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Unit 3 Patho

Chapters 25, 26, 27, 28

QuestionAnswer
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
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