Heme And Immunity

Question 1

What is DIC?

Answer 1

Overactivation of coagulation factors

Question 2

What is thrombotic thrombocytopenia purpura (TTP)?

Answer 2

Clotting and bleeding at the same time.
Blood disorder where the platelets abnormally clump together causing blood clots which will reduce # of platelets b/c they are being used to form clots.

Question 3

What does it mean to have a hypersensitivity?

Answer 3

When the immune system is reacting in a way that damages the body instead of protecting it.

Question 4

What antibodies are associated with type 2 hypersensitivities?

Answer 4

IgM and IgG

Question 5

Which hypersensitivity has an environmental antigen IgE?

Answer 5

Type 1

Question 6

What is a type 3 hypersensitivity?

Answer 6

When antigen-antibody complexes deposit in blood vessel walls leading to inflammation and tissue damage.

Question 7

What is a type 4 hypersensitivity?

Answer 7

When inflammation and tissue damage is caused by T cells.

Question 8

What are the 3 different types of anemia?

Answer 8

Blood loss, hemolytic, and deficient RBC production

Question 9

What will labs look like in a patient with anemia?

Answer 9

decreased Hbg/Hct and RBC count.

Question 10

What does microcytic and hypochromic RBC mean?

Answer 10

Cell is too small and too pale

Question 11

What happens to the RBCs in sickle cell disease?

Answer 11

RBC’s sickle to a crescent shape when the hemoglobin is deoxygenated

Question 12

What is the characteristic of the RBCs in iron deficiency anemia?

FAST

Answer 12

microcytic and hypochromic

F= iron deficiency
A= anemia of chronic disease
S= seroblastic anemia
T=thalassemia

Question 13

What are megaloplastic anemias?

Answer 13

B12 and folic acid deficiency

Question 14

What is B12 deficiency anemia called?

Answer 14

Pernicious anemia

Question 15

What is the cell shape and color of cells in pernicious anemia?

Big Fat Pig

Answer 15

macrocytic and normochromic (big w/ normal color)

B= B-12
F= folate
P= pernicious

Question 16

What is aplastic anemia?

Answer 16

When there is a reduction in RBC, WBC, and platelets.

Question 17

impaired bone marrow can cause what type of anemia?

Answer 17

Aplastic anemia

Question 18

What is the normal lifespan of RBCs?

Answer 18

120 days

Question 19

Why is erythropoietin important?

Answer 19

It is required to stimulate the bone marrow to create RBCs

Question 20

What is (primary) polycythemia vera?

Answer 20

Increased in all 3 blood cells (RBC, WBC, platelets) caused by overproduction of the bone marrow d/t neoplastic disease.

Question 21

What is a hematocrit level?

Answer 21

The % of total blood volume occupied by RBCs.

I.e : 45% of blood volume is made up of erythrocytes

Question 22

Where is erythropoietin produced?

Answer 22

in the kidneys

Question 23

What are the 3 types of polycythemia?

Answer 23

primary or polycythemia vera, secondary , and relative.

Question 24

What is polycythemia?

Answer 24

Increased RBCs with a hematocrit level greater than 50% which increases blood viscosity.

Question 25

What is secondary polycythemia?

Answer 25

Increase in erythropoietin as a compensatory response to hypoxia. Only RBC levels will be high and WBC and platelets will be normal.

Question 26

What is relative polycythemia?

Answer 26

Only blood volume has been lost, but no cells. There is less of the water component of plasma, concentrating the RBCs.

Question 27

Hypercoagulability can be caused by what 2 factors?

Answer 27

increased platelet function or clotting activity

Question 28

How does endothelial damage increase risk for blood clots?

Answer 28

greater chance for platelets to adhere and aggregate on damaged walls releasing growth factors *think atherosclerosis

Question 29

What is thrombocytosis?

Answer 29

Increased platelet #

Question 30

How does polycythemia increase the risk of blood clots?

Answer 30

high hematocrit increases blood viscosity

Question 31

Where are clotting factors produced?

Answer 31

In the liver

Question 32

Where are clotting/coagulation factors produced?

Answer 32

In the liver

Question 33

What are the 4 causes of thrombocytopenia?

Answer 33

ITP, TTP, splenic sequestration, and dilution

Question 34

What is a splenic sequestration?

Answer 34

When the spleen is enlarged, platelets will get trapped inside and the # of platelets in the serum will decrease.

Question 35

How can ASA and NSAIDs cause a decrease in platelets?

Answer 35

they impair synthesis of thromboxane needed for platelet aggregation.

Question 36

How do ASA and NSAIDs affect platelets differently?

Answer 36

ASA permanently alters the platelets and NSAIDs only affect platelets as long as the life cycle of the drug

Question 37

Why is vitamin K important for coagulation factors?

Answer 37

it is required for activation of factors II, VII, IX, X, and prothrombin.

Question 38

Which clotting factors is calcium required for?

Answer 38

All of them except the first 2

Question 39

How can DIC lead to thrombocytopenia?

Answer 39

Too much clotting uses a lot of the platelets so there will be a reduced amount. This will cause excessive bleeding because there will be less clotting in other areas of the body where platelets can't be found.

Question 40

What labs confirm DIC?

Answer 40

↑ PT, PTT, and D dimer

Question 41

What activates the intrinsic pathway of DIC?

Answer 41

Endothelial injury

Question 42

What activates the extrinsic pathway of DIC?

Answer 42

Tissue injury

Question 43

What does a high PTT mean?

Answer 43

The higher it is the slower it is for the blood to clot

Question 44

What lab values will be abnormal if the extrinsic pathway is affected?

Answer 44

PT and INR

Question 45

Does heparin affect the intrinsic or extrinsic pathway?

Answer 45

Intrinsic

Question 46

Does coumadin/warfarin affect the intrinsic or extrinsic pathway?

Answer 46

Extrinsic

Question 47

Hemophilia A has a deficiency in which coagulation factor?

Answer 47

Factor VIII

Question 48

What is ITP?

Answer 48

When life cycle of platelets is shortened d/t an autoimmune disorder where the body produces anti-bodies that destroys it's own platelets. May seen easy bruising in patients

Question 49

What causes infectious mononucleosis?

Answer 49

Epstein Barr virus infecting B lymphocytes

Question 50

What are the s/sx of infectious mononucleosis?

Answer 50

Swollen lymph nodes, fever, malaise, and enlarged liver and spleen.

Question 51

What causes the enlarged lymph nodes in infectious mononucleosis?

Answer 51

B cells mature in the lymph nodes so if they are infected they will cluster in the area

Question 52

lymphocytic and myelogenous are acute or chronic leukemias?

Answer 52

both

Question 53

Which cells does Acute lymphocytic leukemia (ALL) affect?

Answer 53

Natural killer, B, and T cells

Question 54

Which cells does Acute myelogenous leukemia (AML) affect?

Answer 54

myeloid precursor cells in the bone marrow such as neutrophils, basophils, eosinophils, and monocytes

Question 55

Which acute leukemia primarily occurs in children?

Answer 55

ALL

Question 56

What is pancytopenia?

Answer 56

Reduction or absence of all three blood cell types

Question 57

What are the 2 types of chronic leukemias?

Answer 57

CLL and CML

Question 58

CLL affects which cells primarily?

Answer 58

B cells

Question 59

Presence of Reed-Sternberg cells indicates what type of lymphoma?

Answer 59

Hodgkin's

Question 60

What is multiple myeloma?

Answer 60

proliferation of malignant plasma cells in the bone marrow and osteolytic bone lesions throughout the skeletal system

Question 61

What are the manifestations of multiple myeloma?

Answer 61

pathologic fx, hypercalcemia, hyperviscosity of blood, osteolytic lesions, compression fx

Question 62

A blood type has what kind of antibodies?

Answer 62

B antibodies

Question 63

B blood type has what kind of antibodies?

Answer 63

A antibodies

Question 64

AB blood type has what type of antibodies?

Answer 64

None

Question 65

O blood type has what type of antibodies?

Answer 65

A and B

Question 66

Can type A blood donate to type AB?

Answer 66

yes

Question 67

Can AB blood donate to type B?

Answer 67

No

Question 68

Who is the universal blood type donor?

Answer 68

Type O

Question 69

Who is the universal blood type receiver?

Answer 69

AB

Question 70

Does AML mostly occur in children or adults?

Answer 70

Older adults

Question 71

Which cells are involved in CML?

Answer 71

Pluripotent hematopoietic progenitor cell such as bone marrow granulocytes, erythroid precursors, and megakaryocytes.