Unit 2 - Hematology Part I

Question 1

blood pressure

Answer 1

change in pressure = P1-P2

change in P = flow (Q) x vessel resistance (R)

Question 2

circulatory shock (5 types)

Answer 2

• septic
• neurogenic
• obstructive
• cardiogenic
• hypovolemic

Question 3

edema

Answer 3

accumulation of excessive fluid with the interstitial tissues or within body cavities

Question 4

congestion

Answer 4

implies accumulation of excessive blood within the vessels of an organ or tissue

Question 5

thrombus and embolus

Answer 5

thrombus: blood clot that has formed either in a blood vessel or in the heart that has remained stationary
embolus: blood clot that has been broken off from its original location and has moved through a vessel to lodge at a distant site

Question 6

infarction

Answer 6

cell death and tissue necrosis that is caused by a disruption in the blood supply

Question 7

lymphedema

Answer 7

chronic swelling of an area due to accumulation of interstitial fluid secondary to obstruction of lymphatic vessels/nodes

Question 8

shock

Answer 8

BP falls so low that perfusion of the organs cannot occur

Question 9

anemia

Answer 9

RBC count falls significantly, thus resulting in reduction in hemoglobin and the ability of the blood to carry o2 to the organs and the tissues

Question 10

polycythemia

Answer 10

too many RBCs cause viscosity increase of the blood and congestion

Question 11

leukocytopenia

Answer 11

significant reduction in the total WBC count

Question 12

leukocytosis

Answer 12

blood disorder in which immature WBCs accumulate

Question 13

aging and the hematopoietic system: decrease in… (3 things)

Answer 13

• intestinal absorption of iron
• iron-binding capacity
• iron storage capacity

Question 14

destination

Answer 14

bone marrow

Question 15

decreases result in…

Answer 15

• decreased RBC’s (iron deficiency anemia)

- increased RBC fragility

Question 16

decreased vitamin B12 GI absorption results in

Answer 16

decrease in red bone marrow production of RBCs

disease outcome - pernicious anemia

Question 17

decreased number/size of lymph nodes and cellular immunity/t-cell function outcome

Answer 17

reduced immunity

Question 18

blood composition - plasma

Answer 18

55% of blood volume
Water-90+%
Solids-<10% (electrolytes, proteins)

Question 19

blood composition - cells

Answer 19

45% of blood volume
Red blood cells (Erythrocytes)
White blood cells (Leukocytes)
Platelets (Thrombocytes)

Question 20

blood transfusions

Answer 20

Necessary following prolonged surgery or accident

Elective surgery-autologous transfusions

Question 21

blood transfusion complication

Answer 21

ABO Incompatibility (Type II Hyperimmune reaction)
Signs of complications
Chills and Fever
Rash
Jaundice
Blood stained urine
Adult Respiratory Distress                                                                      Syndrome
Hepatitis B or C infection
HIV infection
Air embolism
Circulatory overload
Delayed reaction

Question 22

erythroprotein

Answer 22

active form of renal erthyropoietic factor, which is produced by the kidneys

when activated, it stimulates bone marrow, thus promoting hematopoiesis

Question 23

Hemochromatosis

Answer 23

genetic disorder

• too much iron absorbed from the GI tract
• too much iron deposited in organs and various tissues
• “rusty” colored skin

Question 24

Hemochromatosis etiology

Answer 24

Men: Women=8:1
Peak age: 50’s and 60’s
Autosomal Recessive 
Defect in the HFE Gene
(High Fe gene)

Question 25

Hemochromatosis - iron accumulates causing

Answer 25

``` Iron induced Arthropathy Iron Induced Cirrhosis and Hepatocellular Cancer Iron induced Cardiomyopathy Fe induced Emphysema-Lungs Fe induced Diabetes Mellitus-pancreas Fe induced Sterility-Reproductive organs ```

Question 26

Porphyria

Answer 26

Accumulation of porphyrins Porphyrins form “Heme” portion of Hemoglobin Accumulate in tissues and organs, i.e. CNS Seizures, cognitive changes, behavioral changes Polyneuropathy with Polyneuritis Spill over as “Port wine urine” Porphyrins are a purple pigment

Question 27

cutaneous porphyria

Answer 27

photodermatitis

Question 28

complete blood count

Answer 28

``` Total rbc count (4.2-6.1 million cells/mcL) Total wbc count (4.5-9.5 thousand cells/mcL) Total platelet count (150, 000-400,00 cells/mcL) Hemoglobin (grams/100 ml) Hematocrit (%) Leukocyte differential count: Granulocytes - 50-75% Neutrophils (PMN’s) - 1-2% Eosinophils - 0.5-1% Basophils Agranulocytes - 25-33% Lymphocytes - 6% Monocytes ``` ``` Reticulocyte count (1% immature RBC’s) RBC indices MCV (~87 cubic microns) MCHC (~30%) MCH (~30 picograms)* ```

Question 29

everything included in a CBC

Answer 29

``` Red Blood Cell count + indices White Blood Cell count + differential Platelet Count Hemoglobin and Hematocrit Reticulocyte Count ```

Question 30

Hemoglobinopathies-Sickle Cell Disease

Answer 30

Abnormal, “sickle cell” shaped erythrocyte in Sickle cell disease Autosomal recessive trait: sickle cell disease (HbSS) Heterozygote: sickle cell trait” (HbAS) Commonly in people from parts of tropical and sub-tropical areas where malaria is common, or their descendants .. .

Question 31

sickle cell disease clinical issues

Answer 31

Poor Affinity for O2 Vascular Occlusive Crisis Hemolytic Crisis

Question 32

Vascular Occlusive Crisis

Answer 32

``` Stroke Heart Attack Venous thrombus Thromboembolism Auto-splenectomy Acute chest syndrome ```

Question 33

Hemolytic Crisis

Answer 33

``` Creates “sludge” and vascular occlusion Stroke Heart Attack Venous thrombus Thromboembolism Auto-splenectomy Acute chest syndrome ```

Question 34

the anemias - CDC

Answer 34

“Hemoglobin < 14 gms/100 ml (males)” | “Hemoglobin < 12 gms/100 ml (females"

Question 35

Anemia s/s

Answer 35

``` Pallor Resting Tachycardia Cardiac Murmurs >100 bpm Angina Dyspnea Anorexia Constipation/Diarrhea Headaches -Dizziness Syncope (fainting) Tinnitus Stomatitis Pica fatigue ```

Question 36

causes of anemia

Answer 36

Excessive Blood Loss Increased Destruction of Erythrocytes Decreased Production of Erythrocytes

Question 37

anemia caused by excessive blood loss

Answer 37

- most common - from cancer, long term use of aspirin/other drugs, menstruation - also known as Normocytic, normochromic - RBC Indices (MCV, MCHC, MCH) all normal

Question 38

anemias caused by destruction of RBCs

Answer 38

- may be congenital or acquired - congenital: sickle cell - acquired: autoimmune, malaria

Question 39

anemia caused by destruction of erythrocytes - type 1

Answer 39

macrocytic, normochronic: - RBCs are enlarged but hemoglobin concentration is normal - when DNA synthesis has been interfered with, b12 deficiency (pernicious anemia)

Question 40

anemia caused by destruction of erythrocytes - type 2

Answer 40

microcytic, hypochromic: - RBCs are smaller than normal, and hemoglobin concentration per RBC is below normal - iron deficiency

Question 41

aplastic anemia

Answer 41

life threatening illness bone marrow is suppressed, resulting in an insufficient number of production of all blood cells - congenital, idiopathic, or acquired - may survive long term on supportive therapy or death by internal bleeding

Question 42

polycythemia

Answer 42

- myeloproliferative disorder (too many RBCs) | - increased blood volume and viscosity

Question 43

primary polycythemia (vera)

Answer 43

- bone marrow overproduces blood cells - older men, progressive Rust colored skin Blood-shot eyes Headache, “fullness” in the head Dizziness Fatigue Pruritus (itchy”) deep venous thrombus - Budd Chiari syndrome

Question 44

secondary polycythemia

Answer 44

- aquired 1) circulating volume of plasma decreases (dehydration) 2) RBCs increase from external causes - smoking high altitude