1-hematology Flashcards
(110 cards)
1
Q
what system is blood part of?
A
cardiovascular system (heart + blood vessels + blood)
2
Q
is blood a connective tissue?
A
YES
3
Q
3 functions of blood?
A
- trans
- regulation
- protection
4
Q
components of blood?
A
fluid and cellular elements:
plasma, buffy coat, red blood cells (platelets, leukocytes, and erythrocytes)
5
Q
Buffy Coat components?
A
white blood cells and platelets 1%
6
Q
Hematocrit (PVC)
A
% of total blood vol red blood cells 40%
7
Q
Plasma
A
proteins (7g/dl) (albumins 50%, globulins 45%, fibrogen 4%, and others 1%), water 91.5%, other solutes (electrolytes, nutrients, gases, regulators, vitamins, waste prod)
8
Q
Plasma proteins do what?
A
maintain plasma oncotic pressure (water balance b/w intra and extracellular fluid compartments)
9
Q
where are plasma proteins derived?
A
liver
10
Q
what are plasma proteins involved in?
A
trans, defense, and blood pressure
11
Q
plasma protein can increase inflammations called? haemo-concentrations?
A
acute phase proteins (greater in lg animals) ABSOLUTE increase or increase haemo-concentration/dehydration RELATIVE increase
12
Q
what do plasma proteins do in end stage liver disease?
A
can decrease (lack of production)
13
Q
where do all formed blood elements originate from?
A
the same pluri-potent stem cell pool
14
Q
pluri-potent differentiates into?
A
myeloid and lymphoid
15
Q
myeloid stem cells create?
A
rbc, platelets, monocytes, and granulocytes
16
Q
lymphoid stem cells create?
A
B and T lymphocytes
17
Q
Hemopoiesis occurs?
A
in the rd bone marrow and lymphoid tissues (before birth in the spleen, liver thymus, yolk sac, and lymph nodes)
18
Q
major site for erythropoiseis in adults?
A
flat bones-sternum, ribs, pelvis (liver and spleen contribute when challenged)
19
Q
what conrols hemopoiesis?
A
colony stimulating factors (interlukins, cytokines, thrombopoietin, and erythropoietin)
20
Q
total blood vol in adults?
A
6-8% of body weight or 60-80 ml/Kg BW (cats are lower than dogs adn warm blooded horses and birds are higher)
21
Q
how much blood can be safely withdrawn from a patient?
A
1% of BW or 10 ml/Kg, MAX 2% or 20ml?kg in a healthy donor animal
22
Q
fluid into a severely dehydrated patient?
A
can give up tot he equivalent of their total blood vol within 1hr using crystalloids. 7% of BW after and 1h 75% of the fluid will have moved to tissues rehydrating ECF and ICF.
23
Q
mx fluids?
A
same vol over 24 hrs
24
Q
RBC/Erythrocytes
A
contain ox carrying hemoglobin, main function is the exchange of gases (oxygen and carbon dioxide) and regulate pH
25
erythroid
precursors and RBCs
26
RBC shape
biconcave round or oval (camelids) discs-lg surface area for gas exchange
27
RBC size
7um in man 4-8um in animals
28
RBC concentration
5 million/ul in man 5-10 million in animals
29
RBC content
33% hemoglobin NO mitochondria, NO golgi, NO ER
30
RBC metabolism
energy depends on anaerobic glycolysis (no mitochondria no krebs no beta oxidation no ETC) glucose dependent
31
RBCs in Reptiles/Amphibians/Birds
nucleated (non functional), larger, oval, almond shape
32
Largest known RBC
salamander 3-x65um
33
RBCs in Fish
nucleated, produced in spleen and liver (bony fish), within circulation in cartilaginous fish (shark)
34
RBC functions
1. oxygen transport (influences by temp, pH, metabolism, and carbonmonoxide)
2. carbon dioxide trans (23% of total CO2 binds to flobulin portions)
3. Carbon dioxide trans as bicarbonate to buffer (tissues-co2 into RBC HCO3 back into plasma and H to globin, Lung-HCO3 back into RC H binds and CO2 expired)
35
RBC travel and life span?
2.5km or 1.5 mi, 4-5 month life (cat and pig are 2 months and 5 weeks in birds).....1% die everyday RBC production = RBC death/removal
36
removal of aged RBCs?
1. rupture during spleen passage and absorbed by macrophages
| 2. selectively removed by phagocytic system, spleen, liver, and bone marrow
37
globulin recycled?
reused for protein synth
38
protoporphyrin recycled?
hem after Fe removal--> bilirubin ---> liver bile
39
Fe recycle?
binds to plasma --> Transferin released when needed .. when fll Fe stores in liver, pancreas, and heart, can leade to toxic cell damage.
40
tissue oxygenation controls?
erythropoiesis-hypoxia-->renal (90-95%) Liver (5-10%)-->EPO--->bone marrow-->stimulation--> new RBCs
41
extrusion of nucleus
reticulocyte
42
stem cell to reticulocyte?
4-5 days
43
reticulocytes
immature RBC, marrow into circulation and mature in 1-2 days, 1-2% in normal blood (horses and ruminants no reticulocytes)
44
peak RBC production after challenge? replacement?
7 days, 14 days
45
3 ways to eval erythron?
1. hematocrut
2. RBC count
3. hemoblobin content
46
MCV, mean corpuscular volume in femtoliter
MCV = Hct x 10/RBC
47
MCV, nomocytic
normal
48
MCV, microcytic
smaller, iron deficiency
49
MCV, macrocytic
larger than normal, immature RBC (cells haven't expelled all organells)
50
MCHC, mean corpuscular hemoglobin concentration
MCHC = Hb x 100/Hct
51
MCHC, normochromic
normal concentration of Hb within RBC 33%
52
MCHC, hypochromic
low concentration, iron deficiency, immature RBCs
53
MCHC, hyperchromic
beyond saturation point, artifact due to hemolytic sample
54
MHC, mean corpuscular hemoglobin
Hb content of 1 RBC .... inaccurate and not used anymore
55
anemia
deficiency in oxygen carrying capacity
56
anemia causes could be?
1. low RBC count
2. low Hb content
3. malfunctional RBCs
57
Types of anemia causes?
1. haemorrahagia
2. haemolytic
3. dyshemopoietic (reduced or defective eruthropoisis)
58
types of anemia according to bone marrow?
1. regenerative
| 2. degenerative
59
types of anemia according to RBC parameters?
1. RBC size: normo, micro, macrocytic
| 2. Hb content: normo, hypochromic
60
hemorrhagic anemia
due to acute blood loss-plasma replaces in 1-3 days RBCs 2 weeks, but signs of regeneration are seen in 3-5 days
61
hemolytic disorders
blood parasites, toxins, immune mediated (IMHA), inherent defects (sickle cell anemia)
62
dyshemopoietic anemias
1. non-regenerative, nutritional def, lack of iron... initially regenerative but quickly turn into non regen.
2. ACD, AID - Anemia of chronic disorders - cancer, necrosis, sepsis-shorten RBC life
3. chronic renal diseases - lackc of EPO
4. Drug related suppression - estrogene
63
hemorrhagic and hemolytic anemias
become chronic (GI ulcers) --> exhuastion of iron stores--> become non regen.
64
polycythemia types?
increased RBC numbers
1. primary (rare) - lack of feedback control
2. secondary (common) - physio responce to oxygen deficiency due to high altitudes, caardiac failure, lung diseases
3. transient - spleenic contraction due to excitement, exercise..horses, cats, sight hounds
4. relative (very common) - dehydration, fluid loss
65
two types of antigens are known?
natural and those withou natural antibodies
66
o-a-b
humans
67
a-b
cats
68
a-c-q-r-s
horses
69
1.1,1.2,3,4,5,6,7,8,
dogs
70
b-j-a-f
cattle
71
natural antibodies are present in?
cat and man
72
mismatched blood transfusions can lead to ...?
fatal reactions
1. rupture of capillaries --> shock
2. phagocytosis --> attack RBCs
3. precipitation of excess Hb--> renal blockage and acute renal failure
73
before you do a blood transfusion you?
blood type or cross match recipients plasma with donors RBCs to avoid rxns
74
dog should be neg for?
DEA 1.1, 1.2, and 7
75
major rxns in cross matching vs minor?
major - donors RBCs to Recipients plasma
minor - recipients RBCs to Donors plasma
observe for agglutination in both.
76
Hemostasis definition?
sequence of responses that stop bleeding
77
hemostasis is?
fast, localized, and carefully controlled
78
5 steps of hemostasis?
1. vascular spasm
2. platelet plug formation = primary
3. blood clot formation = coagulation = secondary
4. healing
5. clot removal = fibrinolysis
79
platelets
thrombocytes
80
platelet shape
round to oval, enucleated discs
81
platelet size
2-4um, birds and reptiles 4-8um nucleated
82
platelet concentration
150-300/ul
83
platelet half life
10 days
84
platelet origin
bone marrow - megacaryocytes (myeloid) - controlled by hepatic thrombopoietin
85
platelet contents
1. contractile proteins (actin, myosin, thrombosthenin)
2. ADP, ATP
3. prostaglandins, serotonin, clotting factors, endothelial growth factors
4. calcium
86
platelet functions
1. release chemicals to promote vasospasm
2. formation of plug
3. release coagulation factors
4. heal
87
Vasospasm (step 1)
1. occurs immediately upon injury (reduced blood flow, blood loss)
2. caused by release of endothelin form damaged cells then from thromboxane A2 and serotonin from platelets
3. can last min to hrs
88
Platelet plug (step 2)
damaged endothelial cells release von Willbrand Factor (vWF) - they bind with collagen fibers and receptor sites for platelets. then adhesion begins.
89
Binding in step 2 activated platelets to?
1. send out pseudopodia (degranulation)
2. release serotonin and thromboxane A2 --> promote vasospasm
3. release ADP and thromboxane A2 --> attract more platelets (aggregation)
4. release ADP and Fibronectin -->promote adhesion
5. release several platelet factors (V and VII) and calcium --> clotting
6. expose receptor sites for fibrinogen and prothrombin --> later clotting
* *** plug is formed in 1-2 min
90
deficiency in platelet plug formation
Petechial bleeding
91
Clot formation (step 3)
secondary hemostasis - cascades of chem rxns. 3-6 min,
1. extrinsic and/or intrinsic path --> prothrombin activator complex
2. Common path --> activation of prothrombin to thrombin
3. convert soluble fibrinogen to insouble fibrin
92
>.....clotting factors
50, lack of any can lead to a bleeding disorder
93
extrinsic-tissues bases
tissue factor thromboplastin 15-30 sec --->prothrombin activator complex
94
intrinsic-plasma based
endothelial bind and activate plasma factor XII 1-6 min --> CTIVATED ENZYMATIC XASCADE (XI, IX, VIII< X, V, CA) ---> PROTHROMBIN ACTIVATOR COMPLEX
95
extrinsic vs intrinsic
extrinsic is faster and more powerful intrinsic is an amplifier
96
prothrombin
a hepatic alpha globulin, liver synth Vit K dependent, attaches to activated platelets
97
Healing (step 4)
fibrin meshwork serves as a scaffolding for invading fibroblasts, endothelial growth factor and scar formation begins.
98
fibrinolyis (step 5)
clot is removed after healing sets in. plasminogen to plasmin= proteolytic enzyme --> FDP fibrin degrading products, removes clot and opens blood vessels
99
intact WBC and endothelial cells ...??
secrete prostacyclin and nitric oxid --> inhibit platelet adhesion
100
Prevention of excessive clot formation
1. fibrin binds to thrombin --> limits formation and pos feedback
2. anti-thrombin III --> deactivated thrombing and other factors
3. heparin from mast cells/basophils with andti thrombin III augment effectiveness
4. in vitro - Ca binding agents
5. in vivo - heparin, vit K antagonists
101
platelet count
via blood smears ... inaccurate
102
mucosal bleeding time
incision into skin or mucosa (expected clot 1-5 min)
103
OSPT - one stage prothrombin time
measures clot formation --> extrinsic common pathway (< 10 sec)
104
APTT - activated Partial thromboplastin time
measures clot formation after clean veinpuncture plasma and contact activator, measures intinsic path (60 - 120 sec)
105
thrombocytopenia (bleeding disorder)
decreased production or increased destruction (immune mediated) or consumption
106
bleeding disorders
1. thrombocytopenia
2. vWF disease
3. Vit K dificiency
4. hemophilias
107
vWF disease
most commono- genetic lack ---> platelets fail to adhere to injury sites --> spont. bleeding --> petechial
*** highest prevalence in dobermans
108
Vit K def/rodenticide
impairs liver synth and clotting factors
109
hemophilias
very rare - genetic def in clotting factor
110
Thrombosis
clotting in an unbroken blood vessel-due to stasis, atherosclerosis, trauma, parasites or tumors. If it dislodges --> embolisms --> ischemia ex. saddle thrombus in cats
