep muscle
hemorrhage, blood in urine, and repeated episodes
of bleeding into joints causing pain and deformity
109
what is the treatment for hemophilia
Treatment includes administration of factor VIII,
injury prevention, and avoiding drugs such as
aspirin that alter the clotting mechanism
110
what is thrombocyopenia caused by
- Most common cause is bone marrow
destruction by drugs, chemicals, radiation,
and diseases such as cancer, lupus, and
HIV/AIDS
- Caused by reduced platelet counts
111
what is thrombocytopenia characterized by
Characterized by bleeding from small blood
vessels, most visibly as purpura (purplish
spots) in the skin and mucous membranes
112
expand on the platelet count in thrombocytopenia
Platelet count below 20,000/mm3 may cause
catastrophic bleeding (normal platelet count
150,000 to 400,000/mm3)
113
what is the treatment in thrombocytopenia
Treatment may involve transfusion of
platelets, corticosteroid-type drugs
114
expand on vitamin k deficiency
- Necessary to make several clotting
factors
- Vitamin K mostly produced by bacteria
in intestines, where it is absorbed into
bloodstream
- Infants may lack bacteria to produce
enough vitamin K for normal clotting
