Hematology - Ch 30 - 1
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| Red marrow found where? | Flat and irregular bones – ends of long bones, pelvic, vertebrae, sacrum, sternum, cranial, scapulae
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| All 3 types of blood cells come from | matopoieitic stem cell within bone marrow
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| Serum refers to | plasma minus clotting factors
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| Plasma proteins | albumin, globulin, clotting factors, fibrinogen
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| Globin | simple protein
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| Heme | iron compound
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| Carbon dioxide bind to? | the globin portion of hemoglobin
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| Erythropoiesis | process of RBC production – regulated by cellular o2 requirements and general metabolic activity.
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| Essential nutrients for erythropoiesis | protein, iron, folate (folic acid), cobalamin (B12), riboflavin (B2), and pyridoxine (B6).
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| Reticulocyte | immature erythrocyte
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| Reticulocyte count measures? | rate at which new RBCs appear in circ
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| Reticulocytes develop into mature RBCs in what time frame? | 48 hours of release into circ
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| Hemolysis | destruction of RBCs
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| What performs hemolysis in body? | monocytes and macrophages that remove abnormal, defective, damaged, and old RBCs from circ
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| Where does hemolysis usually occur? | in bone marrow, liver, and spleen
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| Hemolysis of RBCs results in? | increased bilirubin in body
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| Primary function of granulocytes is | phagocytosis
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| Most common type of granulocyte | neutrophil 50 – 70 percent
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| Neutrophils primary phagocytic cells involved in | acute inflammatory responses
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| Mature neutrophils is called a | segmented neutrophils or “seg” or “polysegmented neutrophils” – cuz nucleus is segmented into 2 – 5 lobes
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| One of primary functions of eosinophils is to | engulf antigen-antibody complexes during allergic response
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| Basophils | less that 2%, cytoplasmic granules that contain heparin, serotonin, and histamine – allergic and inflammatory rxns
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| Lymphocytes | 20 – 40%, immune response, B and T cells, migrate to thymus and differentiate into T cells
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| Monocytes | 4-8%, potent phagocytic, 2nd type to arrive at scene of injury, become macrophages, Kupffer cells in liver, osteoclasts in bone, macrophages in lungs
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| Interact with lymphocytes to facilitate humoral and cellular immune responses | macrophages
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| Thrombocytes | platelets – initiate clotting process
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| Megakaryocyte | produce platelets
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| Thrombopoietin | regulates platelet production – growth factor acting on bone marrow
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| Platelets have life span of | 5-9 days
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| The __ of hemoglobin accounts for 2/3 of iron in body | heme
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| 1/3 of iron in body stored as | ferritin and hemosiderin (degraded form of ferritin) in bone marrow, spleen, liver, and macrophages
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| When stored iron is not replaced __ production is reduced | hemoglobin
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| Transferrin | synthesized in liver – serves as carrier plasma protein for iron
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| Vascular spasms of vasoconstriction can last for | 20 – 30 mins – allowing time for platelet response and clotting factors to activate
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| Platelet response and plasma clotting factors are triggered by | endothelial injury & release of substances such as tissue factor (TF)
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| Platelets are activated when exposed to | interstitial collagen from injured blood vessel
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| Which platelet factor facilitates coagulation? | factor 3
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| What chemical increases platelet adhesiveness and aggregation | adenosine diphosphate
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| Intrinsic pathway activated by? | collagen exposure
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| Extrinsic pathway initiated when? | tissue factor is released extravascularily from injured tissues
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| vWf (von Wildebrand factors) is important for? | forming adhesive bridge between platelets
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| Thrombin is most powerful enzyme in the | coagulation process – converts fibrogen to fibrin
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| Fibrin split products (FSPs) | fibrin split into smaller elements by plasmin
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| If fibrinolysis is excessive, the pt will be predisposed to | bleeding
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| Increased FSPs (fibrin split products) lead to | impaired platelet aggregation, reduced prothrombin, and inability to stabilize fibrin
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| Functions of spleen | hematopoietic, filtration, immunologic, and storage
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| Hematopoietic function | spleen’s ability to produce RBCs during fetal development
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| What does spleen do regarding hemoglobin? | catabolizes it and returns iron component back to bone marrow for reuse
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| 90% of platelet mass is stored in | spleen
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| By means of __, proteins and fat from GI tract are able to return to circ. Sys. |
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| Lymph capillaries do not contain | valves
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| All lymph fluid carried to | right lymphatic duct or thoracic duct, then subclavian veins in neck.
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| Primary function of lymph nodes is | filtration of pathogens and foreign particles carried by lymph to nodes.
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| __ produces all the procoagulants essential to hemostasis and blood coagulation. | liver
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| Hepcidin, produced by liver, is key regulator of | iron balance
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| Synthesis of hepcidin stimulated by | iron overload or inflammation
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| Amount of marrow and stem cells __ with aging | decreases
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| The ___ of RBCs in increased in the older person | osmotic fragility
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| The total WBC count and differential are generally __ by aging. | not affected
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| There is diminished bone marrow reserve of __ in older adults | granulocytes
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| Where does iron absorption occur? | in the duodenum
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| Surgical excision of the duodenum affects what? | iron absorption
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| Partial or total gastrectomy affects blood how? | removes parietal cells, thus reducing intrinsic factor needed to abosorb cobalamin (b12)
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| Ileal resection affects blood production how? | This is where cobalamin (B12) absorption takes place
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