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Chapter 13
The Blood System
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Learning Objectives
- Identify terms relating to the composition, formation, and function of blood.
- Differentiate among the different types of blood groups.
- Identify terms related to blood clotting.
- Build words and recognize combining forms used in blood system terminology.
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Learning Objectives (cont’d)
-
- Describe various pathologic conditions affecting blood.
- Describe various laboratory tests and clinical procedures used with hematologic disorders, and recognize relevant abbreviations.
- Apply your new knowledge to understanding medical terms in their proper contexts, such as medical reports and records.
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Chapter 13
Lesson 13.1
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Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Introduction
Blood: Transports foods, gases, and wastes to and from the cells of the body.
- Other transported items:
- chemical messengers
- blood proteins, white blood cells, and platelets
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- What are chemical messengers called? (hormones)
- What do white blood cells do? (Fight infection)
- What do platelets do? (Help the blood clot)
- What is the medical term for WBC? (leukocyte)
- What is the medical term for platelet? (thrombocyte)
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Composition of Blood
- cells
- plasma
- water
- proteins
- sugar
- salts
- hormones
- vitamins
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*
- What are cells? (Formed elements, suspended in a clear, straw-colored liquid called plasma)
- What percentage of blood volume do cells constitute? (45%. The other 55% are items listed here.)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Cell Types and Function
Erythrocytes: red blood cells transport nutrients and oxygen
Leukocytes: white blood cells
Thrombocytes: platelets; clot blood
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*
- What is an immature red blood cell called? (erythroblast)
- Where do erythrocytes originate? (In bone marrow)
- What are cells in the spleen, liver, and bone marrow that destroy worn-out erythrocytes? (macrophages)
- What is a phagocyte?
- See next slide. Review a normal differential of these cell types in a smear of whole peripheral blood.
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Cell Types and Function
Leukocytes: or white blood cells
basophils: contain heparin (prevents clotting) and histamine (involved in allergic responses)
eosinophils: phagocytic cells involved in allergic responses and parasitic infections
neutrophils: phagocytic cells that accumulate at sites of infection
monocytes: phagocytic cells that become macrophage and digest bacteria and tissue debris
lymphocytes: control the immune response; make antibodies to antigens
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
- What is an immature red blood cell called? (erythroblast)
- Where do erythrocytes originate? (In bone marrow)
- What are cells in the spleen, liver, and bone marrow that destroy worn-out erythrocytes? (macrophages)
- What is a phagocyte?
- See next slide. Review a normal differential of these cell types in a smear of whole peripheral blood.
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
STAGES IN BLOOD DEVELOPMENT (HEMATOPOIESIS)
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- Explain phagocytosis.
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Review: Composition of Blood
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
- Describe each section of the chart.
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Plasma
Plasma Proteins
-
- albumin
- globulins: immunoglobulins
(IgG,IgA, IgM, IgD, IgE)
-
- fibrinogen
- prothrombin
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*
- What are fibrinogen and prothrombin? (Clotting proteins)
- What does albumin do? (Maintains the proper proportion and concentration of water in the blood)
- What are globulins? (Another part of the blood containing plasma proteins: alpha, beta, and gamma globulins)
- What are immunoglobulins? (Antibodies that bind to and sometimes destroy antigens or foreign substances, ie., IgG, IgA)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Blood Types
Type A: A antigen and anti-B antibody
Type B: B antigen and anti-A antibody
Type AB: A and B antigens and no antibodies (universal recipient)
Type O: no A or B antigens and both anti-A and anti-B antibodies (universal donor)
Rh factor (positive and negative)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
- Why is blood type matching important for transfusions?
- What is Rh factor? What is the difference between Rh-positive and Rh-negative?
- Why is blood type matching important for identification of pregnancy? (Most people are Rh positive so problem arises with Rh negative mother with Rh positive fetus.)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Blood Clotting
Coagulation: fibrin clot
Anti-coagulants: heparin, warfarin (Coumadin)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
- What is blood clotting or coagulation?
- The final result (usually taking less than 15 minutes) is the formation of a fibrin clot from the plasma protein fibrinogen.
- Why are platelets important in the beginning of the process following injury to tissues or blood vessels?
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
The blood contains the following to transport oxygen:
white blood cells
plasma
platelets
red blood cells
QUICK QUIZ:
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
CORRECT Answer is D, red blood cells
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
QUICK QUIZ:
2. Blood contains these clotting cells:
erythrocytes
plasma
thrombocytes
leukocytes
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
CORRECT Answer is C, thrombocytes
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS
AND TERMINOLOGY
- bas/o base
- chrom/o color
- coagul/o clotting
- cyt/o cell
- eosin/o red, dawn, rosy
- erythr/o red
Combining Form Meaning
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
- granul/o granules
- hem/o blood
- hemat/o blood
- hemoglobin/o hemoglobin
- is/o same, equal
- kary/o nucleus
Combining Form Meaning
COMBINING FORMS
AND TERMINOLOGY
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
- leuk/o white
- mon/o one, single
- morph/o shape, form
- myel/o bone marrow
- neutr/o neutral
- nucle/o nucleus
Combining Form Meaning
COMBINING FORMS
AND TERMINOLOGY
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
- phag/o eat, swallow
- poikil/o varied, irregular
- sider/o iron
- spher/o globe, round
- thromb/o clot
Combining Form Meaning
COMBINING FORMS
AND TERMINOLOGY
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Suffixes
- -apheresis
- -blast
- -cyte
- -cytosis
- -emia
- -globin
- -globulin
- -lytic
- -oid
- -osis
- -penia
- -phage
- -philia
- -phoresis
- -poiesis
- -stasis
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
- Ask meanings and examples of terms.
- What is thrombolytic therapy? (Used to dissolve clots)
- What is plasmapheresis? (A centrifuge spins blood to remove plasma from the other parts of the blood.)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Chapter 13
Lesson 13.2
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Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Diseases of Red Blood Cells
Anemia: deficiency in erythrocytes or hemoglobin
Iron Deficiency Anemia or Sideropenia
Other types of anemia:
- aplastic anemia
- hemolytic anemia.
- pernicious anemia
- Sickle cell anemia
- thalassemia
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
- What is the most common type of anemia? (Iron-deficiency anemia)
- What is an example of hemolytic anemia? (Congenital spherocytic anemia)
- B12 cannot be absorbed into the bloodstream with the aid of which substance? (Intrinsic factor, which is normally found in gastric juice.)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
TYPES OF ANEMIA
-
- aplastic anemia: failure of blood cell production due to aplasia or absence of cell formation of bone marrow cells.
-
- hemolytic anemia: reduction in red cells due to excessive destruction.
- pernicious anemia: lack of mature erythrocytes caused by inability to absorb vitamin B12 into the body.
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
- What is the most common type of anemia? (Iron-deficiency anemia)
- What is an example of hemolytic anemia? (Congenital spherocytic anemia)
- B12 cannot be absorbed into the bloodstream with the aid of which substance? (Intrinsic factor, which is normally found in gastric juice.)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
TYPES OF ANEMIA (cont’d.)
sickle cell: A hereditary disease characterized by abnormal shape of erythrocytes and by hemolysis.
thalassemia: An inherited defect in the ability to produce hemoglobin.
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
- Persons of what background are prone to thalassemia? (Mediterranean)
- Sickle cell is prevalent among which group? (Black people of African or African-American ancestry) Why? (Sickling is a genetic response to malaria.)
- What treatment is used for polycythemia vera? How is this similar to doping?
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Types of Anemia
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*
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
QUICK QUIZ:
3. What is the most common type of anemia?
hemolytic anemia
sickle cell anemia
iron deficiency anemia
aplastic anemia
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
CORRECT Answer is C, iron deficiency anemia (see page 498 of text)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Disorders of Blood Clotting
hemophilia: Excessive bleeding caused by one of the protein substances necessary for blood clotting.
Purpura (thrombocytopenia): Multiple pinpoint hemorrhages and accumulation of blood under the skin.
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
- What is a treatment for hemophilia? (Administration of the deficient factor)
- What is autoimmune thrombocytopenic purpura? (A condition in which a patient’s body makes an antibody that destroys platelets)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Diseases of White Blood Cells (cont)
leukemia: An increase in cancerous white blood cells.
- acute myelogenous leukemia (AML)
- acute lymphocytic leukemia (ALL)
- chronic myelogenous leukemia (CML)
- chronic lymphocytic leukemia (CLL)
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*
- What are characteristics of acute leukemia?
- What form of leukemia is most often in children and adolescents? (ALL)
- What form of leukemia usually occurs in the elderly and follows a slowly progressive course? (CLL)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Acute Leukemia
- Acute
Myeloblastic Leukemia
- Acute Lymphoblastic Leukemia
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- The terms acute and chronic discriminate between leukemias of primarily immature and mature leukocytes.
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Diseases of White Blood Cells (cont’d.)
granulocytosis: Abnormal increase in granulocytes in the blood.
mononucleosis: An infectious disease marked by increased numbers of leukocytes and enlarged cervical lymph nodes.
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
- How is mononucleosis usually transmitted? (By oral contact)
- Is treatment necessary for EBV infections? (No)
- What is eosinophilia? (An increase in eosinophilic granulocytes, seen in certain allergic conditions)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Disease of Bone Marrow Cells
multiple myeloma: Malignant neoplasm of bone marrow. Malignant cells destroy bone tissue and cause overproduction of immunoglobulins.
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
- The malignant cells destroy bone tissue and cause the overproduction of immunoglobulins, including Bence Jones protein. What is Bence Jones protein? (An immunoglobulin fragment found in urine)
- How is this treated?
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Chapter 13
Lesson 13.3
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Laboratory Blood Tests
- antiglobulin test
- bleeding time
- coagulation time
- complete blood count (CBC)
- erythrocyte sedimentation rate (ESR)
- hematocrit (Hct)
- hemoglobin test (H, Hg, HGB)
- partial thromboplastin time (PTT)
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*
- What is a normal coagulation time? (Less than 15 minutes)
- What is the speed at which erythrocytes settle out of plasma? (ESR or sed rate)
- What test finds the total amount of hemoglobin in a sample of peripheral blood? (hemoglobin test)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Laboratory Blood Tests (cont’d.)
- platelet count
- prothrombin time (PT)
- red blood cell count (RBC)
- red blood cell morphology
- white blood cell count (WBC)
- white blood cell differential
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*
- What is the number of leukocytes per cubic millimeter or microliter? (WBC)
- What determines the percentage of the total WBC made up by different types of leukocytes? (White blood cell differential)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Clinical Procedures
apheresis: Separation of blood into component parts and removal of a select part from the blood.
blood transfusion: Whole blood or cells are taken from a donor and infused into a patient.
bone marrow biopsy: Microscopic examination of a core of bone marrow removed with a needle.
hematopoietic stem cell transplant: Peripheral stem cells from a compatible donor are administered into a recipient’s vein.
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
- What is plasma exchange? (A procedure in which plasma is removed from the patient and fresh plasma is given)
- What is autologous transfusion? (The collection and later reinfusion of a patient’s own blood or blood components)
- What is a bone marrow aspirate? (When bone marrow is removed by brief suction produced by a syringe)
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
REVIEW SHEET
COMBINING FORMS
- bas/o _________
- chrom/o _________
- coagul/o _________
- cyt/o _________
- eosin/o _________
- erythr/o _________
Combining Form Meaning
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS
- bas/o base
- chrom/o color
- coagul/o clotting
- cyt/o cell
- eosin/o red, dawn, rosy
- erythr/o red
Combining Form Meaning
REVIEW SHEET
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS
- granul/o _________
- hem/o _________
- hemat/o _________
- hemoglobin/o _________
- is/o _________
- kary/o _________
Combining Form Meaning
REVIEW SHEET
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS
- granul/o granules
- hem/o blood
- hemat/o blood
- hemoglobin/o hemoglobin
- is/o same, equal
- kary/o nucleus
Combining Form Meaning
REVIEW SHEET
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS
- leuk/o _________
- mon/o _________
- morph/o _________
- myel/o _________
- neutr/o _________
- nucle/o _________
Combining Form Meaning
REVIEW SHEET
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS
- leuk/o white
- mon/o one, single
- morph/o shape, form
- myel/o bone marrow
- neutr/o neutral
- nucle/o nucleus
Combining Form Meaning
REVIEW SHEET
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS
-
- phag/o _______________
- poikil/o _______________
- sider/o _______________
- spher/o _______________
- thromb/o _______________
Combining Form Meaning
REVIEW SHEET
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
COMBINING FORMS
-
- phag/o eat, swallow
- poikil/o varied, irregular
- sider/o iron
- spher/o globe, round
- thromb/o clot
Combining Form Meaning
REVIEW SHEET
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved.
*
*
*
*
*
*
- What are chemical messengers called? (hormones)
- What do white blood cells do? (Fight infection)
- What do platelets do? (Help the blood clot)
- What is the medical term for WBC? (leukocyte)
- What is the medical term for platelet? (thrombocyte)
*
- What are cells? (Formed elements, suspended in a clear, straw-colored liquid called plasma)
- What percentage of blood volume do cells constitute? (45%. The other 55% are items listed here.)
*
- What is an immature red blood cell called? (erythroblast)
- Where do erythrocytes originate? (In bone marrow)
- What are cells in the spleen, liver, and bone marrow that destroy worn-out erythrocytes? (macrophages)
- What is a phagocyte?
- See next slide. Review a normal differential of these cell types in a smear of whole peripheral blood.
*
- What is an immature red blood cell called? (erythroblast)
- Where do erythrocytes originate? (In bone marrow)
- What are cells in the spleen, liver, and bone marrow that destroy worn-out erythrocytes? (macrophages)
- What is a phagocyte?
- See next slide. Review a normal differential of these cell types in a smear of whole peripheral blood.
*
- Explain phagocytosis.
*
- Describe each section of the chart.
*
- What are fibrinogen and prothrombin? (Clotting proteins)
- What does albumin do? (Maintains the proper proportion and concentration of water in the blood)
- What are globulins? (Another part of the blood containing plasma proteins: alpha, beta, and gamma globulins)
- What are immunoglobulins? (Antibodies that bind to and sometimes destroy antigens or foreign substances, ie., IgG, IgA)
*
- Why is blood type matching important for transfusions?
- What is Rh factor? What is the difference between Rh-positive and Rh-negative?
- Why is blood type matching important for identification of pregnancy? (Most people are Rh positive so problem arises with Rh negative mother with Rh positive fetus.)
*
- What is blood clotting or coagulation?
- The final result (usually taking less than 15 minutes) is the formation of a fibrin clot from the plasma protein fibrinogen.
- Why are platelets important in the beginning of the process following injury to tissues or blood vessels?
*
CORRECT Answer is D, red blood cells
*
CORRECT Answer is C, thrombocytes
*
*
*
*
*
- Ask meanings and examples of terms.
- What is thrombolytic therapy? (Used to dissolve clots)
- What is plasmapheresis? (A centrifuge spins blood to remove plasma from the other parts of the blood.)
*
*
- What is the most common type of anemia? (Iron-deficiency anemia)
- What is an example of hemolytic anemia? (Congenital spherocytic anemia)
- B12 cannot be absorbed into the bloodstream with the aid of which substance? (Intrinsic factor, which is normally found in gastric juice.)
*
- What is the most common type of anemia? (Iron-deficiency anemia)
- What is an example of hemolytic anemia? (Congenital spherocytic anemia)
- B12 cannot be absorbed into the bloodstream with the aid of which substance? (Intrinsic factor, which is normally found in gastric juice.)
*
- Persons of what background are prone to thalassemia? (Mediterranean)
- Sickle cell is prevalent among which group? (Black people of African or African-American ancestry) Why? (Sickling is a genetic response to malaria.)
- What treatment is used for polycythemia vera? How is this similar to doping?
*
*
CORRECT Answer is C, iron deficiency anemia (see page 498 of text)
*
- What is a treatment for hemophilia? (Administration of the deficient factor)
- What is autoimmune thrombocytopenic purpura? (A condition in which a patient’s body makes an antibody that destroys platelets)
*
- What are characteristics of acute leukemia?
- What form of leukemia is most often in children and adolescents? (ALL)
- What form of leukemia usually occurs in the elderly and follows a slowly progressive course? (CLL)
*
- The terms acute and chronic discriminate between leukemias of primarily immature and mature leukocytes.
*
- How is mononucleosis usually transmitted? (By oral contact)
- Is treatment necessary for EBV infections? (No)
- What is eosinophilia? (An increase in eosinophilic granulocytes, seen in certain allergic conditions)
*
- The malignant cells destroy bone tissue and cause the overproduction of immunoglobulins, including Bence Jones protein. What is Bence Jones protein? (An immunoglobulin fragment found in urine)
- How is this treated?
*
*
- What is a normal coagulation time? (Less than 15 minutes)
- What is the speed at which erythrocytes settle out of plasma? (ESR or sed rate)
- What test finds the total amount of hemoglobin in a sample of peripheral blood? (hemoglobin test)
*
- What is the number of leukocytes per cubic millimeter or microliter? (WBC)
- What determines the percentage of the total WBC made up by different types of leukocytes? (White blood cell differential)
*
- What is plasma exchange? (A procedure in which plasma is removed from the patient and fresh plasma is given)
- What is autologous transfusion? (The collection and later reinfusion of a patient’s own blood or blood components)
- What is a bone marrow aspirate? (When bone marrow is removed by brief suction produced by a syringe)
*
*
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