Nx 102 Hematological Function Flashcards
Test 1
1
Q
hematologic system is composed of…
A
blood and blood forming sites
2
Q
blood forming sites
A
bone marrow - primary; red; ribs; pelvis; vertebrae; and sternum
reticuloendothelial system - liver and spleen
3
Q
3 primary types of blood cells
A
erythrocytes
leukocytes
thrombocytes
4
Q
5 types of luekocytes
A
neutrophils (granulocyte) basophils (granulocyte) eosinophils (granulocyte) monocytes lymphocytes (T & B)
5
Q
hematopoiesis
A
blood cell production
6
Q
hematostasis
A
maintaining proper blood level esp when faced w/ trauma
- clot (thrombus) formation
- clot dissolution (fibrinolysis)
7
Q
extramedullary hematopoiesis
A
reticuloendothelial cells of the liver and spleen
8
Q
reticulocyte
A
immature erythrocyte (RBC); nucleated
9
Q
under conditions of _____ _______, reticulocytes and other immature cells may be prematurely released into circulation
A
rapid erythopoiesis
10
Q
erythopoietin
A
hormone produced by kidney; stimulated myeloid stem cells to produce RBCs
11
Q
2 types of blood forming stem cells
A
myeloid - RBC, WBCs (most), and platelets
lymphoid - T and B lymphocytes
12
Q
dietary requirements for erythopoiesis
A
iron, B12, and folic acid
13
Q
iron is stores as
A
ferritin
14
Q
average lifespan for RBC
A
120 days
15
Q
old/damaged RBCs are removed by…
A
reticuloendothelial cells in the liver and spleen
16
Q
most hemoglobin is _____, while small amounts are broken down to ____ and secreted in the ______
A
recycled, bilirubin, bile
17
Q
normal RBC count (MALE)
A
4.7 - 6.1 mm3
18
Q
normal RBC count (FEMALE)
A
4.2 - 5.4 mm3
19
Q
normal Hgb (MALES)
A
14 - 18 g/dL
20
Q
normal Hgb (FEMALE)
A
12 - 16 g/dL
21
Q
normal Hct (MALE)
A
42 - 52%
22
Q
normal Hct (FEMALE)
A
37 - 47%
23
Q
mean corpuscular volume (MCV)
A
volume or size of the RBC
24
Q
normocytic
A
normal MCV = normal size
25
microcytic
decreased MCV = small size
26
macrocytic
increased MCV = larger size
27
mean corpuscular hemoglobin concentration (MCHC)
a measure of the CONCENTRATION of hemoglobin in each cell
28
normochromic
normal MCHC = normal color
| normal MCH = normal color
29
hypochromic
lower MCHC = less color
| lower MCH = less color
30
mean corpuscular hemoglobin (MCH)
the AMOUNT of hemoglobin per RBC
31
risk of bone marrow aspiration and biopsy
bleeding and infection (needs signed consent)
32
common sites for bone marrow aspiration/biopsy
posterior illiac crest (sometimes sternum)
33
anemia is...
lower than normal hemoglobin and fewer circulating erythrocytes
34
anemia is not...
a specific disorder
35
hypoproliferative anema
defective RBC production due to iron, B12, or folate deficiency, decreased erythropoietin production, cancer
- iron deficiency, aplastic, or megaloblastic
36
hemolytic anemia
excessive destruction of RBCs due to altered RBC production, hypersplenism, drug, autoimmune processes, mechanical heart valves
-characterized by increased numbers of reticulocytes & hyperactive bone marrow
37
the more rapid the onset of anemia....
the more sever it is
38
pica
eating extreme "foods"; often a sign of anemia
39
"smooth tongue"
a sign of iron deficiency/anemia
40
"beefy, red tongue"
a sign of megaloplastic anemia
41
cheilosis
sores at the side of the mouth; may be a sign of anemia
42
signs of anemia
```
fatigue/malaise/weakness
pallor or jaundice
cardiac/resp problems (dyspnea/orthopnea)
tongues changes (beefy/smooth)
nail changes
angular cheilosis
pica
```
43
In anemia, the O2 carrying capacity of hemoglobin is _____, causing ____ ____ which can give rise to ____, weakness, ____ and sometimes angina
reduced, tissue hypoxia, fatigue, dyspnea
44
mild anemia Hgb levels
10 - 12 g/dL
normal male: 14 -18 g/dL
normal female: 12 - 16 g/dL
45
moderate anemia Hgb levels
6 - 10 g/dL
normal male: 14 -18 g/dL
normal female: 12 - 16 g/dL
46
severe anemia Hgb levels
< 6 g/dL
normal male: 14 - 18 g/dL
normal female: 12 - 16 g/dL
47
hemolytic anemias are often accompanied by ____ caused by increased blood levels of ____.
jaundice, bilirubin
48
reduced platelet function can cause...
aplastic anemia, petechiae, and purpura
49
the most common hematologic condition affecting elderly patients
anemia
| 40% of hospital admissions, 47% in long-term care
50
anemia in the elderly can result in...
increased fragility, decreased mobility and exercise, increased risk of falling, diminished cognitive function, increased risk for dementia, major depression, decrease muscle mass and bone density
51
the most common type of anemia
iron deficiency (a type of hyperproliferative anemia) - blood loss, inadequate diet, poor absorption
52
pathology of iron deficiency anemia
- microcytic, hypochromic RBCs
- fewer RBCs
- decreased Hgb & Hct
- low serm iron & ferritin levels
- decreased O2 carrying capacity
53
foods high in iron
fish, meats (esp organ), green leafy veggies, enriched breads, cereals & pasta, whole grains, dried fruits (raisins & apricots), egg yolks
54
aplastic anemia
a type of hypoproliferative anemia; rare; insidious; caused by decrease in or damage to marrow stem cells; may be congenital or acquired; most are idiopathic
55
pathology of aplastic anemia
- RBCs normocytic, normochromic
- neutropenia (low neutrophil count)
- throbocytopenia (low platelet count)
- Hgb/Hct low
- RBC count low
- prolonged bleeding time
56
normal platelet count
150000 - 450000/uL
57
normal prothrombin (bleeding) time
11 - 14 seconds
58
signs of iron deficiency anemia
waxy pallor, fatigue, dyspnea, tachycardia, brittle hair and ridged nails, smooth tongue, cheilosis, pica, neurologic manifestations in children
59
signs of aplastic anemia
(often insidious) weakness, fatigue, pallor, dyspnea, signs of infection, purpura, altered level of consciousness, bleeding from the retina
60
megaloblastic anemia
B12 or folic acid deficiency leading to impaired erythopoiesis; characterized by megaloblastic RBCs; brought on by deficiency of B12 or folic acid
61
pathology of folic acid deficiency anemia
- megaloblastic RBCs
| - low serum folate levels
62
signs of folic acid deficiency anemia
weakness, fatigue, smooth tongue, mild diarrhea, very pale, confused, paresthesias in extremities, balance issues, irritablility, poor memory, tachycardia, systolic murmur
63
signs of B12 deficiency (pernicious)
weakness, fatigue, smooth tongue, mild diarrhea, very pale, confused, paresthesias in extremities, balance issues, irritablility, poor memory, tachycardia, systolic murmur
64
pathology of B12 deficiency anemia (pernicious)
- decreased stomach HCL and intrinsic factor
- fatal if not treated
- lack of B12 inhibits myelin formation
65
Schilling test
the definitive test for B12 (pernicious) anemia, measures exrection of radiolabled B12 (24 hour urine collection)
66
In the majority of hemolytic anemias, the premature destruction occurs in the ____
spleen
67
sickle cell anemia
- a type of hemolytic anemia
- chronic disorder resulting in anemia, pain, and organ failure
- RBCs sickle when hypoxic
68
sickle cell hypoxic threshold
- varies between patients
| - illness, cold, stress, infection, dehydration
69
lifespan of a sickle cell
10 - 12 days
70
Hgb level of sickle cell patient
7 - 10 g/dL
71
polycythemia
an abnormal high RBC count with a Hct>50% in females, 55% in males
72
relative polycythemia
- Hct rises due to loss of plasma volume without RBC loss
| - dehydration, diuretics, diarrhea
73
absolute polycythemia
Hct rises due to increase in total RBCs and is classified as primary or secondary
74
polycythemia vera
increased levels of all blood cells due to uncontrolled and rapid cell reproduction, maturation, and proliferation or hyperplasia of the myeloid stem cells
75
signs of polycythemia vera
ruddy cyanosis (flushed) nose, prurititis, headache, dizziness, fatigue, blurred vision, increased BP, erythromyalgia, splenogemaly, gout, renal stones, dyspnea
76
the most common hematologic condition affecting elderly patients
anemia
| 40% of hospital admissions, 47% in long-term care
77
anemia in the elderly can result in...
increased fragility, decreased mobility and exercise, increased risk of falling, diminished cognitive function, increased risk for dementia, major depression, decrease muscle mass and bone density
78
the most common type of anemia
iron deficiency (a type of hyperproliferative anemia) - blood loss, inadequate diet, poor absorption
79
pathology of iron deficiency anemia
- microcytic, hypochromic RBCs
- fewer RBCs
- decreased Hgb & Hct
- low serm iron & ferritin levels
- decreased O2 carrying capacity
80
foods high in iron
fish, meats (esp organ), green leafy veggies, enriched breads, cereals & pasta, whole grains, dried fruits (raisins & apricots), egg yolks
81
aplastic anemia
a type of hypoproliferative anemia; rare; insidious; caused by decrease in or damage to marrow stem cells; may be congenital or acquired; most are idiopathic
82
pathology of aplastic anemia
- RBCs normocytic, normochromic
- neutropenia (low neutrophil count)
- throbocytopenia (low platelet count)
- Hgb/Hct low
- RBC count low
- prolonged bleeding time
83
normal platelet count
150000 - 450000 mm3
84
normal prothrombin (bleeding) time
11 - 14 seconds
85
signs of iron deficiency anemia
waxy pallor, fatigue, dyspnea, tachycardia, brittle hair and ridged nails, smooth tongue, cheilosis, pica, neurologic manifestations in children
86
signs of aplastic anemia
(often insidious) weakness, fatigue, pallor, dyspnea, signs of infection, purpura, altered level of consciousness, bleeding from the retina
87
megaloblastic anemia
B12 or folic acid deficiency leading to impaired erythopoiesis; characterized by megaloblastic RBCs; brought on by deficiency of B12 or folic acid
88
pathology of folic acid deficiency anemia
- megaloblastic RBCs
| - low serum folate levels
89
signs of folic acid deficiency anemia
weakness, fatigue, smooth tongue, mild diarrhea, very pale, confused, paresthesias in extremities, balance issues, irritablility, poor memory, tachycardia, systolic murmur
90
signs of B12 deficiency (pernicious)
weakness, fatigue, smooth tongue, mild diarrhea, very pale, confused, paresthesias in extremities, balance issues, irritablility, poor memory, tachycardia, systolic murmur
91
pathology of B12 deficiency anemia (pernicious)
- decreased stomach HCL and intrinsic factor
- fatal if not treated
- lack of B12 inhibits myelin formation
92
Schilling test
the definitive test for B12 (pernicious) anemia, measures exrection of radiolabled B12 (24 hour urine collection)
93
In the majority of hemolytic anemias, the premature destruction occurs in the ____
spleen
94
sickle cell anemia
- a type of hemolytic anemia
- chronic disorder resulting in anemia, pain, and organ failure
- RBCs sickle when hypoxic
95
sickle cell hypoxic threshold
- varies between patients
| - illness, cold, stress, infection, dehydration
96
lifespan of a sickle cell
10 - 12 days
97
Hgb level of sickle cell patient
7 - 10 g/dL
98
polycythemia
an abnormal high RBC count with a Hct>50% in females, 55% in males
99
relative polycythemia
- Hct rises due to loss of plasma volume without RBC loss
| - dehydration, diuretics, diarrhea
100
absolute polycythemia
Hct rises due to increase in total RBCs and is classified as primary or secondary
101
polycythemia vera
increased levels of all blood cells due to uncontrolled and rapid cell reproduction, maturation, and proliferation or hyperplasia of the myeloid stem cells
102
signs of polycythemia vera
ruddy cyanosis (flushed) nose, prurititis, headache, dizziness, fatigue, blurred vision, increased BP, erythromyalgia, splenogemaly, gout, renal stones, dyspnea
103
secondary polycythemia
-excessive RBCs due to excessive erythopoietin due to hypoxia, renal tumors, heavy smoking, disease, or any condition that causes prolonged hypoxia
104
thrombocytopenia
- bleeding disorder; platelet levels <100000/uL
| - caused by platelet destruction or consumption
105
pathology of throbocytopenia
- platelets <100000/uL
- prolonged bleeding time
- megakaryocytes in bone marrow
- clumping on blood smear
106
idiopathic thrombocytopenic purpura
- platelet deficiency
- immune system destroys platelets
- acute (children) or chronic (adults)
107
normal lifespan of platelets
7 to 10 days
108
lifespan of platelets in idiopathic thrombocytopenia purpura
1 to 3 days or less
109
signs of idiopathic thrombocytopenia purpura
- easy bruising (wet or dry)
- heavy menses
- petechiae on extremities and trunk
- nose bleeds
110
pathology of idiopathic thrombocytopenia purpura
- platelet count <20000/uL
- prolonged bleeding time
- abnormal platelets
- increased numbers of megakaryocytes in bone marrow
- possible H. pylori infection
111
hemophilia
x-linked, recessive bleeding disorder; prolonged coagulation time
-primarily affects males
112
pathology of hemophila
-platelet plug forms at bleeding site but clotting factor deficiency impairs stable clot formation
113
signs of hemophilia
- hemorrhages (75% in joints)
- spontaneous GI bleed and hematuria
- intracranial or extracranial hemorrhages dangerous
- excessive bleeding w/ surgery or dentistry
114
hemophilia A (classic)
no to low clotting factor VIII
115
hemophilia B (christmas)
no to low clotting factor IX
