Flashcards in Hematology/Oncology - Part 1 - Unit 4 Deck (62)
Blood - has a plasma and cellular portion. T/F?
Plasma - __% water, ___% solutes.
90% water, 10% solutes (albumin, electrolytes, proteins - clotting factors, globulins, circulating, antibodies, fibrinogen)
Cellular elements -
mature red blood cells =
White blood cells =
mature red blood cells = RBC/erythrocytes
White blood cells = WBC, leukocytes
Platelets = thrombocytes
where is blood formed?
Red bone marrow/lymphatic system.
What does the RBC do? Life span?
Transports hgb, which carries oxygen to the cells of the body. The lifespan = 120 days.
What does the WBC do? lifespan?
Function in the immune system, life span about 6-8 hours, composed of granulocytes (neutrophils, basophils, eosinophils) and agranulocytes (monocytes, lymphocytes)
What is the function of the platelets?
Function to start the process which will stop bleeding.
What is a granulocyte? Describe each of them.
Made in bone marrow.
Neutrophils - fight bacterial infections, aka segmented neutrophils or segs.
Bands - immature neutrophils.
Eosinophils - increased with allergies, parasitic infections, some cancers.
Basophils - increased with tissue damage.
Agranulocyte - made where? What are the parts?
Made in the bone marrow/lymph nodes, spleen, liver, and thymus.
Monocytes are involved in the early stage of inflammatory reaction and show evidence of chronic infections.
Lymphocytes are involved in development of antibodies and delayed hypersensitivity.
Where are the platelets made? Life span?
Made in bone marrow. Life span is 8-10 days, form plug when there is a bleed. Influence homeostasis by releasing serotonin which produces vascular spasm to decrease blood flow to the area of the injury.
What is anemia? Normal hgb level?
Decreased RBC in mass of cell and / or hgb. Caused by decreased production of RBC's, increased destruction of the RBC's, and loss of RBC's. Normal = 11-5-14.5
What are some clinical manifestations of acute anemia? Chronic (compensated) ?
Headache, lightheadedness, irritability, decreased attention span, tachycardia, fatigue, muscle weakness.
Compensated - growth retardation, delayed sexual maturation, tachycardia, heart murmur.
What might cause a decreased production of RBC's?
bone marrow is not working well (aplastic anemia), medication (chemo, anticonvulsants), kidney disease, decreased iron
What is hereditary spherocytosis?
Inflexible spheres that lead to hemolysis. Treated by IVIG and splenectomy
How does a child get sickle cell?
Should kids avoid extreme temp changes?
The gene is passed - the mother and father must BOTH have the defective gene for a child to be affected. If one parent has it, that means that the kid can have the trait and carry it but won't have it. hmmm.
Asians and Native Americans most commonly get sickle cell anemia. T/F?
What is percentage child could have disease?
Could have trait?
Could have neither trait nor disease?
FALSE - it's usually african american, along with african, indian, caribbean, middle eastern, and the Mediterranean.
Sickle cell anemia - def
normal adult hgb is partly or completely replaced by abnormal sickle hgb.
Sickle Cell C Disease - def
variant or SCA (Hgb SC)
What is sickle thalassemia disease?
Combination of sickle cell trait and b-thalassemia trait.
what is a vaso-occlusive crisis r/t sickle cell?
Non-life threatening, mild/moderate pain, localized, acute abdominal pain, priapism, arthralgia, dactylitis (fingers)
How do we treat a vaso-occlusive crisis?
Bedrest to decrease energy expenditure, hydration, oxygenation, electrolyte placement, pain management, blood replacement, antibiotic therapy.
What is a spleen sequestration crisis?
Causes decrease in blood volume and can ultimately lead to shock. Can be acute or chronic.
What is an aplastic crisis? what usually triggers it?
Decreased RBC reproduction - usually triggered by infection with a virus such as parovirus.
SCA - sickle cell changes form pliable disk shape to a crescent or sickle shape. T/F?
What can initiate sickling?
dehydration, acidosis, hypoxia, temp changes.
How can we reverse sickling?
Sometimes adequate O2 and hydration will do it
How does SCA manifest?
sickle cells adhering to vessel walls, increasing RBC destruction. Cells live only 20 days of the normal 120 days. Spleen can become infarcted and the spleen is replaced by fibrotic tissue. Increased susceptibility to bacterial infection!
How does SCA affect the liver? Kidney? CNS?
Liver - hepatomegaly, cirrhosis, intrahepatic cholestasis
Kidney - inability to concentrate urine, enuresis, progressive renal failure.
CNS - stroke, hemiparesis, seizures
Which lab value tells us that the marrow is not making RBC's? Values?
Reticulocyte count! Tells you what the marrow is doing.
typically 2-3 times higher. If it's 0, IT IS AN EMERGENCY!