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Pathophysiology 2 > Blood & Blood Disorders > Flashcards

Blood & Blood Disorders Flashcards

(78 cards)

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1
Q

Blood is specialized ________ tissue derived from the _______ germ layer

A

connective

mesodermal / mesenchymal

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2
Q

The process of blood formation is known as ________

A

hematopoiesis / hemopoiesis

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3
Q

The major bones containing bone marrow generating blood cells are __________

A

flat bones of axial skeleton - sternum, ribs, pelvic bones
vertebrae
skull

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4
Q

The functions of blood are _________

A
  • carrying O2 and CO2
  • buffering and enabling metabolic reactions
  • elimination of waste
  • delivery of nutrients
  • distribution of hormones and other chemical messengers
  • clotting and prevention of excessive bleeding
  • immune defense
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5
Q

Whole blood is composed of _________

A

plasma - amino acids, nutrients, proteins, nitrogenous waste, electrolytes, gases

formed elements - WBCs, platelets, RBCs

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6
Q

Red bone marrow functions to ________

Yellow bone marrow functions to ________

A

generate formed elements of blood

nourish and support red bone marrow

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7
Q

Myelophthisis is __________. This process is seen in disorders such as __________

A

the degeneration of red bone marrow with the substitution by yellow bone marrow

blood / bone marrow cancers

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8
Q

Active bone marrow is generally termed ________

A

myeloid

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9
Q

When pluri-potent stem cells develop into white blood cell colonies, they differentiate into ________ progenitors and ______ progenitors

A

myeloid progenitors

lymphoid progenitors

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10
Q

Myeloid stem cells mature into what types of white blood cells?

A

monocytes, neutrophils, basophils, eosinophils

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11
Q

Lymphoid stem cells mature into what types of white blood cells?

A

T lymphocytes

B lymphocytes

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12
Q

Cancer of white blood cells are generally termed ______ and are categorized as either _____________ or __________

A

leukemia

myeloid/myelogenous/myelocytic

lymphoid/lymphocytic/lymphoblastic

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13
Q

List major endocrine hormones involved in hematopoiesis and their origins

A

erythropoietin - derives form KD

thrombopoietin - derives from LV

testosterone - derives from testicles/ovaries/adrenal glands

(Thrombin will activate production of fibrin from fibrinogen molecules, supplied by the liver - blood clotting)

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14
Q

Explain the difference in normal Hematocrit levels between males and females

A

Testosterone is more abundant in males than in females leading to more RBC production

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15
Q

Hematocrit is _________ and is measured in ______

A

the packed volume of formed elements (mainly RBCs) per volume unit of whole blood

percentage

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16
Q

The normal value range of Hct in a female is ___ ; in a male it is ___

A

37-46%

41-53%

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17
Q

What is hemoglobin concentration per volume of blood (Hb)?

A

A measure of the total amount of the oxygen-carrying protein in the blood, which generally reflects the number of red blood cells in the blood

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18
Q

What is Mean Corpuscular Volume (MCV)?

A

a measurement of the average size of a single red blood cell

Macrocytic
Microcytic

Normocytic

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19
Q

What is Mean corpuscular hemoglobin (MCH)?

A

a calculation of the average amount of hemoglobin inside a single red blood cell

Hyperchromic
Hypochromic

Normochromic

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20
Q

What is Mean corpuscular hemoglobin concentration (MCHC)?

A

a calculation of the average concentration of hemoglobin inside a single red blood cell

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21
Q

What is Red cell distribution width (RDW)?

A

a calculation of the variation in the size of RBCs

Variety in size is ether high or low

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22
Q

What is the difference between plasma and serum?

A

serum is plasma that has clotting factors removed

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23
Q

List the immediate precursor for each of the following:
erythrocyte
thrombocyte
neutrophil

A

reticulocyte

megakaryocyte

band cell

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24
Q

Leukocytosis is _________. It usually signifies excess of what type of WBC?

A

an excess amount of WBCs in the blood

neutrophils

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25
List examples of excessive white blood cells types
neutrophilia, lymphocytosis, eosinophilia, basophilia, reticolocytosis, bandemia, thrombocytosis
26
Leukopenia is _______
a deficient amount of WBCs
27
An excess of RBCs or all lines of blood cells is called ________
polycythemia
28
Define anemia
a state of a diminished count of erythrocytes and/or content of hemoglobin
29
Anemia can result from one or more of 3 basic mechanisms: _________________
- blood loss - deficient erythropoiesis (nutrient deficit) - excessive hemolysis (sickle cell anemia, thalassemia, malaria, auto-immune, etc.)
30
Describe iron deficiency anemia
lack of iron leads to insufficient hemoglobin production RBCs are smaller than normal and have an increased zone of central pallor There is also increased anisocytosis (variation in RBC size) and poikilocytosis (variation in shape)
31
Describe folate deficiency anemia
lack of folate leads to large red blood cells (deficient production of DNA) and can lead to macrocytic (megaloblastic) anemia
32
Describe B12 (Cyanocobalamin) Deficiency anemia
lack of B12 leads to large red blood cells(deficient production of DNA) and can lead to macrocytic (megaloblastic) anemia
33
Describe pernicious anemia
It is a special type of B12 deficiency anemia due to deficient absorption of vitamin B12. It is caused by auto-immune injury of gastric mucosa w/ the atrophy of parietal cells (produces intrinsic factor complex - carrier protein for B12)
34
Describe aplastic anemia
a rare disease in which the bone marrow, and the hematopoietic stem cells that reside there, are damaged,. causing a deficiency of all three blood cell types
35
The most common cause of iron deficiency anemia within the USA is __________
chronic bleeding (genito-urinary or gastro-intestinal)
36
Describe the character of RBCs in iron deficiency
microcytic and hypochromic RBCs
37
List signs and symptoms of iron deficiency anemia
glossy tongue, nail deformities (koilonychia), pagophagia, pica
38
How is iron deficiency anemia diagnosed?
TIBC test (Total Iron-Binding Capacity) along with serum iron test
39
In iron deficiency, the storage of iron (in the form of _____ ) is ______, while TIBC is _________
ferritin depleted increased
40
The major storage source of iron in the body is _____. TIBC measures __________
ferritin binding of iron to transferrin
41
List major nutritional sources of: Iron Vitamin B12 Folate
- liver, meat, shellfish - shellfish, liver, fish - green leafy vegetables, liver, legumes
42
List general steps of hemostasis
1) initial brief vasospasm 2) temporary platelet plug formation 3) coagulation cascade 4) clot retraction 5) clot dissolution
43
In temporary platelet plug formation, platelet adhesion requires presence of _____ a glycoprotein manufactured by ________ and ______.
vWF (von Willebrand factor) endothelium of blood vessels liver
44
In addition to its role in temporary platelet plug formation, vWF also _________
is a complex carrier for clotting factor VIII
45
Instrinsic coagulation cascade is initiated ________ Extrinsic coagulation cascde is initiated ________ Both coagulation cascades lead to common step of ________ and production of ________.
within an injured blood vessel when the blood is exposed to the surrounding injured tissues (trauma) factor X activation thrombin
46
In hemostasis, thrombin will activate production of _____ from ______, supplied by the liver
fibrin fibrinogen
47
Platelets are _______ and function to ________
anuclear cellular fragments of megakaryocytes initiate clotting process (coagulation cascade)
48
Bandemia is _______ and suggests __________ What are BLASTS? If you see BLASTS what does this suggest?
increase in immediate precursor cells for neutrophils (polys) initial stage of an acute bacterial infection BLASTS are immature WBC (undifferentiated WBC should not see in the blood it belongs in the bone marrow). We can assume leukemia.
49
Reticulocytosis is an indication of _______ and suggests _________
anemia or hypoxia chronic bleeding, respiratory pathology, smoking, change of altitude
50
Relative polycythemia is due to ________
diminished plasma volume (dehydration)
51
Absolute polycythemia is subdivided into _______ and _______
primary - bone marrow malignancy secondary - renal cell carcinoma w/ excess EPO or hypoxia
52
Normocytic and normochromic anemia suggests ________
anemia of chronic disease or acute blood loss
53
Deficiency of Vitamin B12 (aka __________) leads to accumulation of pro-inflammatory amino acid __________. This substance contributes to ______ injury and eventually to chronic _________
cyanocobalamin homocysteine vascular ischemic heart disease and other chronic vascular pathological events
54
Deficiency of Vitamin B12 is known to result in significant _______ deficit, which may progress to irreversible _________
neurological peripheral neuropathies, dementia, loss of coordination
55
What is the prognosis if B12 defciency is mistaken for folate deficiency and treated exclusively with folic acid supplementation?
Anemia might improve but neurological deficit will likely become irreversible
56
Sickle cell anemia is ___________ anemia which is caused by _______ on the gene coding for _________. It is of an _________ inheritance mode
hereditary hemolytic point mutation beta chain of adult Hemoglobin A autosomal-recessive
57
Instead of normal Hemoglobin A, sickle cell anemia leads to production of _______, which is prone to ______ which in turn leads to ________
Hemoglobin S crystallization sickling of the RBCs in peripheral circulation
58
Sickling is an event of RBCs becoming ________. It prompts ________ and leads to ________
rigid and assuming "ice pick" shapes thrombosis generalized ischemia
59
The major pathogenesis of sickle cell anemia is __________
generalized hemolysis with thrombosis and ischemia
60
Major factors contributing to sickling of RBCs in SC anemia are __________
hypoxia, acidosis, stress, dehydration
61
Clinical presentations of sickle cell anemia include ___________
severe jaundice/icterus, priapism, trophic ulcers, neuropathies
62
Hemophilia A and B are both hereditary disorders of ___________ inheritance mode. Von Willebrand disease is hereditary disorder of ________ inheritance mode
X-linked recessive mostly autosomal
63
Hemophilia A presents with deficiency of ________ Hemophilia B presents with deficiency of _________ Von Willebrand diseases presents with deficiency of _________
clotting factor VIII clotting factor IX vWF (qualitative or quantitative)
64
Hemophilia A and B are diagnosed by ___________
clinical presentations, prolonged bleeding times, genetic testing
65
Von Willebrand disease is diagnosed by __________
essaying certain clotting factors and investigating bleeding times
66
The therapeutic approach for bleeding disorders in general is based on ______________
replenishment of the deficient component needed for proper clotting to occur
67
Which bleeding disorder is known as Christmas disease? why?
Hemophilia B was first reported in the medical literature in 1952 in a patient with the name of Stephen Christmas
68
The most common leukemia of childhood is ________
ALL - Acute Lymphocytic Leukemia
69
Philadelphia chromosome is the mutual translocation between _________ and is found in 95% of cases of ______ and 5% of cases of __________
chromosome 9 and 22 CML - chronic myeloid leukemia ALL - acute lymphocytic leukemia
70
Reed-Sternberg cells are __________ and are a characteristic feature of _________
bi-nucleated immature B lympthocytes Hodgkin's lymphoma
71
List major signs of leukemias and lymphomas
painless lymphodenopahty, bruising, nose bleeds, fatigue, fluctuating tidal fever, profuse sweating, "stubborn" infections
72
Multiple Myeloma is a cancer of __________ cells
monoclonal plasma cells
73
In Multiple Myeloma, ____ cells, which are __________, are immature and spread indefinitely within the bone and peripheral blood, secreting ______ that clamp together and form ________, obstructing peripheral circulation and especially ___________
plasma activated B lymphocytes abnormal fragments of antibodies Bence-Jones proteins kidney tubules
74
How does Hodgkin's lymphoma differ from non-Hodgkin's lymphoma?
Hodgkin's lymphoma is cancer of lymphatic structure only | Non-Hodgkin's lymphomas can have a simultaneous component of lymphocytic leukemia as well
75
Multiple Myeloma presents with ____________
initial onset - bone pain worse at night (dull, gnawing, fixed pain) immuno-deficiency - chronic infections abnormal indurations
76
Hemolytic anemias can be caused by ___________
infections, genetic disease
77
Folate deficiency is more common than Vitamin B12 deficiency because __________
folate cannot be readily stored in the body
78
Primary absolute polycythemia is aka _______________
Polycythemia Rubra Vera

Pathophysiology 2 (8 decks)

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