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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.

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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

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*

  • Describe each section of the chart.

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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)

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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)

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*

  • 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)

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*

  • 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:

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*

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

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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.

*

 

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.

*

 

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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*

 

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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)

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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.

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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.

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*

  • 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

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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)

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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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