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Med-Surg Hematologic System Study Guide 2026/2027 | Practice Questions, Answers & Nursing Exam Review

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Med-Surg Hematologic System Study Guide 2026/2027 | Practice Questions, Answers & Nursing Exam Review

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Med surg: Hematologic system

Anatomy of hematologic system
- Consists of the blood and the sites where blood is produced, including the bone
marrow and the reticuloendothelial system (RES)
- Plasma is the fluid portion blood; it contains various proteins, such such as
albumin, globulin, fibrinogen, and other factors necessary for clotting, as well as
electrolytes, waste products, and nutrients
- Albumin: helps in maintaining oncotic pressure and helps keep things within the
vasculature system


Blood
- The cellular component of blood consists of 3 primary cell types: Erythrocytes
(red blood cells), Leukocytes (white blood cells), and thrombocytes (platelets)
- These cellular components of blood normally take up about half of the blood
volume
- Because most blood cells have a short lifespan, the need for the body to
replenish its supply of cells is continuous; this process is termed: hematopoiesis.
- The primary site for hematopoiesis is the bone marrow, this is released when
we need it
- Hematopoiesis: the process of how we form the blood cells and they mature


Neutrophil
- Essential for preventing or limiting bacterial infection via phagocytosis
- In times of infection, the neutrophils will increase to back up the white blood
cells


WBC (leukocyte)
Fights infection


Monocyte




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- Macrophage
- Come in and clean up all the dead stuff; like the garbage truck of the infection
fighters


Eosinophil and basophil
Elevated in allergic and hypersensitivity reactions


Lymphocyte
- Big component in the immune system
- T and B lymphocyte


T lymphocyte
- Responsible for cell-mediated immunity; recognizes material as foreign
(surveillance system)
- Scan the environment to see if they need to take action to keep the immune
system functioning well, HIV attacks the ability to watch and respond to infection


B lymphocyte
- Responsible for humoral immunity; many mature into plasma cells to form
antibodies
- Helps with the immune response when we have future exposure


RBC (erythrocyte)
Carries hemoglobin to provide oxygen to tissues; average lifespan is 120 days


Platelet (thrombocyte)
For coagulation


Bone marrow
- Stem cells: myeloid or lymphoid




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- Lymphoid stem cells produce either T or B lymphocytes
- Myeloid stem cells differentiate into three broad cell types: erythrocytes,
leukocytes, and platelets
- The stroma of the bone marrow refers to all tissue within the marrow that is not
directly involved in hematopoiesis
- However, the stroma is important because it supports hematopoiesis
- Fibroblasts, osteoclasts, and osteoblasts are needed to maintain.remodel bone
growth
- The stroma helps make skeletal bone so it can maintain and support the bone
marrow to produce these cells
- Stem cell/hematopoiesis starts breaking down and forming into all of the
different components that are contained within our blood and the lymph system


Red blood cells
- Transports oxygen to the lung snd tissues
- Need to have iron and oxyhemoglobin
- Oxyhemoglobin: helps bind to hemoglobin and O2
- Erythropoietin: stimulates red blood cell production: need this from the kidney,
Stimulates the red bone marrow to start this process
- Erythropoiesis: term for erythrocyte production
- Iron is present in the heme component of the molecule
- An important property of heme is its ability to bind to oxygen
- Oxygen readily binds to hemoglobin in the lungs and is carried as
oxyhemoglobin in the blood


Erythropoiesis
- Erythropoietin, a hormone produced by the kidney, starts this process from the
myeloid stem cells to eventually mature into the erythrocyte (red blood cell)
- The entire process to make a red blood cells takes about 5 days
- For normal erythrocyte production, the bone marrow also requires iron vitamin
B12, folate, pyridoxine (vitamin B6), and protein


Iron stores and metabolism




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- The average daily diet in the United States contains 1- to 15 mg of elemental
iron, but only a small portion this is absorbed
- With iron deficiency, bone marrow iron stores rapidly deplete; hemoglobin
synthesis is depressed, and erythrocytes produced by the marrow are small and
low in hemoglobin
- Lack of dietary iron is rarely the sole cause of iron deficiency in adults
- Iron deficiency may be a sign of bleeding
- Iron deficiency can affect our production of erythrocytes
- We consume iron but we can only produce so much
- Low iron is depleted to keep up with the production of red blood cells


Vitamin B12 and folate metabolism
- Dietary related types of anemia
- Vegetarians or vegans may be at risk
- Megoblasts die because of their size
- When we don't have vitamins and minerals to support the red blood cells get
bigger and get trapped and then they don't get to the circulation
- People who have had a partial or total gastrectomy may have limited amounts
of intrinsic factors, therefore the absorption of vitamin B12 may be diminished
- These deficiencies are characterized by the production of abnormally large
erythrocytes called megaloblasts
- Because these cells are abnormal, many are trapped while still in the bone
marrow, and their rate of release is decreased
- Some of these cells actually die in the marrow before they can be released into
the circulation
- This results in megaloblastic anemia


Leukocytes (White blood cells)
- Divided into granulocyte or agranulocyte
- Granulocyte: Eosinophils, basophils, and neutrophils, this will have an
increased number of band cells sometimes called the left shift
- Both of these types of leukocytes primarily protect the body against infection
and tissue injury
- Neutrophils: immature forms of white blood cells




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