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Year 1: Patho/Pharm > Haematology PATHO > Flashcards

Haematology PATHO Flashcards

(47 cards)

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1
Q

What is the composition of blood after centrifuge separation

A

45% Cellular (RBC)

1% Buffy coat (leukocytes (WBC), platelets)

55% Plasma (90% water,

10% solutes (albumin, globulins, clotting factors, electrolytes)

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2
Q

List the functions of blood

A

Gas exchange (Co2, O2)

nutrient and waste transport

acid-base balance

thermoregulation

haemodynamic stability

hemostasis (blood clotting)

immune system

Endocrine system

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3
Q

Most abundant blood cell and function

A

Erythrocytes (RBC)
45% of blood

oxygen, carbon dioxide
iron store
acid-base balance

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4
Q

Most abundant blood protein and function

A

Albumin

oncotic pressure
drug transportation

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5
Q

Types of blood proteins and function

A

Albumin
- oncotic pressure
- drug transport

Immunoglobulins
- IgM (innate), IgG (adaptive), IgE (parasite/hypersensitivity), IgA (secretory)

Clotting factors
- Fibrinogen - cross link platelet plug

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6
Q

Anuclear blood cell

A

RBC
- no nucleus
- no organelles
- no mitochondrea
- heme ring
- flexible disc shape
- lifespan 120 days

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7
Q

Cellular fragments in blood

A

Platelets
- cellular fragments
- originate from megakaryocytes in the bone marrow

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8
Q

Two types of leukocytes

A
  1. Granular (Granulocytes)
  • eosinophils (parasitic, hypersensitivity reactions)
  • basophils (allergic reactions)
  • neutrophils (first responders innate immunity)
  • granules of histamine, degranulate during immune response
  1. Agranulocytes
  • B cells (plasma cells, produce immunoglobulins, adaptive humoral immunity)
  • T Cells (helper T cells, killer T cells, adaptive cellular immunity)
  • NK Cells (innate immune response)
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9
Q

Immature blood cells are called

A

BLASTS

myeloblasts

erythroblasts

megakaryoblasts

lymphoblasts

  • not usually found in circulation, unless pathology exists

Ex. immature neutrophils, neutroblasts will be released by bone marrow if system is overwhelmed by infection or inflammation, left shift

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10
Q

Mature blood cells are called

A

Cytes

erythrocytes
thrombocytes
megakaryocytes
lymphocytes

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11
Q

Function of cytokines

A

Cytokines are signal molecules, promote cellular development

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12
Q

Types of cytokine signals

A

autocrine - same cell
paracrine - neighbour cell
endocrine - far away organ/cell

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13
Q

Haematopoetic cytokines

A

Granulocyte colony stimulating factor (G-CSF)
- platelets
- neutrophils

Granulocyte macrophage colony stimulating factor (GM-CSF)
Myeloblasts (neutrophils, basophils, eosinophils, monocytes)

erythropoetin (EPO)
erythrocytes

thrombopoetin (TPO)
thrombocytes
IL-11
platelets

IL3,9, G-CSF, GM-CSF
myeloid stem cells (precursor of both myeloblasts, lymphoblasts)

IL1
Erythroblasts

IL3
myeloblasts - granulocytes
IL5,6
lymphoblasts - B cells
IL7
lymphoblasts - T Cells

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14
Q

Differential diagnosis elevated WBC?

A

Neutrophils
- acute inflammation
- acute infection

basophils
- type I hypersensitivity reaction (asthma, allergies)
- release cytokines IL which activate plasma cells to secrete IgE

eosinophils
- phagocytize IgE-antigen complexes
- parasite reaction
- type I hypersensitivity reaction

Elevated BLASTS
- cancer?

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15
Q

Neutropenia

A

Low neutrophil
< 500
immunocompromised

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16
Q

Prevention platelet activation

A

Prostaglandins released by endothelial cells prevent platelet activation
PGI2

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17
Q

Promotion platelet activation

A
  • collagen
  • ADP
  • PAF, platelet activating factor
  • thrombin
  • activaiton of IIb/IIIa receptor
  • binds to fibrinogen creating cross links and platelet plug
  • also binds clotting factors VWF, IX, V
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18
Q

Activated platelet form

A
  • sticky
  • flat
  • adhere to ECM
  • release 1. dense bodies (ADP, calcium, serotonin), 2. alpha granules (fibrinogen, V)
  • promotes cross linking
  • attracts more platelets
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19
Q

RBC structure

Study These Flashcards
A

2 alpha, 2 beta polypeptides
4 protoporphyrin rings
4 heme groups
4 iron (Fe2+ unbound by oxygen)

20
Q

Where is majority of the bodies iron stored?

Study These Flashcards
A

Erythrocytes 70%
ferritin stores liver

21
Q

Where is heme broken down?

Study These Flashcards
A

heme broken down to bilirubin
recycled in liver
glucuronate attached and excreted in urine or feces

22
Q

Function of folate

Study These Flashcards
A

purine DNA/RNA synthesis
closure of neural tube during pregnancy

23
Q

Types of anemia

Study These Flashcards
A
  1. macrocytic anemia
  2. microcytic anemia
  3. anemia chronic disease (normocytic anemia)
24
Q

Function of vitamin B12

Study These Flashcards
A

myelination of nerves
low vitamin B12 - demyelination and spasticity

25
Function of Iron
carrier of oxygen in the RBC
26
GI malabsorption can lead to anemia Examples
alcoholism drugs crohn's disease UC disease short bowel etc.
27
Laboratory findings of iron deficiency anemia
low RBC low hemoglobin low serum iron low ferritin high transferrin binding capacity low MCV < 80 low MCHC (hypochromic)
28
laboratory findings of folic acid deficient anemia
low RBC low hemoglobin high MCV > 100 (macrocytic) normal MCHC (normochromic) low serum folate high homocysteine low or normal Vitamin B12 (needed for folate activation)
29
Laboratory findings of vitamin B12 deficient anemia
low RBC low hemoglobin high MCV > 100 normal MCHC low serum vitamin B12 high methylmalonic acid level normal or low folate normal, low, or no intrinsic factor
30
laboratory findings of anemia of chronic disease
low RBC low hemoglobin normal or high iron normal MCV normal MCHC or low MCV, low MCHC
31
Cause of anemia for chronic disease
low RBC production low RBC lifespan increase demand RBC
32
3 systems involved in hemostasis
1. vasculature - vasoconstriction 2. platelets - platelet activation, adhesion, aggregation, platelet plug 3. coagulation factors - coagulation cascade (intrinsic, extrinsic, common), and fibrin clot formation
33
4 events of hemostasis
PRIMARY HEMOSTASIS 1. vasoconstriction VSM - serotonin, histamine, calcium 2. platelet plug formation - activation, adhesion, aggregation SECONDARY HEMOSTASIS 3. coagulation cascade and fibrin clot formation - intrinsic, extrinsic, common - prothrombinase complex 4. clot dissolution - TPA (Tissue plasminogen activator) - APC (activated protein C) and protein S - Anti-thrombin and endogenous heparin
34
Platelet activation
ADP TXA2 Collagen thrombin (IIa) PAF
35
Inhibition of platelet activation
PGI2 prostaglandin I2
36
Platelet adhesion
"glue" = von willebrand factor VWF binds GPIb receptor activates platelets results in expression of IIb/IIIa receptors leads to platelet release reaction alpha granules - fibrinogen, V (VWF) dense bodies - serotonin, calcium, ADP
37
Platelet aggregation
cross linking of platelets via fibrinogen mesh VWF + GPIIa/IIIb + Fibrinogen
38
3 phases of Secondary hemostasis
formation fibrin through intrinsic/extrinsic coagulation cascade 1. initiation 2. amplification 3. propagation
39
Fibrin clot formation Common pathway
X --> Xa II --> IIa (thrombin) Fibrinogen --> Fibrin XIII stabilizes fibrin
40
Coagulation cascade extrinsic pathway
Tissue factor VII --> VIIa X --> Xa IX --> IXa Xa II --> IIa Fibrinogen --> FIbrin *Tissue factor activates both the X and the IX
41
Coagulation cascade intrinsic pathway
XII --> XIIa XI --> XIa IX --> IXa X --> Xa II -> IIa fibrinogen --> Fibrin endogenous to the blood vessels
42
Propagation and amplification
IIa activates IX activates V activates VIII VII activates IX
43
Drug that inhibits intrinsic pathway
Heparin binds and activates anti-thrombin anti-thrombin binds clotting factors X, II (thrombin) - common pathway XII, XI, IX - intrinsic pathway measure aPTT activated partial thromboplastin time
44
Drug that inhibits extrinsic pathway
warfarin inhibits formation of vitamin K dependent coagulation factors - IX , X, VII, II extrinsic pathway measured with INR (prothrombin time)
45
Inhibition of coagulation natural physiology
anti-thrombin - made by liver - circulation 2-3 days - binds heparin - binds to coagulation factors XII, IX, IX, X, II Thrombomodulin + Activated protein C + protein S - binds and inactivates V, VIII TPA - tissue plasminogen activator - breakdown of fibrin to D Dimers
46
Virchows Triad
1. injury - endothelial 2. hypercoagulation state 3. stasis - blood flow
47
Why does inflammation promote coagulation?
CK creatine kinase blocks anti-thrombin, thrombomodulin, activated protein C and protein S results in decrease in fibrinolysis

Year 1: Patho/Pharm (45 decks)

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