Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OPACCA > Hematology > Flashcards

Hematology Flashcards

0
Q

roles of blood

A 
transport of oxygen, carbon dioxide, other waste products
transport of hormones
acid base balance
key role in body defence
body temperature regulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

how do kidneys aid in blood production?

A

sensitivity to oxygen levels
low oxygen levels stimulate the release of kidney hormone ethytropoeitin which stimulates red blood cell production in bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

composition of plasma

A

90% water
contains electrolytes, nutrients, wastes, gases, hormones, plasma proteins (large molecules, albumin which helps maintain oncotic pressure, globulins immunology, fibrinogen involved in coagulation cascade)
purpose: medium for transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

composition of leukcytes

A

white blood cells
large cells involved in immune system
life span variable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

life span of erthythrocytes

A

120 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

platelets

A

smallest elements of blood (megacaryocytes break up into 1000 platelets)
initiate coagulation at the site of damaged blood vessel walls
lifespan about 10 days
because they’re the lightest component, they float near the edges of the vessel
reservoir in the spleen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the four phases of hemostasis?

A

primary
seconday
finbrinolysis
restoration of normal blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

primary hemostasis

A

constricts to slow bloodflow
platelets contact collagen layer and release adhesive proteins, coagulation and growth factors
platelets change shape and becomes sticky, adhering to one another
platelet plug is formed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

secondary hemostasis

A

intrinsic and extrinsic coagulation cascades are activated

formation of fibrin clot to stabilize the platelet plug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

compare intrinsic and extrinsic clotting pathways

A

intrinsic - slow, takes 2-6 minutes to begin, inside the vessel, damaged endothelium, contact with plaque
extrinsic - rapid, begins in 15 seconds, outside vessel, tissue damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which electrolytes are required and where are they stored?

A

calcium and vitamin k

fibrinogen, prothrombin, factor 4,5,6,7 found in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe the clotting cascade

A

factor ten, common pathway, prothrombin, thrombin, fibrinogen, fibrin, clot formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what happens at the activation of factor ten?

A

platelets continue to aggregate
thrombin and fibrin are created
fibrin stabilizing factor is activated
clot is stabilized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

fibrinolysis process

A

the process in dissolving the clot
to restore blood flow through the healed vessel, the fibrin clot must be lysed
endothelial cells secrete tissue plasminogen activators
leukocytes begin to clean up debris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

hematocrit

A

measurement of volume of RBCs in 100ml of blood - comparing percentage of rbcs to plasma
looks at hydration status - elevated level indicative of decreased fluid volume
normal 0.36-0.46

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

prothrombin time

A

evaluates the extrinsic pathway and common clotting pathway
normal 8-13 seconds
if clotting factors are deficient, PT will be prolonged
used to evaluate therapeutic range for warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

INR

A

international normalized ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ptt

A

partial thromboplastin time
evaluates intrinsic system and common pathway
if clotting factors deficient it will be elevated
normal <40 seconds
used to evaluate heparin anticoagulation therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

fibrinogen

A

an essential plasma protein synthesized by liver
ordered to further investigate abnormal bleeding
decreased level - liver disease, disseminated intravascular coagulation, leukemia, anemia,
increased level - acute infections, collagen diseases, inflammatory disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

d-dimer

A

a protein fragment produced and usually only detectable during clot degredation
used to diagnose conditions related to thrombosis such as pulmonary embolism, DIC, DVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

reticulocyte count

A

yields information on bone marrow function
reticulocytes are immature cells released by bone marrow that become rbcs
useful in determining cause of anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

esr

A

erythrocyte sedimentary rate

can be elevated in inflammatory states

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

c reactive protein

A

levels increase more rapidly than esr during acute inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

peripheral smear

A

most informative of all blood tests
time consuming
a person takes the time to look and count and differentiate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are some causes of anemia in the adult icu patient?

A 
decreased rate of erythropoeisis
acute kidney injury
chronic renal failure
heorrhage
hemolysis
inflammation
liver disease
excessive phlebotomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

anemia treatment

A 
medications (b12, erythropoeitin, folate, iron)
crrt
blood transfusion
blood conversion
nutritional consult
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

diagnosis and treatment of dvt

A

venous ultrasound
blood work

prevention
if on bedrest, elevate injured leg
analgesic
anticoagualtion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are some risk factors for development of dvt?

A 
immobility
surgery
invasive procedues
spinal cordi njury
obesity
age
sepsis
trauma
28
Q

pulmonary embolus patho and management

A

a clot that travels through right side of the heart and gets lodged in pulmonary vasculature
dvt common cause
can be blood, fat, tumor tissue
treatment anticoagulation therapy, inferior venacava filter, surgical removal
chest pain, rapid onset sob, increased oxygen demands, radiating pain to neck, jaw, worsens with inspiration

29
Q

what are some examples of coagulation disorders

A

thrombotic thrombocytopenic purpura
hellp
hit - heparin induced thrombocytopenia
dic

30
Q

ttp patho, presentation

A

thrombotic thrombocytopenia purpura
usually caused by under regulation coagulation component von Willebrand factor, red blood cell damage
spontaneous platelet aggregation
presents with fever, renal injury, micro hemolytic anemia, neurologic abnormalities

31
Q

hellp

A

hemolytic elevated liver enzyme low platelet count
happens with pre-eclampsia
can lead to stroke

32
Q

hit

A

sudden onset with drop in platelets when patient on heparin
50% drop in platelet count
usually occurs about 4 days of receiving heparin, has occurred up to 3 weeks after heparin discontinued
type 1 - benign, moderate but transient decrease in the platelet count
type 2 - severe, immune mediated formation of heparin-antibody complexes, greater risk for thrombosis than bleeding, thrombin released and platelet clumps are formed, complexes adhere to platelets and endothelium

33
Q

what are some triggers of DIC?

A

sepsis
severe trauma
obstetrical events such as placental abruption
severe inflammation

34
Q

Describe the hemorrhagic signs for various systems

A 
integ- oozing, bleeding from access sites, surgical sites and mucous membranes, purpura, ecchymosis, cyanosis
neuro- altered loc
pulm- hemoptysis
gi- gi bleed, abdominal distension
renal- hematuria
35
Q

Describe the micro-emboli signs for various systems

A 
integ- patchy cyanosis
neuro- altered loc, cva
pulm- pe, ards
gi - bowel infarct
renal- hematuria, oliguria, renal failure
36
Q

how does lab work change in dic

A 
ptt elevated
pt/inr elevated
d-dimer elevated
platelets low
fibrinogen low
37
Q

what is treatment of hemorrhage aimed to prevent

A

decreased oxygen carrying capacity
decreased waste removal
tissue and organ ischemia
circulatory collapse

38
Q

what are some of the risk associated with blood and blood product transfusion?

A

acute transfusion reaction
allergic reaction (anaphylaxis)
TRALI not related to volume overload (transfusion related acute lung injury)
hypothermia (blood products stored in fridge)
metabolic alkalosis (sodium citrate in blood products to prevent clotting, which breaks down into water and bicarb)
volume overload

39
Q

ffp

A

each unit has 650mg of fibrinogen

indicated to reverse bleeding, reverse coagulopathy prior to surgery,

40
Q

cryopreciptate

A

the precipitate of ffp
ffp without the extra fluid
contains fibrinogen, factors 8 and 13 and von willebrand factor
indicated in hemophilia, bleeding from excessive anticoagulation, hemorrhage, dic

41
Q

important thing to remember about platelet infusions

A

never via pressure bag or with warming

42
Q

prothrobin complex concentrates

A 
derived from pooled plasma
contains multiple clotting factors
protein
stored at room temp
vitamin k administered with initial dose
indicated in reversal of warfarin, vitamin k deficiency with life threatening emergency
43
Q

transexamic acid

A

synthetic
inhibits fibrinolysis
indicated in polytrauma, hemorrhage, risk of bleeding

44
Q

organs of immunology

A

lymphatics- bacteria, virus, and debris are removed by wbcs
mucous membranes and skin - immuno globulin a
gastric fluid
thymus - t lymphocyte maturation
tonsils and adenoids - exchange lymphocytes with lymph, produce antibodies and sensitized t cells, remove microbes
spleen - exchanges lymphocytes with blood, produced antibodies an d sensitized t cells, removes microbes, stores rbcs
bone marrow- origin of all blood cells, b lymphocyte maturation
appendix - rich in lymphoid cells, manufactures hormones in fetal development

45
Q

goals of the immune system

A

defence against invading organisms
removal of worn out cells and tissue debris
homeostasis
surveillance with recognition and removal of mutant/abnormal foreign cells

46
Q

what are the components of the general immune response?

A

inflammatory
humoral (antibody) slower to response, b cells
cellular immune response t cells

47
Q

inflammatory response

A

release of phagocytes, wbcs
secretion of inflammatory mediators
immediate and nonspecific

48
Q

inflammatory mediators

A

molecules released by immune cells against invaders
initiate, augment, and terminate aspects of the inflammatory response
MAST CELLS is one of the key activators in the inflammatory response
hitamine, bradykinin, prostaglandins

49
Q

what are some local and systemic symptoms of inflammatory response?

A

inflamatory mediators being released from cells
local vasodilation and increased capillary permeability
increased blood delivery to tissue and local accumulation of fluid
redness, heat, swelling and pain

50
Q

innate immunity

A

skin, chemicals in blood, phagocytes,

first line of defence

51
Q

adaptive immunity

A

recognition and processing of specific antigen
creation of special antibodies to attack a specific antigen
slower response to invader

52
Q

adaptive immunity

A

recognition and processing of specific antigen
vaccines
exposure related immunity
creation of special cells and antibodies to attack a specific antigen
slower response to invader
slower to invader

53
Q

b cell lymphocytes

A 
mature in bone marrow
storedi n lymph nodes
some circulatei n blood
responsable for production of antibodies or immunoglobulins
inactive circulating antigens
54
Q

what are the five classes of immunoglobulins?

A

IgG- responsible for the majority of antibody basedi mmunity, only antibody crosses placenta to fetus
IgM- first on the scene, largest, starts working to eliminate pathogens before there is enough IgG
IgA prevents colonization of pathogens, found on the skin
IgD- activates basophils and mast cells
IgE involved in allergic response and against parasites

55
Q

how does the complement system amplify the immune response?

A 
help phagocytes engulf the pathogen
attract more phagocytes to site (chemotaxis)
create pores in bacterial membranes
increase vascular permeability
neutralize some viruses
56
Q

t cell lymphoctyes

A

mature in thymus
function in the peripheral tissues
acquire the ability to distinguish self and non self
60-70% lymphocytes
provides protection against viruses, intracellular bacteria and cancer cells
three types: cytotoxic ( killer, release lymphotoxins causing cell lysis)’ helper (immune managers, secrete lymphokines that stimulate ta nd b cells, attract neutrophils and enhance macrophages ability)’ suppressor (inhibit t cell production when no longer needed)

57
Q

natural killer cells

A

less than 2% of circulating volume
from innate immunity system
seek and destroy

58
Q

neutorphils

A 
most abundant
first responder to inflammation
very involved in bacterial infection
segmented mature
banded immature
increased bands indicates an accelerated production or release of neutrophils
59
Q

basophils

A

less than 1% of wbc

secrete inflammatory mediators that attract leukocytes to injury site

60
Q

eospinophils

A

less than 6% of wbcs

levels may increase with parasitic infection and allergic response

61
Q

gram positive

A

staphylococcus
streptococcus
c-diff

62
Q

gram negative

A 
e coli
salmonella
pseudomonas
enterobacter
legionella
klebsiella
63
Q

bone marrow aspirate

A

reveals number, size, shape of cells throughout all stages of development
diagnosis and staging of hematologic disease, or to confirm a diagnosis

64
Q

define infection

A

the invasion and multiplication of microorganisms in body tissue, making you unwell
may be clinically unapparent
may result in localized cellular injury
may extend to a systemic infection

65
Q

define colonization

A

microorganisms live on or in a host but do not invade or cause cellular damage
once colonization invades or begins to cause localized cell injury, it becomes an infection

66
Q

hypersensitivity

A

allergic reaction
anaphylaxis
four varieties based on mediators

67
Q

autoimmune disease

A

inappropriate immune response of the body against substances and tissue normally present in the body
may be systemic or against a specific organ
the immune system mistakes some part of the body as a pathogen and attacks its own cells

OPACCA (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions