V- Phys of Blood Flashcards
plasma has what vs serum
plasma has clotting factors and fibrinogen so to collect blood must use heparin/anticoag
anion gap equation
sodium - (chloride + bicarb)
cations - anions
causes of high anion gap acidosis
- ketoacidosis (diabetic)
- lactic acidosis
- salicylate poisoning
anything that builds up acids so inc unmeasured anions bc bicarb is being consumed to buffer
causes of normal anion gap acidosis
- severe diarrhea aka renal causes
bicarb is lost in stool and replaced by chloride bc kidneys are stimulated to inc retention
steps of erythropoiesis
- hematopoietic stem cells @ BM
- erythroid progenitors with EPO growth factor @ BM
- erythroblasts @ BM - Hgb accumulates, nuclear condensation, dec cell size, nucleus lost
- immature erythrocytes/reticulocytes- @ blood
- mature @ blood
high reticulocytes indicates
hyper-responsive bone marrow
-hemolytic anemia
blood loss before iron def
recovery from iron, B12, folate deficiency
low reticulocytes
hypo-responsive bone marrow
1. iron def anemia
2. chronic dz anemia
3. aplastic anema/BM failure
or renal dz bc EPO def
high hematocrit
- polycythemia vera aka BM disorder so hyperprolif of progenitors
- EPO prod by cancer cells
- environment/dz that dec blood oxy levels i.e pulmonary dz
- dehydration- normal RBC but reduced plasma vol
low hematocrit
- BM failure
- nutrient defs
- RBC lysis
- bleeding
- overhydration
factors that inc EPO
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
inc EPO etiologies
- hyporesp anemias - aplastic, iron def
- secondary polycythemia- high altitude hypoxia, COPD
- EPO tumors
- kidney transplant rejectino
- pregnancy
- polycystic kidney dz
dec EPO etiologies
- anemia of chronic dz
- renal failure
- primary polycythemia/vera
- HIV infection with AZT treat
aplastic anemia
BM dysfunction = def erythropoiesis so dec reticulocytes
iron deficiency anemia
low iron = dec Hgb synthesis so RBCs not carry enough oxy
low reticulocytes
pernicious anemia
vitamin B12 def so prevent normal prod of RBCs
low reticulocytes
hemolytic anemia
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
