AP2 Exam #1 (Summer semester)

Chapter 17: Blood

What is the Buffy Coat?

A thin layer of WBCs and platelets between plasma and RBCs after centrifugation

What is the difference between plasma and serum?

Plasma has clotting factors; serum does not

What are the components of whole blood?

Plasma, red blood cells, white blood cells, and platelets

What does Erythropoietin (EPO) do?

Stimulates red blood cell production

What does thrombopoietin do?

Stimulates platelet production

What stimulates RBCs production?

Hypoxia, anemia, hemorrhage, high altitude

what is hematocrit?

% of blood volume occupied by RBCs

What is hemoglobin?

Oxygen-carrying protein in red blood cells

What is a reticulocyte count?

% of immature RBCs; indicates bone marrow activity

What causes sickle cell disease?

Mutation in hemoglobin (HbS); causes RBCs to sickle

What is the function of albumin?

Maintains osmotic pressure

What are immunoglobulins?

Antibodies involved in immune response

What is fibrinogen’s function?

Precursor to fibrin in clotting

Which WBCs are granulocytes?

Neutrophils, Eosinophils, Basophils

Which WBCs are agranulocytosis?

Monocytes and Lymphocytes

What is the function of neutrophils?

Phagocytosis of bacteria

What is the function of Eosinophils?

Fight parasites; involved in inflammation

What do monocytes do?

Become macrophages; Phagocytosis

What do B lymphocytes do?

Produce antibodies

What do T lymphocytes do?

Destroy infected cells; help immune response

Difference between innate and adaptive immunity?

In ate is fast and nonspecific; adaptive is slow and specific

What is adult hemoglobin (HbA)?

Has 2 alpha and 2 beta chains

What is fetal hemoglobin (HbF)?

Has 2 alpha and 2 gamma chains; higher O2 affinity

What do platelets do?

Help form blood clots by forming a plug and releasing clotting factors

What are the 3 phases of hemostasis?

Vascular phase, Platelets phase, Coagulation phase

What happens in the Vascular phase?

Blood Vessels constrict

what happens in the platelets phase?

Platelets stick and form a plug

What happens in the coagulation phase?

Fibrin mesh stabilizes the clot

What pathway involves Factor XII, XI, IX, VII?

Intrinsic pathway

What factor initiates the extrinsic pathway?

Factor VII

What factors are involved in the common pathway?

Factors X,V,II (prothrombin), I (fibrinogen)

What is fibrinolysis?

Breakdown of fibrin clot by plasmin

What in Hemophilia?

Factor VIII deficiency

What is Hemophilia B?

Factor IX deficiency

What is Von Willebrand disease?

Deficiency or defect in vWF protein

What is DIC (Disseminated Intravascular Coagulation)?

Widespread clotting followed by bleeding

What is polycythemia Vera?

Increases RBC production and thick blood

What does Vitamin K deficiency affect?

Decreases clotting factor production (II, VII, IX, X)

What is erythroblastosis fetalis?

Rh incompatibility between Rh-mother and Rh+fetus

How does heparin work?

Activates antithrombin; blocks thrombin and Xa

How is heparin monitored?

PTT ( partial thromboplastin time)

How does warfarin work?

Inhabits vitamin K-dependent clotting factors

How is warfarin monitored?

PT/INR ( prothrombin time)

Who can type O donate to?

A,B, AB, O, (Universal donor)

Who can type “AB” receive from?

“A”, “B”, “AB”, “O”, (universal Recipient)

What is the Rh factor?

D antigen; positive means it is present

What happens if an “Rh-“ person gets “Rh+” blood?

They may develop “anti-D” antibodies

Which one can transport metal in the blood?

Metalloprotein

Which stem cells make Red Blood cells?

Myeloid stem cells

Which term describes hemoglobin when bonded with oxygen?

Oxyhemoglobin

A child is suspected of having Sickle cell disease is seen in a clinic, and laboratory studies are performed. A nurse checks the lab results, knowing that which of the following would be increased in this disease?

Reticulocyte count

What is erythropoiesis?

Red blood cell formation

Why is Hydroxyurea is used to treat patient with Sickle-cell anemia?

Increases their Fetal hemoglobin level

A young couple wants to start a family. The wife talked to you ( the healthcare provider) in private that she had a history of third trimester miscarriage from her previous relationship and she did not know the blood type of her previous boyfriend. Which disease below should any healthcare provider be worried for her second pregnancy?

Erythroblastosis fetalis

A patient has type “B” blood. Which blood type can the patient receive (Pick 2)

• Type “B”

• Type “O”

A patient has type “A-“ blood. Which of the following blood types can the patient receive?

• Type “A-“

• Type “O-“

A patient has type “O+” blood. Which of the following blood types can the patient receive?

• Type “O+”

• Type “O-“

Which blood clotting inhibitor drug works by inhibiting vitamin K?

Warfarin

Critical thinking: A dying patient who badly needed blood is Rh(D) positive. The blood bank sends Rh(D) negative RBCs. What is the nurse’s best action?

Use the blood product supplied because Rh(D) negative RBCs may be safely transfused to Rh(D) positive patients

Platelets are primarily involved in hemostasis

True

Which one is NOT an example of plasma proteins?

Platelets

A patient has type '“A-” blood. Which of the following blood types can the patient receive?

“A-” and “O-”

A patient has type “O+” blood. Which of the following blood types can the patient receive?

“O+” and “O-”

A patient has type “O-” blood. Which of the following blood types can the patient receive?

O-

A patient has type “A+” blood. Which of the following blood types can the patient recieve?

“A+”, “O+” , “A-” , “O-”

A patient has type “AB-” blood. Which of the following blood types can the patient receive?

“O-”' , “A-” , “B-” , “AB-”

A patient has type “B-” blood. Which of the following blood types can the patient receive?

“B-”, and “O-”

Which one is an example of clotbuster medication?

Recombinant tRA

Which one elevates hematocrit?

Dehydration

Chapter 20: Lymphatic System

What are the three main functions of the lymphatic system?

1. Return excess interstitial fluid to the blood

2. Absorb dietary fats (via lacteals in intestines)

3. Provide immune defense by housing and transporting lymphocytes

What is hydrostatic pressure in capillaries?

The pressure exerted by blood plasma that pushes fluid out of capillaries into tissues.

What is osmotic pressure in capillaries?

The pressure exerted by plasma proteins that pulls fluid back into capillaries from tissues.

What structural features help lymph vessels move fluid?

Valves, thin wall, and muscle contractions (Skeletal and smooth).

Describe the flow of lymph through the lymphatic system

Lymphatic Capillaries, Collecting vessels, Lymph trunks, Lymph Ducts, Subclavian Veins.

What body regions does the thoracic duct drain?

Entire left side of body and right side below the diaphragm

Where does the thoracic duct empty?

Into the left subclavian vein

What regions does the right lymphatic duct drain?

Right upper limb, right side of head and thorax

Where does the right lymphatic duct empty?

I to the right subclavian vein

What causes lymphatic filariasis (elephantiasis)?

Blockage of lymphatic vessels by parasitic worms (e.g., Wuchereria Bancrofti)

What are the effects of elephantiasis on the lymphatic system?

severe swelling, mainly in the limbs and genitals, due to impaired lymph drainage

What are the primary lymphoid organs and their functions?

• Bone Marrow: Produces all blood cells, B cell maturation

• Thymus: Site of T cell maturation

What are the secondary lymphoid organs?

Lymph nodes, spleen,tonsils, MALT, Peyer’s patches-where immune responses are initiated

What are afferent and efferent lymphatic vessels?

• Afferent: Bring lymph into the node

• Efferent: Carry filtered lymph out of the node

What are medullary cords and sinuses in a lymph node?

• Cords: Dense lymphatic tissue with immune cells

• Sinuses: Channels that allow lymph to flow through for filtration

What is the function of lymph nodes and where are they found?

Filter lymph; found throughout the body along lymphatic vessels

What does the spleen do?

Filters blood, removes old RBCs, stores platelets, initiates immune responses

What is the thymus and its role?

Site of T cell maturation; located in the upper chest (Mediastinum)

What are Peyer’s patches and MALT?

Lymphoid tissue in intestinal wall (Peyer’s) and other mucosal areas (MALT) that detect ingested pathogens

What are tonsils and their function?

Lymphoid tissue in the pharynx; trap and destroy airborne and ingested pathogens

Chapter 21: Immune System

What is the key difference between innate and adaptive immunity?

In ate immunity is non-specific and present at birth, while adaptive immunity is specific and develops after exposure to antigens

What are the cardinal signs of inflammation?

Redness, heat, swelling, pain, and loss of function.

which chemicals are involved in inflammation?

Histamine, prostaglandins, kinins, cytokines

What is the function of IgG?

Most abundant, provides long-term immunity and crosses placenta.

What is the function of IgA?

Found in mucosal areas (saliva,tears); protects mucosal surfaces

What is the function of IgM?

First antibody produced; activates complement

What is the function of IgE?

Involved in allergic reactions and parasitic infections

what is the function of IgD?

Functions mainly as a B cell receptor