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57 Cards in this Set

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What is blood made of?
45% cells
55% plasma
How much blood is in the body?
5-6 liters
pH norm:
7.35-7.45 (avg 7.4)
1/10th in changes
T/F - Blood is made up of organic and inorganic components.
True!
Which is more accurate - Hgb or HCT?
HCT
What are the cellular components of blood?
1. erythrocytes
2. leukocytes
3. platelets
erythrocytes:
=RBC
-transport O2 and CO2
-buffer blood pH
-Hgb carries O2
-live 80-120 days
Why do RBC's only live about 100 days?
no nucleus, cytoplasm or cell membrane
leukocytes:
=WBC
-phagocytosis of microorganisms
-5-10,000 normally
-live months to years
In adults, where are most RBCs formed?
iliac crest (most accessible) and sternum
hematopoiesis:
-development of all blood cells
-marrow converts from yellow (fatty) bone to red marrow when necessary
What is bone marrow conversion stimulated by?
erythropoietin
What is needed for the production of RBCs?
1. folic acid (forms RBCs)
2. Fe
3. B12 (division of RBCs)
Where is Fe absorbed in the body?
in the small intestines where it is either stored or used
Which is more soluble - O2 or CO2?
CO2 is 20 times more soluble than O2.
Aplastic anemia:
-worst type of anemia
-causes are chloramphenicol, benzene and radiation
-toxic, radiologic, or immunologic
-up to 75% morbidity
-best prognosis is from transplants
What are some examples of aplastic anemia?
leukopenia and thrombocytopenia
What are the treatments for aplastic anemia?
transfusions, bone marrow transplants and drugs to stimulate marrow
4 diseases caused from decreased RBC production:
1. aplastic anemia
2. anemia from CRF
3. vitamin B12 (folate) deficiency
4. iron deficiency anemia
anemia from CRF:
-decrease in erythropoietin production
Name 3 causes for anemia from CRF.
decrease in exccretion causing hemolysis, depression of bone marrow and blood loss in urine
vitamin B12 deficiency:
-aka Folate deficiency
-aka pernicious anemia
-lack of intrinsic factor and B12 is not absorbed
-an autoimmune disease
-can cause possible peripheral nerve degeneration or in spinal cord
-can cause achlorhydria
achlorhydria:
lack of sufficient gastric juice in the stomach
iron deficiency anemia:
-most common nutritional deficiency in the world
-very little lost except from bleeding
-can cause hypochromic and microcytic effects
-majority of pts are asymptomatic
What is the treatment for iron deficiency anemia?
Fe
What is the treatment for folate deficiency?
B12
Name the anemias related to inherited disorders.
1. thalassemia
2. sickle cell anemia
3. spherocytosis
thalassemia:
-anemia where RBCs produced are abnormal and prone to destruction
-in Asians and Mediterranean descent (familial in nature)
-skeletal deformities and organomegaly endocrine disorders
-Tx: blood tranfusions, drugs, splenectomy
splenectomy:
-surgery to remove all or part of the spleen
-this increases RBCs bc the destroying capacity has been destroyed
sickle cell anemia:
-prominent in the black race
-aka HbS where RBC decrease stability and solubility
-homozygous (HbS only) or heterozygous (HbA>HbS)
What are the signs and symptoms of sickle cell anemia?
1. vascular occlusion
2. thrombosis and emboli
3. acute episodes of "crisis" (hemolytic or vascular)
spherocytosis:
-abnormal membranes
-anemia manifestations
-splenectomy usually curative
What are the 2 general causes of anemias?
1. decreased production of RBCs
2. increased destruction of RBCs
Types of transfusion therapy:
1. whole blood
2. packed RBCs
3. fresh, frozen plasma (for low proteins)
4. pheresis
pheresis:
-transfusion of components of blood; for example, platelets, RBCs
polycythemia:
overproduction of RBCs
cause is unknown
increases blood viscosity causing occlusive vascular lesions, bleeding and florid expression
-muelosuppressive therapy (radioisotope)
-prognosis: 7-15 yrs with tx
Types of polycythemia:
1. polycythemia
2. secondary polycythemia
3. relative polycythemia
secondary polycythemia:
-increased RBCs secondary to tissue hypoxia
-inappropriate erythropoietin, androgens or steroid
-tx: treat underlying process
relative polycythemia:
anemia due to dehydration or stress related issues
Which transfusion therapy is no longer common?
whole blood transfusion
What is considered acute blood loss?
-20% loss (symptoms occur with exercise)
-40% loss (causes shock)
-blood replacement necessary
What is a common treatment for polycythemia?
phlebotomy (removing blood to reduce blood volume)
Describe the hemoglobin synthesis:
1. Fe is absorbed in the duodenum (jejunum)
2. RBC are formed
3. RBCs are stored as ferritin or synthesized heme
hemolytic disease of newborn:
-fetal RBCs cross the placenta and maternal antibodies destroy the fetal RBCs
-causes maternal ABO compatability or Rh factor
-causes anemia, reticulocytosis, jaundice
-CV neural changes and organomegaly
hematopoesis:
-development of all blood cells
-marrow converts from yeelow (fatty) bone to red when necessary
-marrow conversion is stimulated by erythropoetin
Describe RBC production process:
1. decrease in Hgb (means a decrease in O2 renal tension)
2. erythropoetin is stimulated by kidneys
3. eryth stimulates RBC production
Describe RBC destruction process:
1. heme converts to bilirubin
2. attaches to plasma proteins for transport
3. removed from blood by liver
4. excreted in bile
5. moves to small intestines
6. converts to urobilinogen
7. urob is either absorbed or excreted in feces
RBC destruction:
-digested by macrophages
-80-90% occurs in spleen and liver
-Fe breaks down, is used, released and stored
-bilirubin degradation of heme
How much Hgb transports oxygen?
97%
Partial pressure of O2:
-measurement of O2 in the blood
-high in the lungs where O2 binds easily
-low in the tissues where O2 is released
-80-100 in the arteries and 35-40 in the veins
CO2 transport process:
1. gas is dissolved in the blood as HCO3 ion
2. combines with Hgb
reticulocytes:
immature red blood cells
Where are most plasma proteins found?
in the liver
Functions of plasma proteins:
1. regulates blood volume
2. regulates fluid balance
3. contributes to blood viscosity for maintaining BP
Types of plasma proteins:
1. albumin
2. globulin
3. fibrinogen
4. misc-CHO, fats, amino acids, glucose, cholesterol, electrolytes
What does globulin transport?
1. bilirubin, lipids and steroids
2. Fe and Cu
3. antibody molecules
Effects of sickle cell anemia:
-a type of severe anemia
-increase of bilirubin form excessive breakdown of RBCs
-causes hemoglobinuria