PATHO 2- TEST 2

Hemostasis

"arrest of bleeding, aka blood clotting." keeps us from hemorrhaging!

**Mononuclear phagocyte system (MPS)

*FILTERS & CLEANS THE BLOOD, MOSTLY IN THE LIVER & SPLEEN* by INGESTING & DESTROYING MICROORGANISMS, FOREIGN material, & CELLULAR DEBRIS. CONSISTS of; a LINE of CELLS that ORIGINATE IN BONE MARROW, & then are TRANSPORTED INTO the BLOODSTREAM where they DIFFERENTIATE into MONOCYTES, & then SETTLE IN THE TISSUES as MATURE MACROPHAGES.

Malignant Lymphomas

Consist of a diverse group of neoplasms that develop from the proliferation of malignant lymphocytes in the lymphatic system, i.e., your lymph nodes. Includes 2 major categories, Hodgkin lymphoma, & Non-Hodgkin lymphoma (a CATCH ALL TERM).

Macrophages = BIG

MATURE VERSIONS of MONOCYTES, these phagocytic AGRANULOCYTE white blood cells *FULLY MATURE IN the TISSUES of the LIVER, SPLEEN & LYMPH NODES*.

Plasma differs from serum BECAUSE

PLASMA HAS clotting proteins, mainly FIBRINOGEN, which may interfere with some diagnostic tests.

Globulins

PLASMA PROTEINS that function as CARRIER PROTEINS and IMMUNOGLOBULINS, like ANTIBODIES, these carry out the bloods IMMUNE FUNCTIONS

MYELOPROLIFERATIVE RBC DISORDERS

Polycythemia aka Overproduction of red blood cells. Exists in two forms, Relative & absolute polycythemia

Adults Have 2 kinds of bone marrow

Red bone marrow, known as ACTIVE OR HEMATOPOIETIC MARROW, also called myeloid tissue, & yellow bone marrow, which is inactive bone marrow. Bone cavities contain only red marrow at birth.

Basophils

Type of *WBC GRANULOCYTE*, Structurally & functionally, these are SIMILAR TO MAST CELLS, play a role in *INFLAMMATION.

Infection & Steroid Presence triggers an Increase in_____ Cells

WBCs, leading to overproduction, aka Leukocytophilia.

*"shift to the right"

When WBC count population returns to normal.

Clotting factors

are PLASMA PROTEINS, such as prothrombin & FIBRINOGEN which makes fibrin clots to promote coagulation & stop bleeding.

The secondary lymphoid organs include the

spleen, lymph nodes, tonsils, and Peyer patches in the ileum of the small intestine.

The primary lymphoid organs include the

thymus & bone marrow.

Hemostasis Requirements

1) Endothelial cells of the vasculature 2) Platelets-Contribute to the regulation of blood flow into a damaged site, Initiate platelet-to-platelet interactions resulting in the formation of a platelet plug, Activate the coagulation (or clotting) cascade, Initiate repair processes, including clot retraction and clot aka break down of a fibrin clot dissolution (fibrinolysis) Clotting factors. Control of Hemostatic Mechanisms- Clot retraction & Lysis of blood clots (Fibrinolytic system)

The classification of leukemia is based on

1) the predominant cell of origin 2) the degree of differentiation that took place before the cell became malignant.

NORMAL Erytrocyte Concentration is __- __ ____ cells/mcL in Males & __- __ ____ cells/mcL in Females

4.7-6.1 MILLION cells/mcL, & 4.2 - 5.4 MILLION cells/mcL

NORMAL WBC VALUE-_______-________ cells/mm.

5,000-10,000

Leukocytes (WBCs)

5,000-10,000 cells/mm. These NUCLEATED cells, are either granulocytes or agranulocytes, & immunocytes or phagocytes GRANULOCYTES MATURE IN the bone MARROW. AGRANULOCYTES and MONOCYTES are RELEASED INTO the BLOODstream BEFORE they FULLY MATURE. ORIGIN-these arise FROM STEM CELLS IN the BONE MARROW. LIFE SPAN-Days, depends on type.

Albumins=___ % of Plasma Proteins

57

The average TOTAL BLOOD VOLUME in ADULTS = __ QUARTS or ___ LITERS, which = ___% of their TOTAL BODY WEIGHT, & 4% of their TBW.

6 QUARTS, or 5.5 L, 8%

The FORMED ELEMENTS, aka CELLS

= 45% of the Bloods total volume, this is a mixture of RBCs, WBCs, & PLTs, THAT all CIRCULATE, SUSPENDED IN PLASMA. (which makes up the other 55% of bloods total volume)

PLASMA

=55% BLOOD VOLUME, THIS COMPLEX AQUEOUS SOLUTION is made of organic & inorganic elements, making it 90% WATER & 10% SOLUTES. 10% SOLUTES = 7% are the 4 PLASMA PROTEINS/CLOTTING FACTORS, 3% = (MAINLY) ELECTROLYTES

Plasma Proteins

=7% of all Plasma, it's 2 major constituents are ALBUMIN & GLOBULINS, but it also contains CLOTTING FACTORS, mostly FIBRINOGEN & Prothrombin (also Transferrin & Ferritin) These provide OSMOTIC PRESSURE of plasma, act as buffers, binds other plasma constituents to one another, (e.g., lipids, hormones, vitamins, minerals), & act as CARRIERS.

Yellow Bone Marrow

ACTS as a blood reserve called into action in response to serious infection or red bone marrow loss.

Posthemorrhagic anemia (Normocytic-Normochromic Anemias)

Acute blood loss from the vascular space

Infectious Mononucleosis (QUALITATIVE)

Acute, self-limiting infection of B lymphocytes transmitted by saliva through personal contact. Commonly caused by the Epstein-Barr virus (EBV)—85% of B cells have an EBV receptor site. SYMPTOMS-Fever, Sore throat, Swollen cervical lymph nodes, Increased lymphocyte count Epstein-Barr virus (EBV). Serious complications are infrequent (<5%)-Splenic rupture is the most common cause of death, with>50% lymphocytes & at least 10% atypical lymphocytes. Diagnostic test-Monospot qualitative test for heterophilic antibodies. TREATMENT-Symptomatic, Rest, Analgesics/antipyretics

Stem cell system

At least 2 populations of stem cells are found in bone marrow niches. Hematopoietic stem cells (HSCs) are progenitors of all hematologic cells. Mesenchymal stem cells (MSCs) are stromal cells (connective tissue cells) that can differentiate into a variety of cells, including osteoblasts, adipocytes (store fat), chondrocytes (produce cartilage), sinusoidal endothelial cells, fibroblasts, and other stromal cells (connective tissue cells) that have a role in maintaining HSCs.

HODGKIN LYMPHOMA Comparisons

BETTER LYMPHOMA TYPE, only a SINGLE, LOCALIZED, AXIAL GROUP OF NODES (i.e., cervical, mediastinal, paraaortic) are present. Meaning the Nodes spread CONTIGUOUSLY and orderly, so EXTRANODAL involvement is RARE. NODES are SOFT, SIGNS & SYMPTOMS of Fever, weight loss, & night sweats ARE COMMON, so early Dx is easier.

BLOOD VOLUME & NORMS

BLOOD VOLUME & NORMS 6 QUARTS, or 5.5 L, 8% PLT (no mitosis) 150,000-400,000 cells/mL, RBCs (no mitosis, 120 days) (mult hgb x3) HEMOGLOBIN (Hgb) MEN = 13.8-17 WOMEN= 12-15 WBC (Mitosis, Life DEP) 5,000-10,000

Pediatrics & Hematologic System

Blood cell counts increase above adult levels at birth, Trauma of birth and cutting the umbilical cord, The hypoxic intrauterine environment stimulates erythropoietin production, Resulting in polycythemia, Children tend to have more atypical lymphocytes as a result of frequent viral infections

Anemia classified by

CAUSE SIZE/SHAPE-Identified by terms that end in -cytic, (Macrocytic, microcytic, normocytic-Hemoglobin) CONTENT-Identified by terms that end in -chromic (Normochromic and hypochromic)

ALL BLOOD ABNORM RESULTS are Found in what lab test

CBC w/DIFFERENTIAL.

Hodgkins Lymphoma

Characterisics- 1) Localized to a single axial group of nodes (i.e., cervical, mediastinal, paraaortic) and the Progression from one group of lymph nodes to another 2) Development of systemic symptoms 3) Presence of *REED-STERNBERG cells is NECESSARY FOR DIAGNOSIS, & FOR DIFFERENTIATION FROM NON-HODGKINS-BUT THEY ARE NOT SPECIFIC TO HODGKIN LYMPHOMA, their presence indicates lymphocyte malignancy has occurred. Physical findings- the FIRST SIGN of disease is PAINLESS, LARGE, SOFT, & FIXED LYMPH NODES in the Neck, which is a form of Adenopathy, aka ENLARGED swollen lymph nodes, is *** Mediastinal mass aka, swelling of the lymph nodes in your mediastinum, splenomegaly, aka spleen enlargement, and abdominal mass, which is also usually because of lymph node swelling in other parts of the body. Symptoms- Fever, weight loss, ***night sweats, pruritus, aka ITCHING. Laboratory findings- elevation, i.e., Thrombocytosis, leukocytosis, eosinophilia, elevated ESR, aka, Erythrocyte Sedimentation Rate, & elevated alkaline phosphatase. TREATMENT-Chemotherapy alone in most cases, Sometimes radiation

1) Macrocytic-Normochromic Anemias (megaloblastic anemias)**

Characterized by LARGE RBCs, aka erythrocytes, that are defective at DNA synthesis, but the HEMOGLOBIN IS FINE. Deficiencies in vitamin B12 or folate cause these anemias. These defective erythrocytes die prematurely, which decreases their numbers in circulation. Usually characterized by RBCs made in the bone marrow that are TOO BIG and weirdly shaped, they're so that are DESTROYED BY THE MPS SYSTEM D/T their abnormalities BEFORE THEY CAN BE SYNTHESIZED CAUSING US NOT TO HAVE ENOUGH.

3) Normocytic-Normochromic Anemias

Characterized by RBCs that are relatively NORMAL IN SIZE & HEMOGLOBIN CONTENT, but RBCs are INSUFFICIENT IN NUMBER.

Adult Red, aka ACTIVE, bone marrow Locations

Cranium and mandible, Sternum and ribs, Vertebrae, Pelvic bones, Humerus, & Femur.

Aging & Hemato System

Erythrocyte life span is normal, but erythrocytes are replaced more slowly. Possible CAUSES-Iron depletion. DEC total serum iron, iron-binding capacity, and intestinal iron absorption. Lymphocyte function decreases with age. The humoral immune system is less responsive.

Clot retraction

Fibrin strands shorten, become denser, and stronger to approximate the edges of the injured vessel and "seal" the injury site, which is facilitated by large numbers of platelets within the clot & contractile proteins in the platelets.

**Monocyte-derived macrophages

From the circulation begin appearing at the inflammatory site as soon as 24 hours after the initial neutrophil infiltration but do not arrive in large numbers until 3 to 7 days later. They are attracted by chemotactic factors released by the neutrophils that are already present at the site.

Leukocytosis

HIGHER WBC type count, this disorder is a normal protective physiologic response to physiologic stressors. CAUSES-Bacterial/Viral Infections

Neutrophilia, aka Granulocytosis (QUANTITATIVE)

HIGHER WBC type count, usually seen in the *FIRST STAGES OF AN INFECTION OR INFLAMMATION*. The disease begins when stored blood cells are released from bone marrow. If the need for neutrophils increases beyond that supply, immature neutrophils are released into the blood.

Lymphocytosis (QUANTITATIVE)

HIGHER, due to ACUTE VIRAL INFECTION predent. For example, EPSTEIN-BARR VIRUS, aka EBV.

Eosinophilia (QUANTITATIVE)

HIGHER, due to either the occurrence of an *ALLERGIC REACTION OR PARASITIC INVASION* & SUBSEQUENTLY, TRIGGERS THE RELEASE OF EOSINOPHILIC CHEMOTACTIC FACTOR, which CAUSES ANAPHYLAXIS to be RELEASED FROM *MAST CELLS* & CAUSES A HYPERSENSITIVITY, aka ANAPHYLACTIC, REACTION!

Monocytes

IMMATURE WBCs MACROPHAGES FOUND IN THE BONE MARROW. These cells are PHAGOCYTES & ARE THE LARGEST OF THE WHITE BLOOD CELLS (14-20 µm in diameter). These cells MIGRATE TO THE SITE OF *INFLAMMATION, where they transform into macrophages. They're also the precursors of specific tissue macrophages, including Kupffer cells (liver), alveolar macrophages (lungs), & microglia (brain).

Endomitosis

In the DEVELOPMENT OF PLTs, this megakaryocyte undergoes the nuclear phase of cell division but fails to undergo cytokinesis. The megakaryocyte expands due to the doubling of the DNA & breaks up into fragments. PLT levels are MAINTAINED BY THROMBOPOIETIN, & they CIRCULATE FOR 10 DAYS before losing their ability to carry out biochemical reactions. After that, SENESCENT or "OLD" PLATELETS ARE SEQUESTERED & DESTROYED IN THE SPLEEN. -EXPOSURE TO SUBENDOTHELIAL LINING CAUSES STICKY PLATELETS

ANEMIA

LOW RBC COUNT or LOW QUALITY/QUANTITY of hemoglobin It can be an umbrella diagnosis with several variations based on etiology of the disease in each patient. CAUSES- 1) Impaired erythrocyte production. 2) Acute or chronic blood loss. 3) Increased erythrocyte destruction. 4) Combination of all three. PHYSIOLOGIC MANIFESTATIONS-Reduced oxygen-carrying capacity-hypoxemia/Variable symptoms based on severity and the ability of the body to compensate. SYMPTOMS-*Classic anemia symptoms*-Fatigue, Weakness, Dyspnea, Pallor, Dizziness & Pounding heartbeat, INC HR, W/OUT INC IN BP, INC RESPIRATIONS TO TRY TO INC, TRYING TO COMPENSATE FOR LACK OF BLOOD & OXYGEN AROUND IT BY PUSHING OUT MORE BLOOD AND EXTRA BREATHING TO PULL IN OXYGEN. In mild cases, these symptoms aren't always there & only show up upon exertion, but these symptoms are always seen in SEVERE cases.

Neutropenia (QUANTITATIVE)

LOWER WBC type count due to *SEVERE PROLONGED INFECTION*. CAUSED-when production of granulocytes cannot keep up with demand* Decreased production/interference with development. Reduced survival Abnormal neutrophil distribution and sequestration Chemotherapy and radiation CLINICAL MANIFESTATIONS-infection/sepsis, malaise, fever, tachycardia "Shift to the Left."

Lymphocytopenia (QUANTITATIVE)

LOWER WBC type count, CAUSES-Abnormalities of lymphocyte production associated with neoplasias and immune deficiencies, Destruction by drugs, viruses (AIDS), or radiation

Leukopenia (QUANTITATIVE)

LOWER WBC type count, this is NOT NORMAL OR BENEFICIAL response. Predisposes a patient to infections. CAUSES-Chemo, Radiation, anaphylactic shock, autoimmune disease, immune deficiencies, i.e., things causing BONE MARROW SUPRESSION.

Eosinopenia (QUANTITATIVE)

LOWER, due to *DECREASED PRODUCTION causes there NOT to be ENOUGH of them to CIRCULATE IN THE BLOOD PROPERLY*. Usually DUE TO the migration of cells to the inflammatory sites, like those found in Surgery, Shock, Trauma, Burns, & Mental distress.

Spleen

Largest & MASTER lymphoid organ, this is the SITE OF ALL FETAL HEMATOPOIESIS, aka blood production; however, after birth, it mostly happens in the BONE MARROW. MPS filters & cleanses the blood through its lymphocyte's mount immune response to blood-borne microorganisms & SERVES AS A RESERVOIR for BLOOD, especially platelets, as 1/3 of all PLTs are stored here! The spleen is divided into masses of lymphoid tissues, including splenic pulp, venous sinuses, & lymph nodes.

Leukemias

Malignant disorder of the blood and blood-forming organs. Uncontrolled proliferation of malignant leukocytes. Pancytopenia occurs if cells crowd the bone marrow. PATHO-Tendency to reappear in families; several genetic errors are observed in leukemia. Risk factors-Enviornmental Factors, cigarette smoke, ionizing radiation, HIV, Hep C, & Down syndrome.

Erythrocytes, RBCs

NORMAL AMT- Males-4.7-6.1 MILLION cells/mcL, Females-4.2 TO 5.4 MILLION cells/mcL. MOST ABUNDANT CELL in the body. Its FLATTENED, DONUT-like SHAPE makes it CAPABLE OF BICONCAVITY & diapedesis. ORIGIN- created by ERYTHROPOETIN secretions DURING HYPOXIA causing erythroblasts, (aka normoblasts) to mature into these cells. LIFE SPAN-*120-DAY LIFE CYCLE is quite short*, but it's because they *CANNOT DO MITOTIC DIVISION, DUE to having NO NUCLEUS.* PURPOSE-Does *TISSUE OXYGENATION by BINDING TO any of the 4 HEMOGLOBIN (Hb) molecules & performing gas diffusion by transporting it throughout bodt

Platelets, PLTs

NORMAL Concentration-150,000-400,000 cells/mL, CYTOPLASMIC MEGAKARYOCYTIC FRAGMENTS, NOT CELLS, NO mitosis. LIFE SPAN- 10 DAYS, & old ones filtered out in spleen by MPS. ORIGIN-Created by ERYTHROPOIESIS, from erythroblasts, aka normoblasts mature into them. 1/3 of ALL cells STORED IN SPLEEN. PURPOSE-Essential FOR **BLOOD COAGULATION**/clots & control of bleeding, aka HEMOSTASIS after vascular injury. Release of growth factors. REGULATOR-**THROMBOPOIETIN.**

Absolute Primary-Polycythemia Vera (PV)

Neoplastic, nonmalignant condition, Abnormal proliferation, or OVERPRODUCTION of RBCs from bone marrow stem cells causes increased RBCs, Occurs despite normal to below normal levels of erythropoietin. CLINICAL MANIFESTATIONS-Clogging and occlusion of blood vessels, Ischemia/infarction of tissues. TREATMENT-Phlebotomy, aka DRAINING of blood to reduce red cell mass and blood volume at approximately 500 ml 2-3x/week.

Albumins

PLASMA PROTEINS, that are the most ABUNDANT & FAST moving CARRIERS of blood components & drugs, & that CONTROL the PLASMA ONCOTIC PRESSURE by regulating the passage of water & solutes through the capillaries**

Absolute Secondary-Polycythemia Vera (PV)

Physiologic response resulting from CHRONIC HYPOXIA CAUSING OVER SECRETION of ERYTHROPOIETIN, because that is TRIGGERED BY HYPOXIA, & whose job is to literally make more RBCs. Thereby, this oversecretion is caused by issues that cause CHRONIC HYPOXIA, SUCH AS DISORDERS OR LOCATIONS FACTORS, LIKE PEOPLE W/COPD or PPL LIVING AT HIGH ALTITUDES.

Chronic leukemia

Predominant cell is mature but does not function normally. The slow growth of more differentiated cells, gradual onset, & the prolonged clinical course leads to longer survival time. Chronic myelogenous leukemia (CML). Chronic lymphocytic leukemia (CLL)

Acute leukemia

Presence of undifferentiated or immature cells, usually blast cells. The rapid growth of immature blood cells & onset of abrupt/rapid disease progression leads to short survival time. Examples-Acute lymphocytic leukemia (ALL) & Acute myelogenous leukemia (AML).

CLASSIFIED INTO QUANTITATIVE & QUALITATIVE DISORDERS:

QUANTITATIVE DISORDERS of these cells D/T Bone marrow causing the release MONOCYTES, i.e., immature WBCs in response to an infectious microorganism's over invasion causing a high destruction/premature destruction of MATURE cells. Qualitative disorders of these cells disrupt cellular function.

Hgb test

TELLS US THE BLOODS OXYGEN CARRYING CAPACITY.

**Hematopoiesis

THE PROCESS OF BLOOD CELL PRODUCTION. For a FETUS, this process ONLY occurs in the LIVER & SPLEEN, *AFTER BIRTH THIS PROCESS OCCURS ONLY IN BONE MARROW, aka MYELOID TISSUE. PROCESS REQUIRES 2 biochemical stimulation processes to occur, known as mitosis, aka cell proliferation, which stops before the cell enters the peripheral blood, & cell differentiation. Cycle Continues throughout life but can increase in response to many factors, e.g., pregnancy, hemorrhage, etc. ** (typical human requires 100 billion new blood cells each day, don't need to memorize)

Splenic pulp

THINK OF A *SCREEN DOOR FILTER*; this MASS in the SPLEEN the *CHIEF SITE OF IMMUNE & PHAGOCYTIC FUNCTION*. Mass is comprised of macrophages and lymph tissue that is responsible for the process in the spleen of filtering out microorganisms IN THE BLOOD

Pernicious anemia (megaloblastic anemias)**

TOO BIG RBCs! Caused by a LACK OF INTRINSIC FACTOR FROM THE GASTRIC PARIETAL CELLS, required for gastric absorption of vitamin B12, Results in vitamin B12 deficiency, With Hgb level of 7 to 8g/dL. B12 is ESSENTIAL FOR nuclear maturation and synthesis of RBCs, which causes inadequate absorption of the vitamin B12, which causes the RBCs created to be DEFECTIVE & in this case, TOO BIG! SIGNS & SYMPTOMS-FATIGUE, WEAKNESS, DYSPNEA, PALLOR, DIZZINESS & POUNDING HEARTBEAT, NEURO CHANGES= Nerve demyelination leads to paresthesia, Loss of appetite, Abdominal pain, BEEFY RED TONGUE AKA ATROPHIC GLOSSITIS, SPLENIC ENLARGEMENT DUE to ALL THE WORK the MPS system is having to do so much work to filter everything out. TREATMENT-PARENTERAL OR HIGH ORAL DOSES OF VITAMIN B12. Normally it TAKES a LONG TIME FOR PROBLEMS TO GET BAD, BUT IF the TREATMENT ISN'T DONE, the disease CAN BE DEADLY.

2) Microcytic-Hypochromic Anemias

TOO SMALL RBCs, & contain LACK OF hemoglobin. Related to CAUSES-Disorders of *IRON METABOLISM*, which is usually D/T iron inadequate intake, is the most COMMON type of anemia worldwide. But this type also includes Disorders of porphyrin & hemoglobin synthesis on RBCs, Disorders of hemoglobin synthesis.

The Hematologic System, aka BLOOD's 6 Chief Functions 1) ______ SUBSTANCES for ________ ___________, 2) REMOVE _____, 3) ______ against _______ & _____ 4) MAINTAIN _____-_____ BALANCE, 5) _____ Blood, & 6) Perform ______, thereby aid in overall homeostasis. Proper blood circulation is critical since all tissues & organs need nutrients to survive.

The Hematologic System, aka BLOOD's 6 Chief Functions 1) DELIVER Substances for CELLULAR METABOLISM, 2) Remove WASTE, 3) DEFEND against microorganisms & injury, 4) Maintain ACID-BASE Balance, 5) Filter Blood 6) Perform clotting.

Iron deficiency anemia (Microcytic-Hypochromic Anemias)

The most common type of anemia worldwide, Nutritional iron deficiency, Metabolic or functional deficiency, and Manifestations start when serum Hgb decreases to 7 or 8 gm/dl. Clinical EARLY SYMPTOMS-Early Fatigue; weakness; shortness of breath; pale ear lobes, palms, conjunctiva, PROGRESSION SYMPTOMS-Brittle, thin, coarsely ridged, and SPOON-SHAPED NAILS, aka KOILONYCHIA, BEEFY RED TONGUE AKA ATROPHIC GLOSSITIS, which is A RED, SORE, & PAINFUL TONGUE, DRY, SORE CORNERS OF MOUTH AKA ANGULAR STOMATITIS). TREATMENT-Eliminate or rule out blood loss. Iron replacement therapy is REQUIRED & is VERY EFFECTIVE, but it requires PTS TO STAY ON THERAPY!

Clot Dissolution or Retraction is regulated by _____ & _____ activators

Thrombin & Plasminogen, which is why it is also called Fibrinolysis.

t-PA stands for

Tissue Plasminogen Activator. A NATURALLY OCCURRING substance that HELPS US BREAK UP the FIBRINOGEN, aka ALL CLOTS in our body. BUT Because it breaks up ALL CLOTS, it

Mast cells

Type *WBC GRANULOCYTE*, that function as the *CENTRAL CELL in INFLAMMATION*. Found in *VASCULARIZED CONNECTIVE TISSUE* have *CYTOPLASMIC GRANULES that CONTAIN HISTAMINE*, which **CAUSES VASODILATION & VESSEL PERMEABILITY**.

*E*osinophils

Type of *WBC GRANULOCYTE*, production INDUCED by *IgE HYPERSENSITIVITY REACTIONS, aka ALLERGIC REACTIONS, or PARASITIC INFECTIONS* these cells INGEST ANTIGEN-ANTIBODY COMPLEXES to eliminate parasites & control the bodies reactions to the allergen, i.e., ask mast cells to induce histamine release.

Venous sinuses

Venous sinuses in the red pulp of the spleen, does PHAGOCYTOSIS OF OLD, DAMAGED, AND DEAD BLOOD CELLS, i.e., those that have been around for 90 DAYS & BLOOD STORAGE OF UP TO 300ML.** Sudden reductions in blood pressure cause the sympathetic nervous system to stimulate constriction of the sinuses and expel as much as 200 ml of blood into the venous circulation, helping restore blood volume or pressure in the circulation and increasing the hematocrit by as much as 4%.

NON-HODGKIN LYMPHOMA Comparisons

WORSE, MULTIPLE PERIPHERAL NODES are present and SPREAD NONCONTIGUOUSLY, cancerous nodes aren't close but are on the same side of the diaphragm , so EXTRANODAL involvement is COMMON. So the extent of the disease is RARELY LOCALIZED. Nodes are HARD SIGNS & SYMPTOMS such as Fever, weight loss, and night sweats are RARE, making it harder to ID early on.

"shift to the left"

When the premature release of WBCs is detected in the blood, causing an increase in WBCs, is not a good sign.

NORMAL Hemoglobin (Hgb) VALUES Women-____-____ gm/dL & Men ____-____ gm/dL

Women-12.1 to 15.1 gm/dL; Men-13.8 to 17.2 gm/dL

Non-Hodgkin Lymphoma

a Generic CATCH all TERM used to describe THE *MOST AGGRESSIVE & diverse group of lymphomas THAT DO NOT HAVE REED STERNBERG CELLS* until they are classified by the lymphoma cell type that they infiltrated, aka either B, T, or NK cells, & further differentiated based on etiology, unique features, & response to therapies. Changes in proto-oncogenes and tumor-suppressor genes contribute to cell immortality and thus an increase in malignant cells L/T Clonal expansion of B cells, T cells, and/or NK cells. CAUSES- Related to chromosome translocations, viral & bacterial infections, environmental agents, immunodeficiencies, and autoimmune disorders.- DISEASE OF MIDDLE AGE, like 50+ MANIFESTATIONS- these BEGIN as localized or generalized lymphadenopathy but SPREAD VERY FAR***Cervical, axillary, inguinal, and femoral chains are the most commonly affected sites. SWELLING GENERALLY PAINLESS, WHICH IS CONCERNING Nodes have enlarged and transformed over months or years. Dark urine, muscle pain, and weakness are common in rhabdo?? TREATMENT- also Chemo & Radiation, success of the treatment depends on many different factors, such as spread/progress, age, organs affected, etc., but the survival rate is GENERALLY LOW.

Granulocyte

a TYPE of WBC, These WBCs ARE ALL PHAGOCYTES. MEMBRANE-BOUND GRANULES in their cytoplasm are like little bags of goodies that break open to secrete ENZYMES CAPABLE OF DESTROYING MICROORGANISMS &/or creating INFLAMMATORY responses for IMMUNE FUNCTIONS. Capable of AMEBOID MOVEMENT, aka DIAPEDESIS, which allows them to adhere to BOTH THE INSIDE & THE OUTSIDE OF BLOOD VESSEL WALLS & just walk RIGHT THROUGH IT,

Natural killer (NK) cells

a WBC cell type that INNATELY KNOWS how TO KILL some TUMOR/CANCEROUS CELL TYPES IN VITRO, & some VIRUSES, without prior exposure. They DEVELOP IN THE BONE MARROW & circulate in the blood. These cells have inhibitory and activating receptors that allow differentiation between infected or tumor cells & normal cells. If the cell binds to a target cell through activating receptors, it produces several cytokines & toxic molecules, killing the target cell.

Lymphocytes

a type of WBC, *PRIMARY CELLS OF THE IMMUNE RESPONSE*, circulate MATURE IN The THYMUS to T-cells, the BONE MARROW to B-cells, or pLasma cells in the lymphoid.

Neutrophils (Polymorphonuclear MN)

a well understood WBC TYPE, this *WBC GRANULOCYTE* is the *MOST ABUNDANT WBC*, these function as the *CHIEF* & *FIRST PHAGOCYTES* present *AFTER INJURY INDUCED INFLAMMATION*, to phagocyte microorganisms & debris found on the damaged tissue after they migrate out of the capillaries.

Lymph nodes

are pieces of both hematologic & immunologic systems and responsible WBC MATURATION, & LYMPH FLUID CIRCULATION from outside of our tissues back into them & after FILTERING & CLEANING IT of microorganisms & foreign particles, BEFORE SECRETING the now CLEAN LYMPH FLUID INTO CIRCULATION AROUND THE HEART. Lymph node infection causes tenderness & enlargement of the nodes upon palpation because they become so full of foreign particles that they can't filter them fast enough. The enlargement causes an increase in pressure leading to tenderness. When palpated, it feels like a grape. Unless the nodes are cancerous, then they would be HARD and FIXED in place.

Hemoglobin Synthesis

as the O2-CARRYING PROTEIN for ERYTHROCYTES, this molecule ENABLES the BLOOD to TRANSPORT 100 TIMES MORE O2 THAN could be transported if dissolved in PLASMA ALONE. ONE ERYTHROCYTE, aka RBC, HAS UP TO 300 Hgb molecules, & each Hgb can CARRY 4 O2 MOLECULES. CO2 will literally kick O2 off of blood cells & take over, so an overproduction causes an extreme decrease in overall saturation. O2 SATURATION=% of hemoglobin that is actually being saturated by oxygen.

H&H test

blood draw results tells us the patient's current hgb & hct values.

Agranulocytes

cells that FILTER & CLEANSE THE BLOOD, & DO NOT HAVE LITTLE BAGS OF GOODIES. Includes Monocytes, macrophages, lymphocytes, as well as natural killer cells.

Fibrinolysis, aka the Lysis of blood clots

done by the Fibrinolytic system; it is INITIATED BY t-PA ACTIVATING PLASMINOGEN for it TO CONVERT TO PLASMIN, which then digests the fibrin clot by d breaking it down into soluble pieces so that the clot can dissolve. A BALANCE BETWEEN THE AMOUNTS OF THROMBIN AND PLASMIN IN THE CIRCULATION MAINTAINS NORMAL COAGULATION AND LYSIS.

Hypoxia triggers _____ secretion

erythropoietin, which Increases RBC Production, causing Erythrocytophilia.

Relative polycythemia

is NOT D/T RBC overproduction, but instead is a RESULT OF DEHYDRATION or some other type of Fluid loss results that CREATES an IMBALANCE relative increases of red cell counts and hemoglobin (Hgb) and hematocrit (Hct) values, treated w/IV FLUIDS to RE-BALANCE OUT FLUID to RBC %.

**B lymphocytes

produce antibodies.

**T lymphocytes

regulate other immune cells and kill viruses and cancer cells.

Oncotic pressure

regulates the passage of fluids and electrolytes into the surrounding tissues.

Erythropoietin

states of *HYPOXIA STIMULATES THIS SECRETION* to be RELEASED FROM THE KIDNEYS & SENT TO THE BONE MARROW to STIMULATE RBC MATURATION, to cause an INCREASE in RBC PRODUCTION & STIMULATE IT'S RELEASE FROM BONE MARROW to INCREASE the number of RBCs circulating in the blood and hopefully increase overall oxygen concentration.

After careful CONSIDERATION OF a PATIENT'S LIKELIHOOD TO HEMORRHAGE, What Naturally Occurring Substance is given to patients experiencing a stroke to help DISSOLVE FIBRINOGEN, aka CLOTS?

t-PA

Bone marrow (MYELOID TISSUE)

the SITE OF HEMATOPOIESIS, aka blood cell production, AFTER BIRTH.

Thrombopoietin

the main regulator of platelets, but another thing that aids in RBC production.

Erythropoiesis

the process of DEVELOPING erythroblasts, aka normoblasts, INTO ERYTHROCYTES, aka RBCs.

LYMPHOID ORGANS

thymus gland & bone marrow are primary organs, lymph nodes, & spleen.

NORMAL Platelet Concentration

150,000-400,000 cells/mL

NORMAL Hematocrit (Hct) VALUES Women-_____% & Men _____%

40 50

Blood Volume is Comprised of __%=______ & __%= ______

55% Plasma, & 45% Formed Elements