Week 7 (exam 2) Flashcards
Describe Innate Immune System
immediate onset
1st and 2nd line of defense
- (physical barriers)
- (chemical barriers)
Describe Adaptive Immune System
humoral
cell-mediated
third line of defense
- active immunity
- passive immunity
What happens in an autoimmune disease
when the body mistakenly makes antibodies against itself
What are the main types of antibodies
immunoglobin A
immunoglobin G
immunoglobin M
immunoglobin E
immunoglobin D
Describe the immunoglobins
IgA: found in the lining of the respiratory tract, digestive system, spit, tears, and breast milk
IgG: most common antibody, long term, and found shortly after a primary response
IgM: first antibody found in New infection or primary response
IgD: least understood antibody
When do we order immunoglobins tests?
history of recurrent infections
rare infections in newborns
certain types of cancers
test efficacy of certain immunizations
allergy testing
When do we suspect an immunoglobin deficiency
multiple unexplained infections
- see in kids first
- weird infections
Immunoglobins and associated condition
IgA high: rheumatoid arthritis, lupus (SLE)
IgA low: congenital deficiencies
IgG high: long term chronic infections
IgG low: often congenital deficiencies
IgD high: unknown
IgD low: unknown
IgM high: acute infections
IgM low: congenital deficiencies
Define immunization titer testing
tests that measure the antibodies in your blood to determine if you have immunity to a disease
if positive IgG and not vaccinated…
still MORE likely to get a bad infection than those without a vaccine
What is RAST Testing and what is it indicated for
allergy testing
identify specific allergens
elevated IgE levels
Define leukemia
cancer of bone marrow stem cells
begins in the BONE MARROW
What are the diagnostic tools for leukemia
CBC: total WBC count always ELEVATED
peripheral smear
flow cytometry (of bone marrow - usually hip)
What are the cells involved, WBC results, and demographics for:
1. acute lymphocytic leukemia
2. chronic lymphocytic leukemia
3. acute myelogenous leukemia
4. chronic myeloid leukemia
- immature B or T cells, >30% lymphoblasts, children
- peripheral B or T cell (lymph nodes), lymphocytosis, MC leukemia in adults
- myeloblasts, monoblasts, auer rods, >30% myeloblasts, older adults
- elevated eosinophils and basophils, WBC >50,000 some blasts including eosinophils and basophils, ages 20-50 and rare in children
What are the indications for ordering a platelet count
signs of petechiae, spontaneous bleeding, increasingly heavy menses
pts with thrombocytopenia
to monitor course or therapy of thrombocytopenia or bone marrow failure
define thrombocytosis
increased levels of platelets
major complication = vascular thrombosis
- leads to tissue/organ infarction (decreased blood flow d/t excessive clumping/clotting causing obstruction)
Causes of thrombocytosis
most common cause: infections
How do you evaluate thrombocytosis
CBC with peripheral smear
- high platelets –> call heme
PTT/PT/INR
define thrombocytopenia
decreased levels of platelets
major complication = spontaneous hemorrhage
Causes of thrombocytopenia
hypersplenism, hemorrhage, immune thrombocytopenia (antibodies destroy platelets), thrombotic thrombocytopenia (HELLP syndrome)
What is the initial evaluation of thrombocytopenia
CBC with peripheral smear
- low platelets –> call heme
PTT/PT/INR
Bone marrow aspiration
- check if there are issues with production
VWF antigen
What is primary hemostasis and secondary hemostasis
primary: platelet aggregation
secondary: clotting cascade
What is the goal of the clotting cascade
to create a fibrin clot from two separate paths
What is prothrombin time
test used to evaluate the adequacy of the extrinsic system and common pathway in the clotting mechanism
What does prothrombin measure the clotting ability of
factor 1 (fibrinogen)
factor 2 (prothrombin)
factor 5
factor 7
factor 10 (extrinsic system and final common pathway)
When the above clotting factors (factors 1, 2, 5, 7, and 10) are deficient in quantities
prothrombin time gets prolonged
Live produces clotting factors
1, 2, 5, 7, 9, and 10
Which factors depend on vitamin K
2, 7, 9, 10
no vitamin K absorption –> no factor synthesis
What is the impact of warfarin on vitamin k dependent clotting factors
interfere with production of vitamin k dependent clotting factors = prolonged PT
What are the interfering factors for prothrombin time
alcohol ingestion - prolongs PT time
high fat and leafy vegetables diet - shortens PT time
diarrhea/malabsorption syndromes - prolongs PT time
certain drugs/medications
- warfarin
Relationship between PT and INR
INR too low = pt is fast/high
INR too high = pt is slow/low
What is INR used for
used to measure effectiveness and adequacy of anticoagulation therapy with warfarin
What is the partial thromboplastin time
test used to evaluate the intrinsic system and the clotting pathway of clot formation
also used to monitor heparin therapy
What does partial thromboplastin time (PTT) measure the clotting ability of
factor 1 (fibrinogen), factor 2 (prothrombin), factor 5, factor 8, factor 9, factor 10 (extrinsic and common pathway), factor 11, and factor 12
- when the above clotting factors exist in deficient quantities, the PTT gets prolonged
What does heparin inactivate
prothrombin (factor 2)
- prevents the formation of thromboplastin –> prolongs the intrinsic clotting pathway
What deficiencies are seen in hemophilia A, B, C and Von Willebrand Disease
A: 8
B: 9
C: 11
Von Willebrand disease: vwf
Why is only the PTT prolonged and not the PT/INR in hemophilia
only factors 8, 9, and 11 are involved in hemophilia
PT is factors 1, 2, 5, 7, and 10
What are the key points in blood typing
when transfusing, make sure that recipient does not have antibodies to donor blood RBC’s
crossmatch: mixing of recipient’s serum with donor RBC’s in saline with Coombs serum
