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PNU Adult Health II Spring Exam 2 Questions With Rationale
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PNU Adult Health II Spring Exam 2 Questions WithRationale 2024-2025
The bone marrow is the main site for ____
hematopoiesis
____ ____ are undifferentiated cells that have the ability to become any type of blood
cell
stem cells
Brainpower
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3 types of myeloid stem cells
-erythrocytes (RBCs)
-leukocytes (WBCs)
-thrombocytes (platelets)
2 types of lymphoid stem cells
-T cells
-B cells
(main functioning cells of the immune system)
____ ____ is the name for the locations of massive erythrocyte production
red marrow
____ ____ is the name for the areas where red marrow is replaced by fat in adults
yellow marrow
2 main functions of erythrocytes (RBCs)
-pick up O2 in lungs & carry it to tissues
-pick up CO2 in tissues & carry it lungs
____ is the pigment part of hemoglobin that contains iron
heme
____ is the part of hemoglobin that is a special protein that binds reversibly with O2
(4) globin
what is erythropoiesis?
production of RBCs
3 components needed for RBC production
-iron
-folic acid
-vitamin B12
leukocytes (WBCs) function
protect the body against infection
____ cells are immature granulocytes (WBCs)
band
____ ____ is an increase in band cells (immature WBCs) which increases the risk for
____
left shift; infection/sepsis
5 types of WBCs
,-neutrophils
-eosinophils
-basophils
-monocytes
-lymphocytes
where is erythropoietin produced?
kidneys
____ is platelet formation
thrombopoiesis
thrombopoiesis is stimulated by the release of thrombopoietin from the ____ & ____
liver & kidneys
where are thrombocytes (platelets) stored?
spleen
thrombocytes are responsible for the formation of what?
clots
2 main functions of spleen
-storage of platelets
-filtration of old RBCs
in older age adults, bone mass & intracellular fluid decreases causing a decrease in
____ ____
blood volume
increased vitamin K can cause increased ____
clotting
3 categories of meds that affect hematologic function
-anticoagulants
-fibrinolytics
-platelet inhibitors
other categories/types of meds that can interfere with platelets
-NSAIDs
-ASA
-acetazolamide
-thiazide diuretics
-PCN (penicillin)
why is important to be cautious with an enlarged spleen?
it can rupture very easily = lots of bleeding
normal WBC count
5,000-10,000
normal RBC count (M & W)
M: 4.71 - 5.14
W: 4.2 - 4.87
normal hemoglobin (M & W)
M: 13 - 18
W: 12 - 16
____ is defined as percentage of RBCs in total blood volume
hematocrit
normal hematocrit (M & W)
M: 43-49%
W: 38-44%
,MCV (mean corpuscular volume) is the average size of the ____
erythrocyte
MCV (mean corpuscular volume) results
-macrocytic (elevated)
-microcytic (decreased)
-normocytic (normal)
reticulocyte count tells the number of immature ____
RBCs
reticulocyte count is helpful with what 3 things?
-determining types of anemia
-assessing blood loss
-evaluate bone marrow response
normal platelet count
150,000-450,000
ESR (erythrocyte sedimentation rate) is the rate at which erythrocytes ____; this number
increases with ____
settle; inflammation
____ is the protein that stores iron
ferritin
low levels of ferritin could indicate what 3 things?
-iron deficiency anemia
-chronic GI bleed
-heavy menstrual bleeding
high ferritin causes (2)
-ETOH liver disease
-hemolytic anemia
____ is the plasma protein that transports circulating iron to the liver, spleen, or BM for
storage
transferrin
PT (prothrombin time) is the time required for a ____ ____ to form in a plasma sample
fibrin clot
PTT (partial thromboplastin time) is used to screen for ____ in clotting factors & to
monitor response to thrombin inhibitor therapy
deficiencies
what two labs are tested in those using warfarin?
PT & INR
what lab is tested in those using heparin?
PTT
if PT, INR, and/or PTT are increased, the person is at an increased risk for ____
bleeding
an ____ biopsy is removal of fluid from the bone marrow
aspiration
a ____ biopsy is removal of a core of marrow cells from the bone marrow
needle
what are some things a bone marrow biopsy are used to diagnose?
"issues with production or cancer"
-thrombocytopenia
-leukemia
, -anemia
-tumors
-infections
-stage diseases such as hodgkin's
-evaluate chemotherapy
-monitor myelosuppression
components of pt education prior to a bone marrow or aspiration biopsy?
-takes 10-15 min
-except pressure on insertion & brief pulling pain upon aspiration
-may hear a crunching sound or feel a scraping sensation
is informed consent required for a bone marrow or aspiration biopsy?
yes
after a bone marrow or aspiration biopsy, direct pressure should be held to the puncture
site for how long?
5-10 minutes
the puncture site for a bone marrow or aspiration biopsy should be covered with a ____
dressing that SHOULD NOT be removed for the first ____ hours under any
circumstance
sterile; 24 hours (if bleeding through dressing, reinforce as needed, DO NOT remove)
what is leukopenia?
low WBC count
what is neutropenia?
low neutrophil count
neutrophils prevent & limit bacterial infections, therefore neutropenia increases the risk
of ____
infection
what is lymphopenia?
decreased lymphocytes
what is leukocytosis?
high WBC count
leukemia is a malignant disease also called ____ cancer
blood
leukemia is defined as unregulated proliferation of ____ in the bone marrow
WBCs (mostly immature)
leukemia can occur due to a defect in either ____ or ____ stem cells
myeloid or lymphoid (2 types)
common causes of leukemia
-genetics
-BM damage from radiation
-BM damage from chemicals
the immature WBCs that are produced but never mature in leukemia are known as
leukemic cells aka ____ cells
blast
the leukemic (blast) cells do not ____ like normal cells & the BM becomes filled with
these & they eventually enter ____
die (apoptosis); circulation
what 3 areas in the body can become congested d/t overproduction of leukemic (blast)
cells?
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