Case 7 Flashcards

(47 cards)

1
Q

What parameter drives Hb gas exchange in both lung capillaries and peripheral tissues?

A

plasma [02]

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

What are the two factors that effect oxygen delivery to tissues?

A

[02]

cardiac output

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

What are the two states of Hb? How do they relate of oxygen binding?

A

Tense (low 02 affinity)

Relaxed (high O2 affinity)

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

What is myoglobin? How does its affinity for O2 differ to Hb?

A

Myoglobin is an 02 found in muscles

it has a higher affinity for O2 than Hb, meaning 02 is always given up at the muscles

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

How much blood does the average adult male have?

A

5-6L

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

What is the make up of bone marrow at birth?

A

Only red marrow

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

What is the function of red bone marrow?

A

Site of haematopoiesis

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

What is the function of yellow bone marrow?

A

Part of bone marrow stroma that makes up a microenvironment that provides physical support for haematopoiesis

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

Apart from yellow bone marrow, what other cells are contained within the stroma of bone marrow? (5)

A
Fibroblasts
Macrophages
Adipocytes
osteoclasts
osteoblasts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name the two ways in which EPO increases RBC production…

A

Increasing HSC rate of division and differentiation down erythroblast lineage

Increasing rate of Hb synthesis in RBC maturation process

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

From what lineage are natural killer cells derived?

A

Common lymphoid progenitor lineage

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

What is the average lifespan of a platelet?

A

7-9 days

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

What is the average lifespan of an RBC?

A

120 days

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

What is the average lifespan of a monocyte?

A

1-2 days

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

What is the average lifespan of a neutrophil?

A

5 days

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

What is the average lifespan of a basophil?

A

60-70 hours

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

What is the average lifespan of a eosinophil?

A

8-12 hours

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

Anti-A and anti-B antibodies are most commonly which class of immunoglobulin?

A

IgM

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

Why are ABO and Rhesus the most important blood group antigens?

A

Individuals who lack a blood group antigen have naturally occuring antibodies to that antigen

Can lead to transfusion reactions if exposed to the wrong blood type

20
Q

What is the function of the ABO gene product?

A

Enzyme that adds carbohydrate residues to H substance

H substance is a glycoprotein on the RBC cell surface

21
Q

What blood group is known as the universal donor group?

22
Q

What blood group is known as the universal recipient group?

23
Q

What is the universal plasma donor group?

A

AB

only 4% of population

24
Q

What is the kleihauer test? How is it performed?

A

Blood test used to measure the amount of HbF transfer from foetus to mother during pregnancy, which in turn determines Rh+ exposure

Blood sample added to acid bath. HbF resistant to denaturation

25
When should doses of anti-RhD+ antibodies be given to prevent haemolytic disease of the newborn?
28 weeks and 6 hours after birth
26
How is anaemia classified?
By cause e.g haemolytic anaemia | By RBC size e.g microcytic, normocytic, macrocytic
27
In addition to [Hb] measurement, what else may indicate iron deficiency anaemia?
Low serum ferritin
28
What is anaemia of chronic disease? How is it caused? How is it treated?
Impaired RBC production that is not related to any form of deficiency Caused by chronic diseases such as inflammation, renal disease, liver failure and cancer Treatment of underlying disease will treat anaemia collaterally
29
What is aplastic anaemia? What examination sign forms a key part of the differential diagnosis?
Rare form of anaemia in which the HSC of the bone marrow become dysfunctional. Deficiencies seen in erythrocytes, leukocytes and thrombocytes Increased rate of bruising suggests thrombocyte deficiency
30
What is spherocytosis and elliptocytosis? How does this relate to anaemia?
Abnormal shape of RBCs that make them more likely to burst open (lyse) Often found in patients with hereditary haemolytic anaemia
31
What is haemolytic anaemia? How is it classified?
Anaemia that results from an increase in rate of RBC destruction Classified as either hereditary or acquired (autoimmune)
32
What is hydroxyurea used to treat? What is its mechanism of action?
Sickle cell anaemia Increases the rate of HbF production. HbF doesn't have the capacity to sickle in the way that the faulty B globulin sickle chains do
33
What is the process of 'group and save'?
Blood group investigations are performed (including antibody status). This is then kept on file
34
What is crossmatching? What happens to the process during an emergency?
Patients blood sample matched with blood products they are intended to receive prior to transfusion Wavered in cases of emergency, universal donor blood type given. Risks of transfusion reactions thought to outweigh harm if non-treated
35
What is compatability testing? How does it differ to crossmatching?
Blood group and antibody investigations performed AND patients sample matched with tranfusion product they intend to receive Cross matching is only the later
36
What is the function of a leucodepletor?
Function to remove all white blood cells from the blood. This removes risk of transmission of WBC-born diseases such as variant CJD, BSE, cytomegalovirus
37
What is the shelf life of RBCs?
35 days
38
What viruses are blood products tested for?
HIV, hepatitis, syphilis
39
what blood product has the highest risk of bacterial infection?
Platelets- they are stored at room temperature
40
What is disseminated intravascular coagulation?
Aggregation of RBC throughout the body that block small arterioles and capillaries Initiated by incompatible blood transfusions that activate complement, leading to aggregation and agglutination
41
Each unit of erythrocytes raises HB levels by approximately.... g/L
10g/L
42
What is fresh frozen plasma most commonly used to deliver?
Clotting factors
43
What is cryoprecipitate most commonly used to deliver?
Fibrinogen
44
Why is it important to consider haemodynamics before administration of blood products?
Blood products raised blood volume and increase cardiac output This can exacerbate heart failure and pulmonary oedema
45
Define altruism...
The selfless concern for the wellbeing of others Driving force behind blood donation process
46
What is the moral personhood argument (relating to ethics of blood donation)?
An argument against the commercialisation of blood donation suggesting that people and their components are not something that should be bought and sold
47
A patient has to understand 3 things about their treatment before consent can be said to be 'informed'. What are these three things?
Have to have an understanding of: 1. What it is and why they need it 2. Associated risks 3. Any other alternatives