Blood main

What percent of RBC cytoplasm is hemoglobin?

25%

What's the length of the erythropoietic process?

4

Too many RBCs

polycythemia

What's the difference between absolute and relative polycythemia?

absolute is a defect in the marrow where too many RBCs are being produced (polycythemia vera). Relative is hydration related where plasma drops leading to a higher RBC concentration.

Polycenthemia vera

body is actually producing too many RBCs

The two types of absolute polycythemia

primary is polycythemia vera and secondary is an increase due to an outside stimulus, usually increased EPO.

The main issue with polycythemia

viscosity increase

life span of a platelet?

10 days

platelets adhere to these on vessel walls during activation

von willebrand factor (8) and collagen

Platelets use these during aggregation to do what?

use fibrinogen to form bridges and plugs

platelet problem that is a key in the development of Atherosclerosis

unwarranted platelet activation leads to excessive clotting.

Tissue factor that speeds up fibrin conversion

thromboplastin

Main tissue extrinsic factor and where its found

thromboplastin. High in brain, heart, and lungs. Low in sm and joints

Retraction process of clots

the clot solidifies by shortening the fibrins and pushes out fluids to better seal the injury site.

the fibrolytic system

The fibrinolytic system breaks down a clot: plasminogen is activated to plasmin, and plasmin breaks down fibrin.

A few factors that activate the creation of plasmin

factor XII (hageman), lysosomal enzymes, thrombin

some clotting tests

platelet count, plasma fibrinogen, clot retraction time, and FDP (fibrin degradation products)

the fibrin degradation product that specifically measures degradation of fibrin only

D dimer .. indicates you have formed clots because your body is breaking it down

the time it takes for blood to clot

prothrombin time

Clotting trigger in prothrombin time test for extrinsic measure

thromboplastin

Prothrombin time used to be measured with time but now it uses

INR (international normalized ratio

Explain the activated partial thromboplastin time test

stimuli such as silica, phospholipids, and Ca are added to the intrinsic pathway and then the time it takes for clotting to occur is measured.

3 types of shock and what they are

cardiogenic is heart not pumping properly, hypovolemic is loss of blood, and septic is infection

CBC comprising of 6 elements

Complete Blood Test (automated test)

Anemia

impaired O2 carrying of blood due to RBC quality or quantity

Most common macrocytic normochromic anemia and why it exists

megaloblastic anemia. It occurs when RBC precursor cells have impaired DNA synthesis (likely from folate B12 deficiency), so cell division is delayed while the cells continue growing, producing abnormally large RBCs. Hemoglobin remains relatively normal because protein/Hb synthesis continues in proportion to cell size through RNA

Pernicious anemia

a tricky type of megaloblastic anemia caused by vitamin B12 deficiency due to a lack of intrinsic factor.

A few reasons for iron deficiency

led poisoning, infection, absorption issue, and poor diet

Main two causes of microcytic hypochromic anemia

iron deficiency and sideroblastic anemia

explain the role iron plays in microcytic hypochromic anemia

an iron deficiency causes low Hb production and low Hb production leads to smaller Hb free RBCs

explain the role sideroblastic anemia plays in microcytic hypochromic anemia

iron is present, but developing RBCs cannot use it properly because of mitochondrial dysfunction. This impairs conversion of Fe³⁺ to Fe²⁺ needed for heme and hemoglobin synthesis. As a result, hemoglobin production decreases, producing small, pale RBCs.

ringed sideroblasts

immature RBC precursor cells in the bone marrow whose nuclei are surrounded by a ring of accumulated iron.

Causes of normochromic normocytic anemia

conditions, aplastic, hemorrhagic, hemolysis, sickle cell, inflammation

aplastic

failure of marrow to make all 3 cell types leading to hypocellularity of the marrow and fat replacing where the cells would be in the marrow.

The reasons and percentages for aplastic

75% idiopathic, 15% secondary, 10% hereditary

The SNP causes this in sickle cell disease

switching from glutamic acid to valine on the HB beta chain.

Triggers the sickle cell shape

stress such as dehydration, heat, or deoxygenation

Another disorder related to sickle cell disease and what it impairs

thalassemia, impairs production of Hb

The two heritages that are affected by thalassemia and by which chains

mediterranean beta chain, southeast asian alpha chain.

4 disorders of increased homeostasis

platelet related, increased clotting, fibrinolytic cascade defect, and increased viscosity

Common cause of secondary thrombocytosis

post

What factor mutation leads to increased clotting activity

factor V

An example of fibrinolytic cascade defect

congenital thrombophilia

Which factor is the von willenbrand

factor 8

normal platelet count range

150 to 450k

The three types of hemophilias and their factors

type a is factor 8, type b is factor 9 x linked recessive, and type c is factor 11 autosomal recessive

What phagocytoses platelets in circulation and where

neutrophils, monocytes, and macrophages in the spleen and liver

which coagulation testing is better for testing minor clotting defects

Activated Partial Thromboplastin time

2 main causes of pernicious anemia

end stage gastritis and congenital defect

Which morphological classification of anemia is the most common consisting of 20% of the population

microcytic hypochromic

Atherosclerosis

buildup of fatty, cholesterol

wheres prostacyclin made

endothelial cells and smooth muscle cells

5 things that activated platelets secrete

ADP, histamines, serotonin, factor V, PDGF

How many clotting factors are there?

12 to 15

Main 3 things that activate plasmin

hageman factor 12, lysosomal enzymes, and thrombin

Under what number is considered thrombocytopenia?

under 150k

Under what number of thrombocytopenia is advised no exercise?

20k

How much fibrinogen in plasma?

200

Clot retraction time

a day (typically 4

Normal, healthy INR

0.9 to 1.2

Stable anticoagulant INR

2 to 3

3 acquired deficiencies that may cause reduced clotting

vitamin k, liver disease, gallbladder disease