V- Phys of Blood

Question 1

plasma has what vs serum

Answer 1

plasma has clotting factors and fibrinogen so to collect blood must use heparin/anticoag

Question 2

anion gap equation

Answer 2

sodium - (chloride + bicarb)
cations - anions

Question 3

causes of high anion gap acidosis

Answer 3

1. ketoacidosis (diabetic)
2. lactic acidosis
3. salicylate poisoning

anything that builds up acids so inc unmeasured anions bc bicarb is being consumed to buffer

Question 4

causes of normal anion gap acidosis

Answer 4

1. severe diarrhea aka renal causes

bicarb is lost in stool and replaced by chloride bc kidneys are stimulated to inc retention

Question 5

steps of erythropoiesis

Answer 5

1. hematopoietic stem cells @ BM
2. erythroid progenitors with EPO growth factor @ BM
3. erythroblasts @ BM - Hgb accumulates, nuclear condensation, dec cell size, nucleus lost
4. immature erythrocytes/reticulocytes- @ blood
5. mature @ blood

Question 6

high reticulocytes indicates

Answer 6

hyper-responsive bone marrow
-hemolytic anemia

blood loss before iron def

recovery from iron, B12, folate deficiency

Question 7

low reticulocytes

Answer 7

hypo-responsive bone marrow
1. iron def anemia
2. chronic dz anemia
3. aplastic anema/BM failure

or renal dz bc EPO def

Question 8

high hematocrit

Answer 8

1. polycythemia vera aka BM disorder so hyperprolif of progenitors
2. EPO prod by cancer cells
3. environment/dz that dec blood oxy levels i.e pulmonary dz
4. dehydration- normal RBC but reduced plasma vol

Question 9

low hematocrit

Answer 9

1. BM failure
2. nutrient defs
3. RBC lysis
4. bleeding
5. overhydration

Question 10

factors that inc EPO

Answer 10

anything that dec oxy delivery to kidneys
1. low blood vol
2. low erythrocyte #
3. low functional Hgb
4. poor blood flow
5. pulmonary dz
6. low level environmental oxy

Question 11

inc EPO etiologies

Answer 11

1. hyporesp anemias - aplastic, iron def
2. secondary polycythemia- high altitude hypoxia, COPD
3. EPO tumors
4. kidney transplant rejectino
5. pregnancy
6. polycystic kidney dz

Question 12

dec EPO etiologies

Answer 12

1. anemia of chronic dz
2. renal failure
3. primary polycythemia/vera
4. HIV infection with AZT treat

Question 13

aplastic anemia

Answer 13

BM dysfunction = def erythropoiesis so dec reticulocytes

Question 14

iron deficiency anemia

Answer 14

low iron = dec Hgb synthesis so RBCs not carry enough oxy
low reticulocytes

Question 15

pernicious anemia

Answer 15

vitamin B12 def so prevent normal prod of RBCs
low reticulocytes

Question 16

hemolytic anemia

Answer 16

inc premature RBC destruction via hemolysis so dec in mature RBCs
1. large dec in haptoglobin bc clearing faster than being made > inc free Hgb in blood and urine
2. inc reticulocytes bc inc EPO (want to make more blood cells)
3. inc plasma bilirubin > jaundice
4. inc plasma lactate dehydrogenase for glycolysis