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159 Cards in this Set

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

cells unable to produce hemoglobin
Other causes of anemia
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
Anemia due to inherited muctions in genes for hemoglobin chains resulting in a.a. substitutions is what?
hemoglobinopathies
Anemia due to inherited defects in synthesis of mRNA for hemoglobin chains is what?
thalassemias
anemia due to destruction of RBC in circulaiton id called what>
hemolytic anemia