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  1. RBC value
  2. hematocrit level
  3. hemoglobin value
    12-18 g/dl
  4. typical symptoms of anemia
    • fatigue
    • weakeness
    • dyspnea
    • pallor
  5. macrocrytic
    abnormally large
  6. microcytic
    abnormally small
  7. normocytic
    cells of normal size
  8. hyperchromic
    contains unusually high concentration of hgb in cytoplasm
  9. hypochromic
    contains abnormally low concentration of hgb
  10. normochromic
    nml amounts of hgb
  11. Macrocytic-Normochromic anemias
    • pernicious anemia 
    • Folic acid
  12. Pernicious anemia
    • insufficent influence of vit b12 on developing cells
    • lack of intrinsic factor in stomach
    • may result from chronic gastritis
    • typical symptoms + peripheral neuropathy, tingling, numbness, loss of vibratory senses, glossitis
    • treated with vit b12 injections
  13. folic acid is necessary for
    red blood cell production and neural tube formation
  14. iron deficiency
    caused by excessive bleeding that depletes iron, poor diet, possible H. pylori infection
  15. dietary factors of iron def
    • low iron
    • haem iron
    • low vit c
    • excess phytate
    • excess tea/coffee
    • fad diets
  16. demographic factors in iron def
    • elderly 
    • teen
    • female
    • immigrant
    • aborigine
    • widower
  17. social/physical factors of iron def
    • poverty
    • poor detention
    • candle burning
    • depression
    • GIT disease
    • alcohol abuse
  18. sideroblastic anemia
    decreased heme synthesis; genetic

    aquired from lead, chlormphenicol (chloromycetin), antitubercular drugs

    causes typical symptoms, mild hepatomegaly, splenomegaly
  19. aplastic anemia
    • radiation, viruses
    • lesions in red bone marrow that depresses its action
    • Typical symptoms, petechia, purpura, ecchymosis, bleeding, infection; PANCYTOPENIA
  20. hemolytic anemia
    causes jaundice, splenomegaly
  21. Microcytic-hypochromic
    iron deficient anemia
  22. normocytic-normochromic
    • aplastic anemia
    • posthemorrhagic anemia
    • hemolytic anemia
    • anemia of chronic disease (ACD)
  23. pathophysiology of anemias
    compensation for reduced O2 carrying capacity of blood requires CV, Res, and hematologic systems to respond

    hypoxemia: reduced O2 in the blood causes arterial dilation

    Tissue hypoxia: end result of anemia. causes inadequte cellular o2, Rate and depth of breathing increases as compensation 

    Decreased blood flow sensed by kidneys, renal renin-angiotensisn response activated
  24. decreased 02 supply to GI tract causes
    • abdominal pain
    • N/V
    • anorexia
  25. polycythemia
    INCREASE in RBC production

    2 forms: Relative and Absolute

    Relative: r/t dehydration for any reason

    Absolute: primary results from abnormality of bone marrow stem cells. Called polycythemia vera

    Neoplastic, nonmalignant condition increases RBCs, WBCs, and platelets. Characterized by splenomegaly

    Affected individuals have acquired mutation in Janus kinase 2 (JAK2) that increases erythropoietin receptors in bone marrow regardless of the level of erythropoietin
  26. secondary polycythemia
    most common

    caused by increase in erythropoietin in response to chronic hypoxia (high altitude, smokers, COPD) or erythropoietin tumors

    Treatment objectives: - minimize risk of thrombosis - prevent progression to acute leukemia
  27. leukocytosis
    higher than normal > 10,000 - protective response to invading microorganisms, allergic responses, inflammatory response after surgery, anesthesia. May indicate malignancy/hematologic disorders
  28. leukopenia
    lower than normal < 5, 000 - never beneficial
  29. granulocytosis or neutrophilia
    prevalent in early stages of infection or inflammation when stored neutrophils from venous sinuses released into circulating blood
  30. neutropenia
    low neutrophil count < 2000 r/t decreased marrow production
  31. agranulocytosis
    < 500….very serious
  32. shift to the left
    When demand for neutrophils > circulatory supply. Marrow releases immature WBCs into blood…..blood smears look similar to leukemia
  33. eosinophilia
    • Absolute increase in total numbers of eosinophils in blood.
    • - Remember: Associated with allergic disorders associated with asthma, hay fever, parasitic invasions!
  34. eosinopenia
    decrease due to migration into inflammatory sites
  35. monocytosis
    increase in monocytes most common in late stages of bacterial infections
  36. monocytopenia
    hairy cell leukemia/prednisone therapy
  37. lymphocytosis
    most often with viral infections, especially with Epstein-Barr virus (infectious mononucleosis)
  38. lymphocytopenia
    major problem with AIDS
  39. infectious mononucleosis
    • Acute infection of B lymphocytes
    • Symptomatic IM usually affects young adults between 15-35 yo
    • Begins with invasion of B lymphocytes that possess an EBV receptor site
    • Proliferation of B and T cells cause rise in absolute lymphocyte count and presence of atypical lymphocytes (diagnosis based on atypical lymphocytes and classic symptoms confirmed with positive serologic test called Monospot test)
  40. leukemia
    • Malignant disorder of blood and blood-forming organs
    • Uncontrolled proliferation of dysfunctional WBCs
    • Results in pancytopenia or reduction in all blood cells
    • Classifed according to:
    • - predominant cell of origin (myeloid or lymphoid)
    • - rate of progression (acute or chronic)
    • Four types: AML, ALL, CML, CLL
    • Familial tendency
    • Most common genetic abnormality is on chromosomes 9 and 22 (the Philadelphia chromosome)
    • Drugs such as chloramphenicol cause bone marrow depression, can predispose
  41. Acute lymphocytic leukemia
    • Progessive neoplasm, most common form in children
    • Defined by > 30% lymphoblasts in marrow or blood
    • Originates from transformed precursor B cells in children, from precursor B and T cells in adults
    • Liver, spleen, lymph node enlargement
  42. Acute myelogenous leukemia
    • Most common adult leukemia
    • Pancytopenia b/c of bone marrow involvement
    • bleeding, anemia, infection,
    • Typical symptoms of all acute leukemias: fatigue, fever, night sweats, petechial hemorrhages, weight loss, uricemia, pallor r/t bone marrow depression
  43. chronic lymphocytic leukemia
    • B cells fail to mature into plasma cells that synthesize immunoglobulin
    • Hypogammaglobulinemia so humoral immunity affected and increased infection with encapsulated bacteria
  44. chronic myelogenous leukmia
    • CML: clonal and believed to arise from hematopoietic stem cell
    • Philadelphia chromosome in > 95% of cases
    • Hyperuricemia common and produces gouty arthritis
  45. malignant lymphomas
    Develop from proliferation of malignant lymphocytes in lymphoid system, classified by cell type
  46. Hodgkin lymphoma
    • - caused by Reed-Sternberg cells that are malignant tissue macrophges that are scattered among normal cells
    • - B cells deviated
    • - painless node in neck; single or chain: cervical, inguinal, axillary, retroperitoneal
    • - symptoms: night sweats, fever, wt loss, weakness
  47. non-hodgkin lymphoma
    • - cancer causing viruses, immunodeficiency, H. pylori infection
    • - Deviation of B cells, T cells and NK cells
    • - Symptoms similar to Hodgkin plus pleural effusion, abdominal pain, splenomegaly
  48. burkitt lymphoma
    B cell tumor involving jaw and facial bones of children in East Africa and New Guinea
  49. lymphoblastic lymphoma
    NHL in children; predominant in males, majority has T-cell origin
  50. malignant myelomas
    • Bone lesions and hypercalcemia
    • Abnormal antibody called M-protein becomes protein with highest level in blood
  51. most common initial symtpom of malignant myeloma
    Most common initial symptom: bone pain in single or entire skeletal system, pathologic fractures, renal failure, recurrent bacterial infections (most common cause of death)
  52. waldenstrom macroglobulinemia
    produces IgM that leads to high blood viscosity that interferes with circulation to eyes, brain, kidneys

    type of malignant myeloma
  53. thrombocytopenia
    Platelet count < 100,000 - hemorrhage from minor trauma can occur when < 50,000
  54. thrombocytopenia is secondary to
    viral infections that destroy platelets, bacterial infections that consume platelets, IgG autoantibodies, or drug hypersensitivity (ex: heparin)
  55. immune thrombocytopenic purpura
    • acute or chronic
    • - acute more common in children and young adults and preceded by viral infection
    • - chronic more common in females 20-40 yo
  56. thrombocythemia
    platelet count > 600,000
  57. essential (primary) thromocythemia
    • - chronic condition with excess megakaryocytes produced in marrow
    • - causes microvascular thrombosis (erythromyalgia) manifested as thrombosis of peripheral blood vessels or hepatic, mesenteric, cardiac or pulmonary vessels
  58. secondary thrombocythemia
    Follows splenectomy b/c platelets stored in spleen now in blood
  59. coagulation disorders
    • Usually caused by defects/ deficiencies of one or more of clotting factors.
    • Others are acquired
  60. vit k deficiency
    vit k necessary for synthesis of clotting factors by liver.

    Most common cause is parenteral nutrition combined with broad-spectrum antibiotics that destroy normal gut flora
  61. liver disease causes
    range of defects in clotting cascade and platelet function and fibrinolytic systems
  62. Disseminated intravascular coagulation (DIC)
    • Acquired with variety of predisposing conditions
    • 3 pathologic processes:
    • - endothelial damage
    • - exposure to tissue factor (TF) which complexes with Factor VII. Excess TF activates clotting pathway
    • - direct activation of factor X
    • Gram-negative sepsis, septic shock, hypoxia can damage endothelium and precipitate DIC by activating the clotting pathway
    • Plasmin begins to degrade fibrin before stable clot can develop and pieces of it are released
  63. DIC, clotting and hemorrhage occur
  64. D-dimer test
    most reliable and speific test for diagnosis of DIC
  65. d- dimmer
    neoantigen produced by plasmin lysis of fibrin clots
  66. thromboembolic disease
    Occur from a fixed clot (thrombus) or moving clot (embolus) that obstructs blood flow
  67. Hypercoagulability results from
    deficiency of anticoagulation proteins

    part of thromboembolic diseases
  68. secondary thromboembolic diseases
    conditions that promote venous stasis
  69. Triad of Virchow
    • - loss of vessel wall integrity from injury (TF released)
    • - blood flow abnormalities such as obstruction
    • - blood constituent alterations such as polycythemia

    part of thromboembolic diseases
Card Set:
2014-11-17 16:58:23
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