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Flashcards in hematological disorders Deck (155):
1

What are the function of blood?

delivery of substances for cellular metabolism (esp. glucose and O2), transport waste substances, defense against invading organisms and injury, acid-base balance

2

Blood is made up of ______ and ________.

Plasma (water portion 50-55%, 91-92% water, 8% solids-clotting factor, proteins, fats, glucose etc.) Formed elements (45-50% cells and platelets)

3

What are formed elements?

Erythrocytes (RBC's), Leukocytes (WBC's) Platelets

4

______ is the process of growing new formed elements.

hematopoiesis

5

_____ solition has large particles

colloid

6

______ solution has much smaller particles than _____ solution

crystoloid: colloid

7

Where do platelets come from? (three cells that precede it)

Megakaryocyte from erythroid and from hematopoietic stem cell

8

What types of cells form from myeloid cells?

Immune cells (meutrophils, Eosinophils, basophils, dendritic, mast and macrophage cells)

9

What cells form from lymphoid cells?

B cells, T cells and natural killer cells

10

What are the three cells that form from hematopoietic stem cells?

Myeloid, lymphoid, and erythroid cells

11

How many erythrocytes do normal adults have?

(RBC's) 5 million

12

RBC's have a lifespan of ______. This is important because______.

120 days- if your body isn't making any new ones, this is a real problem

13

what do RBC's mostly do?

responsible for tisuue oxygenation

14

What are the 4 types of Henoglobin?

Hb A- adult, Hb F- fetal, Hb S sickle cell, Hb A1C glycosolated

15

What could a low hemoglobin level indicate?

anemia

16

What could a high hemoglobin indicate?

polycythemia, look flush, viscous blood

17

There are 3 types of granulocytes _______ predominant phagocyte in early inflamation, _____ ingest antigen antibody complexes, _____ associated with allergic reations

Neutrophils, eosinophils, basophils

18

What are the 2 types of lymphocytes?

B & T

19

What is the primary function of platelets?

form blood clots, contain cytoplasmic granules that release in response to enothelial injury

20

What is the lifespan of a platelet?

7-10 days

21

What is the normal value for WBC's?

5,000-10,000/ mm3

22

What is the normal value for RBC's?

4.5-5.5 million/mm3 (4-5 for females)

23

What is the normal value for Hgb?

14-17 g/dl (12-16 females)

24

What is the normal value for Hct?

42-52% (36-48 females)

25

What is the normal value for platelets?

140,000-400,000/mm3

26

What is sickle cell anemia?

changes ability to bind to O2

27

What is aplatic anemia?

bone marrow doesn't make RBC

28

What would a decrease in hydration cause in terms of RBC's?

polycythemic

29

What would an increase in hydration cause in terms of RBC's?

hemodiluted

30

Anemia can be caused by an increase in destruction this is ______ to the host an example is_____ or a decrese in production which is ____ to the host an example is ____.

extrinsic ; injury and bleeding ; intrinsic ; bone marrow abnormality

31

What are the terms to describe the morphology of anemia's?

Size: normocytic, macrocytic, microcytic Color: normochromo, hypochromo, hyperchromo

32

What is the normal value for MCV?

84-96fL: Mean corpuscular volume

33

What is the normal value for MCH?

28-34 pg/cell: Mean corpuscular hemoglobin

34

What is the normal value for MCHC?

32-36 g/dL: mean corpuscular hemoglobin concentration

35

What can Iron deficiency( Hgb synthesis) cause?

Decreased production of RBC's: microcytic, hypochromic (small and reduced Hgb erythrocytes)

36

What can Vit B deficiency ( DNA defects) cause?

Decreased production of RBC's: macrocytic, normochromic (defective DNA synthesis resulting in large and fragmented erythrocytes)

37

What can a folate deficiency ( DNA defects) cause?

Decreased production of RBC's: macrocytic, normochromic

38

What are intrinsic causes of increased destruction of RBC's ?

immature cells, old cells, abnormal cells, sickle cell anemia, autoimmune diseases, conditions that speed up apoptosis of RBC's

39

What are extrinsic causes of increased destruction of RBC's?

physical trauma, antibodies, infectious agents, toxins

40

What is a description and example of an anemia with macrocytic normochromatic morphology?

Large abnormal shape, normal HgB, pernicious anemia or folate deficiency anemia

41

What is a description and example of an anemia with microcytic hypochromic morphology?

small abnormal shape, decrease HgB, iron defeciency anemia, thalassemia

42

What is a description and example of an anemia with normocytic normochromic morphology?

destruction of normal erythroblasts or mature erythrocytes, aplastic anemia, sickle cell anemia, hemolytic anemia

43

What is an indication of microcytic anemia?

MCV< 80fl

44

What is an indication of macrocytic anemia?

MCV> 95 fl

45

What are classic signs of anemia?

pallor, fatigue, dyspnea on exertion, dizziness

46

What are two conditions that would contribute to less symptomatic forms of anemia?

gradual onset and less severe (Hgb of 8 g)

47

What happens in the cardiovascular system in anemia?

tachycardia, palpations, vasoconstriction

48

What happens in the respiratory system in anemia?

tachypnea, increased breathing depth

49

What are other manifestations of anemia?

increased plasma volume, salt and water retention

50

How does one manage anemia?

provide O2, blood products, nutrition supplements, bone marrow stimulation

51

What is whole blood?

given with more volume is needed- provides all factors including platelets and coagulation factor

52

What is packed cells (PRBCs)?

provies RBC's only, indicated in anemia, slow blood loss, CHF, RF

53

What is leukocyte poor, washed, frozen RBC blood product?

prevent sensitivity reaction

54

What is platelet concentrate?

Low volume 35-50 ml, raises platelet about 10,000/unit/m2

55

What is fresh frozen plasma (FFP)?

provides all clotting factors except platelets, low volume

56

What type of blood factor is specific to certain clotting factors?

cyroprecipitate

57

When would you give volume expanders?

shock patient, hypovolemic, burn patient

58

when would you give intravascular to restore oncotic pressure?

shock, burns, cerebral edema, hypoproteinemia, but NOT dehydration!

59

How does one get sickel cell anemia?

both parents must be carriers or have the disease- recessive replacing the Hb A with Hb S, primary to african and mediteranian descent

60

What is the numberone treatment for sickle cell anemia?

isotonic fluids

61

For a patient with sickle cell anemia a drop in oxygen levels will cause:

sickling of RBC's

62

Acidosis is an issue for a person with sickle cell anemia because:

It causes healthy cells to become lysed

63

What role does erythrostasis play in a sickle cell crisis?

will enhance the effects of the sickling crisis

64

A sickle cell crisis becomes more severe when the RBC blockage occurs in:

the brain (stroke-like) the heart, or the kidneys-renal failure

65

What are two chronic (long-term) effects of sickle cells anemia

hepatomegaly, splenomegaly

66

A person with sickle cell anemia is at an increased risk for_____________

infections

67

In the heart, a sickle crisis can cause:

infarctions, thrombosis ischemia (from occlusion)

68

The main clinical manifestation of a sickle cell attack is:

severe pain

69

Sickle cell crisis effects the joints by causing:

arthralgias (severe joint pain)

70

A sickle cell crisis can effect the GI tract by:

causing severe abdominal pain

71

Poor circulation in a patient with sickle cell anemia can cause:

skin, peripheral ulcers that do not heal

72

Before treating sickle cell anemia, one must:

identify trigger factors as they vary from person to person

73

What is the number one reason for a sickle cell patient to go into crisis?

dehydration

74

T or F: A change in lifestyle or emotional stressors can cause a sickle cell patient to go into crisis.

TRUE

75

T or F: Sickle cell anemia is cureable.

FALSE. It can be managed, but not cured.

76

Supportive treatments for sickle cell anemia include:

rest, oxygen, hydration

77

Besides hydration, what is the other main factor to consider when treating a patient in the middle of a sickle cell crisis?

pain management! And sedatives

78

You are treating a patient who has recently recovered from a sickle cell crisis and are going to be discharged soon. In educating your patient about avoiding sickle cell crises you will want to stress:

staying hydrated, eating a proper diet, getting adequate rest

79

Define Aplastic Anemia:

Deficiency of all types of blood cells caused by failure of bone marrow development.

80

When RBC, WBC, and platelet counts are all low this is referred to as:

pancytopenia

81

T or F: pure red cells aplasia affects all types of blood cells.

FALSE. PRCA only affects red blood cells

82

____________ is an associated condition of sickle cell anemia

Pure Red Cell Aplasia

83

What is pancytopenia?

Deficiency of all three cellular components of the blood (red cells, white cells, and platelets)

84

What are the two classic signs of anemia?

Low WBC's and low platelets

85

What can you expect if WBC's are low?

infections

86

What can you expect if platelets are low?

bleeding

87

What are two ways to evaluate the possiblity of anemia?

CBC, bone marrow biopsy analysis

88

T or F: Prevention is a treatment for anemia.

TRUE

89

What are three treatments for anemia administered in the clinical setting?

Give EPO, blood transfusion, bone marrow transplant

90

Define Polycythemia:

excessive increase in RBC's

91

Primary Polycythemia is caused by:

neoplastic disease, cell defects that result in abnormal regulation of the multipotent hematopoietic stem cells

92

Secondary Polycythemia is caused by:

an increase in erythropoietin as a physiologic response to chronic hypoxia

93

A patient comes in complaining of headaches, vertigo, and angina. Further investigation reveals they have HTN and CHF, hyperuricemia, and hepato-splenomegaly. You predict that this patient has:

polycythemia

94

How would you treat a patient with polycythemia?

decrease blood volume and viscosity through hydration and phlebotomy

95

Define leukocytosis:

increase in # of WBC's

96

An increase in WBC may be caused by:

infection, leukemia, neoplasms, trauma, stress

97

T or F: A WBC count of >10,000 is considered leukocytosis.

TRUE

98

Define leukopenia:

decrease in WBC count

99

Leukopenia may be caused by:

bone marrow failure, autoimmune disease, mass infection

100

T or F: Leukopenia is defined as having <7000 WBC.

FALSE. Leukopenia =<5000 WBC

101

T or F: Neutropenia refers to a decrease in basophils.

FALSE Neutropenia is a decrease in neutrophils

102

Granulocytopenia is defined as a WBC count of:

< 1500 cells/L

103

Agranulocytosis is defined as a WBC count of:

<500

104

_____________, _______________, and ______________ may be caused by acute infection, sepsis, toxins, chemicals, drugs, anaphylaxis, and underproduction of WBC's.

neutropenia, granulocytopenia, agranulocytosis

105

Leukemia, lymphomas, and multiple myelomas are all:

blood cell cancers

106

A disease caused by uncontrolled proliferation of abnormal immature BC precursors is:

leukemia

107

The most common leukemias originate from which type of blood cells?

WBC

108

In this disorder immature cells infiltrate circulation, crowd out mature normal cells, and release inhibitory factors causing anemia and thrombocytopenia.

Leukemia

109

What are the two types of leukemia?

myeloid, lymphoid

110

What is the difference between acute and chronic leukemia?

acute: rapid division, less differentiation chronic: slower, more mature

111

ALL stands for

Acute Lymphocytic Leukemia

112

CLL stands for

Chronic Lymphocytic Leukemia

113

A virus, radiation, chemical exposure, and genetics (chromosomes) are all possible causes of:

leukemia

114

A patient comes into the clinic complaining of fatigue, infection, fever, weight loss, bone/joint pain and bleeding. These are all clinical manifestations of:

leukemia

115

Leukemia can be managed through:

chemotherapy, radiation, bone marrow transplants, transfusions, and prevention of infections

116

Cancers of the lymph tissue are called:

lymphomas

117

T or F: Lymphomas only involve the lymph nodes.

FALSE. Lymphomas involve lymph nodes, vessels, T and B cells

118

T or F: Supraclavicular nodes, axillary nodes, retroperitoneal nodes, and inguinal nodes are all common cites for developing lymphomas

TRUE

119

Cancer of plasma cells is referred to as:

multiple myeloma

120

Thrombocytopenia, thrombocytosis, anticoagulation, and hemophilia are all:

platelet and clotting factor disorders

121

Thrombocytopenia is defined as platelet counts of <_____________/mm3

150,000

122

A platelet count of < 50,000/mm3 is considered

bleeding potential

123

A platelet count of < 20,000/mm3 is considered

high risk for spontaneous bleeding

124

Defective platelet production, disordered platelet distribution, and accelerated platelet destruction are all possible causes for:

thrombocytopenia

125

A platelet count of >400,000/mm3 is considered:

thrombocytosis

126

A disorder in which megakaryocytes in bone marrow overproduce is called:

Primary hemmaohagic thrombocytosis

128

____________________ are caused by defects or deficiencies in one or more clotting factors

coagulation disorders

129

Vitamin K deficiencies, thromboembolic disease, and hemophilia are all examples of:

coagulation disorders

130

______________ is necessary for the production of prothrombin, factors II, VII, IX, and X

vitamin K

131

T or F: Vitamin K is a water soluable vitamin.

FALSE- it is a fat soluable vitamin

132

Which population is at increased risk for vit. K deficiency?

neonates because they have an immature liver and lack of normal intestinal flora

133

We can get vitamin K from eating:

green leafy vegetables

134

Insufficient dietary intake, absence of bile salts, intestinal malabsorption syndromes, and use of oral antibiotics that kill resident intestinal bacteria are all causes of:

vit. K deficieny

135

Abnormal blood clotting is called:

Thromboembolic disease

136

What is a thrombus?

A stationary clot adhering to the vessel wall

137

What is an embolus?

A floating clot within the blood

138

Virchow's triad outlines:

factors favoring clot formation

139

What three factors can lead to clot formation?

loss of integrity of vessel wall (atherosclerosis), abnormalities in blood flow (sluggish or turbulent), alterations in blood constituents (thrombocytosis)

140

What is anticoagulant therapy?

The theraputic use of anticoagulants to discourage the formation of blood clots. It's main purpose is preventative

141

Patients with these issues can benefit from therapeutic anticoagulation:

cardioangioplasty, CV disease and hypertension (CAD, PVD), dialysis, venous stasis (DVT), and patients who must be immobilzed for long periods of time

142

T or F: Coagulation disorders may cause abnormal clotting test results.

TRUE

143

T or F: Coagulation disorders may cause abnormal clotting test results, but theraputic anticoagulation will not.

FALSE- they both have the potential to result in abnormal test results.

144

What is the difference bewteen theraputic and pathological anticoagulation?

Theraputic anticoagulation will keep clotting factor numbers within acceptable parameters, pathological won't necessarily

145

Partial thromboplastic time (PTT) is a test of:

the intrinsic and common pathway of blood coagulation

146

PTT is used as a screening test and to monitor ___________therapy.

heparin

147

How long is PTT?

25-35 seconds

148

How long is prothrombin time?

12-15 seconds

149

PT is useful when using which drug?

Warfarin

150

INR(1), heptest-LMW heparin, and fibrinogen are all used to test the__________

PTT-Partial Thromboplastin time

151

Plasminogen is used to test for____________

anticoagulation

152

What is Purpura?

A disorder that occurs when small blood vessels join together or leak blood under the skin

153

What are the clinical manifestations of Purpura?

red or purple spots on skin that do not blanch on applying pressure

154

What are the clinical manefestations of anticoagulation?

bleeding-petechiae, purpura, ecchymosis

155

__________ and__________ work together to make clots

platelets and clotting factors

156

What three categories can promote inappropriate clotting?

arterial inflammation, slowed blood flow, and inflammatory disorders