Hematology

Question 1

Blood:

Blood is a unique organ because it is a ______.

Answer 1

Fluid

Question 2

Blood:

Composed of plasma, various cells, proteins, ______ _____, electrolytes, nutrients, to include ___, and waste products.

Answer 2

Clotting factors;O2

Question 3

Blood:

Formed by bone marrow in response to ____ ___ level.

Answer 3

low O2

Question 4

Hematopoiesis:
Occurs in 5 days.
____ O2 level-> stimulates kidney to secrete _______, which increases erythroblast formation, which forms ___________ (immature RBCs)

Answer 4

Low; erythropoitin; reticulocytes

Question 5

Hematopoiesis:
If rapid erythropoiesis is necessary may release ________ and nucleated _____. After maturity, cells live about ____ days

Answer 5

reticulocytes; RBCs; 120

Question 6

RBC Function:
95% of cell mass is ________.
Have no nucleus.
Flexible and disk shaped to facilitate ________ and release of gases.

Answer 6

hemoglobin; absorption;

Question 7

RBC function:

Transport gases through _______. Main function-transport of O2 between ______. Also aids in buffer system

Answer 7

diffusion; lungs

Question 8

RBC needs:
_____ stores and metabolism.
Vitamin ____ and folic acid metabolism. Destruction.

Answer 8

Iron; B12

Question 9

WBC:
Total amount = 5,000- 10,000
-60-70% are ________
-30-40% are _________

Answer 9

granulocytes; lymphocytes

Question 10

WBC function:

Protect against bacterial invasion and other foreign entities. Name the 5 components of WBCs and their function.

Answer 10

1. Neutrophils- Fast arrival for short lived phagocytosis
2. monocytes- long term phagocytosis
3. lymphocytes- produces substances that attack foreign material that kill directly or that enhance phagocytic cells (T). B cells differentiate into plasma cells which produce immunoglobulins
4. Eosinophils- allergic reactions (neutralizes histamine) and phagocytosis of parasites
5. basophils produce and store histamine which when released provokes an allergic reaction.

Question 11

Other Components:
Platelets (thrombocytes)- granular Fragments.
Where are they produced?

Answer 11

In the marrow

Question 12

Other components:

What are platelets regulated by?

Answer 12

the hormone thrombopoitin

Question 13

Other components:

Platelets control bleeding, how exactly do they do this?

Answer 13

Collect and activate at the site of injury forming a plug. They release substances that activate coagulation factors.

Question 14

Other components:

Platelets also nurture and maintaining the ______ of the vessels.

Answer 14

lining

Question 15

Other components:
Plasma and plasma proteins
90%=water rest=plasma proteins, \_\_\_\_\_\_ \_\_\_\_\_, nutrient enzymes, waste and \_\_\_\_\_\_\_. 
-serum
-proteins- albumin, globulins

Answer 15

clotting factors; gases

Question 16

Hemostasis Disorders:

What are the clinical manifestations?

Answer 16

1. occasionally none
2. Bleeding- mucosa/skin, hemorrhage frank/insidious, prolonged bleeding for venipuncture sites, with TTP, increased range of PCs due to clots in system

Question 17

Hemostasis disorders:

What diagnostics are used?

Answer 17

Labs: Platelet count, peripheral smears, PT, PTT, RBC morphology, Bone marrow exams.

Question 18

Acquired coagulation disorders:

Name 4 coagulation disorders.

Answer 18

1. liver disease
2. Vitamin K deficiency
3. Complication of anticoagulant therapy
4. Disseminated intravascular coagulation.

Question 19

Hemostasis Disorders: Thrombocytopenia- platelets below 150,000
What is thrombocytopenia?

Answer 19

• decreased production of platelets within the bone marrow
• increased destruction of platelets
• increased consumption of platelets

Question 20

Hemostasis Disorders: Etiology
Thrombocytopenia- platelets below 150,000
it can be inherited or acquired name the two acquired etiologies.

Answer 20

1. immune- (ITP) Immune thrombocytopenia Purpura- Most common
2. Non-immune- due to shortened circulation, turbulent blood flow, decreased production

Question 21

Hemostasis Disorders: Immune Thrombocytopenia Purpura

Used to be called idiopathic thrombocytopenia. Normal function of platelets- ______ _____.

Answer 21

shortened life

Question 22

Immune thrombocytopenia Purpura: acquired immune

platelets coated with _______.
platelets recognized by _____ as foreign material and destroyed by macrophages
______ cannot keep supply to demand.

Answer 22

antibodies; spleen; marrow

Question 23

Thrombotic thrombocytopenia Purpura (TTP): Non-immune (shortened circulation)
What is TTP?

Answer 23

Absence of anti clotting plasma enzyme leads to enhanced agglutination of platelets form MICROclots that deposit in capillaries, decreasing # in system.

Question 24

What is a medical emergency of TTP?

Answer 24

Clotting and bleeding at the same time

Question 25

What is Heparin induced thrombocytopenia and thrombosis syndrome (HITTS)?

Answer 25

- Microclotting with reduction of circulating platelets - immune-mediated response to heparin= antibodies= removal= decreased platelets and platelet/fibrin clots - heparin neutralized

Question 26

What contributes to Non-immune thrombocytopenia?

Answer 26

1. damage from turbulent blood flow 2. decreased production due to: - drugs - infections - alcoholism/marrow suppression - malignancies - radiation - invasive tumors - fibrosis

Question 27

Disseminated Intravascular Coagulation: | It begins with small clots in blood stream, blocking vessels. What is it stimulated by?

Answer 27

substances that enter blood-stream as part of a disease (infection), toxin, complication of child birth, dead fetus.

Question 28

Disseminated Intravascular Coagulation: | It begins with small clots in blood stream, blocking vessels. What else contributes to this problem?

Answer 28

- hemorrhage | - severe injury

Question 29

Disseminated Intravascular Coagulation (DIC): It begins with small clots in blood stream, blocking vessels. Increased clotting _______ platelets and clotting factors needed to ______ ______

Answer 29

depletes; control bleeding

Question 30

``` What are DIC clinical manifestations for the following systems: Integumentary Respiratory Cardiovascular GI/GU Neuro M/S ```

Answer 30

Edit card

Question 31

What labs would we look at for DIC?

Answer 31

- decreased platelets/clotting factors - increased clotting time - increased proteins from clot breakdown

Question 32

What is the treatment for DIC?

Answer 32

- correct underlying cause - heparin therapy to slow clotting - transfuse platelets and clotting factors to replace those depleted.

Question 33

Hemostasis disorders: treatment | Depends on the type. Name 6 treatments that can be done.

Answer 33

1. address underlying cause usually D/C offending med 2. temporary fix is steroids or IV immune globulin 3. Drugs that suppress the immune system 4. Transfusion of platelets 5. Splenectomy 6. With TTP often treated with plasma transfusions and plasmapheresis (plasma exchange)