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Pathophys Exam 3

Parts of whole blood -formed elements (WBCs, RBCs, platelets) -plasma proteins - solutes (electrolytes, gases, nutrients, waste products)
The plasma contains a large number of _______________ proteins
Plasma proteins albumin, globulins
Most plasma proteins are produced by the ___________ liver
Serum Plasma that has been allowed to clot to remove fibrinogen and other clotting factors
Albumin makes up about ___% of total plasma protein 60
Albumin roles Regulation of the passage of water and solutes through the capillaries.
3 types of globulins alpha, beta, and gamma
______________ is the most plentiful of the clotting factors fibrinogen
normal amount of WBCs 5000-1000 /mm^3
Leukocytes are divided into ___________ and ______________ granulocytes, agranulocytes
Types of granulocytes Basophils, neutrophils, eoisinophils
Types of agranulocytes Monocytes/macrophages, lymphocytes, natural killer cells
Platelets are also known as ______________ thrombocytes
thrombopoietin a hormone growth factor that regulates the circulating platelet mass
Most common leukocyte neutrophils
Neutrophil characteristics -Phagocytes -first cell on the job of inflammation/injury -Fight bacterial infections
Eosinophil characteristics -Phagocytes -Attack parasites
Basophil characteristics -contain histamine and anticoagulant
____________ are the primary cells of the immune response Leukocytes
Primary lymphoid organs Thymus, bone marrow
Secondary lymph organs Spleen, lymph nodes, tonsils, Peyer Patches of small intestine
Spleen functions -filters and cleanses the blood -contains masses of lymphoid tissue (white pulp) full of WBCs -Removes old or damaged cells from the blood -stores platelets
Lymph nodes functions -Filter lymph fluid -foreign objects trapped and destroyed
medullary hematopoiesis Inside the bone marrow
extramedullary hematopoiesis outside the bone (in the liver, spleen, other tissues)
Define hematopoiesis The production of ALL formed elements
Hematopoiesis process Cells formed in red bone marrow from pluripotent stem cells, mature in the bone marrow or lymphoid tissue
Messengers that talk cell-to-cell are: cytokines
Specific colony stimulating factors (CSFs) are necessary for: growth of myeloid, erythroid, lymphoid, and megakaryocytic cells
G-CSF Colony Stimulating Factor: originates from macrophage or fibroblast. Stimulates granulocytes to control hematopoiesis
GM-CSF Colony Stimulating Factor: originates from T cell. Stimulates neutrophils and macrophages to control hematopoiesis
Erythropoietin Colony Stimulating Factor: originates from kidney cells and Kupffer cells. Stimulates erythrocytes to control hematopoiesis and to produce RBCs
Platelets originate from: megakaryocytes
Platelets functions Aid in clotting
Platelets are also known as: thrombocytes
Thrombyctopenia too few platelets - bleeding out possibility
thrombocytosis too many platelets - clotting where we don't want it possibility
3 steps in hemostasis 1. Vascular spasm 2. Platelet plug formation 3. Activation of coagulation cascade
extrinsic pathway in clotting cascade activated by something outside the vessel
intrinsic pathway in clotting cascade activated by contact with injured vessel
stages of coagulation -Extrinsic and intrinsic pathways -common pathway begins with formation of prothrombinase -prothrombin to thrombin -thrombin forms fibrin from fibrinogen
When plasmin is formed, it digests ____________ clots
What can you learn from a bone marrow biopsy? -anemias, leukemias, platelet disorders, immunoglobulin disorders
What does Prothrombin Time test measure Measure the extrinsic pathway
What does Activated Partial Thromboplastin Time test measure Measures intrinsic pathway
Bleeding Time test measures platelet function, not number
Symptoms of anemia Fatigue, weakness, dyspnea, pallor
Microcytic Hypochromic anemia -Pale, small cells -Usually Fe++ deficiency
Macrocytic Normochromic anemia -Large cells -Usually folic acid or B12 deficiency
Normocytic normochromic anemia Usually caused by hemorrhage or hemolysis
4 types of normocytic normochromic anemia 1. Hemolytic (RBCs destroyed) 2. Hemorrhagic (blood loss) 3. Anemia of Chronic disease 4. Aplastic (chemotherapy, drugs)
2 types of macrocytic normochromic anemia 1. pernicious anemia (B12 deficiency) 2. folic acid deficiency
2 types microcytic hypochromic anemia 1. iron deficiency 2. sideroblastic (dysfunctional iron uptake)
relative polycythemia increase in RBCs because of loss of plasma
absolute polycythemia increase in RBCs regardless of plasma
2 types of absolute polycythemias 1. Polycythemia Vera 2. Secondary Polycythemia
Polycythemia vera primary polycythemia. Hypersensitive bone marrow. High viscosity, can start clotting
Secondary polycythemia normal physiologic response to hypoxia (high altitude, smoking, sleep apnea)
Treatment of polycythemia 1. Blood draws 2. Treat cause of hypoxia
Neutrophilia too many neutrophils. normal response most of the time
"shift to the left" immature neutrophils are released if the body needs more than the supply
neutropenia not enough neutrophils. indication of severe disease
causes of neutropenia Prolonged severe infection (depletes neutrophils), decreased production (starvation, aplastic bone marrow, chemotherapy), reduced survival (autoimmune diseases, lupus and rheumatoid arthritis)
eosinophilia Increase in eosinophils.
Reasons for eosinophilia Allergic disorders (asthma, hay fever, drug reactions), Parasites
Monocytosis too many monocytes. Usually occurs with neutropenia in later stages of infections
Lymphocytosis increase in lymphocytes
reasons for lymphocytosis Acute viral infections, malignancies
lymphocytopenia decrease in lymphocytes
reasons for lymphocytopenia immune deficiencies, drug destruction, viral destruction (AIDS)
Infectious mononucleosis is caused by the ________________ virus Epstein-Barr
Infectious mononucleosis infection of the B lymphocytes
ALL - symptoms, age, lab findings Symptoms: fatigue, easy bruising, pallor. Age: 5. Lab findings: lymphoblasts
CLL - symptoms, age, lab findings Symptoms: fatigue, easy bruising, pallor. Age: 65. Lab findings: lymphoblasts
AML - symptoms, age, lab findings Symptoms: fatigue, easy bruising, pallor. Age: 40. Lab findings: myeloblasts
CML - symptoms, age, lab findings Symptoms: fatigue, easy bruising, pallor. Age: 40-50. Lab findings: Philadelphia chromosome
Multiple myeloma - symptoms, lab findings Symptoms: fatigue, easy bruising, pallor, bone lesions in spine, ilium, ribs. Lab findings: plasma cells invading bone marrow, abnormal amounts of M protein. Light chains of immunoglobulins (Bence Jones proteins) damage kidneys
Hogdkin lymphoma - symptoms, lab findings Symptoms: fatigue, easy bruising, pallor, progressive lymph node swelling. Lab findings: Reed Sternberg cells
General signs and symptoms of leukemia Splenomegaly (large spleen), infections, night sweats, fatigue, weight loss, anemia, bleeding
Types of lymphomas 1. Hodgkin's disease 2. Non-Hodgkin's lymphoma
Would you rather be diagnosed with Hodgkin's or Non-Hodgkin's lymphoma? Hodgkin's - more localized, more treatable
thrombocythemia too many platelets
thrombocytopenia not enough platelets
Possible causes of thrombocytopenia Hypersplenism, aplastic bone marrow, autoimmune disease, hypothermia, viral or bacterial infections that lead to DIC
DIC Fibrinolytic and clotting systems are activated at the same time - we get clots where we don't want to
2 main causes of Hemolytic Disease of the Newborn (HDN) 1. ABO incompatibility 2. Rh factor incompatibility
inheritance pattern of sickle cell anemia autosomal recessive
inheritance pattern of the thalassemias autosomal recessive
beta-thalassemia -defect in beta chain formation. too much alpha chain. -Alpha chains unstable, precipitate inside cells -Bone marrow macrophages attack and destroy the cells. -Results in anemia
Thalassemia minor heterozygous. Enlarged spleen, slightly smaller RBCs
Thalassemia major Homozygous. Sever anemia. Regular transfusions required
Hemophilia A X linked recessive deficiency of factor VIII
Hemophilia B X-linked recessive deficiency of factor IX
Clinical manifestations Hemophilia Excessive bleeding
Clinical manifestations of the thalassemias -anemia -chipmunk-like face -mild splenomegaly -hyperplasia of bone marrow -growth and maturation retarded
Created by: taylormoyes
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