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Pathophys Exam 3
| Term | Definition |
|---|---|
| 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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