Hematology #1 Flashcards Preview

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Flashcards in Hematology #1 Deck (24):
1

Normal lab values: WBC, Plt

WBC: 5k-10k
Plt (thrombocytes): 150k-400k

2

Normal lab values: Na, K, Cl

Na: 135-145
K: 3.5-5.0
Cl: 95-107

3

Normal lab values: CO2, BUN, creatine

CO2: 22-26
BUN: 10
Creatine: 1

4

Plasma

Fluid part of blood,
-91% is H2O
-7% are proteins, primarily albumin

5

Primary factors for oncotic pressure

#1: Na
#2: proteins (albumin)

6

Consequences of low albumin level

1. Decreased oncotic pressures - 3rd spacing
2. Decreased drug binding = increased bioavailability drug per dose

7

High BUN

Decreased kidney function
-high levels of products normally excreted.

8

What is the best colloidal solution during a traumatic resuscitation?

Blood

9

What is the target MAP during a trauma resuscitation?

80-90 mmHg

10

Deliberate hypotension technique

Intentional hypotension to limit bleeding and keep clear surgical fields during surgery.
-requires intensive hemodynamics monitoring
-not performed prehospital

11

Permissive hypotension

BP maintained normal to slightly low to limit bleeding

12

Blood should only be administered with NS, why not LR?

LR has calcium component
-blood contains calcium kelating to prevent clotting in bag, can be overwhelmed by calcium in LR resulting in clotting in the line.

13

Von Willembrand's Factor

Free flowing in blood. Adhere to exposed collagen, then to platelets.

14

Individual platelets adhere to one another by which 2 factors?

-G2B3A receptors
-thromboxane A2 (TXA2)

15

Thromboxane A2 development

Tertiary development from prostaglandins
ASA / NSAIDs interfere with prostaglandin conversion to TXA2

16

Extrinsic Clotting cascade

Damaged tissue, exposed collagen and thromboplastin.

17

Where are the highest concentrations of thromboplastin?

Brain and placenta
-thus high incidence of DIC in head and pregnancy related trauma

18

Intrinsic clotting cascade

Damage to inside of the vessel wall (endothelium)

19

Which cation is most important during the clotting cascade.

Calcium
-low Ca levels result in malfunction of clotting cascade

20

Extrinsic pathway to final common pathway

Tissue damage => release of thromboplastin from tissues => activates factor X => final common pathway

21

Intrinsic pathway to final common pathway

Blood vessel damage => cascade of clotting factors in the blood => activates factor X => final common pathway.

22

Final common pathway

Factor X converts prothrombin to thrombin => converts fibrinogen to fibrin => blood clot

23

Fibrin clot break down

Plasminogen within clot converts to plasmin => clot breaks down to fibrin degradation products.

24

Normal lab values: RBC, Hgb, Hct

RBC is 5, x3= Hgb, x3=Hct

RBC: 5
Hgb: 15
HCT: 45 (% blood that is not fluid)