306 exam 3 Flashcards
(164 cards)
1
Q
Erythrocytes are ______ and shaped ______
A
Non-nucleated and shaped biconcave disk with flexible membrane
2
Q
RBC’s are not released into the blood until they ______
A
mature
3
Q
RBC’s lose their nucleus at (time)
A
maturation
4
Q
RBC’s proliferate in the _______ with nucleus
A
bone marrow
5
Q
mature RBC’s in the blood do not have a ______
A
nucleus
6
Q
Polychromasia is
A
There are lots of immature RBC’s in the bloodstream when there should not be.
7
Q
Polychromasia is a sign that ____
A
Mature RBC’s are being destroyed
8
Q
The birth of RBC’s is called _____
A
Hematopoiesis
9
Q
Iron stored in the liver is called __
A
Ferritin
10
Q
Iron in the blood plasma is called _____
A
Transferrin
11
Q
RBC’s live for _____
A
120 days
12
Q
Hemoglobin is broken down into ____ and _____
A
heme and globin
13
Q
heme is _____
A
the blood protein that binds to iron
14
Q
globin is ____
A
the blood protein that binds oxygen
15
Q
____ and _____ are recycled by the ____ when RBC’s die off
A
heme and globin are recycled by the spleen
16
Q
When RBC’s are destroyed, _____ is recycled and _____ is wasted
A
heme is recycled and reused and globin is wasted
17
Q
DMT-1 is
A
the major iron transporter enzyme
18
Q
Transferrin is
A
enzyme responsible for iron metabolism
19
Q
Hepcidin
A
Liver protein that allows iron to be released into the system
20
Q
Four most severe signs of Anemia
A
- fainting
- chest pain
- angina
- myocardial infarction
21
Q
What is hematocrit?
A
% of red blood cell mass in 100ml of plasma
22
Q
MCV stands for ____
A
mean corpuscular volume
23
Q
MCV (mean corpuscular volume) measures
A
average size of your red blood cells
24
Q
Microcytic refers to ____
A
Low MCV
25
Normocytic refers to ____
regular MCV
26
Macrocytic refers to ____
high MCV
27
Four types of anemia's with Microcytic RBC's
Iron deficiency
Thalassemia
Chronic Anemia
Lead Poisoning
28
Five types of anemia's with Normocytic RBC's
acute bleeding
aplastic
hemolytic
low erythropoietin
malignancy
29
Two types of anemia's with Macrocytic RBC's
pernicious
low folate
30
3 main all causes of Anemia
1. Loss
2. Increased Destruction (Hemolysis)
3. Deficiency in necessary components to form RBC's
31
How long does it take for RBC's to be replaced after acute severe blood loss?
3-4 weeks
32
Chronic unknown blood loss leads to _______ anemia
iron deficiency anemia
33
Chronic blood loss anemia is asymptomatic until hemoglobin levels reach _____
8g/dl or less
34
Dysfunction of bone marrow stem cells in aplastic anemia effects ______ cells
Both cells lines myeloid and lymphoid
35
Aplastic Anemia is
Decreased or impaired production from the bone marrow
36
Four causes of Aplastic Anemia
Chemotherapy and Radiation
Infections such as Mono or Hepatitis
Autoimmune such as SLE or RA
Leukemia's
37
Acute chest syndrome is where _____
sickle cells occlude blood vessels in heart and lungs
38
Thalassemia is _____
Genetic defect resulting in the body not making enough hemoglobin.
39
Thalassemia is most common in people from ______ descent.
Mediterranean
40
Red blood cells in Thalassemia are ______ in MCV
Microcytic
41
Red blood cells in Thalassemia are _____ in color
Hypochromic (light color)
42
Red blood cells in Thalassemia ______ in size
varies in size
43
Most common anemia worldwide _____
Iron Deficiency Anemia
44
______ does not allow iron to be recycled
Chronic bleeding
45
Iron deficiency RBC's are ____ in MCV
microcytic
46
Iron deficiency RBC's are ______ in color
Hypochromic (light in color)
47
Observable signs of Iron deficiency anemia
cyanosis
brittle nails
pica
poor wound healing
headache
48
Pernicious Anemia is ____
Vitamin B12 deficiency
49
Two main functions of Vitamin B12
DNA synthesis
Nuclear Maturation
50
Intrinsic factor is ___
The enzyme in the stomach that absorbs Vitamin B12
51
Red blood cells produced by Pernicious (B12) anemia are _____
Large (macrocytic) and oval shaped
52
Signs/symtoms of pernicious anemia
bleeding gums
impaired sense of smell
parenthesis of extremities
unsteady gait
53
pernicious anemia is also called ____
megaloblastic anemia
54
polycythemia can be the result of increased erythrocyte production due to _______
hypoxia
55
relative polycythemia is due to ______
loss of plasma
56
absolute polycythemia is due to _____
increased number of red cells
57
2 Red blood cell changes in the Elderly
Hemoglobin levels decline with age
cannot replace hemoglobin as quickly in times of stress
58
official definition for hemostasis or coagulation
the arrest of bleeding or circulation of the blood
59
thrombocyte life span
5-10 days
60
old thrombocytes are removed via _____
macrophages in the spleen
61
thrombopoetin is secreted by the (3 organs)
liver, kidneys, spleen
62
platelets are made from _____
megakaryocytes
63
platelets are stored in the ______
spleen
64
prostacyclin is _____
an enzyme released by the endothelium that results in vasodilation just like nitric oxide
65
adenosine diphosphatase (ADP) prevents _____
platelet aggregation
66
von willebrand factor is ____
glycoprotein in endothelium that promotes hemostasis specifically platelet adhesion
67
lactated ringer's solution contains _____
calcium
68
never give lactated ringer's solution with blood transfusions because ______
it contains calcium and calcium causes clotting cascade to happen
69
calcium is factor _______
IV
70
Vitamin K is the building block for making ______ and ______
clotting factors and Protein C&S
71
factor responsible for adhesion
von willebrand
72
Chronological order of coagulation steps
1. vessel spasm
2. platelet plug formation
3. blood coagulation ending with fibrin
4. clot retraction (pulls clot together tightly)
5. clot dissolution
73
prostaglandin thromboxane A2 increases vasospasm by ______
vasoconstriction
74
Primary hemostasis is the act of ______
Forming the platelet plug
75
Two factors responsible for platelet activation
ADP - Fibrinogen
Thromboxane A2
76
ADP is a _____
Fibrinogen
77
Bilirubin is a breakdown product of
hemoglobin in which increased amounts can point to early erythrocyte destruction
78
_____ is needed to make hemoglobin
Iron
79
common finding of acquired autoimmune TTP _____
mucosal bleeding
80
TTP is
thrombotic thrombocytopenia purpura
81
the result (final step) of both the intrinsic and extrinsic coagulation pathways is ______
activation of factor X, leading to conversion of prothrombin II to thrombin IIa
82
______ does not blanch with pressure
petechiae
83
von willebrand factor is directly involved in _____ 3 things
primary hemostasis
platelet aggregation
platelet adhesion
84
two things needed for the bone marrow to synthesize RBC's
erythropoietin and Iron
85
ADP causes the platelet membrane to become ______
rough and stick to bind together easier
86
calcium is released from ____ and serves as a _____ on the surface of the platelet where coagulation factors can bind.
released from the platelet, serves as a binding site for coagulation factors
87
thromboxone A2 is made from platelets through thromboxone A synthase, what is the action of thromboxone A2?
potent vasoconstriction
88
instrinsic pathway:
factors within the blood that activate platelets
89
extrinsic pathway:
factors in response to changes in blood vessels like injury or trauma
90
example of an extrinsic response
platelets are exposed to collagen and are activated
91
PTT measures the ______
Intrinsic pathway
92
PT measures the ______
extrinsic pathway
93
Warfarin measures the _____
extrinsic pathway
94
heparin measures the ____
Intrinsic pathway
95
merging of the two clotting pathways occurs at _____
Activation of factor X = Xa
96
what can be triggered directly by snake venom, amniotic fluid, embolism, and acute pancreatitis?
merging of the two clotting pathways (intrinsic and extrinsic)
97
three main coagulation inhibitors
adequate blood flow
antithrombin III
proteins C and S
98
Adequate blood flow functions to ____
clearance of coagulation factors by the liver
99
Antithrombin III functions to ______
inactivates thrombin and decreases the conversion of fibrinogen to fibrin
100
Proteins C and S function to ______
vitamin K dependent proteins. they inactivate co-factors Va and VIII.
101
Plasminogen is ______ in the blood and is activated by _____
inactive in the blood and is activated by tissue plasminogen activator (TPA)
102
Tissue plasminogen activator (TPA) converts ______ to _______ and then ______
tpa converts plasminogen to plasmin and they digests the fibrin strand
103
TPA is produced by (3 organs)
endothelium, liver, kidney
104
factors that are synthesized from vitamin K
II, VII, IX, X
105
antiplatelet medications work on ______
canceling out ADP thus stopping platelet aggregation
106
thrombocytopenia is any platelet count below _____
150,000
107
highest risk for bleeding when platelets are under _____
50,000
108
normal prothrombin time (PT)
11-12.5 seconds
109
normal INR time for DVT
2-3 for DVT
110
normal INR time for heart valve replacement
2.5-3.5
111
normal partial thromboplastin time (PTT)
30 - 40 seconds
112
normal D dimer
0.4mcg
113
virchow's triad of thrombosis influencers
1. injury to endothelium
2. alterations in blood flow
3. hypergoagulability
114
factor V leiden mutation leads to
prolonged and uncontrolled clotting increasing the risk of venous thrombosis
115
factor V leiden mutation is linked to
pregnancy having abruptio placenta and 3x increase in thromboembolic events
116
factor V leiden is an _______ disorder
inherited autosomal dominant
117
antiphospholipid syndrome
autoimmune disorder resulting recurrent in arterial and venous thrombosis
118
turbulence refers to
disruption of flow through the vessel: platelets contact endothelium
119
stasis refers to:
decrease in clearance of clotting factors by the liver and slowed inflow of clotting inhibitors.
120
6 P's to evaluate arterial insufficiency
Pallor
Pulselessness
Paralysis of extremity
Paresthesia of affected extremity
Pain
Pressure
121
older adults have increases in ______ and reductions in ______
increased platelet aggregability and decreased fibrinolytic response
122
with anticoagulats: _____ is used acutely and ______ is used chronically for maintenance
heparin works faster and is used acutely, warfarin is used chronically for maintenance
123
if anticoagulants are contraindicated: ______ can be placed
a greenfield filter can be placed in the inferior vena cava
124
greenfield filter prevents ______
traveling emboli from reaching the lungs by trapping them in the vena cava
125
major side effect of thrombolytic therapy
hemorrhage
126
contraindications to fibrinolytic therapy
internal bleeding
thrombocytopenia
use of anticoagulants
intracranial surgery
CVA
recent seizure
recent MI
recent surgery or trauma
arterial puncture site
lumbar puncture
aneurysm
AV (arteriovenous) malformation
blood pressure above 185/110
127
Risks for increased bleeding
liver disease
thrombocytopenia
HIV and other viral infections
Hypersplenism
Clotting factor deficiencies
128
Hemophilia A is a ______ linked disorder
X-linked recessive disorder
129
in Hemophiliac patients, avoid _____
Aspirin, antiplatelets, and NSAIDS
130
cryoprecipitate (cryo) is
the portion of plasma that is rich in factor III
131
von willebrand disease is the most _________
most common hereditary bleeding disorder
132
von willebrand disease is ________ trait
autosomal dominant and occurs in both males and females
133
in von willebreand disease, factor ____ has _____
factor VIII has two separate proteins where von willebrand factor larger than factor VIII protein. Acts as a carrier
134
how to recognize von willebrand disease
spontaneous bleeding from mucous membranes and nosebleeds, excessive bleeding from wounds and heavy periods
135
drugs that increases platelet destruction
thiazide diuretics, heparin, alcohol
136
biggest risk for heparin induced thrombocytopenia
surgery
137
Idiopathic or immune thrombocytopenic purpura (ITP)
disorder of platelet consumption | IgG destroys platelets
138
How to see ITP
petechial rash and bruising 1-4 weeks after and infection was acquired
hemorrhagic bullae of gums, lips, and other mucous membranes
139
ITP can be the result of
viral infection
140
bullae are
large purulent blisters
141
mainline treatments for ITP
corticosteriods, splenectomy, iv immunoglobins
142
Thrombotic thombocytopenia purpura is (TTP)
platelet destruction not associated with or caused by the immune system
143
in thrombotic thrombocytopenia pupura (TTP)
platelets and fibrin strands build up in smaller vessels and damage platelets and RBC's flowing by
144
TTP results in
thrombi formation, bleeding, and thrombocytopenia
145
cause of TTP
mutation in ADAM gene
146
DIC - disseminated intravascular coagulation is ________ a primary disease process
not a primary disease process
147
DIC results in
thrombosis and hemorrhage at the same time
148
both intrinsic and extrinsic pathways ultimately result in ___
thrombin generation
149
DIC is through the ______ pathway
intrinsic
150
_____ can trigger DIC
endothelial damage exposing the subendothelial collagen layer
151
in DIC, there is a widespread of _______ deposited into the micro circulation
Fibrin
152
in DIC, hemorrhaging occurs as a result of _____
depletion of clotting factors and platelets due to excessive clotting beforehand
153
platelet destruction NOT caused by immune system
TTP
154
platelet aggregation is induced by the release of ______
thromboxane A2
155
clot dissolution is regulated by ______ and ______ activators
thrombin and plasminogen activators
156
thalassemia is where
there is anemia and hypoxia resulting from the bone marrow not making enough hemoglobin
157
RBC's come from
proerythroblasts
158
tissue factor is also known as _____ and is released upon ______
factor III and is released upon extrinsic tissue damage
159
______ stimulates platelet production
thrombopoetin
160
thrombopoetin is made by the ______
liver
161
polycythemia is recognized as _____
hematocrit above 50%
162
most common inherited bleeding disorder
Von Willebrand disease
163
parasthesia is _____
pins and needles tingling feeling
164
