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Heme/Onc > Hematology Physio > Flashcards

Hematology Physio Flashcards

1
Q

What are the components of blood

A
  • plasma (55%)
  • formed elements (erythrocytes (45%), leukocytes, platelets (1%))
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2
Q

What is the normal pH range of our blood

A

7.35-7.45

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3
Q

What is the average blood volume of adult males and females

A

Male: 5-6L
Female: 4-5L

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4
Q

Describe the functions of blood

A
  • Distribution (O2, nutrients, waste, hormones)
  • Regulation (temp, pH, fluid)
  • Protection (blood loss, infection)
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5
Q

What are the components of plasma

A

- 90% water
- proteins mostly produced by the liver (albumin, globulin, fibrinogen)
- clotting factors
- hormones
- respiratory gases & electrolytes
- nutrients

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6
Q

What is the normal albumin-globulin ration

A

4:2

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7
Q

Does serum contain clotting factors?

A

No, clotting factors are found only in plasma

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8
Q

What cell gives rise to all formed elements of our blood?

A

Multipotential hematopoietic stem cell (hemocytoblast)

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9
Q

What are the two types of cells that differentiate from hemocytoblasts

A

common myeloid progenitor

common lymphoid progenitor

(these branch farther into many cells, leukemias will affect one line or the other)

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10
Q

Define erythrocytes

A
  • biconcave discs
  • anucleate
  • no organelles (anaerobic ATP production)
  • contains spectrin
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11
Q

What is the purpose of spectrin in erythrocyte plasma membranes

A

provides flexibility to change shape as needed

(deficiency leads to a type of anemia)

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12
Q

Describe the structure of hemoglobin

A
  • protein globin: 2 alpha & 2 beta chains (adults, 2 gamma in fetal)
  • heme pigment bonded to globin
  • iron atom in each heme (can bind 4 O2)
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13
Q

What is a reticulocyte

A

a mature form of a red blood cell that is not yet an erythrocyte

(formed during erythropoiesis after nucleus is ejected)

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14
Q

Where does erythropoiesis occur

A

red bone marrow

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15
Q

What is a scenario in which reticulocyte count would be low

A

aplastic anemia

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16
Q

What regulates erythropoiesis

A

Hormones
- erythropoietin
- testosterone

Nutrients
- amino acids, lipids, carbs
- iron
- vit B12

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17
Q

What is iron stored in the cells as and what is it transferred by

A

Storage: ferritin & hemosiderin

Transport: transferrin

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18
Q

What is the lifespan of a RBC

A

100-120 days

(then destroyed by macrophages in the spleen)

(Hgb A1C measures this)

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19
Q

What happens after a RBC is broken down

A
  • iron salvaged for reuse
  • heme degraded to yellow pigment unconjugated bilirubin, which gets conjugated in the liver, excreted as stercobilin & urobilinogen
  • globin metabolized into amino acids
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20
Q

Define anemia

A
  • blood has abnormally low O2 carrying capacity
  • sign, not disease
  • fatigue, pallor, SOB, chills
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21
Q

What kinds of anemia are caused by insufficient erythrocytes

A
  • hemorrhagic
  • hemolytic (RBCs destroyed)
  • aplastic (Bone marrow destroyed)
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22
Q

What kinds of anemia are caused by low Hgb

A
  • iron deficiency (secondary to hemorrhage, impaired iron absorption
  • pernicious (Vit B12 deficiency, lack of intrinsic factor for absorption)
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23
Q

What kinds of anemia are caused by abnormal Hgb

A
  • thalassemia (absent/faulty globin, think delicate RBC)
  • sickle cell (gene code, low in oxygen)
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24
Q

When does sickling happen in sickle cell anemia

A

When oxygen dissociates from the heme (especially during high O2 demand like exercise)

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25
Q

Define polycythemia

A

excess of RBCs that increase blood viscosity
- bone marrow cancer, O2 loss, blood doping

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26
Q

What process allows WBC to leave capillaries

A

diapedesis

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27
Q

What makes up granulocytes & agranulocytes

A

Granulocytes
- neutrophils (50-70%)
- eosinophils (2-4%
- basophils (1%)

Agranulocytes
- lymphocytes (25-45%)
- monocytes (3-8%)

28
Q

Which WBCs will stain with Wright’s stain

A

granulocytes (neutrophils, eosinophils, basophils)
- larger, shorter lived
- lobed nuclei
- phagocytic

29
Q

Which WBC has granules that contain hydrolytic enzymes or defensins

A

Neutrophils (bacteria slayers)

30
Q

Which WBC digests parasitic worms & modulates immune response

A

eosinophils

31
Q

Which WBC contains histamine & functions similarly to mast cells

A

basophils

32
Q

Describe the 2 types of lymphocytes

A
  • T cells: act against virus-infected cells & tumor cells
  • B cells: give rise to plasma cells that produce antibodies
33
Q

What is the largest WBC and what does it do

A

monocytes
- differentiates into macrophages
- activates lymphocytes for immune response

34
Q

What chemical messengers from bone marrow & mature WBCs stimulate leukopoiesis

A

interleukins & colony-stimulating factors

35
Q

Describe platelets

A
  • anucleate cell fragments
  • formation regulated by thrombopoietin (hormone from liver & kidneys)
36
Q

What are in the granules of platelets & why are these important

A
  • Ca, enzymes, ADP, phospholipids, platelet derived growth factor, serotonin
  • important in hemostasis
37
Q

What does the platelet membrane consist of

A
  • lipid bilayer
  • glycoprotein receptors (important in hemostasis)
38
Q

What are the functions of platelets

A
  • form temporary plugs that seal breaks in blood vessels
  • circulating when inactive and made mobile by nitric oxide & prostacyclin from endothelial vessel lining
39
Q

Describe the phases of hemostasis

A
  • primary (vascular spasm & platelet plug)
  • secondary (coagulation)
  • stoppage of hemostasis (proteins)
  • fibrinolysis (clot dissolves)
40
Q

Describe the steps of platelet plug formation (step 2 of hemostasis)

A
  • adhesion via vWB factor
  • aggregation via ADP
  • secretion of granular contents
41
Q

Describe coagulation (step 3 of hemostasis)

A
  • reactions in which blood is transformed from liquid to gel
  • reinforces platelet plug with fibrin threads
  • requires coag/clotting factors, Ca, phospholipids
42
Q

Describe the 3 phases of coagulation

A
  • prothrombin activator formed
  • prothrombin converted to thrombin
  • thrombin catalyzes fibrinogen to form fibrin mesh
43
Q

Which clotting factors require vitamin K

A

Factors II, VII, IX, and X

44
Q

What is the major difference between the intrinsic pathway and extrinsic pathway of clotting

A

Intrinsic: direct to blood vessel injury

Extrinsic: tissue cell trauma prior to blood vessel response

45
Q

What forms all clotting factors

A

the liver

(all circulate in blood in an inactive form)

46
Q

What is the main end product of phase 1 of coagulation

A

formation of prothrombin activator (activates prothrombin to thrombin in phase 2)

47
Q

What is the main end product of phase 3 of coagulation

A

fibrin mesh

48
Q

Describe clot retraction

A
  • actin & myosin in platelets contract within 30-60 mins which squeezes serum from the clot
49
Q

Describe clot repair

A
  • PDGF stimulates division of smooth muscle cells & fibroblasts to rebuild vessel
  • VEGF stimulates endothelial cells to restore lining
50
Q

Which proteins inactivate activated clotting factors

A
  • antithrombin III
  • protein C
  • heparin
51
Q

What things prevent platelet adhesion

A
  • nitric oxide, prostacyclin (from endothelial lining)
  • vit E, quinine (anticoags)
52
Q

Describe fibrinolysis

A
  • begins within 2 days
  • plasminogen converted to plasmin by tPA, factor XII, thrombin
53
Q

Describe disseminated intravascular coagulation (DIC)

A
  • widespread clotting blocking intact blood vessels
  • can cause severe bleeding
  • common in pregnancy, septicemia, incompatible transfusion
  • prevention: ASA, heparin, warfarin
54
Q

Describe thrombocytopenia

A
  • deficiency of platelets
  • petechiae d/t spontaneous widespread hemorrhage
  • tx with transfusion of concentrated platelets
55
Q

Describe the types of hemophilia

A
  • A: most common, deficiency of factor VIII
  • B: deficiency of factor IX
  • mild, deficiency of factor XI
  • prolonged bleeding (into joints)
56
Q

Which blood groups can cause vigorous transfusion reactions

A

ABO & Rh

57
Q

Which blood group is a universal recipient

A

AB

58
Q

Which blood group is a universal donor

A

O

59
Q

Which blood group can receive blood from B or O

A

B (has anti-A antibody)

60
Q

Which blood group can receive blood from A or O

A

A (has anti-B antibody)

61
Q

Which blood group can receive blood from only group O

A

O (has anti-A and anti-B antibodies)

62
Q

Which blood group can receive blood from A, B, AB, or O

A

AB (no antibodies)

63
Q

When do Rh antibodies form

A
  • if an Rh negative person receives Rh+ blood
  • NOT spontaneous
64
Q

Describe hemolytic disease of the newborn (erythroblastosis fetalis)

A

anti-Rh antibodies cross placenta and destroy RBCs of an Rh+ baby after Rh- mom becomes sensitized to Rh+ exposure & produces anti-Rh antibodies

65
Q

What happens in a transfusion reaction

A
  • occurs in mismatched infusions
  • donors cells are attacked by recipients agglutinins, clog small vessels, rupture & release Hgb
  • diminished O2 capacity, renal failure

Heme/Onc (16 decks)

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