Hematology I Flashcards Preview

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Flashcards in Hematology I Deck (136):
1

What type of drug is Warfarin?

Anti-coagulant

2

% breakdown of Plasma, Buffy coat, and Erythrocytes:

Plasma - 55%
Buffy coat -

3

What layers of blood are considered the "formed elements"?

RBC's
Buffy coat (includes leukocytes, platelets, and thrombocytes)

4

Name 3 Plasma Proteins:

Albumins
Globulins
Fibrinogen

5

What is serum?

Plasma minus clotting factors

6

Name 3 things that make up the Plasma?

Water
Solutes
Plasma Proteins

7

What fraction of body weight is blood?

8%

8

How much blood in an adult body?

4-6 Liters

9

What is the normal amount of RBC's in a hematocrit?

45%

10

A low hematocrit suggests...
A hig hematocrit suggests...

Anemia
Polycythemia

11

What is the best method for evaluating and identifying immature and abnormal cells in the blood?

Blood smear

12

A normal blood smear is spaced...

evenly

13

What are the two functions of the RBC biconcave disc?

Increase surface area
Increase flexibility

14

Are platelets cells?

No.

*fragments fo megakaryocytes

15

Where do megakaryocytes come from?

Break off in bone marrow

16

T/F
A platelet plug is another name for a blood clot

False

Precursors to clots (but sometimes all yo need)

17

What does a stained neutrophil nucleus look like?

3-5 lobes
Thin strands chromatin connecting

18

What is the most common type of WBC?

Neutrophils

19

The defining characteristic of a neutrophil is...
(define unequivocally)

Complex shape of nucleus

20

T/F
Neutrophils lack granules

False

small granules in cytoplasm

21

What is the primary function of neutrophils?

Defense against Bacteria and Fungi

22

What formed element usually has a 2 lobed nucleus?

Eosinophil

23

What is the main function of eosinophil?

Parasitic defense

*many dark staining granules

24

What is the appearance of the nucleus in Basophils?
Granulocytes?

2-3 lobes

Deeply blue or red-violet

25

What leukocyte has the most numerous granulocytes?

Eosinophils

26

How to distinguish between eosinophils and basophils?

Eosinophils: Defined 2 lobed nucleus, more granules

Basophils: 2-3 undefined lobes

27

What leukocyte mediates inflammatory rxns of allergy?

Basophils

28

What are basophils called after they migrate into tissues?

Mast Cells

29

What chemical do basophils (mast cells) carry that cause allergy symptoms?

Histamine

30

What often has a c-shaped nucleus and is never lobed or round?

Monocytes

31

T/F
Monocytes have granules and lobes

False

No granules, no lobes

32

Besides the c-shaped nucleus and being agranulocytes, what is another feature of Monocytes?

Golgi apparatus

*appears as white area "negative image"

33

What is the smallest WBC?

Lymphocytes

34

T/F
B and T lymphocytes have small nuclei

False

*Both large (and indistinguishable between the two)

35

What lymphocyte produces antibodies?

B lymphocytes

36

What lymphocytes direct the immune response through chemical intermediaries?
What lymphocyte produces enzymes that directly harm pathogen?

T-helper (CD4)

Cytotoxic (CD8)

37

What is the 3rd type of Lymphocyte (other than B and T)?

NK - Natural Killer

38

What 2 proteins do Natural Killer cells secrete through granules that cause cell death?

Perforin
Granzyme

39

What test panel measures cell counts, Hb, and Hematocrit?
(11 tests)

Complete Blood Count

CBC

40

What test panel measures Proteins, electrolytes, etc?
(14 tests)

Comprehensive Metabolic Panel

CMP

41

What is the term for low WBC count?

Leukokemia

42

What are immature neutrophils called?

Band neutrophils

43

What is seen in acute or chronic lymphocytic leukemia?

Increased Lymphocytes

44

What makes up 1/3 mass RBC's?

Hemoglobin

45

What is the measurement of the average size of RBC's?
What test panel is this part of?

Mean Corpuscular Volume (MCV)

CBC (complete blood count)

46

What causes Macrocytic RBC's?

B12 deficiency

47

What type of RBC is seen in iron deficient anemia?

Microcytic

48

What does MCH stand for and what panel is it part of?

Mean Corpuscular Hemoblobin

CBC - Complete Blood Count

*Large RBC higher Hb count

49

MCH depends on ______, while MCHC is ______

RBC size

independent of size

50

Mean Corpuscular Hemoglobin Concentration reveal two pathologies: either _____ or _____.

Hypochromia - diluted Hb inside RBC
(stain lighter)

Hyperchromia - concentrated Hb inside RBC
(stain darker)

51

What CBC test reveals RBC size variation?

RDW - Red Cell Distribution Width

52

The amount of variation in RBC size is called...

The variation in shape is called...

Normal range:

Anisocytosis

Poikilocytosis

11-15%

53

Thrombocytosis:
Thrombocytopenia:

too much platelet
too little

54

What test in the CBC calculated average size of platelets?

MPV - mean platelet volume

55

What blood panel test usually requires fasting?

CMP - Comprehensive Metabolic Panel

56

What is fasting hyperglycemia associated with?

Diabetes mellitus (type I or II)

57

Too much/too little sodium is called:

Hypernatremia
Hyponatremia

58

What role does Na play in the small intestine?

Glc absorption facilitator

59

Too much/too little Potassium is called:

Hyperkalemia
Hypokalemia

60

T/F
Potassium and Chloride are essential for acid base balance

True

61

Enzyme activation and Blood clotting both rely on what cation?

Calcium

62

What is the most prevalent anion in the blood?

Chloride

63

What 2 type of neurotransmitter does chloride facilitate?

GABA
Glycine

64

What maintains oncotic pressure and transports thyroid hormones and bilirubin?

Albumin

65

T/F
Albumin competitively binds Calcium ions

True

66

T/F
Albumin acts as a buffer

True

67

What nitrogenous waste product increases if kidneys aren't working?

Creatinine

(vs. creatine phosphate)

68

What gives urine its straw color?

Urea

69

What 2 enzymes, if elevated in the blood, suggest liver damage?

ALT - Alanine aminotransferase
AST - Aspartate aminotransferase

*Both involved in AA catabolism

70

What 3 things elevate ALP (Alkaline phosphatase)?

Liver damage
Gall stones
Bone damage

71

Elevation of what suggests liver damage?

ALP - Alkaline phosphatase

72

What is the hydrophobic waste product of Hb metabolism?

Bilirubin

73

In what 3 organs are old RBC's processed?

Liver
Spleen
Bone marrow

74

Where is all bilirubin excreted?

Liver

75

What can too much bilirubin lead to?

Jaundice

hyperbilirubinemia

76

What 4 types of lipid are tested in the lipid panel?

LDL
HDL
Triglycerides
Total cholesterol

77

What lipid test indicates coronary or vascular disease?

cholesterol

78

2 Types of cholesterol

Endogenous (from liver)
Exogenous (diet)

79

What might work differently in people that have high cholesterol?

HMG-CoA reductase negative feedback

80

What drug shuts down cholesterol synth?

Statins like Lipitor or Crestor

81

What is the only way cholesterol is excreted?

Bile

82

What will high Niacin do?

raise HDL (with flushing)

83

What 2 factors lead to plaque formation?

LDL and Triglycerides

*more for LDL

84

What is the normal range serum for triglycerides?

35-160

85

What causes RBC's to settle more quickly when measuring Erythrocyte Sedimentation Rate?

inflammation - from many sources

Specifically Rouleaux Stacks

86

What causes Rouleaux stacking?

Inflammatory mediators produced by liver and immune system

87

Westergren tube:

tube for ESR

88

What test can suggest Temporal Arteritis?
(chronic inflammation of large arteries of the head)

ESR
Erythrocyte Sedimentation Rate

89

What test can diagnose Diabetes?

Hemoglobin A1C

*glc attaches for cell's life

90

5 things that fail in diabetes:

eyes
kidneys
nerves
heart
blood vessels

91

An A1C over _____ suggests diabetes.
Fasting Plasma Glc over ____ suggests diabetes.

6.5%

126

92

What liver produced protein is a marker for inflammation?

CRP
C-reactive Protein

93

What blood marker is just as effective in predicting cardiac risk as cholesterol?

CRP

C-Reactive Protein

94

CRP levels:
low risk CVD
Intermediate
High risk CVD

95

T/F
Periodontal disease is related to diabetes

True

96

T/F
There is a strong association between periodontal disease and cardiovascular disease

True

97

If someone has periodontal disease, what 3 tests should be run?

Lipid Panel
Blood glucose (fasting and A1C)
CRP (c-reactive protein)

98

Where are RBC's made?

Red bone marrow

99

In what 3 areas is red bone marrow found in adults?

Flat bones
Irregular bones
Epiphyses of long bones

100

Where is yellow marrow found?

medullary cavity long bones

101

Where are RBC's made in the fetus?

Liver
Spleen

*can occur in adults with certain diseases

102

What do pluripotential stem cells first divide into in forming cells?

Progenitor cells

103

What is the most important growth factor controlling erythropoiesis?

EPO
erythropoietin

104

What 2 organs release EPO?

Kidneys
Liver

*Mostly Kidneys

105

How do RBC's enter the circulation?

as Reticulocytes

106

What are the 4 essential ingredients for producing normal RBC's?

AA's
Fe
Folic acid
B12

*there are types of anemia associated with each of these

107

How do reticulocytes appear in a blood smear?

Freckled

108

Describe the negative feedback loop for EPO

RBC increase
more oxygen
kidneys sense
EPO drops

*Hypoxia will reverse

109

How many different proteins are in RBC cell membrane?

10-15

110

What are 6 types of integral proteins in RBC's?

Band 3
Glycophorins
Aquaporin-1
GLUT 1
Na/K pumps
Ion channels

111

What is the function of the Band 3 integral protein in RBC's?

Bicarbonate for Chloride
anion transport

(one for one)

*25% total mem. protein

112

What is the function of Glycophorin?

Negatively charged, reduces interaction of red cells with one another and others

113

What integral protein gets glucose inside RBC's?

GLUT-1

114

Name 4 peripheral/cytoskeletal proteins that flexibility and resiliency.
(all inside cell)

Ankyrin
Protein 4.1
Protein 4.2
Spectrin

115

What disease causes sphere-shaped RBC's?

Hereditary spherocytosis

*smaller and lack pale center on smear

116

What % CO2 is transported as carbamino-Hb?

30%

117

Each Hb has -SH in ____ form and Fe in ____ form.

reduced
reduced

118

What happens when ionic gradients fail in RBC's?

Spherocyte

(membrane malfunction)

119

T/F
Glucose metabolism relies exclusively on Cytosolic Proteins.

True

120

What is the primary function of NADH in RBC?

Keeps Fe in reduced state

(Fe 2+)

121

What is the primary function of NADPH in RBC?

maintains Reduced Glutathione

*essential for maintaining structure

122

What does 1 molecule of glc yeild in RBC?

2 ATP
2 NADH

123

What alternate pathway is entered by about 10% of glc in RBC?
What does this produce?

PPP
(hexose monophosphate shunt)

NADPH

124

What is THE enzyme of the PPP (yielding NADPH)?

Glucose-6-phosphate dehydrogenase

125

What links the PPP to glycolysis?

Glc-6-P

*if oxidized enters PPP

126

If Glc-6-P is oxidized it enters _____
If isomerized it _____

PPP
proceeds through glycolysis
(Frc-6-P)

127

What is the lifespan of RBC?

90-120 days

128

Dead RBC is removed from circulation by what 2 organs?

Liver
Spleen

129

What is the waste product of RBC degradation?

Bilirubin

130

What osmotic pressure shrinks RBC
What swells?

Hypertonic
Hypotonic

131

What NaCl solution is isotoinic with plasma?

0.9%

132

Henderson-Hasselbach:

pH = pKa + log [HCO3-] / [CO2]

20:1
7.4

133

How much mEq/L of protons are made daily?

50-100

134

3 blood buffers

Bicarbonate (carbonic anhydrase rxn)
Phosphate
Proteins (albumin, Hb)

135

How does the blood regulate temperature?

Sympathetic - vasoconstrict
(if cold)

Parasympathetic - vasodilate
(warm)

*alpha 1 mediated vessels

136

Warm blood is ____ to the body surface in warm temps.

Shunted

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