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1
Q

What is hemotology?

A

the study of blood

2
Q

Blood is a type of

A

connective tissue

3
Q

what are the functions of blood?

A

transportation
prevention/protection
temperature regulation

4
Q

Blood transports oxygen

A

from the lungs into the cells

5
Q

Blood transports carbon dioxide

A

from the cells to the lungs

6
Q

Blood transports nutrients from

A

the GI tract

7
Q

Blood transports hormones from

A

the endocrine glands

8
Q

How does blood prevent/protect?

A

it prevents infection and blood loss

9
Q

How does blood maintain temperature?

A

it moves blood to the surface when hot and brings blood to the core when cold

10
Q

In a human adult there is _______ amount of blood in the body

A

4-6 L

11
Q

what is the pH of blood?

A

7.35-7.45

12
Q

Blood is composed of

A

plasma and formed elements

13
Q

what are formed elements?

A

RBCs
WBCs
Platelets

14
Q

What is plasma?

A

the fluid portion of blood

15
Q

Plasma is _____ of whole blood

A

55%

16
Q

What is plasma made of?

A
water
electrolytes
wastes 
nutrients
proteins
respiratory gases
17
Q

what proteins are found in plasma?

A

albumin
globulin
fibrinogen (clotting factor)

18
Q

what color is plasma?

A

straw colored

19
Q

what is serum?

A

plasma minus the clotting factors

20
Q

red blood cells are called

A

erythrocytes

21
Q

white blood cells are called

A

leukocytes

22
Q

platelets are called

A

thrombocytes

23
Q

what is hematocrit?

A

measurements of RBCs in the blood

24
Q

what is a normal hematocrit level at sea level?

A

40%

25
Q

What is hempoiesis?

A

Process of forming new blood cells

26
Q

Within the red bone marrow there are stem cells called

A

hemocytoblasts which give rise to RBCs, WBCs and Platelets

27
Q

Hemopoiesis in the fetus occurs in

A

yolk sac, liver, spleen, thymus

28
Q

Hemopoiesis in a young child occurs in

A

red bone marrow of all bones

29
Q

Hemopiesis in an adult occurs in

A

red bone marrow of select bones

30
Q

Erythrocytes are shaped as

A

a bi-concave disc

31
Q

Erythrocytes have no

A

nuclei

32
Q

The absence of a nucleus allows erythrocytes to

A

have more room for hemoglobin

33
Q

what is hemoglobin?

A

an oxygen carrying pigment

34
Q

A hemoglobin molecule is composed of

A

4 polypeptide chains with a HEME structure in the midst of each polypeptide chain.

35
Q

Each HEME contains

A

an iron that will be able to combine with oxygen

36
Q

Each hemoglobin molecule can carry

A

4 oxygens

37
Q

What is the function of the biconcave disc of RBCs?

A

it increases surface area for gas diffusion and gives the cell more flexibility to fit through small vessels

38
Q

Since there is no nucleus, no _______ can occur

A

repair

39
Q

what is erythropoiesis?

A

process of RBC production

40
Q

erythropoiesis starts as a

A

hemocytoblast

41
Q

what is the pathway for erythropoiesis?

A

hemocytoblast
reticulocyte
erythrocyte

42
Q

how long does it take to make RBCs?

A

1-2 days

43
Q

hemocytoblasts are found in

A

red bone marrow

44
Q

reticulocytes and erythrocytes are found in

A

circulating blood

45
Q

what is regenerative anemia?

A

5% reticulocyte count. Bone marrow working. Takes 3-4 days to determine

46
Q

what is nonregenerative anemia?

A

0-1.5% reticulocyte count. Bone marrow is not working

47
Q

The number of erythrocytes in the blood must be kept

A

constant

48
Q

The body maintains RBCs in the blood by

A

erythropoietin

49
Q

what is erythropoietin?

A

hormone that is released by the kidneys that will stimulate the red bone marrow to increase production of RBCs

50
Q

what is the stimulus for erythropoietin?

A

hypoxia

51
Q

what is hypoxia?

A

lack of adequate oxygen

52
Q

renal failure patients may lack erythropoietin and therefore

A

suffer a low hematocrit, often half of the normal level

53
Q

what is administered to renal failure patients?

A

recombinant erythropoietin

54
Q

Males have a higher hematocrit due to

A

testosterone

55
Q

what is testosterone?

A

a male hormone that stimulates the production of RBCs

56
Q

what are the effects of living in the mountains?

A

Higher amounts of RBCs are produced. Hematocrit will be higher

57
Q

what are the effects of visiting the mountains?

A

erythropoietin is released and RBCs are produced three days later. When you go home on the fourth day, you will have more RBCs and more oxygen in the blood

58
Q

RBCs live for

A

120 days

59
Q

Why do the RBCs die?

A

the lack of a nucleus and the inability to produce new proteins.

60
Q

what happens to RBCs that are removed from circulation and destroyed?

A

Macrophages in the liver, spleen, and other tissues phagocytize them

61
Q

when hemoglobin is broken down, iron and polypeptides

A

are recycled

62
Q

when hemoglobin is broken down, heme is

A

converted to biliverdin

63
Q

When hemoglobin is broken down, biliverdin is

A

converted into bilirubin

64
Q

when hemoglobin is broken down, bilirubin is

A

picked up by hepatocytes, glucaronic acid is added and eventually becomes bile

65
Q

when hemoglobin is broken down, bile is

A

converted to urobilinogen in the intestines (some will go to the kidneys)

66
Q

when hemoglobin is broken down, urobilinogen becomes

A

stercobilin in the digestive tract

67
Q

what is icterus/jaundice?

A

bilirubin is present in the blood

68
Q

what is responsible for the color of urine?

A

urobilinogen being processed by the kidneys

69
Q

what is responsible for the color of feces?

A

stercobilin being eliminated

70
Q

what is anemia?

A

reduced oxygen-carrying ability in the blood due to a decreased hemoglobin level

71
Q

what are the symptoms of anemia?

A

fatigue, pale, cold

72
Q

what are the three main causes of anemia?

A

not making RBCs
destroying RBCs
Losing RBCs

73
Q

what is hemorrhagic anemia?

A

blood loss leading to a decreased amount of RBCs in the blood

74
Q

hemorrhagic anemia is an example of

A

losing RBCs

75
Q

what is hemolytic anemia?

A

RBCs rupture prematurely leading to a decreased amount of RBCs in the blood.

76
Q

What causes hemolytic anemia?

A

parasites or a transfusion of mismatched blood

77
Q

what is hemolytic anemia an example of?

A

RBCs being destroyed

78
Q

what is aplastic anemia?

A

pathology of the red bone marrow leading to low rbc count or malformed rbcs.

79
Q

what causes aplastic anemia?

A

cancer, radiation, drugs

80
Q

what is aplastic anemia an example of?

A

RBCs not being made

81
Q

what is dietary anemia?

A

not enough iron in the blood to carry enough oxygen. Oxygen is needed for production of hemoglobin

82
Q

what is dietary anemia an example of?

A

RBCs are not being made

83
Q

who is most at risk for dietary anemia?

A

pregnant women

84
Q

what is pernicious anemia?

A

a lack of intrinsic factor in the stomach.

85
Q

Intrinsic factor is needed for

A

B12 absorption.

86
Q

what is the treatment for pernicious anemia?

A

B12 injections

87
Q

pernicious anemia is an example of

A

RBCs not being made

88
Q

what is sickle cell anemia?

A

genetic disease in which the RBC looses its round shape and sickles. This leads to less oxygen going to the tissues and pain

89
Q

sickle cell anemia is an example of

A

RBCs being destroyed.

90
Q

what is polycythemia?

A

abnormal increase of RBCs that increases the viscosity of blood which slows down the flow and eventually decreases the rate of oxygen traveling to the tissues.

91
Q

why would polycythemia occur?

A

chronic hypoxia as seen in patients with emphysema

92
Q

what is primary polycythemia?

A

more erythrocytes and the same amount of fluid. Blood becomes thicker

93
Q

what is secondary polycythemia?

A

same amount of erythrocytes but less fluid.

94
Q

What usually causes secondary polycythemia?

A

dehydration

95
Q

what is blood doping?

A

After visiting the mountains, blood is drawn and stored. RBCs are then transfused into the person right before a competition.

96
Q

What is another banned practice in sports?

A

the use of recombinant erythropoietin.

97
Q

Unlike erythrocytes, leukocytes are

A

nucleated cells that do not contain hemoglobin

98
Q

What are leukocytes important in?

A

defense of the body against invaders

99
Q

where are leukocytes formed?

A

red bone marrow

100
Q

leukocytes are formed from

A

hemocytoblasts

101
Q

What are the two types of leukocytes?

A

granular and agranular

102
Q

what are granular WBCs?

A

cells that have one lobed nucleus within them and have granules in the cytoplasm.

103
Q

What are the different types of granular WBCs?

A

neutrophils
eosinophils
basophils

104
Q

What are agranular WBCs?

A

they do not have granules in the cytoplasm and their nuclei are large but not lobed.

105
Q

what are the different typed os agraulocytes?

A

lymphocytes

monocytes

106
Q

what color is a neutrophil?

A

colorless

107
Q

what color is a basophil?

A

blue

108
Q

what color is a eosinophil?

A

red

109
Q

what is the pathway for granulocytes?

A

hemocytoblasts–>myloblasts–>neutrophils, eosinophil or basophil

110
Q

what is the pathway for monocytes?

A

hemocytoblasts–>monoblast–>monocyte–>macrophage

111
Q

what is the pathway for lymphocytes?

A

hemocytoblasts–>lymphoblast–>lymphocyte

112
Q

How long do leukocytes live?

A

a few days except for lymphocytes that can live for months or years

113
Q

The number of WBCs will increase when

A

there is an infection

114
Q

When there is an infection ________ will occur

A

leukocytosis

115
Q

What is diapedisis?

A

The movement of WBCs from the blood to infected tissues

116
Q

How does diapedisis occur?

A

WBCs slow down, roll over the endotrhelial cells and then squeeze between the cells of the capillaries out of the vessel.

117
Q

what is chemotaxis?

A

attraction of phagocytes to microbes by chemical stimulus

118
Q

What is the first leukocyte to respond to an infection?

A

neutrophils

119
Q

What do neutrophils do?

A

destroys the pathogen by phagocytosis

120
Q

The second leokocyte to arrive at the scene of infection is the

A

monocytes.

121
Q

What do monocytes do?

A

enlarge and differentiate into macrophages. They then phagocytize the invaders and clean up debris of dead cells after the infection is over.

122
Q

What is the function of neutrophils?

A

phagocytosis

123
Q

where are neutrophils made?

A

red bone marrow

124
Q

where are eosinophils made?

A

red bone marrow

125
Q

what is the function of eosinophils?

A

allergies and parasites

126
Q

where are basophils made?

A

red bone marrow

127
Q

what is the function of basophils?

A

release of histamine and heparin

128
Q

where are lymphocytes made?

A

red bone marrow and lymph nodes

129
Q

what is the function of lymphocytes?

A

making antibodies

130
Q

where are monocytes made?

A

red bone marrow and lymph nodes

131
Q

what is the function of monocytes?.

A

phagocytosis

132
Q

what is the order of the leukocytes from most to least?

A
neutrophils 
lymphocytes
monocytes
eosinophils
basophils
133
Q

what does cytosis mean?

A

increased number of

134
Q

what does penia mean?

A

decreased number of

135
Q

what does philia mean?

A

increased number of

136
Q

what is infectious mononucleosis?

A

contagious disease caused by the Epstein-Barr virus. Infects lymphocytes leading to an immune response

137
Q

what are the symptoms of mononucleosis?

A

fever, swollen lymph nodes. Similar to strep throat

138
Q

what is leukemia?

A

uncontrollable production of WBCs. So many abnormal WBCs are produced that not enough RBCs and platelets can form.

139
Q

What follows leukemia?

A

anemia and clotting difficulties

140
Q

what is the treatment for leukemia?

A

radiation, chemotherapy, bone marrow transplants, umbilical cord blood transplantation

141
Q

what are thrombocytes?

A

fragments of megakaryocytes that will be released into the blood.

142
Q

Do thrombocytes have a nucleus?

A

no

143
Q

How long to thrombocytes live?

A

5-10 days

144
Q

megakaryocytes are derived from

A

hemocytoblasts

145
Q

what is the function of platelets?

A

preventing blood loss

146
Q

what is hemostasis?

A

stoppage of bleeding

147
Q

what are the 3 phases of hemostasis?

A

vascular spasms
platelet plug
coagulation

148
Q

what are vascular spasms?

A

vasoconstriction locally.

149
Q

Vasoconstriction of the injured vessel

A

decreases the amount of blood lost.

150
Q

How long does vasoconstriction occur?

A

minutes to a few hours

151
Q

what is platelet plug formation?

A

temporary plug made of platelets

152
Q

How long does it take for the platelet plug to form?

A

1-2 minutes

153
Q

what causes the platelets to stick to the injured site?

A

platelets swell and their membranes change and become sticky

154
Q

what are the three stages of platelet plug formation?

A

platelet adhesion
platelet activation
platelet aggregation

155
Q

what is platelet adhesion?

A

a break in the endothelium leads to thrombocytes adhering to the collagen. Von Willebrand factor is released by damaged endothelial cells and thrombocytes are tacked down

156
Q

what is platelet activation?

A

prostaglandin is released by thrombocytes and it acts as a chemotaxis for more thrombocytes

157
Q

what is platelet aggregation?

A

new platelets are attached to existing platelets by fibrinogen

158
Q

During coagulation, what is formed?

A

a clot

159
Q

what are procoagulants?

A

substances that enhance the clot formation. Called clotting factors. Circulate in inactive form

160
Q

what are anticoagulants?

A

substances that inhibit the formation of a clot. Have both endogenous and exogenous anticoagulants.

161
Q

what are some examples of endogenous anticoagulants?

A

heparin

antithrombin

162
Q

what are some examples of some exogenous anticoagulants?

A

Coumadin
warfarin
heparin
EDTA

163
Q

what is Coumadin?

A

given after a heart attack or stroke

164
Q

what is warfarin?

A

rat posison

165
Q

what is EDTA?

A

anticoagulant put in test tubes for blood draw

166
Q

What is the coagulation pathway?

A

Begins with factor three in the extrinsic pathway and factor 12 in the intrinsic pathway. Along with calcium, they meet in the common pathway and form factor ten. Factor ten releases prothrombinase which conforms prothrombon into thrombin. Thrombin then conforms fibrinogen into fibrin

167
Q

Fibrin strands then:

A

glue the platelets together and make the basis of the clot.

168
Q

The web-like structure will trap formed elements inside of it and clot formation is normally completed

A

within 3-6 minutes after damage to the vessel

169
Q

what is retraction?

A

the clot contracts and this brings the ruptured edges of the vessels closer together.

170
Q

What does fibrinolysis do?

A

removes the unneeded clot when healing occurs.

171
Q

fibrinolysis begins within

A

2 days and continues over several days until the clot is dissolved

172
Q

In order for the clot to be dissolved, ________ needs to be activatedq

A

plasminogen

173
Q

what is plasminogen?

A

an inactive blood protein

174
Q

what activates plasminogen?

A

tissue plasminogen activator (t-pa)

175
Q

what is the activated form of plasminogen?

A

plasmin

176
Q

what is plasmin?

A

an active enzyme

177
Q

In an emergency situation when a person has formed an abnormal clot that is blocking circulation as in a heart attack,

A

t-pa or streptokinase can be injected into the blood or introduced at the clot site

178
Q

Does aspirin work as an anticoagulant or activator of plasminogen?

A

anticoagulant.

179
Q

what is hemophilia?

A

hereditary deficiencies in clotting factors. Causes spontaneous bleeding

180
Q

Who is mostly affected by hemophilia?

A

males

181
Q

What is the treatment for hemophilia?

A

regular blood transfusions or injections of clotting factors

182
Q

what is vitamin k deficiency?

A

Vitamin K is needed to produce four of the factors in the clotting process

183
Q

what is impaired liver function?

A

unable to synthesize the procoagulants, even if vitamin K is present

184
Q

who is mostly affected by impaired liver function

A

those with cirrhosis and hepatitis

185
Q

what is thrombocytopenia?

A

number of platelets is reduced leading to spontaneous bleeding

186
Q

what causes thrombocytopenia?

A

bone marrow malignancy, radiation and medication

187
Q

what is DIC?

A

disseminated intravascular coagulation

188
Q

what are the causes of disseminated intravascular coagulation?

A

heat stroke, septicemia, pregnancy

189
Q

what is thrombosis?

A

a clot that develops and persists on a wall of an unbroken vessel

190
Q

what si a thrombus?

A

the actual clot

191
Q

If the thrombus is large enough,

A

it may block circulation causing death of tissue

192
Q

what is coronary thrombosis?

A

blockage occurring in small vessels of the heart

193
Q

what does coronary thrombosis lead to?

A

myocardial infarction

194
Q

what is an embolus?

A

a thrombus that breaks away from the vessel wall and floats freely in the blood

195
Q

what are the two most common places for a thrombus?

A

legs and the heart

196
Q

what is the treatment for a myocardial infarction?

A

low dose aspirin
oxygen
t-pa
nitroglycerin

197
Q

what does aspirin do?

A

prevents platelet plug from forming

198
Q

what is a transfusion?

A

transfer of blood or blood components from one individual to another

199
Q

what is an infusion?

A

introduction of a fluid other than blood such as saline

200
Q

The surface of RBCs contain genetically determined glycolipids called

A

antigens

201
Q

what is the ABO system?

A

system of grouping blood according to the presence or absence of antigen A and antigen B