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Flashcards in Hematology Deck (68)
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how do kidneys aid in blood production?

sensitivity to oxygen levels
low oxygen levels stimulate the release of kidney hormone ethytropoeitin which stimulates red blood cell production in bone marrow

1

roles of blood

transport of oxygen, carbon dioxide, other waste products
transport of hormones
acid base balance
key role in body defence
body temperature regulation

2

composition of plasma

90% water
contains electrolytes, nutrients, wastes, gases, hormones, plasma proteins (large molecules, albumin which helps maintain oncotic pressure, globulins immunology, fibrinogen involved in coagulation cascade)
purpose: medium for transport

3

composition of leukcytes

white blood cells
large cells involved in immune system
life span variable

4

life span of erthythrocytes

120 days

5

platelets

smallest elements of blood (megacaryocytes break up into 1000 platelets)
initiate coagulation at the site of damaged blood vessel walls
lifespan about 10 days
because they're the lightest component, they float near the edges of the vessel
reservoir in the spleen

6

What are the four phases of hemostasis?

primary
seconday
finbrinolysis
restoration of normal blood flow

7

primary hemostasis

constricts to slow bloodflow
platelets contact collagen layer and release adhesive proteins, coagulation and growth factors
platelets change shape and becomes sticky, adhering to one another
platelet plug is formed

8

secondary hemostasis

intrinsic and extrinsic coagulation cascades are activated
formation of fibrin clot to stabilize the platelet plug

9

compare intrinsic and extrinsic clotting pathways

intrinsic - slow, takes 2-6 minutes to begin, inside the vessel, damaged endothelium, contact with plaque
extrinsic - rapid, begins in 15 seconds, outside vessel, tissue damage

10

which electrolytes are required and where are they stored?

calcium and vitamin k
fibrinogen, prothrombin, factor 4,5,6,7 found in the liver

11

describe the clotting cascade

factor ten, common pathway, prothrombin, thrombin, fibrinogen, fibrin, clot formation

12

what happens at the activation of factor ten?

platelets continue to aggregate
thrombin and fibrin are created
fibrin stabilizing factor is activated
clot is stabilized

13

fibrinolysis process

the process in dissolving the clot
to restore blood flow through the healed vessel, the fibrin clot must be lysed
endothelial cells secrete tissue plasminogen activators
leukocytes begin to clean up debris

14

hematocrit

measurement of volume of RBCs in 100ml of blood - comparing percentage of rbcs to plasma
looks at hydration status - elevated level indicative of decreased fluid volume
normal 0.36-0.46

15

prothrombin time

evaluates the extrinsic pathway and common clotting pathway
normal 8-13 seconds
if clotting factors are deficient, PT will be prolonged
used to evaluate therapeutic range for warfarin

16

INR

international normalized ratio

17

ptt

partial thromboplastin time
evaluates intrinsic system and common pathway
if clotting factors deficient it will be elevated
normal <40 seconds
used to evaluate heparin anticoagulation therapy

18

fibrinogen

an essential plasma protein synthesized by liver
ordered to further investigate abnormal bleeding
decreased level - liver disease, disseminated intravascular coagulation, leukemia, anemia,
increased level - acute infections, collagen diseases, inflammatory disorders

19

d-dimer

a protein fragment produced and usually only detectable during clot degredation
used to diagnose conditions related to thrombosis such as pulmonary embolism, DIC, DVT

20

reticulocyte count

yields information on bone marrow function
reticulocytes are immature cells released by bone marrow that become rbcs
useful in determining cause of anemia

21

esr

erythrocyte sedimentary rate
can be elevated in inflammatory states

22

c reactive protein

levels increase more rapidly than esr during acute inflammation

23

peripheral smear

most informative of all blood tests
time consuming
a person takes the time to look and count and differentiate

24

what are some causes of anemia in the adult icu patient?

decreased rate of erythropoeisis
acute kidney injury
chronic renal failure
heorrhage
hemolysis
inflammation
liver disease
excessive phlebotomy

25

anemia treatment

medications (b12, erythropoeitin, folate, iron)
crrt
blood transfusion
blood conversion
nutritional consult

26

diagnosis and treatment of dvt

venous ultrasound
blood work

prevention
if on bedrest, elevate injured leg
analgesic
anticoagualtion

27

what are some risk factors for development of dvt?

immobility
surgery
invasive procedues
spinal cordi njury
obesity
age
sepsis
trauma

28

pulmonary embolus patho and management

a clot that travels through right side of the heart and gets lodged in pulmonary vasculature
dvt common cause
can be blood, fat, tumor tissue
treatment anticoagulation therapy, inferior venacava filter, surgical removal
chest pain, rapid onset sob, increased oxygen demands, radiating pain to neck, jaw, worsens with inspiration

29

what are some examples of coagulation disorders

thrombotic thrombocytopenic purpura
hellp
hit - heparin induced thrombocytopenia
dic