Hematology and Coagulation

Question 1

components of blood

Answer 1

plasma, RBCs, WBCs, platelets

Question 2

what makes up liquid portion of blood

Answer 2

plasma (55% of blood overall)

Question 3

what percentage of plasma is water

Answer 3

91

Question 4

percentage of plasma is proteins

Answer 4

7 (57% of proteins are albumin, 30% are globulins for immune defense, rest is clotting factors)

Question 5

2 clotting factors found in plasma

Answer 5

fibrinogen, prothrombin

Question 6

where plasma proteins are made

Answer 6

most in liver except for Ig made by plasma cells in lymph tissue

Question 7

percentage of blood that are cells

Answer 7

45%

Question 8

percentage of cells in blood that are RBCs (erythrocytes)

Answer 8

99%

Question 9

what do CBC differentials tells us

Answer 9

can breakdown percentages of blood components

Question 10

what kind of cells make up leukocytes (WBCs)

Answer 10

neutrophils, lymphocytes, monocytes, eosinophils, basophils (Never Let My Engine Blow)

Question 11

serum vs plasma

Answer 11

serum: liquid remains after blood clots (clotting factors not present)
plasma: liquids remains when clotting is prevented with anticoagulant

Question 12

normal percentage ranges for types of WBCs

Answer 12

neutrophils –> 60-70%
lymphocytes –> 20-25%
monocytes –> 3-8%
eosinophils –> 2-4%
basophils –> 0.5-1%

Question 13

where blood cells made in fetus

Answer 13

liver, spleen

Question 14

2 pathways for blood cell differentiation

Answer 14

myeloid (RBCs, WBCs, platelets)
lymphoid (immune B and T cells)

Question 15

types of lymphocytes

Answer 15

plasma cells and T cells

Question 16

define GM-CSF

Answer 16

stimulating factor that triggers initial myeloid differentiation pathways

Question 17

role of granulocyte progenitors

Answer 17

myeloid cells with granules in them (monocytes and neutrophils)

Question 18

role of megakaryocyte

Answer 18

turns myeloid cells into platelets

Question 19

role of erythropoietin (EPO)

Answer 19

turns pro-erythroblast into mature RBC in bone marrow

Question 20

components of hemoglobin protein

Answer 20

4 heme rings (2 alpha, 2 beta) with an iron atom in each that carries oxygen

Question 21

O2 capacity of RBC

Answer 21

1 heme ring = 1 O2 meaning 1 Hgb = 4 O2 molecules, 1 RBC has MILLIONS of Hgbs so MILLIONS of O2 molecules carried by 1 RBC

Question 22

nutrients needed for heme production

Answer 22

iron –> vitamin c and copper
heme ring –> B6 (pyridoxine), pantothenic acid
cells –> folate, B12, B2, protein

B3 (niacin) and Vitamin E needed

Question 23

meaning of PaO2

Answer 23

partial pressure of O2 in arterial blood, how well O2 can move from lungs to blood stream

Question 24

why can high affinity of O2 in Hgb be bad

Answer 24

less willing to release O2 to tissues

Question 25

how does alkalosis shift O2-Hgb dissociation curce

Answer 25

shifts to left meaning higher affinity

Question 26

definition of anemia

Answer 26

shortage of RBCs

Question 27

define normocytic normochronic

Answer 27

normal size and color, comes from low RBC production or high RBC consumption

Question 28

causes for low RBC production

Answer 28

bone marrow defects, bone marrow mass crowding, leukemia prevention production, chronic disease (leads to chronic inflammation which down regulates production)

Question 29

causes of high consumption of RBCs

Answer 29

hemorrhage, hemolysis, malignancy

Question 30

define microcytic hypochromic anemia

Answer 30

smalls cells and low color, not enough heme which results in defects in Hgb

Question 31

causes of microcytic hypochromic anemia

Answer 31

chronic blood loss, iron deficiency (most common form of anemia), Hgb defects

Question 32

define macrocytic normochromic anemia

Answer 32

big cells and normal color, heme is fine

Question 33

causes of macrocytic normochromic

Answer 33

folate and B12 deficiency

Question 34

normal Hgb range

Answer 34

men --> 13.5 - 17.5 g/dl women --> 12.0 - 15.5 g/dl

Question 35

functions of platelets

Answer 35

regulate blood flow to damaged areas of vessels form platelet plug to stop more bleeding activate further aspects of clotting cascade initiate repair processes including clot breakdown

Question 36

define fibrinolysis

Answer 36

clot breakdown

Question 37

importance of vitamin K

Answer 37

makes coagulation factors functional, Protein C and S (natural anti-coagulants) also dependent on Vitamin K

Question 38

relationship between factor 8 and vWF (von Willebrand Factor)

Answer 38

vWF circulates blood carrying factor 8 and the 2 combined promote platelet adhesion and aggregation

Question 39

deficiencies/defects in factor 8/vWF results in what common bleeding disorders

Answer 39

hemophilia A/von Willebrand Disease

Question 40

define "classic" hemophilia A

Answer 40

deficiency in factor 8

Question 41

define "christmas disease" hemophilia B

Answer 41

deficiency in factor 9

Question 42

explain clot breakdown

Answer 42

T-PA activates plasminogen to make it into plasmin, plasmin breaks down fibrin clot into fibrin degradation products

Question 43

define d-dimer

Answer 43

present in blood when mature clot as been formed and degraded

Question 44

define FDPs

Answer 44

fibrinogen degradation products found when plasmin degrades less mature clot (fibrinogen)

Question 45

anticoagulants on endothelium surface

Answer 45

prostaglandins --> inhibits platelet aggregation nitric oxide --> inhibits platelet adhesion and aggregation

Question 46

anticoagulants from liver

Answer 46

proteins C & S --> inactivate some clotting factors

Question 47

anticoagulation meds that work on platelet level

Answer 47

aspirin --> inhibits platelet activation by inhibiting thromboxane plavix --> binds to receptor on platelets inhibiting binding of fibrinogen and activation

Question 48

what does PTT and Anti-Xa testing look for

Answer 48

factors 8, 9, 11, 12; efficacy of heparin as anticoagulant, examines clot amplification and propagation (should be 25-35s)

Question 49

what does PT/INR test look for

Answer 49

factors 1, 2, 3, 5, 7, 10; efficacy of warfarin as anticoagulant, examines clot initiation (should be 10-13s)

Question 50

what is INR

Answer 50

normalized ratio of PT across lab (0.8 - 1.1)

Question 51

define leukemia

Answer 51

uncontrolled growth of malignant WBCs causing overcrowding of bone marrow and decreased production and function of normal hematopoietic cells