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