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Hematology Clinical Medicine - I

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1. Macrocytic cells
Male: 14-17 Female: 12-15
HbF: 2 alpha and 2 gamma
Greater than 100 MCV - B12 deficiency - folic acid deficiency - pernicious anemia (form of B12)
RBC - most munerous - Mature they are anucleated boconcave cells which allows more surface area for Hb - certain disease cause shape change: sickle cell anemia - ineffective erythropoiesis is a main feature in many blood diseases

2. Liver disease
Variation in size
liver produces most coagulation factors excepts for VIII - vWF - - liver damage: impaired synthesis of most clotting factors - fibrinogen - plasminogen - malabsoprtion of vitamen K - portal HTN - Labs: prolonged PT - advanced increase PT - PTT - Tx:
Starts with vasoconstriction and this causes platelets to come to the site of damage and adhere to damaged collagen
If platelets are below 40 -000 will spontaneously bleed and occurs where pressure it

3. Bleeding disoders can be....
Acquired or inhereited
Careful hx - age and sex of patient: some d/o are more common in certain sexes and age groups - onset and duration - site of bleeding - taking medication? Aspirin? Warfarin? Plavex - Antecedent trauma? - Recent infections? Strep or viral? - PMH: chro
N - M - Eo - Meg - B - RBC - stem
ITP/TTP: platelets destroyed - bone marrow suppression - drugs - prosthetic heart valve: chew up platelets

4. Mild forms of thalessemia need to be differentiated from...
FE deficiency - have normal FE iron studies because cannot attach to Hb molecule
Bleeding usually begins in infancy or childhood - recurrent bleeding - bleeding from multiple sites
liver produces most coagulation factors excepts for VIII - vWF - - liver damage: impaired synthesis of most clotting factors - fibrinogen - plasminogen - malabsoprtion of vitamen K - portal HTN - Labs: prolonged PT - advanced increase PT - PTT - Tx:
Acquired or inhereited

5. Hemocrit
Lymphocytes: 20-40% - Monocytes: 2- 6% (circulate in the blood 1-3 days and mature in tissues)
group of disorders affecting the structure - function - or production of Hgb - Hgb is important for normal O2 delivery to the tissues. If there is an abnormality then can cause hypoxia of the tissue.
Beta genes are on chromosome 11 - 1 gene on chromosome 11 for each globin chain - totatl 2 genes responsible for the 2 beta globin chains
volume % of RBC in blood - Female: 36-48 - Males: 42-52

6. Bleeding/ Hypercoagulation disorders
M- 75-175 F- 65-165
Parasite infections
Platelet problems - factor 10 and vwf deficiency - vitamin K deficiency - anti-thrombin III deficiency - protein C deficiency - acquired disorder or coagulation
Deletion or point mutation of 1 or more globin genes - caused by reduced synthesis of 1 or more alpha globin chains or beta which leads to microcytic hypochromic anemia - means that the globin chain synthesis is defective from mutated or missing 1 or

7. Blood consists of what cellular elements
Hereditary spherocytosis - G6PD deficiency - sickle cell syndrome
RBC (erythrocytes) - WBC (leukocytes) - Platelet (thrombocytes) - blood cells are surrounded in Plasma
FE deficiency - have normal FE iron studies because cannot attach to Hb molecule
Lymphocytes: 20-40% - Monocytes: 2- 6% (circulate in the blood 1-3 days and mature in tissues)

8. HbF
Lymphoid Leukemia - Mono - acute infections a/w viral diseases
Production of RBC - stimulated by decrease in O2 -kidneys produce hormone erythropoietin
What is stored in body M: 18-270 W: 18-160
Fetal Hg - 2 alpha and 2 gamma chains - 1%

9. IL-1
Autoimmnr hypersplensm
O2 bearing molecule and carries 02 throughout the body
Low neutrophil count - seen in bone marrow/ blood diseases - drugs - chemicals (benzene) - radiation (affects bone marrow)
T lymph - stem cell

10. Hemolysis

11. Variations with HbA
Platelet problems - factor 10 and vwf deficiency - vitamin K deficiency - anti-thrombin III deficiency - protein C deficiency - acquired disorder or coagulation
Plasma protein that binds to Fe and helps absorb it - 200-400
4.5-10
HbA2: 2 alpha and 2 delta globin chains - in 2% of the population

12. Classification of anemia
Autosomal co-dominant traits who inherit a different abnormal allele from each parent - Alpha chain is present in HbA - HbA2 - HbF: alpha chain mutations cause abnormalities in all three - beta chains are present in HbA and HbA2
Male: 14-17 Female: 12-15
Pathophysiologic basis: diminished product of increase destruction - Morphologic basis: measure of average RBC size
The flat bones: sternum - pelvis - proximal ends of the long bones

13. Reticulocyte
Humeral immunity: Ab production
T and B lymph
Primary function is to support O2 transport - hard to bind the first O2 to Hgb but once it does it becomes easier to bind - It must bind at the partial pressure of O2 of alveolus and then it releases it to the tissue at the partial pressure of O2 at
Immature RBC right before it fully matures - Mature (spend 3 days in) red bone marrow and then circulate in the peripheral blood for 1 day and fully mature (extrusion of nucleaus) - 1% of RBC in the body

14. Hematopoietic Stem cells
Primary function is to support O2 transport - hard to bind the first O2 to Hgb but once it does it becomes easier to bind - It must bind at the partial pressure of O2 of alveolus and then it releases it to the tissue at the partial pressure of O2 at
Differentiate into whatever cell the body needs - self renewing - uncommitted cells - can differentiate into specialized cells such as progenitor cells
Hereditary disorder than can vary from mild to severe life threatening - common in areas with malaria and causes a problem with the function and structure of Hb - seen in populations from: SE asia - China - Mediterranean - lesser extent: Africa
T lymph - stem cell

15. Hematopoeisis in adulthood is limited to....
Severe infections
Primary function is to support O2 transport - hard to bind the first O2 to Hgb but once it does it becomes easier to bind - It must bind at the partial pressure of O2 of alveolus and then it releases it to the tissue at the partial pressure of O2 at
The flat bones: sternum - pelvis - proximal ends of the long bones
Hgb in the blood is too low to fulfill the O2 demands of the body - can be a specific disease of a sign of disease progress (GI CA)

16. Heme- Heme interction
MCV: 80-100 - sickle cell anemia - G6PD
The property inherent in the arrangement of the heme and globin units that allows for oxygenation acquisition and delivery over a narrow range of tension
Plasma protein that binds to Fe and helps absorb it - 200-400
ITP/TTP: platelets destroyed - bone marrow suppression - drugs - prosthetic heart valve: chew up platelets

17. What is the life span of blood cells?
Bind to receptors on cells and initiate carrying of signals that generate transcription factors and the cell proliferates
HbF: 2 alpha and 2 gamma
Abnormal size of cells and vary in abnormality
Erythrocytes: 120 days - Platelets: 8-10 days - WBC: hours to few weeks - increase during infection

18. Poikilocytosis
MCV: 80-100 - sickle cell anemia - G6PD
Immature red blood cells - normal: 0.5-1.5%: elevated in people with anemic anemia - low retic: anemia from decreased RBC production
Complete blood count with differential: tells what percentage of cells make up the blood
Abnormally shaped cells - schiztocyte - tear drop - oval

19. PE for anemia
Primary function is to support O2 transport - hard to bind the first O2 to Hgb but once it does it becomes easier to bind - It must bind at the partial pressure of O2 of alveolus and then it releases it to the tissue at the partial pressure of O2 at
Mild: tired - pale - often assymptomatic - pallor - jaudnice - tachycardia - palpitation - spleen enlargement - glossitis - cheilosis (sore in the mouth) - neurologic sxs
Severe infections
Confluent areas of bleeding right below the skin

20. von Willebrand Factor
Hemoglobulinopathy - inherited or acquired - Problem: RBC membrane defects so will get episodic or continuous RBC destruction - varies from mild to severe
large gylcoprotein - major adhesion molecule which allows platelets to stick - binding factor in factor VIII and prolongs its half life
Anemia - hemodilution (over hydration) - leukemia - hemolytic reactions - drugs
Lymphoid Leukemia - Mono - acute infections a/w viral diseases

21. RBC
liver produces most coagulation factors excepts for VIII - vWF - - liver damage: impaired synthesis of most clotting factors - fibrinogen - plasminogen - malabsoprtion of vitamen K - portal HTN - Labs: prolonged PT - advanced increase PT - PTT - Tx:
HbA-2alpha and 2 beta chains
Erythrocytes - respond to tissue hypoxia and carry O2 to the body
The property inherent in the arrangement of the heme and globin units that allows for oxygenation acquisition and delivery over a narrow range of tension

22. purpura
1-2% - alpha and gamma
Cause by increase destruction of RBC in the peripheral blood faster than the bone marrow can produce them - decstruction is intrinsic: defect in production - extrinsic: produced healthy
Megakaryocytes (growth stimulated by thrombopoieten) - help prevent hemorrhages
Palpable - slightly raised areas of bleeding

23. Intrinsic Hemolytic anemia
The property inherent in the arrangement of the heme and globin units that allows for oxygenation acquisition and delivery over a narrow range of tension
O2 bearing molecule and carries 02 throughout the body
Hereditary spherocytosis - G6PD deficiency - sickle cell syndrome
liver produces most coagulation factors excepts for VIII - vWF - - liver damage: impaired synthesis of most clotting factors - fibrinogen - plasminogen - malabsoprtion of vitamen K - portal HTN - Labs: prolonged PT - advanced increase PT - PTT - Tx:

24. Neutropenia
Lymphocytes: 20-40% - Monocytes: 2- 6% (circulate in the blood 1-3 days and mature in tissues)
Hb analysis and electrophoresis with functional assays for sickling - solubility - and O2 affinity are used for routine clinical evaluations
Low neutrophil count - seen in bone marrow/ blood diseases - drugs - chemicals (benzene) - radiation (affects bone marrow)
O2 bearing molecule and carries 02 throughout the body

25. Hemostasis
Anti-thrombin III deficiency - Lupus anticoagulant - other conditions for hyper-coagulation
Severe infections
Arrest of bleeding - depends on vessel wall - platelets - and coagulation factors (fibrolytic factors)
Programmed cell death - eliminates old - unnecessary - or unhealthy/ abnormal cells - defects in the pathway are important in causing CA

26. WBC
Asymptomatic until 4 months of life
Leukocytes - neutraphils - monocytes - basophils - lymphocytes - eosinophils--> 5 different cells divided into 3 classes - immune system and fights viral - bacterial - fungal - parasites - and allergens - classified by presence or absence of granules
Production of RBC - stimulated by decrease in O2 -kidneys produce hormone erythropoietin
Platelets - In BM: very large - In blood: small irregular shaped cell fragments - involved in hemostasis

27. Serum Ferritin
Fetal Hg - 2 alpha and 2 gamma chains - 1%
What is stored in body M: 18-270 W: 18-160
Less than 1 persent
MCV - index for classifying anemia - Norma: 80-100

28. bleeding disorders
Starts with vasoconstriction and this causes platelets to come to the site of damage and adhere to damaged collagen
Baseline test - wellness screening - diagnosing certain condition - response to treatment and recovery - monitor certain health conditions
Protein encasement of heme: 2 chains per globin- 1 alpha and 1 non alpha - 4 globin chains per tetrameter - 2 alpha chains and a pair of non-alpha chains (beta or gamma)
Thrombocytopenia - Henoch- Scholein Purpura - Scurvy - ITP - TTP - DIC - Hemophilia A and B - Von Willebrands disease - Vit. K deficiency - Liver disease

29. Production of Hemoglobin
Platelet problems - factor 10 and vwf deficiency - vitamin K deficiency - anti-thrombin III deficiency - protein C deficiency - acquired disorder or coagulation
Adequate supply of iron - proper synthesis of heme - proper synthesis of globin chains
Deletion or point mutation of 1 or more globin genes - caused by reduced synthesis of 1 or more alpha globin chains or beta which leads to microcytic hypochromic anemia - means that the globin chain synthesis is defective from mutated or missing 1 or
O2 bearing molecule and carries 02 throughout the body

30. Platelet problem
Differentiate into whatever cell the body needs - self renewing - uncommitted cells - can differentiate into specialized cells such as progenitor cells
low platelet count - skin bleeding - mucosa: especially bleeding of gums
O2 bearing molecule and carries 02 throughout the body
Usually 40-45% - fat cells make up 50-55Q% - Rest are RBC precursor

31. monocytes are present in....
Alpha genes are on chromosome 16 - 2 genes on chromosome 16 for every alpha globin chain - total of 4 genes responsible for the 2 alpha globin chains
Confluent areas of bleeding right below the skin
Severe infections
Parasite infections

32. Agranulocytes
Polycythemia vera - CHF/COPD - Drugs - Living at high altitudes
N - M - Meg - RBC
Lymphocytes: 20-40% - Monocytes: 2- 6% (circulate in the blood 1-3 days and mature in tissues)
55% of blood plasma - contains all the blood cells

33. Anemia developes because
Differentiate into whatever cell the body needs - self renewing - uncommitted cells - can differentiate into specialized cells such as progenitor cells
1-2% - alpha and gamma
O2 bearing molecule and carries 02 throughout the body
Excessive loss of RBC - inadequate production of RBC (problem with bone marrow) - increased destruction of RBC - secondary to chronic disease

34. WBC Count
Less than 1 persent
Lymphoid Leukemia - Mono - acute infections a/w viral diseases
GF produced by liver and stimulates production of megakariocytes
4.5-10

35. anisocytosis
Variation in size
O2 bearing molecule and carries 02 throughout the body
Differentiate into whatever cell the body needs - self renewing - uncommitted cells - can differentiate into specialized cells such as progenitor cells
Genetic and rare or acquired

36. Erythropoietin
Adequate supply of iron - proper synthesis of heme - proper synthesis of globin chains
The flat bones: sternum - pelvis - proximal ends of the long bones
GF produced by the kidney and is a glycoprotein - stimulates the production of RBC in response to tissue hypoxia - binds to specific receptors on the surface of RBC precursors
Confluent areas of bleeding right below the skin

37. Elevated MCV
Low WBC count - Bone marrow depression: drug related (H2 blockers) - primary bone marrow disorder - immune associated neutropenia (chemo) - fungal infection of bone marrow (HIV)
Vit B 12 and folic acid deficiency
GF produced by liver and stimulates production of megakariocytes
Standard for reporting the PT

38. Blood is produced....
In the bone marrow
ITP/TTP: platelets destroyed - bone marrow suppression - drugs - prosthetic heart valve: chew up platelets
Protein encasement of heme: 2 chains per globin- 1 alpha and 1 non alpha - 4 globin chains per tetrameter - 2 alpha chains and a pair of non-alpha chains (beta or gamma)
Male: 14-17 Female: 12-15

39. Coagulation factor deficiency
Polycythemia vera - CHF/COPD - Drugs - Living at high altitudes
Vit B 12 and folic acid deficiency
Type of anemia characterized by smaller paler than usual RBC
Skin - tend to bleed also into the muscles and joints

40. Mean Corpuscular Volume
Breaking open of the RBC's and release of HgB (spleen)
Hgb in the blood is too low to fulfill the O2 demands of the body - can be a specific disease of a sign of disease progress (GI CA)
MCV - index for classifying anemia - Norma: 80-100
Humeral immunity: Ab production

41. Decreased MCV
Primary function is to support O2 transport - hard to bind the first O2 to Hgb but once it does it becomes easier to bind - It must bind at the partial pressure of O2 of alveolus and then it releases it to the tissue at the partial pressure of O2 at
Hgb in the blood is too low to fulfill the O2 demands of the body - can be a specific disease of a sign of disease progress (GI CA)
Beta genes are on chromosome 11 - 1 gene on chromosome 11 for each globin chain - totatl 2 genes responsible for the 2 beta globin chains
FE deficiency - Hemoglobinopathies - sideroblastic anemia - lead poisoning

42. Composition of HgB
4 globin chaines: globin (each bines to 1 O2 molecule Heme: binds to iron
Standard for reporting the PT
Less than 1 persent
4.5-10

43. When is a CBC with difference ordered?
Cellular Immunity: helper - killer cells: affected with HIV
ITP/TTP: platelets destroyed - bone marrow suppression - drugs - prosthetic heart valve: chew up platelets
Hereditary disorder than can vary from mild to severe life threatening - common in areas with malaria and causes a problem with the function and structure of Hb - seen in populations from: SE asia - China - Mediterranean - lesser extent: Africa
Baseline test - wellness screening - diagnosing certain condition - response to treatment and recovery - monitor certain health conditions

44. Platelet Count
Acquired or inhereited
N - M - Eo - Meg - B - RBC - stem
Megakaryocytes (growth stimulated by thrombopoieten) - help prevent hemorrhages
150 -000-450 -000

45. What do growth factors do?
Bind to receptors on cells and initiate carrying of signals that generate transcription factors and the cell proliferates
Tetramer structure of proteins - proper arrangement of charged amino acids - interaction with low molecular weight substances
GF produced by liver and stimulates production of megakariocytes
Low WBC count - Bone marrow depression: drug related (H2 blockers) - primary bone marrow disorder - immune associated neutropenia (chemo) - fungal infection of bone marrow (HIV)

46. Major Adult Hgb
Acquired or inhereited
Programmed cell death (cyto C. and caspases)
HbA-2alpha and 2 beta chains
Cellular Immunity: helper - killer cells: affected with HIV

47. Neutophilia
large gylcoprotein - major adhesion molecule which allows platelets to stick - binding factor in factor VIII and prolongs its half life
Production of RBC - stimulated by decrease in O2 -kidneys produce hormone erythropoietin
Complete blood count with differential: tells what percentage of cells make up the blood
High neutrophil count - due to acute - localized/ general bacterial infections - inflammation - myeloproliferative diseases

48. Thallassemia Syndormes
Hereditary disorder than can vary from mild to severe life threatening - common in areas with malaria and causes a problem with the function and structure of Hb - seen in populations from: SE asia - China - Mediterranean - lesser extent: Africa
Bind to receptors on cells and initiate carrying of signals that generate transcription factors and the cell proliferates
Parasite infections
Skin: hematomas - petechiae - nose and mouth/ throat bleeding - LN: usually not involved - HLA: look for enlarged spleen - liver - MSS: hemathrosis (bleeding into the joints - swollen - tender)

49. INR
HbF: 2 alpha and 2 gamma
Acyclovir - Phenytoin - Quinin - Amphotericin B - Levamisole - Digoxin - Ibuprofin - Amiodarone - Rifampin - ASA
Standard for reporting the PT
Lymphoid Leukemia - Mono - acute infections a/w viral diseases

50. Albumin
FE deficiency - Hemoglobinopathies - sideroblastic anemia - lead poisoning
Bind to receptors on cells and initiate carrying of signals that generate transcription factors and the cell proliferates
Most abundant protein in the plasma and helps establish the osmotic gradient
MCV: 80-100 - sickle cell anemia - G6PD