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Pathophysiology with Price > Unit 3 > Flashcards

Unit 3 Flashcards

1
Q

What does whole blood consist of?

A

Formed elements, plasma proteins, and solutes

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2
Q

What are formed elements in the blood?

A

WBC’s, RBC’s, and platelets

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3
Q

What kinds of solutes are in the blood?

A

Electrolytes, gases, nutrients, and waste products

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4
Q

What lies between RBC’s and Plasma in centrifuged blood?

A

Buffy coat (WBC’s and platelets)

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5
Q

What percentage of whole blood is plasma?

A

55% to 60%

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6
Q

What percentage of whole blood is RBC’s?

A

45%

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7
Q

Plasma vs. Serum

A

Plasma is unclothed blood, while serum is already clotted

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8
Q

How much of plasma is water?

A

92%

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9
Q

How much of plasma is solutes?

A

8%

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10
Q

What percentage of solutes in the plasma are plasma proteins?

A

7%

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11
Q

Identify 3 plasma proteins in blood plasma

A

Albumin, globulin, and fibrinogen

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12
Q

What does the last 1% of plasma consist of?

A

Other solutes like electrolytes, nutrients, gases, hormones, and wastes

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13
Q

Where is albumin synthesized?

A

The liver

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14
Q

What does albumin do?

A

Contributes to blood viscosity (thickness) and maintains blood pressure

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15
Q

Where is albumin found?

A

In the capillaries; it can not diffuse freely across the vascular endothelium

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16
Q

What is the function of albumin?

A

Acts as an osmotically-active carrier molecule for oxygen by binding to hemoglobin

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17
Q

What are globulins?

A

There are 4 main groups of globulins; alpha, alpha2, beta, and gamma

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18
Q

What are alpha globulins responsible for?

A

Carrier molecule

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19
Q

What are beta globulins responsible for?

A

Carrier molecule

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20
Q

Do alpha and beta globulins interact?

A

Yes, together they control blood osmotic pressure

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21
Q

What is the responsibility for gamma globulins?

A

Immunity; immunoglobulins or antibodies; they are made by plasma cells and are activated B lymphocytes

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22
Q

What electrolytes can be found in the plasma?

A

Na, K, Cl, HCO3, Ca, and lots more

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23
Q

List an example of a blood gas that would be found in the plasma?

A

Oxygen or CO2

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24
Q

What is an example of a waste product found in the plasma?

A

Uric acid, bilirubin, creatinine (see how the kidneys are working), and urea (blood urea nitrogen from a protein)

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25
Q

What is another name for RBC’s?

A

Erythrocytes

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26
Q

What is the lifespan of a RBC?

A

80 - 120 days

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27
Q

What is the function of a RBC?

A

Gas transport; carry oxygen and CO2 –> HCO3

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28
Q

What is unique about RBC’s?

A

They have a biconcave shape, which increases it’s surface area and allows it to have reversible deformity

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29
Q

Define hematocrit (Hct)

A

Percent of whole blood volume occupied by red blood cells

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30
Q

What is hematocrit percent for males?

A

40 -54%

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31
Q

What is the hematocrit percent for females?

A

38-46%

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32
Q

Define hemoglobin

A

Oxygen-carrying molecule consisting of 4 heme + 4 glob in proteins + 1 Fe molecule

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33
Q

What is the average volume of hemoglobin in the blood?

A

14-16 g/dL

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34
Q

What is the normal number of RBC’s in the blood?

A

4-6 X 10^6 mm3; million

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35
Q

Define mean corpuscular (cell) volume (MCV)

A

Volume of an average RBC; measured in fL (femtoliters)

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36
Q

Define mean corpuscular (cell) hemoglobin

A

Amount of hemoglobin in an average RBC; measured in pg (picograms)

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37
Q

Define mean corpuscular (cell) hemoglobin concentration

A

Concentration of hemoglobin in an average RBC; measured in g/dL (Hgb/volume)

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38
Q

Define anemia

A

Decrease in RBC’s

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39
Q

Define polycythemia

A

Abnormal increase in RBC’s

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40
Q

What would cause someone to increase RBC’s and still have it be in the “normal” range?

A

Exercise or being at a higher altitude

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41
Q

What organ recycles RBC’s?

A

The spleen

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42
Q

Describe the development of RBC’s

A

Begin with a nucleus, then the nucleus is kicked out and the cell is now a reticulocyte, and then it matures into a RBC

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43
Q

Define reticulocyte

A

An immature RBC containing hemoglobin, RNA, and mitochondrial remnants

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44
Q

Define microcytic

A

Smaller than normal cell

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45
Q

Define macrocytic

A

Larger than normal cell

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46
Q

What does chrom- mean?

A

Color

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47
Q

Define hypochromic

A

Color is lighter than normal

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48
Q

Define normochromic

A

Color is normal

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49
Q

What are indices?

A

MCV, MCH, and MVHC

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50
Q

What is another name for a WBC?

A

Leukocyte

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51
Q

What is the average range of WBC’s in the blood?

A

5-10 X 10^3/ mm3; Thousands

52
Q

What are the two categories for WBC’s?

A

Granulocytes and agranulocytes

53
Q

What types of WBC’s are granulocytes?

A

Neutrophils, eosinophils, and basophils

54
Q

What is the lifespan of granulocytes?

A

1/2 day to 9 days; most die doing their jobs

55
Q

Which types of WBC’s are agranulocytes?

A

Lymphocytes and monocytes

56
Q

What is the lifespan of a granulocytes?

A

Lymphocytes live forever (days to decades) and monocytes live for months

57
Q

Define leukocytosis

A

Increase is WBC count

58
Q

What is leukocytosis caused from?

A

Viral and bacterial infections; body normal response to disease up to a certain point

59
Q

Define leukopenia

A

Decrease in WBC count; never normal

60
Q

What do neutrophils look like?

A

Pinkish cytoplasm with a segmented nucleus

61
Q

What is the function of a neutrophil?

A

Fight bacterial infections; phagocytic cells that quickly respond to disease

62
Q

What is the concentration of neutrophils in the blood?

A

60% to 70%

63
Q

What do eosinophils look like?

A

Large red granules with nucleus pushed to one side

64
Q

What is the function of an eosinophil?

A

Target antigen-antibody complexes involved with allergies and parasites

65
Q

What is the concentration of eosinophils in the blood?

A

1% to 4%

66
Q

What do basophils look like?

A

Large dark blue granules

67
Q

What is the function of a basophil?

A

Participate in inflammatory responses; release histamine and heparin

68
Q

What is the concentration of basophils in the blood?

A

0% to 1%

69
Q

What do monocytes look like?

A

Large segmented nucleus that takes up most of the cell

70
Q

What is the function of a monocyte?

A

It’s a immature macrophage that wanders to different tissue sites and then matures into a powerful phagocytes; gets it name due to the tissues it matured in.

71
Q

What is the concentration of monocytes/macrophages in the blood?

A

3% to 8%

72
Q

List some examples of macrophages

A

Kupffer cells = liver, histiocytes = tissue, microglial = nervous, alveolar = lungs

73
Q

What do lymphocytes look like?

A

Large nucleus the size of the cell

74
Q

What is the function of lymphocytes?

A

Fight viral infections using adaptive immunity with two types of cells; T cells and B cells

75
Q

What is the concentration of lymphocytes in the blood?

A

They are actually all contained in the lymph, but they account for 20% to 30% of all WBC’s

76
Q

What is the lymphatic system?

A

System consisting of organs and lymph vessels through which lymphatic fluid passes

77
Q

What is the function of the lymphatic system?

A

Drain interstitial fluid, transport dietary lipids absorbed by the GI tract to the blood, and facilitate an immune response

78
Q

What are the primary lymphoid organs?

A

Thymus and bone marrow

79
Q

What is the main function of the primary lymphoid organs?

A

Production

80
Q

What is the bone marrow responsible for? Thymus?

A

Bone marrow makes cells that mature into B cells. The thymus take cells from the bone marrow and mature them in to T cells

81
Q

What are the secondary lymphoid organs?

A

Spleen, lymph nodes, tonsils, and peyer patches of the small intestine

82
Q

What do the lymph organs do?

A

Link the hematologic and immune systems

83
Q

What comprises the lymphatic system?

A

Lymph vessels, lymph nodes, right and left lymphatic ducts, tonsils, spleen, thymus, and bone marrow

84
Q

What does the spleen do in the lymphatic system?

A

Fliters and cleanses the blood- removes old or damaged cells; storage area for extra blood (up to 1/3)

85
Q

What is the main function of the lymph nodes?

A

Filters the lymph

86
Q

Name the important groups of lymph node

A

Submandibular, cervical, axillary, and inguinal

87
Q

What is hematopoiesis?

A

Cells are formed in red bone marrow from pluripotent stem cells and mature in the bone marrow or lymphoid tissue (spleen, thymus, tonsils, and lymph nodes)

88
Q

What type of cells increase hematopoiesis?

A

Cytokines

89
Q

What are the two types of stem cells that come from pluripotent stem cells?

A

Myeloid and lymphoid (lymphocytes)

90
Q

Define medullary hematopoiesis

A

Cellular production in the bone marrow

91
Q

Define extramedullary hematopoiesis

A

Production outside of the bone marrow (liver, spleen) caused by disease

92
Q

What is erythropoiesis?

A

Production of RBC’s

93
Q

What organ is stimulated by hypoxia to generate erythropoiesis?

A

Kidneys

94
Q

What are the steps of erythropoiesis?

A
  1. Kidneys are stimulated by hypoxia
  2. Kidneys release hormone erythropoietin (EPO)
  3. Erythropoietin circulates the red bone marrow and speeds up the maturation of immature RBC’s
95
Q

What is an immature RBC?

A

Reticulocyte

96
Q

Is the rate of erythropoiesis reflected in the rectiulocyte count?

A

Yes as you increase reticulocytes you increase RBC’s

97
Q

What does a retic contain?

A

Hemoglobin, RNA, and mitochondrial remnants

98
Q

What do hematopoietic cells need to develop and differentiate?

A

Growth factors

99
Q

What are colony stimulating factors (CSF)?

A

Cytokines that act as hormones to stimulate proliferation of early cells; necessary for growth of myeloid, erythroid, lymphoid, and megakaryocytic cells

100
Q

List a few growth factors involved with hematopoiesis

A

GM-CSF, G-CSF, and EPO

101
Q

Where do G-CSF come from? what cells do they stimulate?

A

Macrophages and fibroblasts; stimulate granulocytes

102
Q

Where do GM-CSF come from? What cells do they stimulate?

A

T cells; stimulate neutrophils and macrophages

103
Q

Where do EPO come from? What cells do they stimulate?

A

Kidney cells and Kupffer cells; stimulate erythrocytes

104
Q

What are platelets?

A

Cell fragments that originated from megokaryocytes

105
Q

What do platelets do?

A

Aid in the clotting by clumping and the release of biochemical mediators

106
Q

Define thrombocytopenia

A

Low platelet count

107
Q

Define thrombocytosis

A

Increased platelet count

108
Q

What are the three steps in hemostasis?

A
  1. Vascular spasms; involuntary
  2. Platelet plug formation
  3. Activation of the coagulation cascade (fibrinogen –> fibrin mesh)
109
Q

Is the clotting cascade positive or negative feedback?

A

Positive feedback

110
Q

How does the clotting cascade start?

A

Activation of several soluble, inactive clotting factors stimulated in a cascading fashion

111
Q

What are the two pathways in the clotting cascade?

A

Extrinsic pathway and intrinsic pathway

112
Q

Where do the extrinsic and intrinsic pathway meet up?

A

Common pathway converge at factor X

113
Q

What is the extrinsic pathway activated by?

A

Tissue factor (tissue thromboplastin)

114
Q

What is the intrinsic pathway activated by?

A

Contact with the injured vessel; collagen and endothelium

115
Q

What ion plays a role in coagulation?

A

Ca2+

116
Q

What are the stages of coagulation?

A
  1. Extrinsic and intrinsic activation
  2. Common pathway begins with formation of prothrombinase (prothrombin activator)
  3. Prothrombin activator activates prothrombin to thrombin
  4. Thrombin induces the formation of fibrin from fibrinogen
117
Q

What is clot retraction?

A

After 30 - 60 minutes the platelets contract, the plot becomes impacted and the edges of the blood vessel are brought closer together; healing is starting and clot needs to be removed

118
Q

How do the platelets contract?

A

They contain actin and myosin proteins that squeeze out the serum

119
Q

What is going on during healing?

A

Smooth muscle cells and fibroblasts are stimulated to divide

120
Q

How is the clot removed?

A

Fibrinolysis

121
Q

What system is responsible for clot breakdown?

A

Fibrinolytic system

122
Q

What are the steps to clot breakdown?

A
  1. Endothelial cells produce tissue plasminogen activator (TPA) which causes plasminogen –> plasmin
  2. Factor Xll and thrombin in coagulation cascade also change plasminogen –> plasmin
  3. Plasmin digests clots
123
Q

Where is bone marrow biopsy taken from?

A

Posterior iliac crest

124
Q

What does a bone marrow biopsy do?

A

Helps diagnose anemias, leukemias, platelet disorders, immunoglobulin disorders, etc

125
Q

List complete blood count tests

A

WBC count, WBC differential, RBC count, hemoglobin, hematocrit, platelet count, MCV, MCH, MCHC, and RDW (red cell distribution width)

126
Q

Tests for WBC differential

A

Bacterial appendicitis = neutrophils, infectious mono - Epstei-Barr virus = lymphocytes, and chronic lymphocytic leukemia (CLL) = lymphocytes

127
Q

Coagulation tests

A

Prothrombin time/international normalized ratio (PT/INR), activated partial thromboplastin time (APTT), and bleeding time

Pathophysiology with Price (5 decks)

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