Chapter 41 Hematologic System

Question 1

Functions of Neutrophil (Inflammation)

Answer 1

nonspecific ingestion and phagocytosis of microorganisms and foreign protein

Question 2

Functions of Macrophage (Inflammation)

Answer 2

nonspecific recognition of foreign proteins and microorganisms; ingestion and phagocytosis

Question 3

Functions of Monocyte (Inflammation)

Answer 3

destruction of bacteria and cellular debris; matures into macrophage

Question 4

Functions of Eosinophil (Inflammation)

Answer 4

weak phagocytic action; releases vasoactive amines during allergic reactions

Question 5

Functions of Basophil (Inflammation)

Answer 5

releases histamine and heparin in areas of tissue damage

Question 6

Functions of B Lymphocyte (Antibody-Mediated Immunity)

Answer 6

becomes sensitized to foreign cells and proteins

Question 7

Functions of Plasma Cell (Antibody-Mediated Immunity)

Answer 7

secretes immunoglobulins in response to the presence of a specific antigen

Question 8

Functions of Memory Cell (Antibody-Mediated Immunity)

Answer 8

remains sensitized to a specific antigen and can secrete increased amounts of immunoglobulins specific to the antigen

Question 9

Functions of T Lymphocyte Helper/Inducer T Cell (Cell Mediated Immunity)

Answer 9

Enhances immune activity through secretion of various factors, cytokines, and lymphokines

Question 10

Functions of Cytotoxic- Cytolytic T Cell (Cell Mediated Immunity)

Answer 10

Selectively attacks and destroys non self cells, including virally infected cells, grafts, and transplanted organs

Question 11

Functions of Natural Killer Cells (Cell-Mediated Immunity)

Answer 11

Nonselectively attacks non self cells, especially body cells that have undergone mutation and become malignant; also attacks grafts and transplanted organs

Question 12

Clotting Factors: I: Fibrinogen

Answer 12

Factor I is converted to firbrin by thrombin. individual fibrin molecules form fibrin threats which are scaffold for clot formaion and wound healing

Question 13

Clotting Factos: II: Prothrombin

Answer 13

inactive precursor of thrombin. activated to thrombin by coagulation factor X. after it is activated, thrombin converts fibrinogen into fibrin and activates factors V and VIII

Question 14

Clotting Factors: III: Tissue thromboplastin

Answer 14

interacts with factor VII to initiate the extrinsic clotting cascade

Question 15

Clotting Factors: IV: Calcium

Answer 15

a co factor for most of the enzyme activated processes required in blood coagulation. also enhances platelet aggregation and makes RBCs clump together

Question 16

Clotting Factors: V: Proaccelerin

Answer 16

a cofactor for activated factor X, which is essential for converting prothombin to thrombin

Question 17

Clotting Factors: VI: Discovered to be an artifact

Answer 17

NONE involved in coagulation

Question 18

Clotting Factors: VII: Procenvertin

Answer 18

activates factors IX and X, which are essential in converting prothrombin to thrombin. synthesis is vitamin K dependent

Question 19

Clotting Factors: VIII: Antihemophilic Factor

Answer 19

together with factor IX enzymatically activates factor X. in addition, combines with another protein (von willebrand’s factor) to help platelets adhere to capillary walls in areas of tissue injury

Question 20

Clotting Factors: IX: Plama Thromboplastin component (Christmas Factor)

Answer 20

activates factor X to convert prothrombin to thrombin. essential in common pathway between intrinsic and extrinsic clotting cascade. lack of this factor is basis for hemophilia B. synthesis is vitamin K dependent.

Question 21

Clotting Factor: X: Stuart Prower Factor

Answer 21

when activated, converts prothombin to thrombin. synthesis is vitamin K dependent

Question 22

Clotting Factors: XI: Plasma Thromboplastin antecedent

Answer 22

when activated assists in activation of factor IX. however a similar factor must exist in tissues. people deficient in this factor have mild bleeding problems after surgery but do not bleed excessively as a result of trauma

Question 23

Clotting Factors: XII: Hageman Factor

Answer 23

critically important in the intrinsic pathway for activation of factor XI

Question 24

Clotting Factors: XIII: Fibrin-Stabilizing Factor

Answer 24

assists in forming cross links among the fibrin threads to form a strong fibrin clot

Question 25

Findings in Hematologic Assessment: Nail beds for cap refill (hematologic d/o versus older adult)

Answer 25

pallor or cyanosis may indicate a hematologic disorder older adults may have thickened or discolored nails the make viewing skin color impossible use another body area, such as lip, to assess central capillary refill

Question 26

Findings in Hematologic Assessment: Hair Distribution (hematologic d/oversus older adult)

Answer 26

thin or absent hair on trunk or extremities may indicate poor circulation to a particular area progressive loss of body hair is a normal facet of aging a relatively even pattern of hair loss that has occurred over an extended period is not significant

Question 27

Findings in Hematologic Assessment: Moisture (hematologic d/o versus older adult)

Answer 27

skin dryness may indicate nay of a number of hematologic disorders skin dryness is a normal result of aging skin moisture is usually not a reliable indicator of an underlying pathologic condition in the older adult

Question 28

Findings in Hematologic Assessment: Skin Color (hematologic d/o versus older adult)

Answer 28

skin color changes, especially pallor and jaundice, are associated with some hematologic d/o's pigment loss and skin yellowing are common changes associated with aging pallor in an older adult may not be a reliable indicator of anemia. lab testing is required. yellow tinged skin in an older adult may not be a reliable indicator of increased serum bilirubin levels. lab testing is required.

Question 29

Red Blood Cell Count

Answer 29

females: 4.2-5.4 million/mm3 males: 4.7-6.1million/microliter decreased levels: anemia or hemorrhage increased levels: chronic hypoxia or polycythemia vera

Question 30

Hemoglobin (Hgb)

Answer 30

females: 12-16g/dL males: 14-18g/dL same as for RBC

Question 31

Hematocrit (Hct)

Answer 31

females: 37%-37% males: 42%-52% same as for RBC

Question 32

Mean Corpuscular Volume (MCV)

Answer 32

80-95mm3 increased: macrocytic cells, possible anemia decreased: microcytic cells, possible iron deficiency anemia

Question 33

Mean Corpuscular Hemoglobin (MCH)

Answer 33

27-31pg/cell | same as MCV

Question 34

Mean Corpuscular Hemoglobin Concentration (MCHC)

Answer 34

32-36g/dL cells increased: spherocytosis or anemia decreased: iron deficiency anemia or hemogblobinopathy

Question 35

White Blood Cell Count

Answer 35

5,000-10,000mm3 increased: infeciton, inflammation, autoimmune d/os, leukemia decreased: prolonged infection or bone marrow suppression

Question 36

Reticulocyte Count

Answer 36

0. 5%-0.2% or RBC increased: chronic blood loss decreased: possible inadequate RBC production

Question 37

Total Iron Binding Capacity (TIBC)

Answer 37

250-460mcg/dL increased: iron deficiency decreased: anemia, hemorrhage, hemolysis

Question 38

Iron (Fe)

Answer 38

females: 60-160mcg/dL males: 80-180mcg/dL increased: iron excess, hemochromocytosis, liver disorders, megaloblastic anemia decreased: iron deficiency anemia, hemorrhage

Question 39

Serum Ferritin

Answer 39

females: 10-150ng/dL males: 12-300 ng/dL same for iron

Question 40

Platelet Count

Answer 40

150,000-400,00/mm3 increased: polycythemia vera decreased: bone marrow suppression, autoimmune disease, hypersplenism

Question 41

Hemoglobin Electrophoresis

Answer 41

``` Hgb A1: 95%-98% Hgb A2: 2%-3% Hgb F: 0.8%-2% Hgb S: 0 Hgb C: 0 variations indicate hemoglobinopathies ```

Question 42

Direct Coombs' and indirected Coombs' test

Answer 42

negative | positive findings indicate autobodies to RBCs

Question 43

Prothrombin Time (PT)

Answer 43

11-12.5 sec increased: possible deficiency of clotting factors V and VII decreased: vitamin K excess

Question 44

Bleeding Time

Answer 44

1-9min | increased: inadequate platelet function or number, clotting facter deficiencies

Question 45

Fibrin Degradation Products

Answer 45

<10mcg/mL | increased: DIC of fibrinolysis