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159 Cards in this Set
- Front
- Back
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What is a liquid connective tissue
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blood
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What is blood composed of?
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plasma and cells
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How much blood volume per body weight?
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~70ml/Kg
~5 L for average person |
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what are the functions of blood?
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transport O2, CO2, metabolites, hormones, drugs
Acid-base balance Immunological and microbial defense temp control |
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What is a windo into the the body because it is easily accessible?
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blood
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The study of bloods chemical composition and cellular contents and morphology can give great dal of what?
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info regarding the pt's state of health
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What is the liquid componet of blood?
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plasma
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What % of blood is plasma
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55-60%
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What % of plasma is water
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90%
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What are some components of plasma
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ions, glucose, a.a., other metabolites, hormones
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What are the proteins in plasma
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albumin, coagulation proteins, lipoproteins, immunoglobins, others
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clotting factors, such as fibrinogen, prothrombin are what types of proteins
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coagulation proteins
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What protein is mostly coagulation cascade?
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serine proteases
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A series of proteins that react when the endothelium of a blood vessel is disrupted?
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coagulation cascade
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What converts fibrinogen to fibrin?
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thrombin
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Coagulation cascade results in the converstion of what to what
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prothrombin to thrombin
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What forms a clot which stops bleeding from the injured vessel?
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fibrin polymerizes and platelets
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What are substances which initiate the clotting cascade?
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thromboplastins
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The fluid that remains after a clot is formed?
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serum
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What is essentially plasma minus fibrinogen and the other coagulation proteins?
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serum
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What formed elements?
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cells
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Where are blood cells produced in adult
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bone marrow
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primary function of erythrocytes?
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carrying O2 and CO2
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Describe erythrocytes organelles?
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anucleate, no organelles, energy generated by glycolysis
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What is the purpose of hemoglobin in erythrocytes?
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iron-containing heme ring plus globin chain, carries O2
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What is the lifespan of erythrocytes?
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120 days ~1% turnover/day
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Where is erythrocytes destroyed and what happens to iron?
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destroyed in spleen
iron recycled to bone marrow |
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Senescent red cells phagocytized
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erythrocytes
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Waht is the normal shape and diameter of erythrocytes?
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biconcave disc
diameter 7-8um |
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The status of erythrocytes can be quantified in what 3 different ways?
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hemoglobin
hematocrit erythrocyte count |
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Which status of erythrocyte is in grams/deciliter [international units; grams/L] this is often used clinically
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hemoglobin
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Which status of erythrocytes is RBCs as % of blood volume; also often used clinically, packed cell volume
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Hematocirt
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What status of erythrocytes is in millions per microliter [nternaitonal units: 10^12/L] not usually used clinically
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erythrocytes count (RBC)
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what are the approx value of hemoglobin (g/dL)for man and woman
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man- ~14-18
woman- ~12-16 |
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What are the hematocrit (%) values for man and woman
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man- 42-52
woman 37-47 |
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What is the approx values of RBC Count (10^6/uL) for adult
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man- 4.7-6.1
woman- 4.2-5.4 |
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What is the erythrocyte size measured in femtoliter )fL; LfL=10^-15 L)
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mean corpuscular volume (MCV)
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What is the normal mean corpuscular volume
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~80-100 fL
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What is normal cell size
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normocytic
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What is normal central pale area (~1/3rd diameter of RBC)
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normochromic
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What is small RBC (diameter < 6.5 um; MCV< 80fL)
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microcytic
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What is large RBC (diameter > 8.5um; MCV > 100fL
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macrocytic
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Waht is increased variation in RBC size
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anisocytosis
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What is an abnormally shaped RBC
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poikilocyte
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Target cells, spherocyte (no cental pallor), sickle cell, teardrop, schistocyte (fragmented RBC)
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poikilocyte
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What is an immature RBC still containing RNA
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reticulocyte
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How long do RBC normally contain RNA
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1 day after release from bone marrow
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waht is normal reticulocyte count of RBC?
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1% of RBCs
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Reticulocytes appear _____ (bluish; polychromatiophilic) on usual blood smear stin due to containted ____, however definitive ID of reticulocytes requires _______
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basophilic
RNA special stain |
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What happens to reticulocytes in hemolytic anemia?
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increased
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What happens to reticulocytes in anema
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decreased due to decrease RBC produciton
iron deficiency |
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What is the general term for decreased blood O2 carrying capacity
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anemia
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What are 3 causes of anemia
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decrease production of RBC
blood loss (hemorrhage) increased destruction of RBC (hemolysis) |
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What anemia is due to decreased body iron storesl unable to incorporate iron into hemoglobin
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iron deficiency anemia
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What anemia is an anemia with macrocytic (large) RBCs, usually due to defiency of Vit B12 or folic acid
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megaloblastic anemia
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What 2 things are required for DNA systhesis?
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Vit B12 and folic acid
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what 2 defiencies cause megloblastic anemia
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Vit B12 (cobalamin) and folic acit
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what anemia is caused by decrease Vit B absorption
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Pernicious anemia
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What is needed to absorb Bit B12
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intrinsic factor
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Where is intrinsic facot secreted?
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stomach
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What anemia is due to permature destion of RBC
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hemolytic anemia
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What may be due to abnormal hemoglobin [sickle cell anemia] antibodies to red cell, deficiency of metabolic enzyme in RBC
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hemolytic anemia
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What is an example of abnormal hemoglobin
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sickle cell anemia
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What is an example of antibodies to red cell
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transfusion reaction or autoimmune hemolytic anemia
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What is an example of deficiency of metabolic enzyme in RBC
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glucose-6-phosphate dehydrogenase deficiency
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What is the normal range of leukocytes
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4,000-10,000/um
4-10 x 10^3/uL 4-10 x 10^9/L |
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leukocytes traven through what due to what
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bloodsteam due to injury
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Leukocytes attach to endothelium via ___ ___ molucules on WBC surface interacting with ___ on endothelium
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cell adhesion moclecules (CAMs)
CAMs |
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WBC exit blood vessels and enter into tissue by what process
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diapedesis
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What is a listing of types of WBC and propotions of each type present in the blood of an individual pt
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leukocyte differential
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What are the 2 main types of leukocytes
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granulocytes and agranular cells
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What contain spedific granules, which have potent antimicrobial activity; types of granules differ for each type
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granulocytes
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can granulocytes contain lysosomes?
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yes
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Granulocyes are large and numerous and contian what 2 types of cells?
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neurophils, eosinophins, basophils
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What may contain lysosomes (azurophilic or nonspecific granules); however granules usuallu inconspicuous and few in #
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agranular
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What are 2 examples of agranular
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monocytes
lymphocytes |
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What are 2 synonyms to neutrophils
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segmented neurophils (segs)
polymorphonuclear leukocytes (PMNs or polys) band neutrophils (bands) |
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What neutrophils have a nucleus divided into multiple distinct lobes, connected by a thin strand of chromatin
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segmented neutrophils
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What are normally the most common type of WBCs
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segmented neutrophils
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What neutrophils have horseshoe-shaped (unsegmented nucleus)
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band neutrophils
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are smgmeted or band neutrophils more mature
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segmented neutrophils are more mature
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when does the number of band neutrophils increase
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with acute infection or acute inflammation
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The granules of neutrophils do or do not stain intensely esoinophilic or basophilic; thus they are neutophilic
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do not
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what is the most common type of WBC
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neutrophils
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when does neutrophilis increase
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acute infection, particularly bacterial, or acute inflammaiton
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What has the funciton of phagocytosis, mainly bacteria;
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neutrophil
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neutorphils destroy bacteria by what
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bacteriocidal ganes in neutorphil granules (in part by generation of toxic O2 radicals)
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what are the primary defense against bacterial infection
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neutrophils
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What is the lifespan of neutrophils
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circulate in blood for ~10hours, may live 1-4 days in extravascularspace
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at any given time how many of the blood neutrophils are attached to blood vessel endothelium as a mobilizable reserve?
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half
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what is the sum of neutrophils + bands in the peripheral blood
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absolute neutrophil count ANC
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absolute neutrophil count is given in _______ numbers by many hematology analyzers
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absolute
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what is the absolute neutorphil count formula
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WBC (x 10^3/uL) x [(%polys + bands) x 0.01]
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what is usually an adequare amoung of absolute neutrophil to protect against infection
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1,000/uL (1.0 x 10^3/uL)
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Infection risk usually increases when absolute neutrophil count drops below what?
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<500/uL (0.5 x 10^3/uL)
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A decreased Absolute neutrophil count is termed what?
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granulocytopenia
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the primary risk of granulocytopenia is what
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bacterial infection, but some fungal inf
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what are some of the fungal inf that increase with granulocytopenia?
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candida, aspergillus
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which granulocytes contain large, prominent, intensely red-orange granules
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eosinophils (eos0
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What % of eosinophils make up WBC
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2-4
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when do eosinophils increase
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allergic reactions and parasitic infections
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what is the lifespan of eosinophils
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~8hrs
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What is the function of esinophils
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phagocytosis of antigen-antibody complexes, kill parasites
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Which granulocytes contain large, dark, purpilish (basophilic) granules
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basophils
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What % of WBC are basophils
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<1% rare
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Which granulocytes contain heparin (anticoagulant), histamine (fast vasodilator), slow reacting substance of anaphylaxis (slow vasodilator) and other compounds
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basophils
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what granulocyte has the function involved in immediate hypersensitivity reactions related to IgE (asthma, hay fever)
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basophils
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What contain only nonspecific granules (lysosomes)
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agranulocytes
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what % of WBC are monocytes
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3-8%
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what agranulocyte enter tissues to become macrophages, also called histiocytes
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monocytes
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What agranulocyte is a tissue phagocytic cell
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monocytes
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What agranulocyte functions as important antigen processing and presenting cells
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monocytes
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What agranulocyte is large, with abundant light gray to light blue, finely granular cytoplasm
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monocytes
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describe the nucleus of monocyte
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very fine, delicate chromatin, often folded, bean shaped or irregular nucleus
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What is the life span of monocyte?
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~8-14 hrs, may live in tissue for yrs
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What % of WBC are lymphocytes?
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~20-40
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when are lymphocytes higher than normal?
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children and someone with viral infection
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Describe the shape and size of lymphocytes
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small 7-10 um dark round or oval nucleus, with scan amount of pale blue cytoplasm (high nuclearcytoplasmic ratio)
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the nucleus of a small lymphocyte can be compared to the normal size of what?
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RBC
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Which lymphocyte is involved in humoral immune system
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B-cells
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Where are b-cells developed?
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bone marrow
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What do B-cells function in?
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lymph nodes, spleen and other organs
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After stimulaiton what do B-cells differentiate into/
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plasma cells which synthesize and secrete antibodies
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Which lymphocytes has major effectors of cell-mediated immunity
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t cells
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T cells stimulate or inhibit the function of other cells of the immune system, including what?
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monocytes/macrophages, b-cells, and other t-cells
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Describe the development process of t-cell
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born in bone marrow, mature in thymus
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Do b-cells or t-cells make the majority of lymphocytes?
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t-cells 80-90%
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Which t-cell is a major regulator/controller of the immune response.
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T-helper
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T-helper usually express cell surface marked designated what?
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CD4
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Which t-cell is cytotic cells?
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T-suppressor/cytotic
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T-suppressor/cytotic cells usually express cell surface marker designated what?
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CD8
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Which lymphocyte is larger wiht more abundant cytoplasm and larger nucleus, increase in some viral infections
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reactive (atypical) lymphs
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For a leukocyte differential what is done first?
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count 100 or 200 cells seen
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in a leukocyte differential of a normal adult what is the % and absolute # for segmented neutrophils?
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50-70% 1,500-8,000
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in a leukocyte differential of a normal adult what is the % and absolute # for band neutrophils
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2-6% < 1,300
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in a leukocyte differential of a normal adult what is the % and absolute # for eosinophils
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2-4% <700
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in a leukocyte differential of a normal adult what is the % and absolute # for basophils
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<1% <100
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in a leukocyte differential of a normal adult what is the % and absolute # for lymphocytes
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20-40% 600-5,000
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in a leukocyte differential of a normal adult what is the % and absolute # for monocytes
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2-9% 100-800
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Is leukocyte differential more useful in terms of percent of total WBC or absolute #
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absolute #
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What functions to adhere to injured blood vessel wall, form initial plug and participate in function of coagulation cascade
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platelets (thrombocytes)
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What are platelets derived from in the bone marrow?
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megakaryocytes
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What is the normal # of platelets?
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~200,000-400,000/uL (200-400 x 10^3/ uL; 200-400 x 10^9/L
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What is the morphology of platelets?
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anucleated, cytoplasm pale blue, with reddish-purple granules
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What is the average diameter of platelets?
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1-4um
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What are a few of the clotting factors contained in platelet granules?
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ADP, ATP, calcium, sertonin, catecholamines
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The release of platelet granules stimulate what
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aggregration and contration of other platelets and facilitates clotting cascade
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what is the lifespan of platelets in blooc?
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~10 days
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What happens to senescent platelets?
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removed in spleen
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What is the platelet count vs. risk of bleeding?
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>100,000 no risk bleed, should be adequate for surgery
50,000-100,000 no spontaneous bleeding, may have bleeding with surgery or trama <10,000 may be at risk of spontaneous bleeding |
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What is the most common cause of anemia in US
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iron deficiency
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What are 2 main reasons iron deficiency
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inadequate iron absorption- diet
blood loss- GI track |
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populaitons at risk iron deficiency
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infants
young children menstruating women pregnancy and gestation drain iron stores |
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iron deficiency in adult male or postmenopausal women who are on normal dies should be presumed to be what
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chronic bleeding loss from GI tract
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anemia of iron deficiency is characteristically what 2 things
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1. microcytic (small RBC)
2. hypochromic (widened central pallor) cells unable to produce hemoglobin |
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Other causes of anemia
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1. chronic illness and inflammation
2. deficiency of cobalamin (B12) or folic acid 3. inherited mutations in genes for hemoglobin chains resulting in a.a substitutions (hemoglobinopathies) such as sickle cell 4. inherited defects in synthesis of mRNA for hemoglobin chains (thalassemias 5. increased destruciton of RBX (hemolytic anemia) 6. Primary bone marrow disease, such as acute leukemia or aplastic anemia |
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Anemia due to inherited muctions in genes for hemoglobin chains resulting in a.a. substitutions is what?
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hemoglobinopathies
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Anemia due to inherited defects in synthesis of mRNA for hemoglobin chains is what?
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thalassemias
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anemia due to destruction of RBC in circulaiton id called what>
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hemolytic anemia
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