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Questions and Answers
What event initiates the physiological response of hemostasis?
What event initiates the physiological response of hemostasis?
What is the duration of the vasoconstriction response following an injury?
What is the duration of the vasoconstriction response following an injury?
Which of the following describes the formation of a platelet plug?
Which of the following describes the formation of a platelet plug?
What is the primary function of red blood cells (RBCs)?
What is the primary function of red blood cells (RBCs)?
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What is the first step in the blood coagulation process upon vessel damage?
What is the first step in the blood coagulation process upon vessel damage?
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What role do calcium ions play in the coagulation process?
What role do calcium ions play in the coagulation process?
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What happens to aging red blood cells in the body?
What happens to aging red blood cells in the body?
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What does a hematocrit value of 45% indicate?
What does a hematocrit value of 45% indicate?
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How soon does blood coagulation begin after a vessel is severely ruptured?
How soon does blood coagulation begin after a vessel is severely ruptured?
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What happens to a clot after its formation within the first half hour?
What happens to a clot after its formation within the first half hour?
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What can a low reticulocyte count indicate?
What can a low reticulocyte count indicate?
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Which of the following conditions could lead to a high hematocrit value?
Which of the following conditions could lead to a high hematocrit value?
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What is a critical function of the fibrous tissue that grows into the blood clot?
What is a critical function of the fibrous tissue that grows into the blood clot?
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What is the normal lifespan of a red blood cell?
What is the normal lifespan of a red blood cell?
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How many oxygen molecules can each hemoglobin molecule carry?
How many oxygen molecules can each hemoglobin molecule carry?
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What prompts an increase in white blood cell (WBC) production?
What prompts an increase in white blood cell (WBC) production?
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What percentage of total WBC count do neutrophils account for?
What percentage of total WBC count do neutrophils account for?
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Which of the following conditions is NOT associated with an increased WBC count?
Which of the following conditions is NOT associated with an increased WBC count?
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What is the primary role of platelets in the circulatory system?
What is the primary role of platelets in the circulatory system?
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What is the primary treatment approach for primary polycythemia?
What is the primary treatment approach for primary polycythemia?
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Which of the following is NOT a common symptom of primary polycythemia?
Which of the following is NOT a common symptom of primary polycythemia?
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Which factors are specifically evaluated during a Prothrombin time test?
Which factors are specifically evaluated during a Prothrombin time test?
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In which phase of disseminated intravascular coagulation (DIC) is bleeding most likely to occur?
In which phase of disseminated intravascular coagulation (DIC) is bleeding most likely to occur?
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What happens to platelets when a blood vessel is damaged?
What happens to platelets when a blood vessel is damaged?
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What laboratory finding is indicative of disseminated intravascular coagulation?
What laboratory finding is indicative of disseminated intravascular coagulation?
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Which process is activated when the damage to a vessel is severe?
Which process is activated when the damage to a vessel is severe?
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What is the normal clotting time in healthy individuals?
What is the normal clotting time in healthy individuals?
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How does disseminated intravascular coagulation (DIC) typically affect the body?
How does disseminated intravascular coagulation (DIC) typically affect the body?
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What is a major complication associated with primary polycythemia?
What is a major complication associated with primary polycythemia?
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Which type of WBC makes up approximately 5% of the total WBC count?
Which type of WBC makes up approximately 5% of the total WBC count?
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Which symptom is commonly linked to both primary polycythemia and disseminated intravascular coagulation?
Which symptom is commonly linked to both primary polycythemia and disseminated intravascular coagulation?
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What is a critical clinical consequence of the processes in disseminated intravascular coagulation?
What is a critical clinical consequence of the processes in disseminated intravascular coagulation?
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Which factor is NOT associated with the development of leukemia?
Which factor is NOT associated with the development of leukemia?
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What primarily distinguishes acute leukemia from chronic leukemia?
What primarily distinguishes acute leukemia from chronic leukemia?
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Which of the following conditions is most closely associated with acute lymphocytic leukemia (ALL)?
Which of the following conditions is most closely associated with acute lymphocytic leukemia (ALL)?
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Which symptom is NOT commonly associated with leukemia?
Which symptom is NOT commonly associated with leukemia?
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The diagnosis of leukemia is primarily confirmed by which procedure?
The diagnosis of leukemia is primarily confirmed by which procedure?
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What is a common result of the proliferation of leukemic cells in the body?
What is a common result of the proliferation of leukemic cells in the body?
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Which type of leukemia primarily affects middle-aged adults?
Which type of leukemia primarily affects middle-aged adults?
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Which symptom may indicate severe spleen enlargement in leukemia patients?
Which symptom may indicate severe spleen enlargement in leukemia patients?
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What is a common cause associated with Burkitt’s lymphoma in Africa?
What is a common cause associated with Burkitt’s lymphoma in Africa?
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Which factor is NOT linked to an increased risk of certain lymphomas?
Which factor is NOT linked to an increased risk of certain lymphomas?
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How does secondary polycythemia typically develop in individuals at high altitudes?
How does secondary polycythemia typically develop in individuals at high altitudes?
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What is the primary hormone responsible for stimulating red blood cell production in response to low oxygen levels?
What is the primary hormone responsible for stimulating red blood cell production in response to low oxygen levels?
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Which of the following describes primary polycythemia?
Which of the following describes primary polycythemia?
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Which symptom is NOT typically associated with lymphomas?
Which symptom is NOT typically associated with lymphomas?
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What type of polycythemia results from known physiological responses, such as living at high altitudes?
What type of polycythemia results from known physiological responses, such as living at high altitudes?
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Which characteristic is most closely associated with the condition known as polycythemia vera?
Which characteristic is most closely associated with the condition known as polycythemia vera?
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Study Notes
Module 5: Emergencies of Hematological Disorders
- Module covers emergencies related to blood disorders
- Objectives include describing blood physiology and components, discussing the pathophysiology and signs/symptoms of specific hematological disorders, outlining general assessment and management of patients with hematological disorders.
Blood and Blood Components
- Blood consists of cells and formed elements suspended in plasma
- 95% of formed elements are red blood cells (RBCs/erythrocytes)
- Remaining 5% consists of white blood cells (WBCs/leukocytes) and cell fragments (platelets)
- Blood movement keeps formed elements dispersed throughout plasma, allowing various functions
- Chief functions include: delivery of substances needed for cellular metabolism, defense against invading microorganisms and injury, and acid/base balance.
- 55% of blood is plasma, 1% is buffy coat, 45% is red blood cells
Cellular Components of Blood
- Erythrocytes (RBCs)—non-nucleated, contain hemoglobin, responsible for oxygen transport, lifespan 80-120 days.
- Leukocytes (WBCs)—nucleated, various types, crucial for immune defense, lifespan varies by type.
- Lymphocytes
- Monocytes
- Macrophages
- Eosinophils
- Neutrophils
- Basophils
- Platelets (thrombocytes): Irregularly shaped cell fragments, involved in hemostasis, lifespan 8-11 days
- Blood cells are formed within red bone marrow and other blood-forming organs.
Laboratory Tests
- Hematocrit: Percentage of red blood cells in total blood volume.
- Normal values vary by sex.
- Hemoglobin: Measures the amount of hemoglobin in the blood.
- Normal values vary by sex.
- Reticulocyte count: Measures the rate of RBC production.
- Low count suggests decreased production, high count increased production
White Blood Cells
- WBCs arise from bone marrow and lymph glands, destroy foreign substances and debris
- Healthy persons have 5,000-10,000 WBCs/mm³.
Platelets
- Platelets are small sticky cell fragments
- Important in blood clotting following blood vessel injury
- Form a platelet plug to stop bleeding
Clotting Measurements
- Clotting time is typically 7-10 minutes
- Prothrombin time (PT) measures plasma clotting time.
- Used to monitor patients on anticoagulants (eg, warfarin), screen for clotting disorders, liver failure.
- Prolonged PT indicates problems with clotting factors
Hemostasis
- Initial physiologic response to wounding to stop bleeding
- Involves vasoconstriction, platelet plug formation, coagulation, and the growth of fibrous tissue into the clot
Specific Hematologic Disorders
- Anemia, leukemia, leukopenia, lymphomas, polycythemia, disseminated intravascular coagulopathy (DIC), hemophilia, sickle cell disease, and multiple myeloma
- These disorders are often grouped by the affected cell type(s)
- RBC disorders
- WBC disorders
- Hemostasis disorders
Anemia
- Condition where hemoglobin or erythrocyte concentration is below normal.
- Not a disease, but a symptom of underlying conditions.
- Causes: blood loss, decreased production, and increased destruction of RBCs
- Example types: iron-deficiency, pernicious, hemolytic
Iron-Deficiency Anemia
- Caused by inadequate iron intake or loss
- RBCs produced are small and pale, have reduced oxygen-carrying capacity
- Common cause is blood loss (menstruation, GI bleeding)
Pernicious Anemia
- Caused by deficiency of vitamin B12 (needed for RBC production)
- Lack of intrinsic factor (stomach protein necessary for vitamin B12 absorption)
- Results in large, immature RBCs
- Causes neurological complications
Hemolytic Anemia
- Characterized by prematurely destroyed RBCs
- Can be inherited (e.g., sickle cell anemia, thalassemia) or acquired (drug-induced)
Acquired Disorders
- Resulting from mechanical forces, autoimmune disorders, or infections.
Signs and Symptoms of Anemia
- Common symptoms: Fatigue, headaches, sore mouth/tongue, brittle nails, breathlessness, chest pain.
- Additional symptoms related to low WBCs (leukopenia) or low platelets (thrombocytopenia) such as bleeding and other symptoms
Diagnosis and Treatment
- Patient history, blood tests, bone marrow biopsy determine diagnosis
- Treatment varies dependent upon the underlying cause and severity of condition
Leukemia
- Cancer characterized by abnormal proliferation of WBCs (leukocytes)
- Acute leukemia results from immature cells, chronic from more mature cells.
- Causes: Genetic predisposition, exposure to radiation, certain viruses.
- Symptoms: Abnormal blood cell counts, organ enlargement (spleen and liver), fatigue, frequent infections
Leukopenia
- Decrease in the number of WBCs
- Risk of developing infections
- Causes: Chemotherapy, radiation therapy, post-transplant medications, leukemia, certain anemias, and other diseases
Lymphomas
- General term for neoplastic disorders of lymphoid tissue.
- Hodgkin lymphoma : Specific, curable form of lymphoma
- Non-Hodgkin lymphoma: Unpredictable forms of lymphoma that have a high malignancy grade leading to more rapid progression compared to Hodgkin lymphoma.
- Symptoms: Swelling of lymph nodes, fatigue, chills, night sweats, itching, cough, weight loss, shortness of breath and chest discomfort
- Diagnosis and treatment vary dependent on the type of lymphoma
Polycythemia
- Increase in RBC mass.
- Primary polycythemia: No clear cause.
- Secondary polycythemia: natural response to chronic hypoxia (e.g., high altitude)
- Often associated with dehydration.
- Symptoms: Blurred vision, dizziness, generalized itching, headache
Disseminated Intravascular Coagulation (DIC)
- A complication of severe injury, trauma, or illness.
- Characterized by abnormal clotting and bleeding simultaneously.
- Often associated with hypotension, hypoperfusion, and organ ischemia.
Hemophilia
- Inherited bleeding disorder caused by deficiency in clotting factors.
- Typically, factor VIII (hemophilia A) or factor IX (hemophilia B) are deficient.
- Symptoms: Uncontrolled bleeding, easy bruising, prolonged bleeding time.
- Treatment involves factor infusions
Thrombocytopenia
- Low platelet count
- Causes: Reduced platelet production, increased platelet destruction, or splenic sequestration.
- Symptoms: Small red or purple spots on skin, easy bruising, prolonged bleeding, nosebleeds, heavy menstrual bleeding.
- Treatment: Careful monitoring, corticosteroids, platelet transfusions.
General Assessment and Management of Patients With Hematologic Disorders
- Thorough assessment and detailed history, vital signs, focused physical examination.
- Patient should be evaluated for specific conditions like bruising, jaundice, and edema.
- Determining the urgency of emergency transport.
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Description
This quiz covers the key concepts of emergencies related to hematological disorders. It includes essential information about blood physiology, components, and the assessment and management of patients suffering from these conditions. Test your knowledge on the pathophysiology and signs/symptoms of various blood disorders.
