Exam 1

Question 1

Which hormone stimulates red blood cell production? Where is it produced?

Answer 1

Erythropoietin; the kidneys

Question 2

Which hormone stimulates platelet production? Where is it produced?

Answer 2

Thrombopoietin; the liver

Question 3

Example of a disease state that leads to increased erythropoietin production? Two disease states that decrease erythropoietin production?

Answer 3

Increased in hypoxia
Decreased in CKD or chronic inflammation

Question 4

Life span lengths of erythrocytes? Neutrophils? Platelets?

Answer 4

120 days (MONTHS);
6-8 HOURS;
7-10 DAYS

Question 5

Which hormone leads to the growth and differentiation of neutrophils?

Answer 5

G-CSF

Question 6

Which hormone stimulates formation of neutrophils, monocytes, and eosinophils? (“shotgun blast”)

Answer 6

GM-CSF

Question 7

Which CBC value is the best indicator of O2 carrying capacity?

Answer 7

Hemoglobin (not RBC)

Question 8

When it comes to hemostasis, what percentage of functioning levels are needed for the pathway to run smoothly? (This is the case for most organ and organ systems)

Answer 8

30%

Question 9

Which clotting factors are involved in the intrinsic pathway? How do we test this on labs?

Answer 9

12, 11, 9, and 8; PTT - time from inactive factor XII to fibrin formation

Question 10

Which clotting factors involved in the extrinsic pathway? How do we test this on labs?

Answer 10

VII; PT/INR - time from inactive factor VII to fibrin formation

Question 11

Which proteins are involved in platelets binding to collagen during the process of “Adhesion?”

Answer 11

GP Ib and von Willebrand Factor

Question 12

Name of the process in which fibrinogen forms a bridge between platelets.

Answer 12

Aggregation

Question 13

Two potential inhibitors of the “aggregation” process.

Answer 13

Prostacyclin, NO

Question 14

Name of two natural anticoagulants, or coagulation inhibitors.

Answer 14

Antithrombin; protein C

Question 15

What initiates the anticoagulation cascade by activating Protein C?

Answer 15

Thrombin (keeps us from clotting away from the site of injury)

Question 16

What is the next step if a PTT is found to be abnormal?

Answer 16

PTT mixing study

Question 17

What does a PTT correcting during a mixing study indicate?

Answer 17

A likely deficient clotting factor

Question 18

What does a PTT remaining prolonged during a mixing sutdy indicate?

Answer 18

An inhibitor is likely present, like antibodies against clotting factors

Question 19

What does thrombin time measure?

Answer 19

Time from fibrinogen to fibrin (part of the common pathway)

Question 20

Name this myeloid cell: released into circulation in response to G-CSP, GM-CSP, corticosteroids, or endotoxins

Answer 20

Neutrophils

Question 21

Causes of neutrophilia (6)

Answer 21

Inflammation
Stress
Corticosteroid therapy
Splenectomy
Serious bacterial infections
Myeloproliferative disorders (Ex. CML)

Question 22

Causes of neutropenia (4)

Answer 22

Drugs (Most common)
Infection (Bacterial or viral)
Autoimmune (Ex. RA, SLE)
Cirrhosis leading to splenic sequestration

Question 23

Neutropenia is not a problem for healthy people unless below what number?

Answer 23

<500

Question 24

Treatment for neutropenia

Answer 24

Antibiotics; stimulate neutrophil production with G-CSF or GF

Question 25

Job of monocytes

Answer 25

Phagocytosis of bad cells and presentation to CD4+ T-cells

Question 26

What do eosinophils secrete histamine, cytokines, or reactive oxygen species in response to?

Answer 26

Parasites or allergens

Question 27

Potential causes of eosinophilia

Answer 27

NAACP (Neoplasm, allergy/atophy, asthma, connective tissue disorder, parasites)

Question 28

What do basophils do? What do they respond to?

Answer 28

Make most of circulating histamine; Allergies

Question 29

Causes of basophilia (4)

Answer 29

Myeloproliferative disorders Splenectomy Hemolytic anemias Hodgkin disease

Question 30

What does the body make more of, T or B cells?

Answer 30

T cells

Question 31

Role of B cells

Answer 31

Antibody production

Question 32

Where are B cells housed?

Answer 32

Spleen and lymph nodes

Question 33

Role of T cells

Answer 33

Cytoxicity

Question 34

What causes "primary" lymphocytosis? How about "reactive" lymphocytosis?

Answer 34

Cancer; Infection response (most commonly viral)

Question 35

Causes of lymphocytopenia (7)

Answer 35

Viral infection Some bacterial infections Marrow disorders Autoimmune Sarcoidosis Renal Failure Protein-losing Enteropathies

Question 36

Risk factors of relative polycythemia (5)

Answer 36

Male 45-55 yrs old Obesity HTN Heavy smoking

Question 37

What happens to RBC's and plasma volume in relative polycythemia?

Answer 37

RBC amount is normal, but plasma volume decreases

Question 38

Most common cause of secondary polycythemia

Answer 38

Cardiopulmonary disease

Question 39

What is the common theme among all causes of secondary polycythemia?

Answer 39

Hypoxia

Question 40

This mutation to these type of cells leads to primary polycythemia (Polycythemia vera)

Answer 40

JAK2 mutation to stem cells

Question 41

How might the CBC for a primary polycythemia look different than a relative or secondary polycythemia?

Answer 41

You would see pancytopenia with primary (increased RBCs, WBCs, and platelets)

Question 42

Symptoms of primary polycythemia (4)

Answer 42

Headache Pruritis Weakness Neuropathy

Question 43

Physical exam findings with polycythemia

Answer 43

Facial plethora, splenomegaly, hepatomegaly

Question 44

Two most effective treatment options for primary polycythemia

Answer 44

JAK inhibitors Hydroxyurea