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hematology
| Question | Answer |
|---|---|
| 95% of volume in formed elements is | red blood cells |
| 5% of volume in formed elements is | WBC's |
| formed elements chief functions | 1.delivery of substances needed for cell metablosim,2.defence.3.acid base balance |
| all types of blood cells are formed where | in the bone marrow |
| red bone marrow | found in membranous bone such as vetebra,pelvis, sternum and ribs |
| Yellow marrow | produces some WBC's but composed mainly of connective tissue and fat |
| Lymph nodes | produce pymphocytes and antibodies |
| Spleen | stores bld and produces lymphocytes, plasma cells and antibodies |
| liver | blood forming organ during intrauterine life, important in coagulation |
| Plasma | clear portion of bld, 92% water, contains proteins such as albumin, globlin, and fibrinogen |
| Albumin | most plentiful protein,keeps h2o concentrationlow so water diffuses well |
| globulins | (alpha,beta,gamma)transports proteins and provides immunity |
| Fibrinogen | responsible for bld clotting |
| RBC's | most abundant cells in the body, responcible for tissue oxygenation,composed mainly of water and red protein hemoglobin-each RBC contains 270 million hemoglobin molecules, norm 4.2-6.2 million cells |
| RBC's life span | 120 days |
| hemogobin | each molecule carries 4 oxygen molecules, normal amount is 15g/100 ml |
| WBC normal count | 5000-10,000 |
| hematocrit | the fraction of the total volume of blood that consists of red blood cells, normally about 45% |
| norm male hematocrit | 40-54% |
| female hematocrit norm | 38-47% |
| hemoglobin | normal for men 13.5-18g/100ml,females 12-16g/100ml |
| Reticulocyte count | shows rate of RBC production-<0.5%=deceleration in process, >1.5 % =acceleration of RBC formation |
| Monocytes make up | 5% of total WBC |
| Lymphocytes make up | 27.5% of WBC |
| Neutrophils make up | 65% of WBC |
| Eosinophils and basophils together make up | 2.5% |
| Differential count (diff) | identifies the different types of leukocytes (WBC'S) present in the blood-identified by shape,appearance of nucleus,color of cytoplasm n presence n color of granules |
| Platelets (thrombocytes) | plug the leak and allow other cells to stick to them and form clot |
| Hemostasis | the initial phsyilogical response to wounding that causes bleeding to cease |
| Physiology of Hemostasis | vasoconstriction, formation of platelet plug, coagulation, and the growth of fibrous tissue |
| vasoconstriction of vessel is sustained for | 10 minutes |
| Clotting time is normally | 7-10 minutes |
| Prothrombin time (PT) | measures the clotting time of plasma (the extrinsic clotting cascade)-used to monitor pts taking certain drugs and evaluates the presence of factors V,X,VII,prothrombin and fibrinogen- |
| Partial prothromboplastin time (PTT) | screens for hemophilia and othe clotting dx, measures the integrity of the extrinsic clotting cascad, which is effected by blood thinners |
| Coagulation progresses within | 3-6 minutes after injury to vessel |
| clot retracts and is sealed within | 30minutes |
| Blood clotting mechanism | 1.prothrombin activator is formed in response to injury,2.it stumulates conversion of prothrombin to thrombin,3. thrombin in the presence of Ca++ converts fibrinogen to fibrin threads |
| ASA affects | decreases platelet activity |
| Warfarin | supresses the abilty of the liver to make certain clotting factors |
| Anemia | condition in which the hemoglobin or erythrocytes in the blood is below normal-not a disease but a symptom of one |
| Anemia Causes | chronic or acute blood loss, decreaased production of erythrocytes, n increased destruction of erythrocytes |
| Disorders of RBC's | Anemia polycythemia sickle cell disease |
| Disorders of WBC's | Hodgkins disease Non-hodgkins disease Leukimia Leukopenia multiple myolomas |
| Disorders of Hemostsais | Disseminated intravascular coagulation (DIC) thrombocytopenia |
| Iron deficiency anemia | the lack of iron prevents the bone marrow from making enough hemoglobin for RBC's, iron gives hemoglobin the ability to bind to oxygen-most common cause is bld loss from menstration or intestinal bldg |
| Lack of folic acid | is the most common form o vitamin deficiency anemia |
| Hemolytic anemia | premature destruction of RBC's in the bld (hemolysis)is the cause.can be a result of inherited disorder,acquired later in life |
| Inherited disorders | can occur as a result of abnormal rigidity of the cell membrane,becomes trapped usually in the spleen |
| Acquired disorders | 1.mechanical forces (abn bld vessel linings or clots,2.autoimmune disorders,3.disease (malaria) |
| Anemia S/S | fatigue,HA,sore mouth or tongue,brittle nails,breathlessness CP |
| Leukemia | an abnormal proliferation of WBC's occuring in the bone marrow,the excess crowds and impairs normal production,common in white ppl,cause unknown,acute or chronic |
| Acute leukemia | begin proliferating at an early stageof their development(immature cells) |
| Chronic Leukemia | an abnormal proliferation of more mature but not fully differenciated cells |
| Lymphocytic or lymphoblastic | indicates that the cancerous change takes place in a type of marrow cell that forms lymphocytes |
| Myelogenous or myeloid | indicates that the cell change takes place in a type of marrow cell that normally matures to form red cells, some white cells and platelets |
| Acute lymphocytic leukemia & acute myelogenous leukemia | composed of blast cells, progress rapidly without tx. |
| Chronic leukemias | have few or no blast cells,progress slowly |
| Leukemia S/S | abd fullness,bleeding,bone pain.elevated body temp,enlargement of lymph nodes and liver ,spleen and testes,fatigue,bruising, HA,weight loss |
| Blood transfusion complications | Allergy reaction,disease,fever,circulatory overload,iron overload,lung injury,hemolytic reactiongraft versus host disease |
| Lymphoma | any neoplastic disorder of the lymphoid tissue,all are malignant and can metastisize-result from acquired genetic injury to the DNA of a single cell |
| Hodgkins disease | painless progressive enlargement of lymphoid tissue found maily in he lymph nodes and slpeen, unknown cause, more common in males, peak incidence at 20-29 & 55-70yrs,confirmed by presence of REED STERNBERG cells-one of the most curable cancers |
| Hodgkins S/S | swollen lymph nodes in neck,axillae or groin,fatigue,chills and night sweats,severe itching, cough,weightloss,SOB,CP |
| Non Hodgkins lymphomas | vary in malignancy and activity of abn cells,ranked by low,intermediate n high based on agressiveness of the dx. |
| Burkitt's lymphoma | childhood cancer, in africa its associated w/eptein barr,TX radiation,bone marrow transplant |
| Stem cell | a cell whos daughter cells may develop into other cell types, reside in marrow and circulate in bld. |
| Autologous transplants | transplant uses patients own marrow |
| Allogenic transplant | uses marrow from donor |
| Polycythemia | increase in the Total RBC mass of the blood, |
| Secondary polycythemia | natural responce tp chronic hypoxia-may be naturally present in ppl who live in high altitudes, due to reduced air pressure |
| Primary polycythemia(polycythemia vera) | unknown reasons-rare,causes blood to thicken,occurs in pts >50 yrs ,S/S blurred vision,dizzy,itching,HA,HTN,splenomegaly,red hands n feet |
| Apparent polycythemia | from dehydration |
| Erythropoietin | this hormone stimulates RBC production in the bone marrow |
| Disseminated intravascular coagulopathy | a comlication of severe injury,trauma, or disease,common abn clotting disorder.Disrupts the balance among procoagulants,inhibitors,thrombus formation and lysis-S/S=SOB, bleeding,hypotension, hypoperfusion |
| DIC-First phase | characterised by free thrombin in the bld, fibrin deposits, and aggregation of platelets |
| DIC-Second phase | hemmorrage caused by the depletion of clotting factors=myulti system organ failure from bleeding and coagulation disorders caused by:loss of platels,fibrinolysis,fibrin degradation |
| dic-tx | REPLACEMENT OF PLATELETS, COAGULATION FACTORS AND BLOOD |
| Hemophilia | uncoontrolled bleeding and involves the loss of bleeding control mechanisms |
| Hemophilia A | deficiency in factor VIII esscential in the process of blood clotting |
| Hemophilia B (christmas disease) | less common, |
| Hemophilia S/S | bleeding into joints, deep muscles, the urinary tract and intracranial sites are most common-CNS bleeding is the major cause of deaths for pts with heophilia |
| Thrombocytopenia | low platelet count, normal levels 150,000-450,000. levels at 20,000-30,000 causes bldg with minor trauma,levels <20,000 causes spontaneous bldg. S/Spetechiae, purpura,prolonged bldg,heavy menses flow |
| Idiopathic Thrombocytopenic purpura (ITP) | when antibodies attack and destroy the bodys platelets for unknown reasons |
| Thrombotic thrombocyopenic purpura (TTP) | a life threatning dx that occurs when small bld clots form suddenly throughout the body, resulting in cardiac hemmorrage and death-associated w/pregnancy,cancer,chrmo,hiv/aids,and Rx drugs TX:CORTICOSTEROIDS (prednisone) |
| Sickle cell disease | inherited bld disorder that affects RBC's. most common type is sickle cell anemia-S/S delayed growth in children,jaundice,priaprism,splenomegaly,stroke-produces abnormal type of hemoglobin called hemoglobin S |
| sICKLE CELL CRISIS | a blockage of flow to various tissues and organs due to the cells being unable to pass through tiny vessels causing vasooclisiveness-S/S=weakness, CP,SOB,ABD pain,bony deformities, icteric(jaundice sclera,fever,arthralgia(joint pain) |
| Aplastic Crisis | bone marrow temporarily stop producing RBC's |
| Hemolytic crisis | the RBC;s break down too rapidly tp be replaced adequately |
| Splenic sequestration | usually in childhood, difficulty that occurs when bld becomes trapped in the spleen |
| Multiple Myeloma | a malignant neoplasm of the bone marrow,the tumor is composed of plasma cells, destroys bone tissue (especially in flat bones) |
| In myeloma the neoplastic cells produce | large amounts of protein (M protein) that affect the viscosity of the bld.coagulated protein accumalate in tissues and organs-kidney failure occurs due to build up, plasma proliferation is confined to the bone marrow |
Created by:
rebeccabelleth
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