Term
| How many Oxygen molecules can hemoglobin hold? |
|
Definition
|
|
Term
| What takes over if we lose our spleen? |
|
Definition
|
|
Term
| Stops blood loss by promotion coagulation. Emergency mechanism. |
|
Definition
|
|
Term
| First substance released by ECM in response to a tissue insult |
|
Definition
|
|
Term
| What does vWf attract and what do they do? |
|
Definition
| Platelets. They promote adhesion between platelets. Form bridges between platelets and ECM. |
|
|
Term
| When platelets adhere to one another what happens? |
|
Definition
| They become activated, causing reactivation of actin fibers and a change in their shape. The activated platelets now release AdP and increase the synthesis of thromboxane A2, both of which attract more platelets to the area and further plug the breach. |
|
|
Term
| When platelets adhere to one another what happens? |
|
Definition
| They become activated, causing reactivation of actin fibers and a change in their shape. The activated platelets now release AdP and increase the synthesis of thromboxane A2, both of which attract more platelets to the area and further plug the breach. |
|
|
Term
| The process of stabilizing the clot that begins with the coagulation cascade. |
|
Definition
|
|
Term
| Coagulation cascade ends with? |
|
Definition
| Formation of a fibrin clot. |
|
|
Term
| First part of coagulation cascade? |
|
Definition
| Factor 7 binds to tissue factor. |
|
|
Term
| what happens in first step of coagulation cascade? |
|
Definition
| Activated factor 7 and tissue complex formed binds itself to the platelet surface, |
|
|
Term
| What happens after activated factor 7 binds to platelet surfaces? |
|
Definition
| It activates factor 10 so that there's a rapid increase in the level of factor 10a in the blood. |
|
|
Term
| Once activated, what does factor 10a do? |
|
Definition
| It cleaves prothrombin to form thrombin. |
|
|
Term
| Once cleaved, what does thrombin do? |
|
Definition
| It cleaves fibrinogen to form strands of fibrin. |
|
|
Term
| Where do the intrinsic and extrinsic systems join? |
|
Definition
| At the level of factor 10. They are complimentary. |
|
|
Term
| Which is slower? Intrensic or extrinsic system? |
|
Definition
|
|
Term
| What triggers the intrinsic system? |
|
Definition
| Exposure to a negatively charged surface, such as collagen or glass. |
|
|
Term
| What does polymerized fibrin do? |
|
Definition
| Forms a network which anchors blood cells and platelets in the clot. |
|
|
Term
| A differential WBC count: |
|
Definition
| When the 5 classes of WBCs are counted. |
|
|
Term
| Neutrophils typically compose: |
|
Definition
| 50-70% of the WBCs in circulation. |
|
|
Term
| Neutrophil numbers may be elevated in: |
|
Definition
| Bacterial infection, burns, stress, or inflammation. |
|
|
Term
| Neutrophil numbers decrease after: |
|
Definition
| radiation and Vit b12 deficiencies. |
|
|
Term
| Lymphocytes are the second most common WBC what percentage do they compose of total WBCs? |
|
Definition
|
|
Term
| What can elevate lymphocytes? |
|
Definition
| Viral infection, immune disorders and some leukemias. |
|
|
Term
| Third most common WBC. What percentage of WBC do they compose? |
|
Definition
|
|
Term
| What can increase monocytes? |
|
Definition
| Viral or fungal infections, tuberculosis, Mono, and some leukemias. |
|
|
Term
|
Definition
| eosinophils and basophils |
|
|
Term
| Eosinophils compose what percentage of WBCs? |
|
Definition
| Eosinophils 1-2%, basophils less than 1% |
|
|
Term
| Eosinophils increase during: |
|
Definition
| Allergies, pyrocitic infections, autoimmune diseases |
|
|
Term
| Eosinophils decrease during: |
|
Definition
| stress and cushing syndrome. |
|
|
Term
| Basophils increase during: |
|
Definition
| Allergies, Hypersensitivity reactions, cancers and hypothyroidism |
|
|
Term
|
Definition
| Pregnancy, ovulation, stress, and hyperthyroidism |
|
|
Term
| Where does blood cell production occur? |
|
Definition
| Adult bone marrow or in the liver or spleen of the fetus. |
|
|
Term
| What percent of granulocytes are stored vs functional? |
|
Definition
|
|
Term
| What percent of thrombocytes are stored vs functional in a healthy person? |
|
Definition
|
|
Term
| What percent of erythrocytes are stored vs functional in a healthy person? |
|
Definition
|
|
Term
| What is secreted by the kidneys in response to tissue hypoxia? |
|
Definition
|
|
Term
| What does high retic count indicate? |
|
Definition
| Overwhelming need to produce more RBCs in the body. |
|
|
Term
| Is neutrophil count higher at birth? |
|
Definition
|
|
Term
|
Definition
| Are replaced more slowly. |
|
|
Term
| Too many erythrocytes is: |
|
Definition
|
|
Term
| Too few erythrocytes or hemoglobin |
|
Definition
Anemia- impaired erythrocyte production
Acute or chronic blood loss
increased erythrocyte destruction
Abnormal blood cells (sickle cell) |
|
|
Term
| When red blood cells are present in various sizes |
|
Definition
|
|
Term
| When RBCs are present in various shapes |
|
Definition
|
|
Term
| A person has inadequate intake of folic acid. What will happen to this persons RBCs? |
|
Definition
|
|
Term
| RBCs are unusually large and hemoglobin is normal. R/t vitamin deficiency in b12 or folate. |
|
Definition
| Macrocytic-normocromic anemia |
|
|
Term
| History of h-pylori bacteria and long term proton pump inhibitors causing lack of intrinsic factor which doesn't allow b12 absorption. May have gastrectomy or GERD. |
|
Definition
|
|
Term
| Lack of intrinsic factor: |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Pernicious anemia treatment: |
|
Definition
|
|
Term
| Folate replacement in folate deficiency is given for how long? |
|
Definition
| Until levels return to normal. Lifelong treatment is not necessary. |
|
|
Term
| Removal of a portion of the stomach may cause: |
|
Definition
| Lack of intrinsic factor/pernicious anemia |
|
|
Term
| Highest incidence of anemia worldwide is: |
|
Definition
|
|
Term
| A person presents with a brittle, thin, coarse nails that are odd shaped. They have a beefy red tongue that is sore, and dryness and soreness in the corners of the mouth (angular stomatitis). What might be the cause? |
|
Definition
|
|
Term
| What is the hemoglobin level where people usually become symptomatic? |
|
Definition
|
|
Term
| Highest risk populations for iron deficiency anemia |
|
Definition
| Older adults, women, infants, and people from 3rd world countries. |
|
|
Term
| Major causes of iron deficiency anemia: |
|
Definition
-GI BLEEDING, sometimes d/t aspirin or nsaids.
-excessive blood loss
-Chronic parasite infections
-disorders of iron and heme metabolism
-Heavy periods
-Eating disorders such as pica
-surgical procedures that decrease stomach acid
- |
|
|
Term
| Microcytic-hypochromic treatment and eval |
|
Definition
Eval: serum ferritin
Treatment: Iron supplement |
|
|
Term
| Hypocellular bone marrow that has been replaced with fat is: |
|
Definition
| Aplastic anemia. More than just red blood cells can be effected |
|
|
Term
| Treatment for aplastic anemia: |
|
Definition
Bone marrow transplant
Peripheral blood stem cell transplant
-Possible radiation or chemo
Immunosuppression |
|
|
Term
| What medications are used for immunosuppression in aplastic anemia? |
|
Definition
Antithymocyte globulin with cyclosporin
corticosteroidal medications |
|
|
Term
| A person is admitted with an autoimmune disease directed against the hematopoietic stem cells. The nurse knows this will produce: |
|
Definition
|
|
Term
| What type of anemia is hemolytic anemia? |
|
Definition
|
|
Term
| 90% of drug induced anemias are produced by: |
|
Definition
| Penicillins and cephalosporins. Steroids can also contribute. |
|
|
Term
| When prescribing cephalosporins and penicillins, it is important to: |
|
Definition
| Have a start and end date that will not cause an anemia. |
|
|
Term
| Drug induced hemolytic anemia is usually the result of: |
|
Definition
| An allergic reaction against foreign antigens. |
|
|
Term
| Anemia of chronic disease from chronic disease causes: |
|
Definition
| Mild to moderate anemia from decreased erythropoesis or reduced response to erythropoeitin. |
|
|
Term
| Anemia of chronic disease is what category of anemia? |
|
Definition
|
|
Term
| How does the liver respond to tissue hypoxia? |
|
Definition
| Fatty cells replace cells that are dying. |
|
|
Term
| How does the cardiovascular system compensate for anemia and what can be the results? |
|
Definition
| Increase stroke volume-Increased HR, Angina (increased oxygen demand), Cardiac murmurs, high output cardiac failure |
|
|
Term
| How do the kidneys respond to tissue hypoxia? |
|
Definition
| Produce renin aldosteron, increase salt and o2 retention, increased extracellular fluid |
|
|
Term
| Anemia of chronic diseases happens because of: |
|
Definition
| Decreased erythrocyte life span, decreased production of erythropoietin, decreased bone marrow response to EPO, and altered iron metabolism |
|
|
Term
| An acquired mutation in JAK2 |
|
Definition
|
|
Term
| Polycythemia vera is what category of anemia? |
|
Definition
| Myeloproliferative red blood cell disorders |
|
|
Term
| Chronic neoplastic, nonmalignant anemia caused by a gene mutation: |
|
Definition
|
|
Term
| Increased blood viscosity is a concern in which anemia? |
|
Definition
|
|
Term
| Overproduction of RBCs, with increased levels of WBCs (leukocytosis) and platelets (thrombocytosis) may lead you to suspect what type of anemia? |
|
Definition
|
|
Term
| Where are most of the red blood cells sequestered in polycythemia and what does this cause? |
|
Definition
| The spleen; spleenomegaly-painful itching, increased blood viscosity, abdominal pain |
|
|
Term
| Why is increase in blood viscosity a concern? |
|
Definition
| Because thrombosis, especially in the periphery can happen very frequently (polycythemia vera) |
|
|
Term
| What are some of the treatments for polycythemia vera? |
|
Definition
| Phlebotomy, Low dose aspirin, hydroxyurea, interferon-a |
|
|
Term
| A person has an infection with early inflammation. Which granulocyte is the primary immunogenic WBC? |
|
Definition
| Lymphocytes (they are in the agranulocyte class) |
|
|
Term
|
Definition
|
|
Term
| Chief phagocytes of early inflammation? |
|
Definition
|
|
Term
| Lymphocytes are about ____ percent of the total leukocyte count. |
|
Definition
|
|
Term
| Neutrophils, basophils and epsinphils are: |
|
Definition
|
|
Term
| First white cells at an area of inflammation of infection? |
|
Definition
|
|
Term
| Precursors of macrophages: |
|
Definition
|
|
Term
| What type of immunity are natural killer cells involved in? |
|
Definition
|
|
Term
| What type of immunity are B and T cells involved in? |
|
Definition
|
|
Term
| Where do leukocytes mature? |
|
Definition
|
|
Term
| NK cells and B and T cells are: |
|
Definition
|
|
Term
| Where do granulocytes mature? |
|
Definition
|
|
Term
| What percent are neutrophils? |
|
Definition
|
|
Term
| What percent are lymphocytes? |
|
Definition
|
|
Term
| What percent are monocytes? |
|
Definition
|
|
Term
| What percent are eosinophils? |
|
Definition
|
|
Term
| What percent are basophils? |
|
Definition
|
|
Term
| Deficiency in the quality or quantity of leukocytes |
|
Definition
|
|
Term
|
Definition
|
|
Term
| numbers of leukocytes are increased |
|
Definition
|
|
Term
| Increase in white cells may be: |
|
Definition
| a normal response to infection, which is why differential is important. |
|
|
Term
| An individual has leukocytosis. What would the NP expect to find while taking the history? (multiple choice from slides) |
|
Definition
| Stressful work environment |
|
|
Term
| Term used when someone's bone marrow is not making enough basophils, eosinophils and neutrophils |
|
Definition
|
|
Term
| When bone marrow fails to make enough neutrophils it is called: |
|
Definition
|
|
Term
| Which is more concerning? Agranulocytosis or neutropenia? |
|
Definition
|
|
Term
| What is another name for agranulocytosis? |
|
Definition
|
|
Term
| What are some causes of agranulocytosis? |
|
Definition
-Interference with hematopoiesis
-Immune mechanisms
-chemotherapy destruction
-ionizing radiation |
|
|
Term
| What is the particular body system infection of concern mentioned in the slides in relation to agranulocytosis? |
|
Definition
|
|
Term
| Sepsis caused by agranulocytosis often results in: |
|
Definition
|
|
Term
|
Definition
-prolonged severe infection
-decreased production
-decreased neutrophil survival
-abnormal neutrophil distribution and sequestration |
|
|
Term
| What can contribute to decreased survival of neutrophils? |
|
Definition
| Immune or autoimmune destruction |
|
|
Term
| Where does sequestration of neutrophils occur? |
|
Definition
|
|
Term
| Hypoplastic anemia, aplastic anemia, leukemias, and lymphomas are examples of what category of neutropenia? |
|
Definition
|
|
Term
| Neutropenia from drugs such as chemo is known as: |
|
Definition
|
|
Term
| What stage of infection can neutrophilia be evident? |
|
Definition
|
|
Term
| Immature neutrophils are known as what on a cbc differential? |
|
Definition
|
|
Term
| Premature release of immature leukocytes is termed: |
|
Definition
| A "Shift to the left" or leukemoid reaction. |
|
|
Term
|
Definition
Surgery
acute or chronic inflammation
shock
trauma
burns
mental distress |
|
|
Term
| When might an increase on basophils occur? |
|
Definition
| Inflammation or hypersensitivity reactions |
|
|
Term
| When might basophils decrease? |
|
Definition
| Acute infection, hyperthyroidism, and long-term steroid therapy. |
|
|
Term
| Usually occurs with neutropenia in later stages of bacterial infections: |
|
Definition
| Monocytosis: numbers of circulating monocytes increase. |
|
|
Term
| In hairy cell leukemia, what happens to monocytes? |
|
Definition
| They decrease. Can also be caused by steroids. |
|
|
Term
| What happens to lymphocytes during acute viral infections like EBV? |
|
Definition
|
|
Term
| Leukemia comes from what main 2 cells of origin? |
|
Definition
|
|
Term
| Presence of undifferentiated or immature cells, usually blast cells, indicates: |
|
Definition
|
|
Term
| When the predominant cell is mature but does not function normally, what type of leukemia is indicated? |
|
Definition
|
|
Term
| Is CLL most common in adults or children? |
|
Definition
|
|
Term
| What is the most common adult form of leukemia? |
|
Definition
|
|
Term
| What leukemia is found mostly in adults? |
|
Definition
|
|
Term
| Which leukemia arises from a hematopietic stem cell and has no cure? |
|
Definition
|
|
Term
| Prenatal x-ray exposure, postnatal radiation, viral infections with HTLV-1 and ____ ____ increase a child's chances of _____. |
|
Definition
|
|
Term
| An ADULT with down syndrome has increased risk of: |
|
Definition
|
|
Term
| Abnormal proliferation of myeloid precursor cells, decreased rate of apoptosis, and arrest in cellular differentiation are descriptors of: |
|
Definition
|
|
Term
| Exposure to radiation, benzene, chemotherapy and hereditary conditions are risk factors of: |
|
Definition
|
|
Term
| What are the clinical manifestations of AML? |
|
Definition
| Anemia, fatigue, bleeding from thrombocytopenia, fever from infection, anorexia, wasting away of muscles and difficulty swallowing with possibleT CNS involvement |
|
|
Term
| The nurse practitioner recalls that acute lyphocytic leukemia is defined as: |
|
Definition
| Greater than 30% lymphoblasts in the bone marrow or blood. |
|
|
Term
| What virus is hodgkins linked to? |
|
Definition
|
|
Term
| What type of lymphoma is localized to a single axial group of nodes? |
|
Definition
|
|
Term
| What type of lymphoma is present in multiple peripheral nodes? |
|
Definition
|
|
Term
| Which type of hodgkin's spreads in an orderly way? |
|
Definition
|
|
Term
| Which type of hodgkin's might you suspect in someone with fever, night sweats and weight loss? |
|
Definition
|
|
Term
| Which type of lymphoma is characterized by the presence of reed stern berg cells? |
|
Definition
|
|
Term
| Which lymphoma is rarely localized? |
|
Definition
|
|
Term
| Which lymphoma has a better survival rate? |
|
Definition
|
|
Term
| Which lymphoma treatment uses radiation and chemotherapy along with monoclonal antibodies like Rituximab? |
|
Definition
|
|
Term
| What do platelets come from? |
|
Definition
|
|
Term
| What helps with maturity and production and maintenance of platelets? |
|
Definition
| Thrombopoeitin and interleukin 11 |
|
|
Term
| How long do circulating platelets maintain their function? |
|
Definition
|
|
Term
| What percent of new platelets circulate? |
|
Definition
|
|
Term
| What percent of new platelets are stored in the spleen? |
|
Definition
|
|
Term
| What is the level of platelets at which the condition is known as thrombocytopenia? |
|
Definition
| less than 100,000 cubic millimeters |
|
|
Term
| What level of platelets might cause severe, fatal bleeding? |
|
Definition
| less than 10,000 cubic mm. |
|
|
Term
| What platelet level might cause hemorrhage from minor trauma? |
|
Definition
|
|
Term
| What platelet level might cause spontaneous bleeding? |
|
Definition
| Less than 15,000 cubic mm. |
|
|
Term
| How does endothelium control hemostasis? |
|
Definition
| By preventing platelet activation. |
|
|
Term
| When injury activates inflammation, what enzymes are produced? |
|
Definition
| Prostacyclins (cox-1, arachidonic acid) |
|
|
Term
| Arachidonic acid is converted into: |
|
Definition
| PGI2-Prostacyclin I^2 in endothelial cells. |
|
|
Term
| In Hemostasis: What does PGI^2 eventually increase? |
|
Definition
| Intracellular cyclic adenosine monophospate cAMP. |
|
|
Term
| In Hemostasis: What does cAMP do? |
|
Definition
| Inhibits platelet aggregation and induces vasodilation. |
|
|
Term
| In Hemostasis: After cAMP is produced, what happens with NO syntheses? |
|
Definition
| They cause increased cyclic guanosine monophosphate cGMP which is used by NOs to control platelet aggregation. |
|
|
Term
| What happens with activation of the nitric oxide system? |
|
Definition
| Endothelial cell NOS produces nitric oxide, which controls platelet activation through cGMP-mediated signaling. |
|
|
Term
| What happens with ADPase activation? |
|
Definition
| Endothelial cells express a surface bound ADPase (CD39) that converts circulating ADP and ATP to AMP. |
|
|
Term
| What happens with activation of the antithrombin III-heparin sulfate system? |
|
Definition
| Antithrombin III (AT-III) inhibits thrombin slowly when heparin sulfate (HS) is absent. When HS is present, it quickly activates thrombin because it binds to a specific site on AT-III that causes an instant conformational change in AT-III, allowing it to quickly activate thrombin. |
|
|
Term
| Hemostasis: Tissue factor inhibitor (TFI) system activation causes what: |
|
Definition
| Expression of TFI on the endothelial cells and secreted into the circulation complexes with factor IXa to form a competitive inhibitor of TFI on the endothelial cells and secreted into the circulation complexes which is secreted into the circulation complexes with factor IXa to form a competitive inhibitor of the tissue factor/factor VIIa complex (TF/VIIa) and prevent further activation of factor X to Xa. |
|
|
Term
| Hemostasis: Protein C/Protein S pathway: |
|
Definition
| Thrombin in the circulation binds to thrombomodulin on the endothelial cell, creating a complex that can bind and activate protein C to activated protein C (APC) that complexes in the blood or on the surface of active platelets with protein S. |
|
|
Term
| What does function do ACP complexes serve? |
|
Definition
| The complex degrades circulating clotting factors Va and VIIIa to inactive forms to prevent further activation of clotting. |
|
|
Term
| After endothelial denudation, what happens to platelets and leukocytes? |
|
Definition
| They adhere to the sub-endothelium in a monolayer fashion. |
|
|
Term
| How is platelet binding mostly mediated? |
|
Definition
| By the binding of platelet surface receptor gycoprotein-Ib (GPIb [In a complex with clotting factors IX and V]). |
|
|
Term
| When does subendothelial exposure occur? |
|
Definition
| After sub endothelial sloughing. |
|
|
Term
| What happens first after sub endothelial sloughing? |
|
Definition
| Platelets begin to fill endothelial gaps. |
|
|
Term
| The release of ______ induces platelet aggregation during phase IV. |
|
Definition
|
|
Term
|
Definition
| RBCs and platelets enmeshed in fibrin |
|
|
Term
| What is clot dissolution regulated by? |
|
Definition
| thrombin and plasminogen activators |
|
|
Term
| Factor that is Source of fibrin to form the clot? |
|
Definition
|
|
Term
| Factor that is the source of thrombin that activates fibrinogen V, VII, VIII, XI, XIIIm protein C |
|
Definition
|
|
Term
| Cofactor for factor VIIa. |
|
Definition
| Tissue Factor- Previously called factor III |
|
|
Term
| Cofactor for clotting factor binding to phosphatidylserine |
|
Definition
| Calcium. Previously called factor IV. |
|
|
Term
| After _____ weeks gestation, circulating erythrocytes play a major role in delivering oxygen to the tissues. |
|
Definition
|
|
Term
| erythropoiesis in the liver and spleen and lymph nodes reaches a peak at about ______ months. |
|
Definition
|
|
Term
| By the _____ month of gestation, hematopoiesis begins to occur in the bone marrow, and by the time of delivery, it is the only significant site of hematopoeisis. |
|
Definition
|
|
Term
| Biochemically distinct type of hemoglobin synthesized during fetal life include: |
|
Definition
| Gower 1, gower 2, and portland. |
|
|
Term
| Blood count levels tend to ____ _____ adult levels at birth and then _____ ______ throughout childhood. |
|
Definition
| rise above, decline gradually |
|
|
Term
| Fetal life, trauma at birth, and cutting of the umbilical cord are all contributors to: |
|
Definition
| The immediate rise in blood cell counts which is the result of hematopoeisis that they induce. |
|
|
Term
| The active rate of fetal erythropoiesis is observed in: |
|
Definition
| The large numbers of reticulocytes in the peripheral blood of the full-term neonate. |
|
|
Term
| The lymphocyte count at birth is: |
|
Definition
| High and continues to rise in some healthy infants during the first year of life. |
|
|
Term
| Platelet counts in neonates are comparable to: |
|
Definition
| Platelet counts in children and adults (if full term) |
|
|
Term
| The most common blood disorder of infancy and childhood: |
|
Definition
|
|
Term
| When does the highest occurrence of IDA occur? |
|
Definition
| between 6 months and 2 years of age. |
|
|
Term
| Results from incompatibility between the maternal and fetal blood. |
|
Definition
| Hemolytic disease of the newborn. |
|
|
Term
| HDN may involve differences in: |
|
Definition
| Rh factors or blood type (ABO). |
|
|
Term
| Immature liver is unable to excrete excess bilirubin in _____ and ______ _______ or _______ can develop or both. |
|
Definition
| HDN, icterus neonatorum, kernicterus |
|
|
Term
| Results in breakdown of red blood cells or decreased liver output of enzymes. |
|
Definition
|
|
Term
| A heterogenous group of hereditary hypo chromic anemias of varying severity |
|
Definition
|
|
Term
| Basic genetic defects in thalassemias include: |
|
Definition
| Abnormalities of messenger RNA processing or deletion of genetic materials resulting in a decrease in the chains for hemoglobin. |
|
|
Term
| An anemia of chronic disease results from _______ ________, and may cause ________ ______. |
|
Definition
| Decreased erythropoiesis, renal failure. |
|
|
