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Pathophysiology- focus 8- Hematologic System
Flashcards for studying focus 8 Hematologic System
60
Physiology
Undergraduate 2
07/07/2009

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Term
Plasma
Definition
Aqueous Component with subsets H20, Proteins and Solutes
Term
Water
Definition
91%
Term
Proteins
Definition
7% with subsets: Albumin, Globulins, Fibrinogens
Term
Albumin
Definition
58% and is used for osmotic pressure
Term
Globulins
Definition
38% and is used for immunoglobulins
Term
Fibrinogen
Definition
4% and is used for clotting
Term
Solutes
Definition
2% and have electrolytes, nutrients, gases, hormones and wastes
Term
Formed elements
Definition
erythrocytes, leukocytes, thrombocytes
Term
Erythrocytes
Definition
RBCs and O2 and CO2 transport
Term
Leukocytes
Definition
WBCs and deal with infection control. subset: neutrophils 60-70%, lymphocytes 20-25%, Monocytes 3-8%, Eosinophils 2-4%, and basophils 0.5-1%
Term
Thrombocytes
Definition
used as platelets or for clotting
Term
CBC with diff.
Definition
complete blood count with differential count
Term
RBCs
Definition
4.2-5.8million per mm3. Anemia and Polycythemia
Term
WBCs
Definition
5,000-9,000 per mm3 Leukopenia and Leukocytosis
Term
Platelets
Definition
250,000-400,000 per mm3 Thrombocytopenia and Thrombocythemia
Term
Differntial count
Definition
Neutropenia/Neutrophilia, Lymphocytopenia/Lymphocytosis, Monocytopenia/Monocytosis, Eosinopenia/Eosinophilia, Basopenia/Basophilia
Term
RBC's Lab Tests
Definition
hematocrit, hemoglobin and Reticulocyte count (reflects bone marrow activity)
Term
Hematocrit
Definition
Percent of whole blood composed of RBCs
Term
Hemoglobin
Definition
amount of Hgb in specific volume of blood
Term
Reticulocyte Count
Definition
Immature RBCs
Term
Bone Marrow Biopsy
Definition
Taken from sternum, vertebrae or iliac crest. Determines number of myeloid, erythroid, megakaryocytes
Term
Myeloid
Definition
bone marrow leukocytes
Term
Erythroid
Definition
bone marrow RBCs
Term
Megakaryocytes
Definition
Mega-platelet precursors
Term
Red Blood Cells
Definition
Production stimulated by erythropoietin, maturation depends on vitamin b12, folic acid, protein, iron, copper. Rapid hemolysis(will cause increased bilrubin levels, retic count, Hgb in blood and urine) causes jaundice(from rapid release of bilrubin into extracellular fluids).
Term
Anemia
Definition
Reduction in number of RBCs, Hgb, hematocrit, sudden reduction results in symptoms of hypovolemia and hypoxemia(restlessness,diaphoresis(cold clammy), tachcardia, SOB), slow reduction allows compensatory mechanism(increased CO and respirations, increased release of O2 from Hgb, fluid being pulled into vascular space, blood shunted to vital organs) to adapt.
Term
2 classifications of anemia are:
Definition
size of RBCs and amount of Hgb or etiology
Term
Normocytic
Definition
normal size
Term
Normochromic
Definition
normal amount of Hgb
Term
Normo normo
Definition
acute blood loss, hemolysis, renal disease
Term
macro normo
Definition
vitamin b12 or folic acid deficiency, interfere with DNA synthesis
Term
Micro hypo
Definition
chronic blood loss, iron deficiency
Term
Major causes of Anemia
Definition
bleeding(trauma, ulcers, colon polyps, malignancy, hemorrhoids, menstration) and hemolysis(from defective RBCs, isoimmune(incompatible blood), autoimmune(drugs,lymphoma, lupus, RA, Chronic lymphocytic leukemia), malaria, enlarged spleen), decreased/defective RBC production= leukemia, lymphoma, mulitple myeloma, renal disease, nutrient deficiency
Term
Aplastic Anemia
Definition
All types of blood cells reduced, normocytic, normochromic. Etiology: Autoimmune, antineoplastic agents, radiation, drugs/chemicals, viral diseases. Signs/symptoms: attributable to deficiences in platelets and WBCs. Treatment: supportive, bone marrow transplant, immunosuppressants. Pancytopenia, drugs=anticonvulsants, thyroid meds, Chemicals=insecticides, Viral=infectious mono, HIV, viral hepatitis
Term
Iron Deficiency Anemia
Definition
Microcytic, hypochromic, decreased hemoglobin synthesis, normal RBC count, decreased Hgb. Etiology: menstral losses, pregnancy demands, inadequate iron intake, persistent blood loss. Treatment: treat underlying cause, supplemental iron. Koilonychia, Cheilosis, Palmar pallor. Tongue pale, smooth, shiny, brittle fine hair
Term
Koilonchia
Definition
deals with iron deficiency anemia. spoon shaped nails.
Term
Cheilosis
Definition
deals with iron deficiency anemia. redness and cracking at cornors of mouth
Term
Palmar pallor
Definition
pale, clammy
Term
Megoblastic Anemia
Definition
Macrocytic, normochromic, disordered DNA synthesis often due to vitamin b12 and folic acid deficiencies, pernicious anemia(caused by lack of intrinsic factor in stomach, vitamin b12 isnt absorbed). Signs/symptoms: severe glossitis, diarrhea, loss of appetite, Treatment: correct dietary deficiencies
Term
Sickle Cell Anemia
Definition
Deoxygenation causes sickling of RBCs, sickling causes cells to clump in microvasculature, vascular occlusion, organ infarctions, pain crisis. Treatment: Prevenetive and supportive, antibiotics, snalgesics, hydration
Term
Polycythemia Vera
Definition
too many blood cells, increaed blood viscosity and blood volume, brick-red complexion, blood shot eyes, headache and dizziness, predisposed to thrombosis and hemorrhage, bone marrow may become non-productive or convert to acute myelogenous leukemia. Treatment: weekly phlebotomies, drugs to suppress bone marrow activity
Term
Neutrophils
Definition
deals with leukocytes. Have bacterial infections and phagocytosis
Term
Eosinophils
Definition
antigen-antibody reactions, asthmatic attacks, drug reactions, parasitic infections
Term
Basophils
Definition
carry heparin, histamine-activating factors, platelet-activating factors to inflamed tissues
Term
Monocytes
Definition
leave circulation and become tissue macrophages
Term
Lymphocytes
Definition
Tcells= antigen-antibody reactions, Bcells=immunoglobulins
Term
Natural killer cells
Definition
kill tumor cells and virus infected cells without prior exposure
Term
Leukemia
Definition
Signs/symptoms= elevated WBCs, lymphadenopathy, hepatisplenomegaly, thrombocytopenia(gum and nose bleeding, petechia, ecchymosis, GI bleeding, UTbleeding), enemia, infections. Malinancy of blood-forming tissues causing suppression and replacement of normal blood cells. Etiology: genetic predisposition, environmental factors. Acute- predominantly undifferentiated cells, Chronic-more mature cells
Term
Lymphoma
Definition
malignancy of lymphatic system. initial tumor formation in lymph nodes and spleen where abnormal lymphocytes replace normal structure. Etiologies= immunosuppression, environemntal exposure, viral. Categories: hodgkin's disease(has reed-sternberg cells), non-hodgkin's lymphoma
Term
Stages of Lymphoma
Definition
1-involves single lymph node or one organ. 2-involves more than two adjacent or two nonadjacent regions. 3-extends above and below diaphrgam, limited to lymph nodes or organ or spleen. 4- involves one or more extralymphatic organs(liver) of tissues.
Term
Stages of Lymphoma
Definition
1-involves single lymph node or one organ. 2-involves more than two adjacent or two nonadjacent regions. 3-extends above and below diaphrgam, limited to lymph nodes or organ or spleen. 4- involves one or more extralymphatic organs(liver) of tissues.
Term
Multiple Myeloma
Definition
Plasma cell(b lymphocyte) dyscrasia with proliferation of immature and mature plasma cells in bone marrow. Bone destruction and replacement of normal nlood cells in bone marrow. Etiology: Genetic susceptibility and radiation exposure. Signs/Symptoms: anemia, thrombocytopenia, Leukopenia, bone destruction(hypercalcemia, pathologic fractures, bone pain)
Term
Treatment of Hematoloci Malignancies
Definition
Chemotherapy and radiation
Term
Coagulation Disorders
Definition
At time of injury three major processes occur: Transient vasoconstriction, aggregation of platelets, activation of clotting factors.
Term
Clotting Factors
Definition
Labeled I through XIII. Synthesized in liver. Vitamin K essential for synthesis of some clotting factors. Most are plasma proteins that circulate in blood as inactive molecules. After clot formation=natually occuring anticoagulants neutralize the activity of clotting factors and inhibit clotting. Fibrinolytic system= fibrin is split by plasmin into firbin degradation products and dissolution of clot occurs
Term
Hemophilia
Definition
Hemophilia A=mutation in factor VIII. Hemophilia B=Mutation in factor IX. Classifications=severe-factor activity less than 1%, moderate-factor activity 1-5%, Mild-factor activity 5% or greater. Spontaneous bleeding occurs with factor activity less than 1%. With 5% or greater bleeding is generally related to trauma or surgery. Clinical Manifestations: bleeding into soft tissues, muscles, joints, particularly weight-bearing joints. Retroperitoneal bleeding, intracranial bleeding. Treatment: Minor bleeding=20-50% factor activity level for a few days. Surgery or intracranial bleeding=100% factor activity level for minimum of 2 weeks. Fresh frozen plasma contains clotting factors
Term
Acquired clotting factor deficiencies
Definition
decreased production of clotting factors: liver disease, vitamin K deficiency from malnutrition, malabsorption or GI sterilization from antibiotics. Increased consumption of clotting factors: disseminated intravascular coagulation.
Term
Disseminated Intravasular Coagulation (DIC)
Definition
not disease but consequence of underlying disease process. Alteration of any component of vascular system(vessel wall, plasma proteins, platelets) can result in consumptive disorder. Any condition in which tissue thromboplastin is released due to tissue injury causes initiation of clotting pathway.
Term
Clinical manifestation of DIC
Definition
diffuse clots occulde microvasular, mostly affects kidney, skin, brain, pituitary, lungs, adrenals, GI tract. After consumption of clotting factors, see bleeding from every orifice. Hypotension, oliguria or anuria, convulsions and coma, N&V, diarrhea, abdominal pain, back pain, dyspnea, cyanosis. Foot and arms are from snake bites, hang after spleenectomy
Term
Treatment of DIC
Definition
correct underlying cause, replacement of clotting factors, RBC and Platelet transfusions. Heparin=neutralizes thrombin activity and prevents consumption of clotting factors. Is controversial but is used when replacement of factors doesn't stop bleeding.
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