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HEME EXAM STUDY GUIDE
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HEME EXAM STUDY GUIDE...
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HEME EXAM STUDY GUIDEErythrocytes - ANSWER -red blood cells
-contain molecule hemoglobin that binds oxygen
-no nucleus so they can bind more oxygen
-biconcave shape allows for movement through small capillaries
Leukocytes - ANSWER -has nucleus and organelles
-produces proteins and peptides
-non-specific and specific immunity
-capable of chemotaxis
Granulocytes - ANSWER -basophils
-eosinophils
-neutrophils
Agranulocytes - ANSWER -monocytes
-B and T lymphocytes
Platelets - ANSWER -involved in clot formation
Neutrophils - ANSWER -polymorphonuclear leukocytes
-*1st line defense*
-phagocytosis
Eosinophils - ANSWER -*allergic rxns and parasitic infections*
Basophils - ANSWER -allergic rxns and inflammaton
-release histamine
Erythropoietin - ANSWER -hormone produced by kidneys
-decreased oxygen in blood that is filtered through kidneys triggers EPO
production
-EPO stimulates bone marrow to increase RBC production
-more RBC= more oxygen in the blood -> EPO reduced
,Hemostasis - ANSWER Primary hemostasis- at the site of vascular
damage
Step 1:
Platelet adhesion- mediated von Willebrand's factor and platelets that
anchor to vessel walls
Step 2:
Platelet activation- adhesion of platelets to vessel wall activates them
causing them to change shape
-platelets release thromboxane A2 and platelet activating factor
Step 3:
Platelet aggregation
Secondary hemostasis- stabilizing the clot
Intrinsic pathway - ANSWER
Extrinsic pathway - ANSWER
vitamin k dependent cofactors - ANSWER II, VII, IX, X
Men red cell volume (Mean corpuscular volume) - ANSWER -
measurement of the average size of your RBCs
-elevated when RBCs are larger than normal (macrocytic) such as in
Vitamin B12 deficiency
-decreased in microcytic anemia like Iron deficiency or thalassemia
Mean corpuscular hemoglobin concentration - ANSWER -average
concentration of hemoglobin inside a red cell
-decreased MCHC (hypochromia) are seen where hemoglobin is diluted
in the red cells like in iron deficiency anemia and in thalassemia
-increased MCHC (hyperchromia) seen where hemoglobin is abnormally
concentrated like in burn pts and hereditary spherocytosis
Reticulocyte count - ANSWER -clue into possible causes of anemia
,-serve as indicator of adequacy of bone marrow red blood cell
production
-increased= associated with increased RBC production, response to
blood loss or hemolytic anemia
-decreased= decreased production of RBC
Hematocrit - ANSWER -percent of total blood volume made up by RBCs
compared with the height of the total whole blood column
Hemoglobin - ANSWER -measure of the total amount of Hgb in
peripheral blood which= number of RBCs in the blood
Serum iron - ANSWER -quantity of iron bound to transferrin
TIBC - ANSWER -total iron binding capacity
-measurement of all iron binding proteins
-indirect measurement of transferrin which is the largest quantity of iron
binding proteins
*Increased in iron deficiency anemia*
Ferritin - ANSWER -*measures iron body stores*
-major iron storage protein
-indicates available iron in body
-increased in megaloblastic anemia
-decreased in iron def anemia
Haptoglobulin - ANSWER -binds to free Hb that is released during
hemolysis (rupture of RBCs) so it is used to detect hemolysis
-used as acute phase protein as nonspecific way to detect inflammatory
dz
Transferrin - ANSWER -measures body's ability to transport iron in the
blood
Iron Absorption - ANSWER -absorbed in the stomach and upper SI
, Iron transport - ANSWER -ferroportin transports iron from the diet across
the intestinal lumen
Anemia - ANSWER -defined as decrease in RBC number and function
S&S:
-fatigue
-loss of stamina
-SoB
-tachycardia
-*pallor*
-some younger pt's may not initially have S&S
Anemia of Chronic Disease - ANSWER -normocytic
-chronic inflammatory conditions: infection, inflammation, autoimmune
disorders, malignancy
-occurs in chronic infection like tuberculosis, lung abscess, kidney
disease, RA, cancer, inflammation, lupus, or trauma
-inflammatory cytokines suppress erythropoiesis
Labs:
-low serum iron
-*low TIBC*
-low serum transferrin
-*serum ferritin levels are increased or normal*
Tx:
-treat precondition causing anemia
-EPO if renal disease
Iron Deficiency Anemia - ANSWER -MC anemia worldwide
-*MC due to bleeding*
-microcytic hypochromic
Etiologies:
-blood loss due to excessive menstruation, occult (colon CA, parasitic
hook worms)
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