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2 - hematologic function Flashcards

1
Q

red blood cells:

purpose

A

carry oxygen and CO2

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2
Q

red blood cells:

characteristics

A

round with dent

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3
Q

red blood cells:

building blocks

A

iron, B12, folic acid and others

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4
Q

red blood cells:

lab values

A
  • hemoglobin: 120-180 g/L

- hematocrit: % of blood that is RBCs

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5
Q

Anemia

A
  • low levels of RBC
  • reduction in the total number of erythrocytes in the circulating blood or decrease in the level of hemoglobin
  • decreased oxygen-carrying capacity
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6
Q

anemia - needs

A

02, hemoglobin and functioning heart to be clear of anemia

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7
Q

anemia - effects and manifestations

A
  • vary depending on body system, degree and ability to compensate
  • fatigue
  • weakness
  • dyspnea
  • pallor (pale)
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8
Q

anemia - etiology

A
  1. impaired production
  2. blood loss or increased destruction of rbc’s
  3. combination of above
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9
Q

anemia - size

A

identified by terms that end in “cystic”

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10
Q

microcytic

A

small

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11
Q

macrocytic

A

large

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12
Q

normocytic

A

normal

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13
Q

anemia - color

A
  • hemoglobin

- identified by terms that end in “-chromic”

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14
Q

anemia due to inadequate production

A
  • iron deficiency anemia
  • pernicious anemia
  • folate deficiency anemia
  • anemia due to chronic disease
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15
Q

iron deficiency anemia - cell

A
  • lacking iron

- RBC will be microcytic and hypochromic

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16
Q

iron deficiency anemia

A
  • most common type
  • nutritional iron deficiency
  • pregnancy, continous blood loss
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17
Q

iron deficiency anemia - clinical manifestations

A
  • fatigue, weakness, dyspnea, pallor
  • spoon-shaped nails
  • glossitis (red, sore and painful tongue)
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18
Q

iron deficiency anemia - treatment

A
  • treat cause

- iron supplements

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19
Q

pernicious anemia

A
  • caused by a lack of intrinsic factor from the gastric parietal cells
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20
Q

pernicious anemia - intrinsic factor

A
  • required for vitamin B12 absorption
  • lack of B12 leads to anemia
  • cells are large and microcytic
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21
Q

pernicious anemia - clinical manifestations

A
  • fatigue
  • weakness
  • dyspnea
  • nerve demyelination
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22
Q

nerve demyelination

A
  • parenthesis of feet
  • loss of position sense
  • confusion and dementia
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23
Q

pernicious anemia - treatment

A
  • lifelong B12 supplement
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24
Q

Folate deficiency anemia

A
  • folate deficiency
  • poor absorption of folate
  • increased requirement of folate (pregnancy)
  • produces RBC’s similar tot hose of pernicious
  • Large RBC “macrocytic”
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25
folate foods
- green leafy vegetables - fruits - cereals - meats
26
folate deficiency anemia - clinical manifestations
- fatigue - weakness - dyspnea
27
folate deficiency anemia - treatment
- dietary adjustments | - supplements
28
folate deficiency also linked to
- neural tube defects (mother doesn't have enough folic acid)
29
anemia due to chronic disease
- pathologic mechanisms | - associated with systemic lupus erythematous, rheumatoid arthritis and chronic renal failure
30
pathologic mechanisms
- inadequate production of erythropoietin - ineffective bone marrow response to erythropoietin - decreased erythrocyte life span - depletion of iron stores
31
erythropoietin made in
the kidney
32
anemia due to increased loss or destruction
- blood loss anemia | - hemolytic anemia
33
blood loss anemia
- can be acute or chronic
34
blood loss anemia - acute
symptoms are usually related to blood loss e.g. hypotension
35
blood loss anemia - chronic
use up iron stores which lead to iron deficiency
36
hemolytic anemias
- premature destruction - sickle cell disease - hemolytic disease of the newborn - venoms, infections, mechanical heart valves
37
sickle cell anemia
- characterized by the production of abnormal hemoglobin - an autosomal recessive disorder - most common in persons of african ancestry but also those who live near the equator - estimated that 1 in 10 african americans
38
sickle cell pathophysiology
- due to a mutation in hemoglobin molecule - sickle crises triggered by dehydration and hypoxemia - HbS can revert to normal or can become irreversibly sickled
39
sickle cell - 2 major consequences
- chronic hemolytic anemia | - blood vessel occlusion
40
chronic hemolytic anemia
premature destruction by spleen
41
blood vessel occlusion
- pain | - organ failure
42
alterations in leukocytes
- increased white blood cells | - decreased white blood cells
43
increased white blood cells are called
- leukocytosis | - may be a normal protective physiologic response to physiologic stressors
44
decreased while blood cells are called
- leukopinea - NEVER normal - radiation, immune deficiencies
45
neoplasia of white blood cells
- leukemia - lymphoma - both caused by malignancies of white blood cells
46
leukemia
- starts in the bone marrow - malignancy of precursors to white blood cells - immature white blood cells (leukaemia blasts) - leukemia blast crowd out bone marrow and causes pancytopenia - infiltrate spleen, liver etc.
47
pancytopenia
decreased cellular proliferation of all typed of blood cells
48
leukemia - types
- acute lymphocytic leukaemia - acute myelogenous leukemia - chronic lymphocytic leukemia - chronic myelogenous leukemia
49
leukemia - incidence (more of an FYI)
estimate more than 6000 Canadians - 2nd leading cause of death
50
leukemia - cause
unknown but likely a combo of environment and genetic condition
51
leukemia - risk factors
- down syndrome - previous exposure to chemo and radiation - smoking - family genetics
52
leukemia - manifestations
- recalling the manifestations of neoplasm - pale - weakness/fatigue - bruising - bleeding - risk for infections - bone pain - enlarged liver and spleen
53
leukemia - acute
- sudden onset - rapid deterioration - rapid progression
54
leukemia - chronic
- slower onset - slower deterioration - slow progress
55
leukemia - diagnosis
measurement of WBC and bone marrow biopsy
56
leukemia - treatment
chemotherapy and supportive measures (blood transfusions, fluid replacements etc)
57
lymphatic system
- links immune and hematological systems | - site where various WBC can mature and function
58
lymphatic system - primary structures
thymus and bone marrow
59
lymphatic system - secondary structures
lymph nodes, spleen, tonsils and intestinal tract
60
lymphadenopathy
- enlarged lymph nodes that become palpable and tender | - can be local or generalized
61
local lymphadenopathy
typically due to infection
62
generalized lymphadenopathy
typically due to malignancy
63
lymphoma
- proliferation of malignant lymphocytes in the lymphatic system
64
lymphoma - 2 major categories
- hodgkins lymphoma | - non-hodgkin lymphoma
65
hodgkin lymphoma
- cause is unknown although could be genetic or immune - bimodal: two separate age groups (15-40 and >55 yrs) - 5 year survival is 83%
66
non hodgkin lymphoma
- generic term for neoplasms of B-cells, T-cells, NK-cells - impairment of immune system and infectious agents - incidence has almost doubled since 1970 - usually in people > 50 yrs of age - 5 year survival is 55-60%
67
lymphoma - manifestations
- lymphadenopathy - fever - night sweats - fatigue - weight loss
68
lymphoma - diagnosis
- lymph node biopsy | - reed-sternberg cells in lymph tissue for hodgkin lymphoma
69
lymphoma - treatment
chemo and radiation
70
platelets (thrombocytes) - purpose and normal
- to help with clotting | - 140-450x10^9/L
71
platelet disorders
- thrombocytopenia | - thrombocytosis
72
thrombocytosis
higher platelet count than normal
73
thrombocytopenia
- lower than normal platelet count
74
thrombocytopenia - cause
- decreased production - increased breakdown or consumption - or both
75
thrombocytopenia - types
- immune thrombocytopenia - heparin induced thrombocytopenia - other
76
immune thrombocytopenia purpura (ITP)
- also known as idiopathic thrombocytopenia purpura - IgG antibody coats platelets - antibody -platelet combination removed from circulation by the spleen - acute or chronic
77
immune thrombocytopenia purpura (ITP) - causes
- following an infection | - autoimmune
78
immune thrombocytopenia purpura (ITP) - manifestations and diagnosis
- petechiae purpura - purpura - brusing
79
immune thrombocytopenia purpura (ITP) - treatment
corticosteroids for suppression or removal of spleen
80
petechiar purpura
tiny dots
81
purpura
a little bit bigger dots
82
bruising
big spots
83
heparin-induced thrombocytopenia
- adverse drug reaction to unfractionated heparin - platelets are used - thrombocytopenia about 5-10 days after heparin
84
bleeding disorders due to genetics
- von Hillebrand disease - hemophilia A - hemophilia B - hemophilia C
85
von Hillebrand disease
- factor VIII (8) deficiency - autosomal dominant - 20 variants
86
hemophilia A
- factor VIII (8) deficiency | - x-linked autosomal recessive
87
hemophilia B
- factor IX (19) deficiency | - x-linked autosomal recessive
88
hemophilia C
factor XI (11) deficiency
89
bleeding disorders affect
- joints - skin - muscle - mouth/gum - urine/stool - nosebleeds

pathophysiology (16 decks)

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