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91 Cards in this Set
- Front
- Back
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What is blood?
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connective tissue consisting of cells and cell fragments (formed elements) and liquid matrix (plasma)
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What percentage of blood is the formed elements?
Plasma? |
45% formed elements
55% plasma |
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What are the 7 functions of blood?
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1. transport gases, nutrients and waste
2. transport of processed molecules (Vit. D , lactic acid) 3. Transport of regulatory molecules (hormones / enzymes) 4. Regulation of pH and osmosis 5. Maintanence of body temp. 6. Protection against foriegn substances 7. Clotting formation |
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What's in plasma?
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91% H2O
9% ions, proteins, nutrients, gases, waste |
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What are the plasma proteins?
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Albumin--58%
Globulins--38% Fibrinogen--4% |
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What is albumin and what does it do?
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plasma protein
regulates H2O movement between tissues and blood --blood viscosity --osmotic pressure --buffer --transports fatty acids, free bilirubin & thyroid hormones |
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What are the 3 globulin plasma proteins?
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Alpha
Beta Gamma |
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What do Alpha globulins do?
(5) |
protect tissues from damage by inflammation
transport thyroid hormones convert Fe2+ ions to Fe3+ ions (Fe transport) transport lipids transport hemoglobin released from damaged RBC |
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What do Beta globulins do?
(4) |
Transport Fe
Transport lipids immunity (think complement) prevent blood loss (coagulation proteins) |
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What do gamma globulins do?
(1) |
immunity
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What does fibrinogen do?
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involved in blood clotting
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What is serum?
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plasma without the clotting factors
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How does the water content of the plasma maintain relatively constant?
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The water uptake from the intestines closely matches the urine output.
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What are the major organs that produce suspended or dissolved substances in the blood?
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kidney
liver spleen intestines endocrine gland lymph nodes |
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What are the formed elements in the blood?
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RBC
WBC Platelets |
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Describe RBC's and their main purpose.
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RBC's are 95% of formed elements
no nucleus contains hemoglobin Transports Oxygen and CO2 |
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Describe WBC's and their main purpose.
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Leukocyte cells have nucleus,
ameboid movement, diapedesis phagocytize promote and reduce inflammation antibodies and immunity |
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Describe platelets and their main function
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thrombocytes forms plugs and work in blood clotting
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What is a neutrophil and what does it do?
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granulocyte (WBC)
phagocytizes microorganisms and other substances (bacteria, antigen and antibodies secretes lysozomes |
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What is a basophil and what does it do?
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granulocyte (WBC)jj
releases histamine (promotes inflammation) releases heparin (prevents clot formation) |
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What is an eosinophil and what does it do?
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Granulocyte (WBC)
reduces inflammation destroys histamine and attacks worms |
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What is a lymphocyte and what does it do?
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Agranulocyte (WBC)
B cells produce anti-bodies contributes to allergic reactions and graft rejection tumor control and T cells regulate immune system |
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What is a monocyte and what does it do?
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Agranulocyte (WBC)
phagocytize in blood, macrophage in tissues eats bacteria, dead cells, cell fragments and other debris |
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In chronic infections, which type of WBC is high?
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monocytes
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What is hematopoiesis and where does it take place?
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RBC production
red bone marrow |
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Describe how O2 is carried?
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98% carried by RBC / hemoglobin
rest is in the plasma |
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Describe how CO2 is carried?
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7% in plasmaj
23% in hemoglobin 70% in form of bicarbonate ions |
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What 3 things does hemoglobin transport?
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O2
CO2 nitric oxide |
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How does hemoglobin utilize Fe?
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Each O2 molecule is associated with a Fe atom when it is attached to a heme
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How long does erythropoiesis take?
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4 days
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What are 3 essential nutrients needed to make healthy RBC's?
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Folate
B12 Fe |
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What stimulates the production of RBC's?
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low blood levels of O2
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When low levels of O2 are detected in the blood what happens?
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kidneys release erythropoietin which stimulates the red bone marrow
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How long do RBC's stay in circulation for females?
For males? |
115 days for females
120 days for males |
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What happens when a RBC degenerates and ruptures?
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macrophages take up hemoglobin and recycle the Fe
heme turns into free bilirubin and is sent to the liver to become conjugated with bile |
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What is jaundice?
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buildup of bile pigments in circulation and interstitial space
High number of RBC's are being destroyed and the liver cannot keep up with getting rid of it. |
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What is hemostasis?
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Stopping the bleeding
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What are the 2 main things that occur to stop bleeding?
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1. Vascular spasm
2. Platelet plug formation |
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Describe vascular spasm
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immediate (but temporary) constriction of a blood vessel from contraction of smooth muscle in wall of vessel
Activated by damage and release of chemicals: thromboxanes & endothelin |
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What is platelet plug formation and what are the 4 actions that take place?
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accumulation of platelets that seal up small breaks in blood vesselsj
1. platelet adhesion 2. platelet release reaction 3. Platelet aggregation 4. Activated platelets express platelet factor III and coagulation factor V |
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What is Platelet adhesion?
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Step 1 in platelet plug formation
platelets bind to collagen at site of damage (mediated by von Willebrand factor) |
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What is platelet release reaction?
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Step 2 in platelet plug formation
platelets exocytosis ADP, thromboxanes which activates other plateletes and create a cascade |
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What is platelet aggregation?
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Step 3 in platelet plug formation
bridges form by fibrinogenj |
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What do activated platelets express in platelet plug formation?
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platelet factor III and coagulation factor V
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What is a blood clot?
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a network of threadlike protein fibers (fibrin) that traps blood cells, platelets and fluid
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What are coagulation factors?
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proteins found in plasma that are normally inactive, that activate in response to injury forming a clot
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Describe the extrinsic pathway of activating clotting proteins.
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Tissue damage
Thromboplastin released from damaged tissue (III) Ca2+ combined with Thromboplastin forms a complex with factor VII which activates Factor X |
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Describe the intrinsic pathway of activating the clotting proteins.
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tissue damage
collagen comes into contact with factor XII and activates factor XI which activates factor IX which joins with factor VIII and Ca2+ to activate factor X |
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What occurs on the common pathway of activating clotting proteins?
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activated factor X
X, V, phospholipids and Ca2+ form prothrominase prothrombinase converts prothrombin to thrombin thrombin converts fibinogen to fibrin thrombin activates factor XIII which stabalizes the clot. |
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What mineral is vital to blood clotting and where does the body get it?
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Vitamin K
1/2 from diet 1/2 from bacteria in intestines |
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Name 3 anticoagulants
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1. antithrombin
2. heparin 3. prostacyclin |
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What is antithrombin?
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a plasma protein made by the liver
that slowly inactivates thrombin |
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What is heparin?
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produced by basophils and endothelial cells
It's like a catalyst for antithrombin and rapidly activates it |
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What is prostacyclin?
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prostaglandin derivative produced by endothelial cells.
It counteracts thrombin by causing vasodilation and inhibiting the release of coagulating factors from the platelets |
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Explain why blood clots don't form all throughout the body once the cascade is initiated.
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Only when coagulation factor concentrations exceed a given threshold in a local area does coagulation occur. At the site of injury, so many coagulation factors are activated that the anticoagulants are unable to prevent clot formation.
Away from the injury site, however, the activated coagulation factors are diluted in the blood, anticoagulants neutralize them and clotting is prevented. |
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Define thrombus
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platelets encounter damaged or diseased areas on the walls of blood vessels or the heart and an attached clot forms
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Define embolus
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a thrombus that breaks loose and begins to float thru circulation.
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What drugs are associated with thrombus and embolus?
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Heparin--fast acting anticoagulant
Coumadin or warfarin act more slowly |
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What is clot retraction?
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contraction of platelets which pull the edges of damaged tissues together.
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What is a transfusion?
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transfer of blood components
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What is an infusion?
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transfer of fluid other than blood (saline or glucose solutions)
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What happens in a rejection reaction?
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RBC's have antigens (agglutinogens) and plasma has antibodies (agglutinins).
These 2 are very specific and can only combine in certain ways |
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What is agglutination?
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BAD
clumping, results in hemolysis |
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Name the antigens and antibodies in Type A blood
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A antigens in RBC
anti-B antibodies in plasma |
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Name the antigens and antibodies in Type B blood
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B antigens in RBC
anti-A antibodies in plasma |
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Name the antigens and antibodies in Type O blood
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no antigens
anti-A and anti-B antibodies |
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Name the antigens and antibodies in Type AB blood
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both A and B antigens
neither anti-A or B antibodies |
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name the order (highest to lowest) of the percentages of different blood types
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Type O
Type A Type B Type AB |
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What does it mean if you are Rh-positive?
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You have a certain Rh antigen (the D antigen) on surface of RBC's.
86ish% in US are Rh positive |
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How are Rh antibodies developed in and Rh negative person?
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Exposure to Rh positive blood either in transfusion or in mother from fetus.
Once the Rh negative person is exposed they develop antibodies against the Rh |
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Explain why Rh incompatibility is a problem in pregnancy, specifically the second or subsequent pregnancies.
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If mother is Rh negative and fetus is Rh positive, mother is exposed to Rh and begins to make antibodies.
This causes agglutination and hemolysis of fetal RBC's |
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What is hemolytic disease of the newborn or erythroblastosis fetalis?
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disorder of Rh incompatibillty in which agglutination and hemolysis of fetal RBC's can be fatal to the fetus.
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What does a shot of RhoGAM do?
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Creates antibodies that bind to fetal Rh antigens and inactivates them. Prevents sensitization of mother.
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How is HDN treated in newborn?
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replace the newborn blood thru transfusion
expose newborn to fluorescent light to help breakdown the large amounts of bilirubin (from lots of RBC's being destroyed) |
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What is a type and crossmatch?
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testing for agglutination and to make sure it doesn't create a transfusion reaction
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What is the normal range for RBC's?
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4.6 - 6.2 million /microLiter of blood (males)
4.2 - 5.4 million / microL (females) |
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What is the normal range for WBC's?
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5000-10,000 per microL of blood
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What is the normal range for hemoglobin?
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14 -18 g / 100 mL of blood
(males) 12 - 16 g / 100mL of blood (females) |
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What is erythrocytosis?
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overabundance of RBC's
results in low blood viscosity, reduced flow rates and plugging of capillaries Relative dehydration (reduced plasma) burns diuretics Primary polycythemia vera stem cell defect (enlarged spleen) Secondary polycythemia decreased Oxygen supply altitude chronic obstructive pulmonary disease congestive heart failure creates hypertension |
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Describe anemia
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deficiency of hemoglobin in the blood
causes lower oxygen delivery and lack of energy and excessive tiredness |
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What is a hematocrit measurement?
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the percentage of total blood volume composed of RBC
centrifuge and assess the percentage that is RBC above the buffy coat 40 -54% (males) 38 -47% (females) |
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What about RBC's affect a hematocrit measurement?
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normocytes-- normal sized RBC
microcyte-- smaller than normal RBC macrocyte--larger than normal RBC |
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What are leukopenia and leukocytosis?
Which one is usually present with leukemia? |
lower than normal WBC count
higher than normal WBC count leukocytosis |
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What is a differential WBC count?
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% of each of the 5 different WBC's
neutrophils -- 60-70% lymphocytes -- 20-30% monocytes --2-8% eosinophils --1-4% basophils -- 0.5-1 % |
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If the pancreas is not producing enough insulin, what will be high in the blood?
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glucose levels
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If a patient has reduced kidney function what will you find in the blood?
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high blood urea nitrogen (BUN)
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What does high levels of bilirubin in the blood indicate?
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liver dysfunction or hemolysis
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What is a normal platelet count?
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250,000-400,000 per microliter of blood
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What is thrombocytopenia?
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platelet count greatly reduced resulting in chronic bleeding through small vessels and capillaries.
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What are risk factors for cardiovascular disease?
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age (men over 40 and postmenopausal women)
high blood cholesterol levels history of smoking diabetes family history previous clotting experience |
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Why does aspirin therapy help in those at risk for cardiovascular disease?
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Aspirin inhibits COX, the enzyme that makes thromboxane, thereby reducing platelet activation and keeping the vessels more free of platelet plug and clot formation
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