Exam 2 (general info) Flashcards

(92 cards)

1
Q

What method is used to determine the Hb concentration?

A

cyanmet-Hb method

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2
Q

What are the 3 structures of Hb that can affect the function of Hb?

A

heme | iron | polypeptide

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3
Q

What is MCV?

A

(mean corpuscular volume) | indicates RBC SIZE patient has | fempto liter (fl) (10^-15)

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4
Q

What is MCH?

A

(mean corpuscular Hb) | indicates AMOUNT Hb per EACH RBC | pictogram (pg)

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5
Q

What is MCHC?

A

(mean corpuscular Hb concentration) | indicates AMOUNT Hb per VOLUME of RBC | in %

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6
Q

What are the first 5 things to look for while examining a patient’s blood? (to determine if something is wrong)

A

increased anisocytosis | increases poikilocytosis | increased reticulocytes | presence of inclusion bodies | Hb content

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7
Q

What is serum bilirubin?

A

breakdown product of Hb from lysed RBCs

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8
Q

What is an elevated level of serum bilirubin indicate?

A

increase RBC hemolysis

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9
Q

How can you determine the amount of bilirubin in urine and feces?

A

will be darker in color

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10
Q

What happens to the heme after RBC lysis?

A

degraded and excreted out as bilirubin by the liver and spleen

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11
Q

What indices help with determining the category of anemia a person has?

A

MCH, MCV, MCHC indices

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12
Q

What happens if a person’s immune system creates Abs against TCBII-F?

A

no TCBII-F &raquo_space;> no B12 transported into BM from intestines &raquo_space;> delay DNA synthesis &raquo_space;> increases size of RBCs and WBCs

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13
Q

What is the occult blood test used for?

A

check feces for internal bleeding

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14
Q

From the occult blood test, what does dark oreo-cookie color blood in the stool indicate?

A

upper GI bleeding

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15
Q

From the occult test, what does bright red blood in the stool suggest?

A

lower GI bleeding

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16
Q

What is an increased number of reticulocytes indicate?

A

increased erythropoiesis

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17
Q

What is polychromasia?

A

pre-mature RBCs released early from BM (abnormal) | bluish color in RBC compared to normal pink

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18
Q

What are the 6 pieces of evidence detected in peripheral blood smear that indicates increased erythropoiesis?

A

anisocytosis | polychromasia | basophilic stippling | Howell-Jolly bodies | nucleated RBC | reticulocytosis

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19
Q

What are the 5 pieces of evidence detected in bone marrow that indicates increased erythropoiesis?

A

increased cellularity | decreased hemosiderin | low M:E | high C:F | high reticulocyte level

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20
Q

How to determine for impaired erythropoiesis in the BM and peripheral blood?

A

opposite of the findings of increased erythropoeisis

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21
Q

What is transferrin?

A

transports iron from intestines to BM or to other places

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22
Q

What is ferritin?

A

apoferritin + iron | in intestines | H2O soluble | not detectable in stained smear or light microscope

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23
Q

What is hemosiderin?

A

ferritin aggregates | H2O INsoluble | detectable in BM smear

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24
Q

What do low hemosiderin and ferritin levels indicate and why?

A

iron deficiency anemia | don’t have iron = no Hb synthesis

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25
What is the only way to lose iron and why?
donating blood (or bleed out) | cannot excrete metals out of body
26
What are the 3 molecules involved in blood cells that are toxic by themselves?
bilirubin | iron | hemoglobin
27
What is jaundice?
elevated bilirubin causing yellow pigmentation on skin
28
What are the 2 types of jaundice?
physiological = w/in 24h after delivery (normal) | pathological = asap after delivery
29
Which cell types are most affected by jaundice?
nerve cells
30
Where does bilirubin come out of?
macrophages
31
What neutralizes bilirubin?
albumin (plethora of these proteins in plasma)
32
What are the characteristics of bilirubin-albumin?
pre-hepatic bilirubin | indirect reacting | H2O INsoluble | unconjugated
33
What are the characteristics of bilirubin-glucuronide?
post-hepatic bilirubin | direct reacting | H2O soluble | conjugated
34
What are the glucuronide causes of an increased level of bilirubin-albumin?
infection | hemolytic anemia | incompatible blood transfusion | increase old RBC lysis
35
Where does bilirubin-glucuronide go to?
intestines
36
What neutralizes Hb?
haptoglobin
37
How abundant is haptoglobin?
very limited
38
What do macrophages convert free Hb into?
bilirubin
39
What gives rise to hematin?
breakdown of methemoglobin | by-product of globin
40
What are the 4 places in the body is iron stored in? (low levels of this indicate Fe-def anemia)
Hb | ferritin | hemosiderin | transferrin saturation
41
What protein is responsible for the absorption into or loss of iron from the body?
transferrin
42
How much % of total body iron is in Hb?
65%
43
How much % of total body iron is in ferritin and hemosiderin?
30%
44
What is heme composed of?
iron and protoporphyrin
45
In which organs are ferritin and hemosiderin commonly found?
liver and spleen
46
How does lead affect hemoglobin synthesis?
inhibits heme and Hb synthesis
47
What is transferrin saturation?
when iron binds to transferrin
48
What is serum iron?
iron bound to transferrin
49
What transferrin saturation indicates iron deficiency anemia?
under 15%
50
What is TIBC?
total iron binding capacity
51
What does TIBC consist of?
sum of serum iron and UIBC
52
What is UIBC?
unsaturated iron binding capacity | transferrin NOT bound to iron
53
What is the equation for transferrin saturation?
serum iron / TIBC
54
Would the TIBC of a person with an infection be high or low? Why?
low | person will not absorb too much iron to help fight off pathogen
55
What does a transferrin saturation of >33% indicate?
body wants more iron in order to increase RBC production
56
What is the main site of protoporphyrin synthesis?
mitochondria
57
What happens to protoporphyrin if there is no iron present or unusable?
protoporphyrin accumulates
58
What are the 6 things that blood transfusion can lead to?
change T-cell subpopulations (less Th cells) | produce idiotypic Abs (ie: anti-FAB Abs) | induce B-cell tolerance = less Ab production | suppress cell-mediated immunity (monocytes and NK cells) | less macrophage-lymphocyte interaction | IL2 production
59
What are the 3 things that can affect immunity?
stress | less cytokine production | pregnancy
60
What are anti-idiopathic Abs?
Abs that bind to other Abs to neutralize them = inactivating them
61
How does blood transfusion decrease Ab production?
constant blood transfusions can decrease sensitivity
62
How does B12 and folate get absorbed into the body?
absorption sites have receptors for the vitamins
63
What does the stomach need to produce in order to absorb B12?
intrinsic factor in the parietal cells of the stomach
64
What is asynchrony?
decreased number of cell division due to folate and B12 deficiency, gives rise to macrocytes
65
What is Crohn's disease?
inflammation of small intestine | malabsorption of nutrients due to the inflammation interfering with the receptors
66
What is the role of intrinsic factor?
to transport B12 from stomach to small intestines
67
What is the role of Transcobalamin II (TCBII)
shuttles B12 to BM for erythropoiesis
68
What is the end result needed from B12 and folate?
synthesis of thymidine for DNA synthesis
69
What are the 2 things that affect the increase or decrease the number of circulating RBCs?
hormones and physiological stimulus
70
What are the 4 physiological stimulus that increase (or decrease) the number of RBCs ciruculating?
emotion | exercise | eating | thinking
71
What hormone influences the increase or decrease in number of RBCs circulating?
erythropoietin
72
What is the role of erythropoietin and where is it made?
stimulates RBC production in BM | produced by kidneys
73
What controls erythropoietin production?
pO2 in the blood | pO2 < normal = increase erythropoietin
74
What is Blood Doping? Its effect on erythropoietin? How can it be detected?
injecting O2-blood into body before athletic event | decreases erythropoietin levels | can be detected via hematocrit measuring erythropoietin
75
What are the 3 conditions in which individual naturally has more erythropoietin?
asthma | lung problems | smokers
76
What shuts down erythropoietin production?
high RBC level
77
What are the 3 things that low pO2 can be due to?
loss of RBC | high altitude | lung diseases
78
What are the 2 minerals needed for erythropoiesis?
cobalt and iron (ferrous 2+)
79
How does the stomach affect hematopoiesis?
produces IF and HCl | HCl = provides acidic environment for efficient absorption of iron
80
How is the small intestine involved in hematopoiesis?
contains receptor for B12, folate, and iron
81
How is the liver involved in hematopoiesis?
stores vitamin K, B12, and iron
82
How is the kidney involved in hematopoiesis?
where erythropoietin is made
83
How are the endocrine glands involved in hematopoiesis?
production of hormones that affect body physiologically which may affect levels of RBC production
84
What color is Oxy-Hb?
bright red
85
What color is met-Hb?
chocolate
86
What color is Hb (reduced)?
purple red
87
What color is carboxy-Hb?
cherry pink
88
Which Hb derivatives are unable to carry O2? Is it reversible or irreversible?
Sulf-Hb and hematin | irreversible
89
Which Hb derivatives function as a O2 carrier? Is it reversible or irreversible?
Met-Hb and carboxy-Hb | reversible
90
Which Hb polypeptide variants are not good?
HbS and HbC
91
Which Hb polypeptide variants are good?
HbA, HbA2, HbF
92
What kind of Hb derivative does a patient have with food poisoning and consumption of germicide?
sulf-met Hb