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78 Cards in this Set
- Front
- Back
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Three anatomic structures of the hematologic system
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Bone marrow
Liver Spleen |
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Function of bone marrow
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Production of blood and immune cells
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Function of the liver
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Removes nonfunctioning erythrocytes from the blood stream
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What are the cellular components of the hematologic system
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Red blood cells
Platelets Coagulation factors Stem cells |
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What 2 types of cells are produced by stem cells
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Lymphoid cells
Myeloid cells |
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What cells are produced by lymphoid cells
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Immune cells- T cells and B cells
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What stem cells are produced by myeloid cells
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Erythrocytes and thrombocytes
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How is erythrocyte production stimulated in the kidney
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During hypoxemia by releasing Erythropoietin hormone
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How do RBCs get oxygenated
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Hgb attached to erythrocytes transports O2 for aerobic metabolism (ATP production) and removal of co2
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Function of erythropoietin
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Acts on stem cells to produce erythrocytes
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Function of cytokines
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Causes additional platelets to be activated
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Hemostasis
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Clotting or coagulation
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2 main functions of the hematologic system
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Coagulation and fibrinolysis
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Anticoagulants
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Stops blood from clotting/prevents coagulation
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Atiplatelet
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Inhibits thrombus formation
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Thrombolytics
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Dissolve clots and reopens arteries and veins
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Anti fibrinogenolytics
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Prevents fibrinolysis
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Causes of thrombocytopenia (decreased platelets)
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Liver dx
Spleenomegally Hemorrhage Massive transfusion Eclampsia Immunosuppression Thyroid disease |
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What does APPT do
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Uses Intrinsic pathway and common coagulation
Normal range 60-70 seconds Measures bleeding times for heparin therapy |
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Lab values for erythrocytosis
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Increased RBCs
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Anemia
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RBCs decreased
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rBCindices include
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MCV- used to categorize by volume
MCHC- used to categorize by concentration RDW |
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What lab is increased in inflammation
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ESR
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What does bleeding time show
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Patient's ability to clot
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What labs measure if a patient is able to form a clot
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Fibrinogen
factor 1 |
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What is produced when crossed link fibrin is broken up
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D dimer
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What can influence the decision to give red cells
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If anemia is symptomatic
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What disorder can precipitate anemia in the critically ill
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Liver disease
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What are characteristics of hemophilia
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Lack factor eight or nine
only males have the disease coag studies are prolonged only during bleeding |
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What does Spleenomegaly r/t liver dx do to platelets
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Trap platelets
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Spontaneous bleeding occurs when a platelet count is what
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< 20,000 mm3
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Platelet transfusions are given when platelet count is what
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<50,000
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What is significant in heparin induced thrombocytopenia
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platelets are less than or equal to 50% of baseline. Platelets are not given in HIT unless bleeding is severe
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What difference in treatment is there in DIC and thrombocytopenia
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Plasmapheresis
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What labs are significant in DIC
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Decreased platelet count and, fibrin, increased bleeding/clotting times
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In what disorder is indirect bilirubin increased
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Hemolysis or liver disease
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What causes an increase in conjugated direct bilirubin
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Gallstones (blocked)
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Normal wbc count
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4.8-10.8
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What is the normal RBC count
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4.2 to 4.5
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What pathway is PT/INR
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Extrinsic pathway
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Warfarin lab
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PT
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Heparin lab
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PTT
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Treatment for anemia
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02
packed red blood cells erythropoietin vitamins |
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The liver is not responsible for synthesizing
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Fibrinolytic factors
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Fibrin forms a stable clot through activation of
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Thrombin
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Clinical presentation of the patient with DIC includes
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Epistaxis, hematoma, and petichiae
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What are the sickle cell patterns
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Acute chest syndrome
Bone crisis Abdominal crisis Joint crisis |
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What most frequent illnesses can lead to DIC
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Sepsis
Burns and liver dx Cancer Hemorrhagic fever Snake bites |
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What is TRALI
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Transfusion related acute lung injury. It is the third leading cause of death among transfusion related deaths caused by the presence of antibodies already present in those who've had previous transfusions.
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What are signs and symptoms of transfusion related acute lung injury or TRALI
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Dyspnea, hypotension and fever
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MCV normal value
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78 to 102
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MCV normal value
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78 to 102
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MCH normal value
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25 to 35
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MCV normal value
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78 to 102
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MCH normal value
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25 to 35
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MCHC value
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31 to 37%
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MCV normal value
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78 to 102
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MCH normal value
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25 to 35
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MCHC value
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31 to 37%
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ESR or sed rate normal value
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0 to 25
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MCV normal value
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78 to 102
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MCH normal value
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25 to 35
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MCHC value
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31 to 37%
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ESR or sed rate normal value
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0 to 25
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Hematocrit normal values
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36 to 49%
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Hemoglobin
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12 to 18
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Hemoglobin
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12 to 18
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WBC
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45,000 to 11,000
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Platelet count
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150,000 to 400,000 mm3
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prothrombin time
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11 to 15 seconds
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INR
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0.7 to 1.8
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APTT
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60 to 70 seconds
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ACT
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70 to 120 seconds
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Fibrinogen norms
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200 to 400
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Thrombin time
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14 to 16 seconds
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Thrombin time
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14 to 16 seconds
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Fibrin split (degradation)
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2 to 10 µg/ml
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D dimer value
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Less than 2.5 µg/ml
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