Language of Medicine Chapter 13

Blood System

Blood

transports nutrients, gases, and wastes to and from the cells of the body

PLASMA:

• water

• proteins

• sugar

• salts

• hormones

• lipids

• vitamins

Serum

Liquid ontop AFTER blood has clotted and has no non-clotting factor

Plasma

Liquid ontop of NONCLOTTED blood because it has anticoagulants

POLL EVERYWHERE:

_________ is the liquid fraction in which the clotting factors are removed (emptied) in the blood

A. Plasma

B. Serum

C. Blood

D. Lymph

B. Serum

POLL EVERYWHERE:

_________ is the liquid fraction in which the clotting factors are still present (retained)

A. Plasma

B. Serum

C. Blood

D. Lymph

A. Plasma

POLL EVERYWHERE:

The liquid portion staying above the blood clot after centrifugation shall be named _________.

A, Plasma

B. Serum

B. Serum

Leukocytes

ONE OF THREE MAIN GROUPS OF BLOOD CELLS

White Blood Cells- fights infection, no color because it lacks hemaglobin

five different kinds of leukocytes divided into 2 categories

PAY ATTENTION TO SHAPE AND COLOR

Granulocytes- have chunky granules in cytoplasm

Basophil

Neutrophil

Eosinophil

Agranulocytes (mononuclear leukocytes)- no chunky granules in cytoplasm

Monocyte/ Macrophage

Lymphocyte

Granulocytes

Type of Leukocyte that has granules in cytoplasm

(Basophil, Neutrophil, and Eosinophil)

Can tell by if there is an equal volume between nuclei and cytoplasm

Nuclei is bizarre/ C shape- split between multiple circles

Agranulocytes (mononuclear leukocytes)

Type of Leukocyte that does not have granules in cytoplasm

(Monocyte, Macrophage, Lymphocyte)

Can tell by a bigger nuclei, smaller cytoplasm

Have rounder shape (hard boiled egg)

Basophil

Granulocyte, PURPLE

Act in allergic reactions. They are developed into effector cells (in tissues) and then re-named as mat cells that release histamine

Can be activated and then developed into MAST cells

Histamine released from granules in mast cells are associated with allergic responses

Alkaline PH

Neutrophil

Granulocyte, PALE

Are phagocytes for ingesting bacterial cells. Elevated during bacterial infections

They are the most abundant type of white blood cell-important in IMMUNE SYSTEM

One of the first responders of inflammatory cells to migrate towards the site of infections, by eating bacterial cells- PHAGOCYTOSIS

Neutral PH

is a phagocyte- Eat infections

Eosinophil

Granulocyte, RED

Contain toxic compounds to defend against infections by parasites and worms. They increased in number in allergic conditions

Responsible for combating multicellular parasites infections

They are increased in number in allergic reactions (ex: asthma)

Acidic PH

Monocytes

Agranulocytes

Are further matured into effector cells called macrophages

Macrophages are better phagocytes compared to the original monocytes

Phagocytes- Eat infections

Lymphocytes

Agranulocytes

Are for combining viral infections. Elevated during viral infections. They also produce antibodies

Round oval shape, surrounded by small cytoplasm- HARD BOILED EGG

POLL EVERYWHERE:

In order to make blood smear and view the individual blood cell, what type of speciman shall be used?

A. Upper layer of the tube that was NOT added with anticoagulants

B. Lower level of the tube that was NOT added with anticoagulants

C. Upper layer of the tube that was added with anticoagulants

D. Lower layer of the tube that was added with anticoagulants

C. Upper layer of the tube that was added with anticoagulants

POLL EVERYWHERE:

The liquid portion of the blood tube where the specimen was taken from, shall be best named as ____.

A. Plasma

B. Serum

A. Plasma

POLL EVERYWHERE:

Which of the following are agranulocytes:

Neutrophils, Lymphocytes, Eosinophils, Basophils, Monocytes

Lymphocytes and Monocytes

POLL EVERYWHERE:

Which of the following are granulocytes:

Neutrophils, Lymphocytes, Eosinophils, Basophils, Monocytes

Neutrophils, Eosinophils, Basophils

POLL EVERYWHERE:

The following leukocytes are made by the myeloid stem cell, EXCEPT

A. Neutrophils

B. Monocytes

C. Lymphocytes

D. Eosinophils

E. Basophils

C. Lymphocytes

Allergic reactions

Basophils open and release histamine

interactions between mast cells (from basophils) and the allergen associated IGE antibodies can trigger allergic reactions

Phagocytes

Eating bacteria- neutrophils and macrophages

Phagocytosis

Filopodia is on surface of phagocyte, and bacteria is folded in by cytoplasm

Bacteria is broken down into pieces by enzyme in lysosome

Neutrophils go first, then monocytes to be turned into macrophages

Coagulation

Blood clotting; tries to make fibrin mesh to group blood cells together

too much: blocks blood vessels and causes ischemia

Anticoagulants

Used for people who clot more, prescribed heparin, warfarin and coumadin

takes away calcium to start process

Extrinsic Pathway

Will be activated by damage to the blood vessel

waiting for FIBRIN to be made

Partial thromboplastin time (PTT)

Fat sitting on blood vessel, Intrinsic pathway/contact activation

waiting for FIBRIN to be made

Hemophilia

excessive bleeding caused by the lack of one of the plasma clotting factors

Hypercoagulation

Excessive coagulation caused by overly activated coagulation cascade, due to the abnormal blood vessel walls (such as atherosclerosis and deep vein thrombosis

Purpura and petechiae

Bigger=Purprua

Petechiae= smaller

Pinpoint hemorrhages and blood under skin, with hemophilia

Idiopathic thrombocytopenic purpura

Autoimmune disease where antibodies are against platelet surface antigens. Some antibodies originally produced against viral antigens can mistakenly cross-react with platelet cells

Low # of platelets, without sufficient clotting, can have purpuric rashes, and bleed a lot

a bleeding disorder where the body's immune system mistakenly attacks and destroys platelets, which are essential for blood clotting

POLL EVERYWHERE:

_______ is a disease associated with excessive coagulation

A. Hemophilia

B. Purpura

C. Hypercoagulation

D. Idiopathic thrombogenic purpura

E. Fibrin Mesh

C. Hypercoagulation

POLL EVERYWHERE:

Hemorrhages under the skin are called ____________

A. Hemophilia

B. Purpura

C. Hypercoagulation

D. Idiopathic thrombogenic purpura

E. Fibrin Mesh

B. Purpura

POLL EVERYWHERE:

Excessive bleeding caused by the lack of one of the clotting factors necessary for blood clotting is called

A. Hemophilia

B. Purpura

C. Hypercoagulation

D. Idiopathic thrombogenic purpura

E. Fibrin Mesh

A. Hemophilia

POLL EVERYWHERE:

The final step of stopping bleeding is triggered by thrombin burst that leads to _________

A. Hemophilia

B. Purpura

C. Hypercoagulation

D. Idiopathic thrombogenic purpura

E. Fibrin Mesh

E. Fibrin Mesh

POLL EVERYWHERE:

An autoimmune disease with antibodies against several platelet surface antigens and destruct them is called ________

A. Hemophilia

B. Purpura

C. Hypercoagulation

D. Idiopathic thrombogenic purpura

E. Fibrin Mesh

D. Idiopathic thrombogenic purpura

POLL EVERYWHERE:

A person has O-type blood shall have ______ antibodies in the blood

A. Anti-A
B. Anti-B

C.Both anti-A and anti-B

D). Neither anti-A nor anti-B

C.Both anti-A and anti-B

POLL EVERYWHERE:

Which of the following is the BEST donor for red blood cells?

A). O Rh+

B). O Rh-

C). AB Rh+

D). AB Rh-

B). O Rh-

POLL EVERYWHERE:

Which of the following is the BEST donor for plasma?

A). O Rh+

B). O Rh-

C). AB Rh+

D). AB Rh-

C). AB Rh+

Choose patient with maximal antigen, minimal antibodies in plasma

Which hormone stimulates red blood cell production?

Erythropoietin- in the bone marrow

Diseases of erythrocytes (7)

Iron deficiency anemia

aplastic anemia

sickle cell anemia

Pernicious anemia

Thalassemia

Hemochromatosis

Hereditary spherocytosis

Iron deficiency anemia

Lack of iron intake or retention results in poor synthesis of hemoglobin in erythrocytes and decreased in the number and size of erythrocytes

CAUSED BY: insufficient dietary intake, impaired absorption of iron, or iron loss from bleeding

Aplastic anemia

lack of growth in stem cells, could be damaged by chemotherapy, or infection, or damage to the stem cell

• failure of blood cell production due to deficiency of hematopoietic stem cells in the bone marrow

• cells are gone and replaced by fat

Sickle cell anemia

Hereditary disorder, abnormal shape in erythrocyte leading to the destruction of blood cells

Destruction by macrophages in the spleen result to hemolytic anemia, jaundice, and splenomegaly

Can cause hemolytic anemia, jaundice, and splenomegaly

hemolytic anemia: reduction in rbc due to excessive destruction (hemolysis)

Pernicious anemia

Patient has no sufficient B12, and has lack of mature erythrocytes

LACK OF INTRINSIC FACTOR- need intrinsic factor to get b12 into circulation

caused by autoimmune destruction of gastric parietal cells and autoantibody inactivation of intrinsic factor lading to a lack of intrinsic factor

Thalassemia

Hereditary and inherited autosomal blood disorder involved with the inability to produce enough hemoglobin

less hemoglobin means less circulating rbc and can result in microcytic anemia, can be helped by routine transfusion

Mediterranean ancestry

Hemochromatosis

Inherited autosomal recessive blood disorder where excess iron deposits through the body

Hereditary spherocytosis

Patient has mutated gene that makes less biconcave shape and more fragile-ROUND/SPHERE SHAPE

Shape makes rbc more prone to rupture and degradation of the spleen

RESULTS IN HEMOLYTIC ANEMIA

Symptoms are: anemia, jaundice, splenomegaly, fatigue

Treatment: splenectomy which eliminates the hemolytic process

Hemolytic anemia

Symptom of sickle cell anemia and Hereditary spherocytosis

a type of anemia where red blood cells are destroyed faster than the body can produce them

Polycythemia vera

Opposite of aplastic anemia

MORE than normal quantity of blood cells-gene defect/mutation

Not good for circulation, causes itchy skin called pruritus

POLL EVERYWHERE:

Inability to absorb vitamin B12 into the body due to a shortage of an intrinsic factor leads to __________

A). Polycythemia vera

B). Pernicious anemia

C). Idiopathic Thrombocytopenic Purpura (ITP)

D). Iron deficiency anemia

E). Aplastic anemia

B). Pernicious anemia

POLL EVERYWHERE:

____ is a recessive genetic disorder that results in insufficient production of hemoglobin chains of either alpha or beta (but not both) as well as microcytic anemia. This disease is prevalent to individuals of Mediterranean ancestry.

A). Polycythemia vera

B). Pernicious anemia

C). Idiopathic Thrombocytopenic Purpura (ITP)

D). Iron deficiency anemia

E). Thalassemia

POLL EVERYWHERE:

Increased numbers in all types of blood cells is a characteristic of _____

A). Polycythemia vera

B). Pernicious anemia

C). Idiopathic Thrombocytopenic Purpura (ITP)

D). Iron deficiency anemia

E. Aplastic anemia

A). Polycythemia vera

POLL EVERYWHERE:

Hemolytic anemia, jaundice, and splenomegaly are associated with (1) polycythemia vera; (2) Hemochromatosis, (3) Sickle Cell anemia, (4)Iron deficiency anemia; (5) Hereditary spherocytosis

Sickle Cell anemia, Hereditary spherocytosis

POLL EVERYWHERE:

Excess iron deposits throughout the body, due to an inherited autosomal recessive disorder, is a characteristic of ___________

A). Polycythemia vera

B). Pernicious anemia

C). Idiopathic Thrombocytopenic Purpura (ITP)

D. Hemochromatosis

E. Aplastic Anemia

D. Hemochromatosis

Anisocytosis

Increased variation of the SIZE of rbc

Anisochromasia

increased variation in STAINING of rbc, variation of haemoglboin concentration between different cells

Poikilocyosis

Varied in SHAPES in erythrocytes

Granulocytosis

Abnormal increase in granuloctes in the blood, as a consequence of infections of leukemia

EX: neutrophilia, esoioniphila, basophilia

A DISEASE OF WHITE BLOOD CELLS

Granulocytopenia

a deficiency or abnormal decrease in the number of granulocytes, may be caused by certain bone marrow diseases, chemotherapy, or drugs

EX: neutropenia, eosinopenia, basocytopenia

A DISEASE OF WHITE BLOOD CELLS

Mononucleosis

An infections disease marked by increased numbers of lymphocytes and enlarged cervical lymph nodes

ORAL transmission

Enlarged atypical t-lymphocytes

Leukemia

Increase in cancerous white blood cells

• Acute myelogenous leukemia (AML)

• Acute lymphocytic leukemia (ALL)- most common pediatric

cells stop maturing any blood cells and BLAST=cancerous stem cells

Chronic:

may or may not need to be treated, less severe

• chronic myelogenous leukemia (CML)

• chronic lymphocytic leukemia (CLL)

  geriatric/eldery

POLL EVERYWHERE:

If abundant blasts are obvious in the blood smear, this patient shall be diagnosed with ______ leukemia

A. Acute

B. Chronic

A. Acute

Multiple myeloma

Malignant neoplasm of bone marrow, Malignant B lymphocytes destroy bone tissue and cause overproduction of immunoglobulins

Bleeding time

Assess the platelets function, cutting and seeing how long it tales to stop bleeding, if more than 10 min, abnormal

Erythrocyte sedimentation rate (ESR)

Uses RBC to test inflammation; quantifies how severe inflammation is

Sees how the red blood cells drop with gravity; quickly means there is a problem and drop faster, don’t have special sticky pieces to make it heavy

Settling faster=rouleaux

POLL EVERYWHERE:

Erythrocyte Sedimentation rate (ESR) shall be ____ than the normal range, if inflammation is occurring to the patient.
A. Higher

B. Lower

A.Higher

POLL EVERYWHERE:

Based on data generated from Erythrocyte Sedimentation Rate (ESR) shown below, which patient has the most severe inflammation?

THE ONE DROPPED FURTHEST AWAY FROM THE TOP AND IS LOWEST

Apheresis

Separation of blood into a few components and removal of a select part from the blood while return the rest back to individual

• blood of a donor is passed through an apparatus that separates out one particular constituent and returns the remainder to the circulation

EXTRACORPOREAL- outside body

3 components are: plasma, red blood cells (erythrocytes), and white blood cells (leukocytes)

Ex: stem cell donation, removal of auto immune antibodies

Autologous Blood Transfusion

Collection of blood from and donation FROM THE SAME PATIENT

Allogenic- random donor

ex: needing to preserve components before heart surgery or chemo

POLL EVERYWHERE:

If you receive an autologous transfusion, the person who donated the blood is ___________

A). your mother

B). your father

C). a sibling in your family

D). yourself

E). an unrelated person

D. yourself

Bone marrow biopsy

Microscopic examination of bone marrow removed with a needle

Used to see if an infection, disease or other problems occur in the bone marrows

POLL EVERYWHERE:

Due to mutations in the genes involved with membrane formation of red blood cells, these erythrocytes become less biconcave, more fragile, and mainly immature. The name of the disease shall be called ________

A. Polycythemia vera

B. Pernicious anemia

C. Hereditary spherocytosis

D. Iron deficiency anemia

E. Aplastic anemia

C. Hereditary spherocytosis