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Unit 3 Patho
Chapters 25, 26, 27, 28
Question | Answer |
---|---|
Blood consists of formed elements. The chief function is to? | 1. deliver substances needed for cellular metabolism in the tissues. 2. defend against injury and invading micro-organisms 3. acid base balance |
3 categories of plasma proteins | albumins, globulins and clotting factors |
albumins | regulate passage of water and solutes through capillaries and venules |
immune globulins | antibodies |
clotting factors | promote coagulation - fibrogen is most plentiful of clotting factors |
RBC's | erythrocytes - responsible for tissue oxygenation cannot undergo mitotic division so dies in 120 days |
shape of RBC's | flattened, bioconcavity and reverse deformability |
WBC's | leukocytes - body's defense either granulocytes or agranulocytes |
granulocytes | phagocytes neutrophils baseophils eosinophils |
agranulocytes | phagocytes or immunocytes phagocytes - monocytes and macrophages immunocytes - lymphocytes |
platelets | disk-shaped cytoplasmic fragments (not cells) made from megakaryocytes essential for blood coagulation |
thrombocytopenia | low platelet count less than 100,000 |
thrombocytosis | increased platelet count more than 600,000 |
Hct | 38-46% in females 40-54% in males % of blood occupied by RBC's |
Hgb | 14-16 g/dl oxygen carrier to body |
RBC count | 4.00-6.00 (million) |
MCV | 80-96 fl volume (size) of average RBC |
MCH | 27-32 pg amount of Hgb in average RBC |
MCHC | 32-36 concentration of Hgb in average RBC |
neutrophils | pinkish cytoplasm, segmented nucleus, fight bacterial infections, phagocytes |
eosinophils | large red granules, target antigen-antibody complexes, increased in allergies and parasites |
basophils | large dark blue, participate in inflammatory response, release histamine and heparin |
monocytes/macrophages | very powerful phagocytes, macrophages have different names depending on their location |
lymphocytes | contained mostly in the lymph, T & B cells, fight viral infections and cancers, major role in adaptive immune response |
primary lymphatic organs | thymus and bone marrow |
secondary lymphatic organs | spleen, lymph nodes, tonsils, peyer patches of small intestines |
hematopoiesis | formation of blood -cells are formed in bone marrow from pluripotent stem cells -mature in bone marrow or lymphatic tissue -mitotic division into common myeloid cells or common lymphoid cells -become eosinophils, monoblasts, plasma cell, NK cell, et |
colony stimulating factors | cytokines that act as hormones to stimulate proliferation of progenitor (early) cells -necessary for growth of myeloid, erythroid, lymphoid and megakaryotic cells |
CSF produces which cells | T-lymphocytes B-lymphocytes eosinophil granulocytes neutrophilic granulocytes monocyte and macrophage megakaryote and platelets erythrocytes |
sequence of events in hemostasis | 1. vascular spasm 2. platelet plug formation 3. activation of coagulation cascade |
intrinsic pathway | (collagen and other substances) activated by thromboplastin |
extrinsic pathway | (injury) activated by contact with the injured vessel |
stages of coagulation | 1. extrinsic and intrinsic activation 2. common pathway beings with formation of prothrombinase 3. prothrombin activates prothrombin to thrombin 4. thrombin induces formation of fibrin from fibrinogen |
fibrinolysis | after 30-60 minutes platelets contract and clot has to be removed TPA "clot buster" removes clots |
bone marrow biopsy diagnosis | anemia, leukemias, platelet disorders, immunoglobin disorders |
WBC's diagnosis | bacterial appendicitis, mono, CLL |
PT/INR diagnosis | measures extrinsic pathway |
APTT diagnosis | measures intrinsic pathway |
bleeding time diagnosis | measures platelet function |
reticulocyte count | measures rate of erythropoiesis |
anemia | reduction in total number of erythrythrocytes in circulating blood or a decrease in the quality or quantity of Hgb |
anemia is classified by | impaired erythrocyte function blood loss (acute or chronic) increased erythrocyte destruction or a combination of one or more |
microcytic-normochromic | pale small cells iron deficiency |
macrocytic-normochromic | large cells folic acid deficiency vitamin b12 deficency (pernicious) |
normocytic-normochromic | RBC's are normal size but caused by hemorrhage or hemolysis anemia of chronic disease aplastic anemia hemolytic hemorrhagic |
iron-deficiency | pale earlobes, palms and conjunctivae, spoon shaped nails, sore tongue |
pernicious | digestive symptoms, neurological symptoms, peripheral neuropathy |
folic acid | digestive symptoms, peripheral neuropathy |
sideroblastic | dysfunctional uptake of iron heptosplenomegly hemochromatosis |
aplastic | petechia, bleeding, infection, pancytopenia |
hemorrhagic | shock, acidosis |
hemolytic | enlarged spleen, jaundice |
polycythemia | excessively large RBC's |
polycythemia s/s | red face, hands, feet, ears, and mucous membranes, high bp, engorgement of veins, heptasplenomegaly |
neutrophilia | cause: infection, inflammation and band neutrophils are released into blood |
neutropenia | cause: prolonged severe infection, reduced survival |
eosinophilia | cause:allergic reaction or parasitic invasion |
monocytosis | cause: blood has poor correlation with disease |
lymphocytosis | acute viral infections, malignancies |
lymphocytopenia | immune deficiencies |
mononucleosis | acute infection cause by EBV. Test for presence of heterophilic antibodies |
ALL | children immature cells/"blasts" acute sudden onset of symptoms B and T cells lymphoblasts |
AML | adults immature cells/"blasts" myeloblasts poor survival rate |
CML | adults well differentiated cells don't form properly gradual onset Philadelphia chromosome (T9:22) |
CLL | adults well differentiated cells don't form properly elderly B cells |
myleoma | involvement of bone marrow/cancer of bone marrow destruction of bones- osteoclastic activity abnormal immunoglobin protein - M protein Bence jones protein skeletal pain renal failure recurrent bacterial infections weakness fatigue weight loss |
Hodgkins Lymphoma | Reed Sternberg cells in lymph nodes targets b cells 25-35 and under 50 night sweats, itching usually localized |
Non-Hodgkins Lymphoma | No Reed Sternberg cells multiple organ/node involvement proliferation or lymph nodes onset usually after 50 |
fibrinolysis | after 30-60 minutes platelets contract and clot has to be removed TPA "clot buster" removes clots |
bone marrow biopsy diagnosis | anemia, leukemias, platelet disorders, immunoglobin disorders |
WBC's diagnosis | bacterial appendicitis, mono, CLL |
PT/INR diagnosis | measures extrinsic pathway |
APTT diagnosis | measures intrinsic pathway |
bleeding time diagnosis | measures platelet function |
reticulocyte count | measures rate of erythropoiesis |
anemia | reduction in total number of erythrythrocytes in circulating blood or a decrease in the quality or quantity of Hgb |
anemia is classified by | impaired erythrocyte function blood loss (acute or chronic) increased erythrocyte destruction or a combination of one or more |
microcytic-normochromic | pale small cells iron deficiency |
macrocytic-normochromic | large cells folic acid deficiency vitamin b12 deficency (pernicious) |
normocytic-normochromic | RBC's are normal size but caused by hemorrhage or hemolysis anemia of chronic disease aplastic anemia hemolytic hemorrhagic |
iron-deficiency | pale earlobes, palms and conjunctivae, spoon shaped nails, sore tongue |
pernicious | digestive symptoms, neurological symptoms, peripheral neuropathy |
folic acid | digestive symptoms, peripheral neuropathy |
sideroblastic | dysfunctional uptake of iron heptosplenomegly hemochromatosis |
aplastic | petechia, bleeding, infection, pancytopenia |
hemorrhagic | shock, acidosis |
hemolytic | enlarged spleen, jaundice |
polycythemia | excessively large RBC's |
polycythemia s/s | red face, hands, feet, ears, and mucous membranes, high bp, engorgement of veins, heptasplenomegaly |
neutrophilia | cause: infection, inflammation and band neutrophils are released into blood |
neutropenia | cause: prolonged severe infection, reduced survival |
eosinophilia | cause:allergic reaction or parasitic invasion |
monocytosis | cause: blood has poor correlation with disease |
lymphocytosis | acute viral infections, malignancies |
lymphocytopenia | immune deficiencies |
mononucleosis | acute infection cause by EBV. Test for presence of heterophilic antibodies |
ALL | children immature cells/"blasts" acute sudden onset of symptoms B and T cells lymphoblasts |
AML | adults immature cells/"blasts" myeloblasts poor survival rate |
CML | adults well differentiated cells don't form properly gradual onset Philadelphia chromosome (T9:22) |
CLL | adults well differentiated cells don't form properly elderly B cells |
myleoma | involvement of bone marrow/cancer of bone marrow destruction of bones- osteoclastic activity abnormal immunoglobin protein - M protein Bence jones protein skeletal pain renal failure recurrent bacterial infections weakness fatigue weight loss |
Hodgkins Lymphoma | Reed Sternberg cells in lymph nodes targets b cells 25-35 and under 50 night sweats, itching usually localized |
Non-Hodgkins Lymphoma | No Reed Sternberg cells multiple organ/node involvement onset usually after 50 proliferation or lymph nodes onset usually after 50 |
2 major causes of hemolytic diseases in newborn | ABO incompatibility RH incompatibility |
ABO incompatibility | difference in fetal and maternal blood types |
RH incompatibility | maternal anti-Rh, IgG antibodies cross placenta and attach to fetal erythrocytes Rh- mothers have Rh+ babies can cause anemia, edema, CNS damage, fetal death |