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Hematology Flashcards

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1
Q

Ave no of RBCs per cubic mm

Ave of hemoglobin

A
  1. 2 Men
  2. 7 Women

15g per 100ml

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2
Q

Each gram of hemoglobin is capable of combining with approximatelt

A

1.34 mm of oxygen

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3
Q

Multiple proteins that promote growth

A

Growth inducers

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4
Q

Causes one type of stem cell to differentiate one or more steps toward the final type of adult cell

A

Differentiation inducers

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5
Q

Factors that affect inducer production in Rbc

A

Exposure of body to low level of oxygen in a prolonged period of time
Differentiation
Production of greatly increased erythrocytes

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6
Q

Principal factor that stimulates RBC production

A

EPO

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7
Q

90% of EPO formed in

A

kidneys and the rest liver

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8
Q

Cells that produce EPO

A

Fibroblast like interstitial cells surrounding tubules in renal cortex and outer medulla

Renal epithelial cell

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9
Q

Essential to synthesis of DNA
Lack of both result in maturarion failure

Deficiency -> megaloblast

A

Vitamin B12

Folic acid

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10
Q

Inability to absorb Vitamin B12 from GIT

Because of atrophic gastric mucosa

A

Pernicious anemia

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11
Q

Parietal cell secrete

A

Glycoprotein called IF binding tightly with B12 and protects vitamin from digestion by GI enzymes

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12
Q

Hemoglobin formation starts in

A

proerythroblast stage -> reticulocyte stage

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13
Q

Bind together loosely to form entire Hgb molecule

A

Four hgb molecules

Most important feature ability to bind loosely and reversibly oxygen

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14
Q

total average quantity of iron

A

4-5 grams

65% hgb
4-% myoglobin
1% various heme

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15
Q

Intestinal enterocyte iron absorption

A

1-2mg/day

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16
Q

Iron is stored i

A

Liver parenchyma as iron-ferritin complex

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17
Q

Secretion during infection or inflammation

A

Hepcidin

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18
Q

After significant hemorrhage

Replaces the plasma 1-3 days

3-4 weeks for RBCs to return to normal levels

A

Blood loss anemia

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19
Q

Non functioning bone marrow

Exposure to gamma radiation, toxic chemicals (insecticide, benzene), autoimmune disorders SLE

blood transfusion or bone marrow transplants

A

Aplastic anemia

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20
Q

Lack of B12, folic acid, intrinsic factor

Slow reproduction of erythrocytes in bone marrow

Large odd shaped cells megaloblast

A

Megalobastic anemia

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21
Q

fragile rbc that rupture as they pass capillary

Number is normal but life span is short

Sickle cell anemia by abnormal composition of globin chain of hemoglobin HgbS precipitating in long crystals

A

Hemolytic anemia

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22
Q

Number of RBCs in circulation inc due to hypoxia or genetic aberation

A

Polcythemia

Physiologic - living in high altitude, cardiac failure

Genetic aberration - HCT 60-70 JAK 2 mutation, increased viscosity of blood

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23
Q

Life span of lymphocyte

A

Months to years

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24
Q

Mobile units of protective system of the body
Formed in BM and lymph tissue and transported in the blood to areas of inflammation

Five types in the blood

A

Leukocytes

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25
Protect body via process of phagocytosis
Granulocyte | Monocytep
26
Granulocyte and monocytes are products of
Myelocytic lineage
27
Lymphocytes are products of
lymphocytic lineage
28
Life span of granulocyte
4-5 h in circulating blood | 4-5d in tissues
29
Monocyte life span
10-12 h before they enter tissues and become macrophages
30
Enter cells and become tissue mac via
Neutrophils Macrophages Amoeboid chemotaxis
31
Factors that inc chance of phagocytosis
Rough surface No protective protein coat Foreign particle
32
Phagocytosis is
highly selective
33
First line of defense against invasion
Macrophages
34
Second line of defense in inflamed tissue
Neutrophil | neutrophilia
35
Third wave of inflamed tissue | Third line of defense
Second macrophage invasion | Predominant leukocyte
36
Fourth line of defense | Greatly increased production of
Granulocytes and monocytes
37
Factors involved in feedback control of mac and neutrophil response Formed by mac and T cells
``` TNF IL-1 GMCSF GCSF MCSF ```
38
Combination of necrotic tissue, dead neutrophils, dead mac and tissue fluid
Pus
39
Produced in large numbers in persons with parasitic infection
Eosinophils
40
Eosinophils release
``` hydrolytic enzymes ROS larvicidal polypeptides called MBP detoxify some of inflammation inducing substances released by mass cells and basophils and destroy allergen-antibody complex ```
41
Circulating mast cells | IgE antibodies have propensity to become attached to mast and this cell
Basophils
42
Basophils and mast cells release
Histamine Bradykinin Serotonin
43
Lymph node or lymphogenous tissue
Lymphogenous leukemia
44
Produced by BM and many extramedullary organs
Myelogenous
45
Leukemic cells are usually
nonfunctional
46
Almost all leukemias spread to
Spleen, LN, liver and other regions that have rich blood supply cause metabolic destruction
47
Antibody-antigen complex activates the
Classical pathway
48
Ability to resist organisms or toxins that damage tissues of the body
Immunity
49
Phagocytosis of bacteria Destruction of pathogen by acidic secretion Digestive enzyme of GIT resistance of skin to invasion Certain chemicals in blood that attach to foreign org or toxin
Innate immunity
50
Ability to develop powerful protective mechanism against specific invading agent
Acquired immunity
51
Development of circulating antibodies
Humoral | B cell immunity
52
Formation of large numbers of activated lymphocytes specifically designed to destroy foreign agent
Cell mediated | T cell immunity
53
Initiates development of immunity at least 8000 kilodaltons
Antigen
54
Smaller substances that attach to proteins
Haptens
55
Responsible for acquired immunity LN, spleen, submucosal areas of GIT and bone marrow T and B lymphocytes
Lymphocytes
56
Where T lymphoctes are preprocessed
Thymus
57
Removal of thymus eliminates
Cell mediated immunity
58
Subsequent exposure to same antigen causes more rapid response due to
Memory cell
59
Antibodies are
Gamma globulin proteins called immunoglobulin
60
Five general classes of antibodies
``` IgM IgA IgG IgD IgE ```
61
Most numerous | 75%
IgG
62
Antibodies act by directly attacking the invader
Agglutination Precipitation Neutralization Lysis
63
System of about 20 proteins normally present in the plasma that can be activated by antigen-antibody reaction
Complement
64
Stimulate phagocytosis both by
Neutrophils | Mac
65
Complement:
Phagocytosis by neutrophil and mac Rupture of cell membrane of bacteria and other invading organism Agglutination Structure of viruses
66
T helper cells secrete
IL 2,3,4,5,6
67
Forms protein mediators called lymphokines
T helper cells
68
Secrete hole forming proteins called perforins
Cytotoxic t cells by direct attack
69
Regulates activity of other cells so excessive immune reactions do not occur
Supressor T cells
70
Failure of tolerance mechanism
Autoimmune diseases
71
Develop during processing of T lymphocytes in thymus and B lymphocytes in bone marrow
Tolerance
72
Continuous exposure to self antigen in fetus is thought to cause self reacting t and b lymphocytes to become
Destroyed
73
Caused by activated T cells Skin eruption, edema or asthmatic attack
Allergy and hypersensitivity
74
Caused by IgE antibodies called reagins
Allergy
75
How many HLA antigens are present over human cell
6
76
Antigens | Cause blood transfusion reactions
Agglutinogen
77
Gamma globulin of IgM and IgG
Agglutinins
78
Entry into body of small numbers of group A and B antigens in food and through contact with bacteria If blood samples are mismatched so that anti A or anti B plasma agglutinins are mixed with RBCs containing A or B agglutinogens -> RBCs agglutinate into clumps Most lethal effects of transfusion
Renal failure
79
Spontaneous occurence of agglutinin almost never happens Individual must first be expsosed to an Rh antigen usually through transfusion of blood or pregnancy anti-Rh agglutinin develop and reach maximum concentration within about 2-4 months
Rh blood types
80
Progressive agglutination and subsequent phagocytosis of RBCs
Erythroblastosis fetalis
81
Transplantation of tissue or whole organ from one part of the body to another
Autograft All cells in transplanted organ contain virtually same antigen Survive indefinitelt if provided with an adequate blood supply Identical twin
82
Transplantation of one organ from one identical twin to another
Isograft
83
One human being to another Immune reaction almost always occur Graft die within 1-5 weeks after transplantation unless specific therapy is given to prevent the immune reaction
Allograft
84
Transplantation of organ from one species to a different species
Xenograft Tx: cyclosphorine, tacrolimus
85
Most impt antigens in graft rejection More than 150 types of HLA but only 6 are present on cell surface of any one person Impossible for two individuals with exception of identical twins to have the same six HLA present on WBC and cells of tissue
HLA antigen complex of antigen
86
Prevention of graft rejection
Glucocorticoid hormone IL-2 Azathioprine toxic to lymphoid block formation of t cell Cyclosporine and tacrolimus inhibit formation of T helper and blocks t cell mediated reaction Immunosupressive antibody therapy anti IL2 receptor antibodies
87
Clotting factor part of extrinsic pathway
7
88
Precention of blood loss
Hemostasis
89
Hemostasis steps
Vascular spasm -constriction TXA2 Formation of platelet plug -release ADP and TXA2 Formation of blood clot - 15-20 seconds (severe) and within 1-2 minutes (minor) Within 3-6 mins: entire opening or broken end of vessel filled with clot After 20 mins to 1 hourclot retracts Growth of fibrous or scar tissue
90
Extrinsic pathway
Trauma to vascular or extravascular tissue Release of tissue thromboplastin, phospholipid, lipoprotein complex Reacts with Factor 7 Activates factor 10 in presence of calcium ions Common pathway via factor 10
91
Intrinsic pathway
After trauma to blood vessel or exposure of blood vessel to collagen Factor 12 or Hageman factor forms activated factor 12 Then releases phospholipids and platelet factor 3 Activates factor 12 acts on factor 11 Activated factor 11 acts on factor 9 Activated factor 9 works with factor 8, PF3, ca and phospholipid ions activating common pathway
92
Most important factors for prevention of clotting in normal vascular system
Smoothness of endothelium Layer of glycocalyx on endothelium Thrombomodulin binding thrombin
93
Most important anticoagulants in blood
Fibrin thread | Alpha globulin: antithrombin III
94
Removes thrombin from circulation
Heparin
95
Conditions that cause excessive bleeding in humans
Vitamin K deficiency 1972 2-prothrombin, protein C Hemophilia Thrombocytopenia
96
Roughened endothelial surface or sluggish blood flow
Thromboembolic conditions
97
Virchow’s triad
Venous stasis Activation of blood coagulation Vein damage
98
Extracted from several animal tissues Therapeutic dose: 0.5 to 1 mg/kg Inc clotting time from 6 mins to 30 mins or longer Antidote
Heparin | Protamine sulfate
99
Heparin inc effetiveness of
Antithrombin III
100
Competes with Vitamin K for active site
Coumarin/warfarin

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