Exam 3 pt 1

Question 1

how are blood cells made? and where?

Answer 1

hematopoeisis in the liver and spleen of fetus
-after birth only in the bone marrow

Question 2

what is a reticulocyte

Answer 2

an erythroblast/ last immature form

Question 3

what indicates if rbc are being made?

Answer 3

erythropoeitc actitity index

Question 4

what does EPO timulate (erythropoetin)

Answer 4

erythropoiesis

Question 5

vitamins for erythropoesis?

Answer 5

B 12 (cobalamin),folic acid for dna and rna synth and maturation, b6 (pyridoxine), B5 (pantothenic acid) and E, and B2 riboflavin and absorbic acid

Question 6

what removes old rbc in spleen

Answer 6

macrophages after 120 days

Question 7

hemoglobin breaks downs to heme then to?

Answer 7

1. porphyrin and biliverdin (green) then unconjugates bilirubin
2. goes to liver ti be conjugates bilirubin (range/yellow)
3. excreted with bile into duodenum

Question 8

what does globulin break down to?

Answer 8

amino acids

Question 9

what does iron break down to

Answer 9

recycled to red bone marrow to make more hb

Question 10

define anemia

Answer 10

low rbc count
-low 2 in blood (hypoxemia) leads to tissue hypoxia
-blood leaves cutaneous tissue leading to pallor
-tachycardia and palpitations
-increase erythropoetin which causes bone marrow to make new rbc

Question 11

hemolytic anemia

Answer 11

-rbc destroyed, iron retention and retention of the hb breakdown products, increase erythropoiesis to compensate

Question 12

low rbc lifespan leads to

Answer 12

hyperactive bone marrow
-high reticulocytes in blood

Question 13

sickle cell

Answer 13

hbS sickle when deoxygenetate and they aggregate changing iron flow, damaging rbc membrane,

Question 14

what does sickle cell cause

Answer 14

premature hemolysis, hemolytic anemia, erythropoisis in bm, rbc adherance to vessel walls, ischemic tissue damage

Question 15

what triggers sickling?

Answer 15

hypoxemia, acidosis, high plasma osmolarity, low plasma volume, low temperature (causes vasoconstriction)

Question 16

what is thalassemia

Answer 16

AR disorder of Hb synthesis
-low synth of alpha or beta globulin chains of HbA

Question 17

what are the types of anemia

Answer 17

-iron deficiency
-megaloblastic
-aplastic
-chronic disease

Question 18

what has impaired dna synth and nuclear maturation leading to lrage rbc

Answer 18

megaloblatic anemia/ cobalamin/ b12 deficiency anemia
-also folic acid deficiency anemia

Question 19

bone marrow failure leads to?

Answer 19

aplastic anemia which affects wbc, rbc and platlets
-pancytopenia (all are low)

Question 20

anemia from bleeding

Answer 20

men and postmeno women can get it from Gi bleed (ulcer, lasions, polyps, hemorid, cancer )
-younger women from period

Question 21

does pregnancy cause anemia

Answer 21

yes it increases the iron demands

Question 22

what can b12 deficieny cause

Answer 22

-pernicious anemia which is from chronic atrophic gastiris (loss of parietal cells), no IF is made, b12 cant be absorbed
-or antibodies against IF or parietal cells that block the binding of vit b 12 to IF

Question 23

demyelinated axons, paresthesia (calambre) spastic ataxia are symptoms of?

Answer 23

b12 deficiency

Question 24

how do you get aplastic anemia

Answer 24

radiation, chemicals, toxins affecting hematopoiesis
-you will see bone marrow replaced by fat

Question 25

too many rbc made?

Answer 25

polycythemia, bm disorder -higher viscosity, blood cant flow right, casues hypercoagulable state vessel occlusion from thrombosis and organ ischemia

Question 26

polycythemia manifestations?

Answer 26

high rbc, high viscosity high blood volume -headache, blur vision, heat causes painful itching (aquagenic purutis), thromboembolism, spenomegaly, hepatomegaly

Question 27

multiple myeloma

Answer 27

proliferation of b cells

Question 28

large non painful neck, splenomegaly, fever, chills night sweats, weight loss

Answer 28

hodgkin disease

Question 29

reed-sternberg cells NOT present, painless lymphadenopathy, extranodal disease

Answer 29

non hodkin

Question 29

leukemia

Answer 29

bone marrow replaces with malignant leukocytes -classified based on acute( immature cells) or chronic (cell is mature but nonfunctioning)

Question 30

which leukemia has granules in all maturation stages, bcr-abl fusion protein, philadelphia chromosome translocation

Answer 30

chronic myelogenous

Question 31

chronic lympocytic leukemia

Answer 31

leukocytposis and lymphocytosis

Question 32

what are the stages of coagulation

Answer 32

1. vasculat 2. platelet phae (amp) they adhere to basement membrane of vessel walls and collagen fibers, aggregate after adhering 3. coagulation phase

Question 33

vit k decifiency

Answer 33

can come from bacteria in colon, dark veggies, this is why babies get IM vit K bc they have a sterile colon

Question 34

risk factors for spontaneous thrombi

Answer 34

1. abnormal bf and turbulent flow in arteries 2. injury to blood vessel endothelium (plaques, smoking, diabetes, cholesterol) 3. hypercoagulability of bloof (thrombophilia) -sensitive to factors that cause aggregation