Unit 2 - Hematology Part I Flashcards
blood pressure
change in pressure = P1-P2
change in P = flow (Q) x vessel resistance (R)
circulatory shock (5 types)
- septic
- neurogenic
- obstructive
- cardiogenic
- hypovolemic
edema
accumulation of excessive fluid with the interstitial tissues or within body cavities
congestion
implies accumulation of excessive blood within the vessels of an organ or tissue
thrombus and embolus
thrombus: blood clot that has formed either in a blood vessel or in the heart that has remained stationary
embolus: blood clot that has been broken off from its original location and has moved through a vessel to lodge at a distant site
infarction
cell death and tissue necrosis that is caused by a disruption in the blood supply
lymphedema
chronic swelling of an area due to accumulation of interstitial fluid secondary to obstruction of lymphatic vessels/nodes
shock
BP falls so low that perfusion of the organs cannot occur
anemia
RBC count falls significantly, thus resulting in reduction in hemoglobin and the ability of the blood to carry o2 to the organs and the tissues
polycythemia
too many RBCs cause viscosity increase of the blood and congestion
leukocytopenia
significant reduction in the total WBC count
leukocytosis
blood disorder in which immature WBCs accumulate
aging and the hematopoietic system: decrease in… (3 things)
- intestinal absorption of iron
- iron-binding capacity
- iron storage capacity
destination
bone marrow
decreases result in…
- decreased RBC’s (iron deficiency anemia)
- increased RBC fragility
decreased vitamin B12 GI absorption results in
decrease in red bone marrow production of RBCs
disease outcome - pernicious anemia
decreased number/size of lymph nodes and cellular immunity/t-cell function outcome
reduced immunity
blood composition - plasma
55% of blood volume
Water-90+%
Solids-<10% (electrolytes, proteins)
blood composition - cells
45% of blood volume
Red blood cells (Erythrocytes)
White blood cells (Leukocytes)
Platelets (Thrombocytes)
blood transfusions
Necessary following prolonged surgery or accident
Elective surgery-autologous transfusions
blood transfusion complication
ABO Incompatibility (Type II Hyperimmune reaction) Signs of complications Chills and Fever Rash Jaundice Blood stained urine Adult Respiratory Distress Syndrome Hepatitis B or C infection HIV infection Air embolism Circulatory overload Delayed reaction
erythroprotein
active form of renal erthyropoietic factor, which is produced by the kidneys
when activated, it stimulates bone marrow, thus promoting hematopoiesis
Hemochromatosis
genetic disorder
- too much iron absorbed from the GI tract
- too much iron deposited in organs and various tissues
- “rusty” colored skin
Hemochromatosis etiology
Men: Women=8:1 Peak age: 50’s and 60’s Autosomal Recessive Defect in the HFE Gene (High Fe gene)
Hemochromatosis - iron accumulates causing
Iron induced Arthropathy Iron Induced Cirrhosis and Hepatocellular Cancer Iron induced Cardiomyopathy Fe induced Emphysema-Lungs Fe induced Diabetes Mellitus-pancreas Fe induced Sterility-Reproductive organs
Porphyria
Accumulation of porphyrins
Porphyrins form “Heme” portion of Hemoglobin
Accumulate in tissues and organs, i.e. CNS
Seizures, cognitive changes, behavioral changes
Polyneuropathy with Polyneuritis
Spill over as “Port wine urine”
Porphyrins are a purple pigment
cutaneous porphyria
photodermatitis
complete blood count
Total rbc count (4.2-6.1 million cells/mcL) Total wbc count (4.5-9.5 thousand cells/mcL) Total platelet count (150, 000-400,00 cells/mcL) Hemoglobin (grams/100 ml) Hematocrit (%) Leukocyte differential count: Granulocytes - 50-75% Neutrophils (PMN’s) - 1-2% Eosinophils - 0.5-1% Basophils Agranulocytes - 25-33% Lymphocytes - 6% Monocytes
Reticulocyte count (1% immature RBC’s) RBC indices MCV (~87 cubic microns) MCHC (~30%) MCH (~30 picograms)*
everything included in a CBC
Red Blood Cell count + indices White Blood Cell count + differential Platelet Count Hemoglobin and Hematocrit Reticulocyte Count
Hemoglobinopathies-Sickle Cell Disease
Abnormal, “sickle cell” shaped erythrocyte in Sickle cell disease
Autosomal recessive trait: sickle cell disease (HbSS)
Heterozygote: sickle cell trait” (HbAS)
Commonly in people from parts of tropical and sub-tropical areas where malaria is common, or their descendants .. .
sickle cell disease clinical issues
Poor Affinity for O2
Vascular Occlusive Crisis
Hemolytic Crisis
Vascular Occlusive Crisis
Stroke Heart Attack Venous thrombus Thromboembolism Auto-splenectomy Acute chest syndrome
Hemolytic Crisis
Creates “sludge” and vascular occlusion Stroke Heart Attack Venous thrombus Thromboembolism Auto-splenectomy Acute chest syndrome
the anemias - CDC
“Hemoglobin < 14 gms/100 ml (males)”
“Hemoglobin < 12 gms/100 ml (females”
Anemia s/s
Pallor Resting Tachycardia Cardiac Murmurs >100 bpm Angina Dyspnea Anorexia Constipation/Diarrhea Headaches -Dizziness Syncope (fainting) Tinnitus Stomatitis Pica fatigue
causes of anemia
Excessive Blood Loss
Increased Destruction of Erythrocytes
Decreased Production of Erythrocytes
anemia caused by excessive blood loss
- most common
- from cancer, long term use of aspirin/other drugs, menstruation
- also known as Normocytic, normochromic
- RBC Indices (MCV, MCHC, MCH) all normal
anemias caused by destruction of RBCs
- may be congenital or acquired
- congenital: sickle cell
- acquired: autoimmune, malaria
anemia caused by destruction of erythrocytes - type 1
macrocytic, normochronic:
- RBCs are enlarged but hemoglobin concentration is normal
- when DNA synthesis has been interfered with, b12 deficiency (pernicious anemia)
anemia caused by destruction of erythrocytes - type 2
microcytic, hypochromic:
- RBCs are smaller than normal, and hemoglobin concentration per RBC is below normal
- iron deficiency
aplastic anemia
life threatening illness
bone marrow is suppressed, resulting in an insufficient number of production of all blood cells
- congenital, idiopathic, or acquired
- may survive long term on supportive therapy or death by internal bleeding
polycythemia
- myeloproliferative disorder (too many RBCs)
- increased blood volume and viscosity
primary polycythemia (vera)
- bone marrow overproduces blood cells
- older men, progressive
Rust colored skin
Blood-shot eyes
Headache, “fullness” in the head
Dizziness
Fatigue
Pruritus (itchy”)
deep venous thrombus - Budd Chiari syndrome
secondary polycythemia
- aquired
1) circulating volume of plasma decreases (dehydration)
2) RBCs increase from external causes - smoking
high altitude
