Exam #2 – Material Review
Composition of Blood – Granulocytes
o Granulocytes mature in the bone marrow
Membrane-bound granules in their cytoplasm
The granules contain enzymes capable of destroying
microorganisms
Inflammatory and immune functions
Capable of ameboid movement (diapedesis) – the migration
through vessel walls to the sites where their action is needed
Natural Killer Cells (NK)
o kill some types of tumor cells and some virus-infected cells
Regulation of Erythropoiesis
o Numbers of circulating red cells in healthy individuals remain constant
o The peritubular cells of the kidney produce erythropoietin
o Hypoxia stimulates the production and release of erythropoietin
Control of Hemostatic Mechanisms – Pulmonary Embolism
o Clot retraction
Fibrin strands shorten; become denser and stronger to approximate
the edges of the injured vessel and site of injury
Facilitated by large numbers of platelets within the clot
o Lysis (breakdown) of blood clots carried out by:
Fibrinolytic system
Plasminogen converted to plasmin (an enzyme that
dissolves clots, a process called fibrinolysis)
The dissolved products are termed fibrin degradation
products (FDP). The major FDP are D-dimers.
Clinical note: measurement of the levels of circulating D-
dimer has been used for diagnosis of DVTs and PEs.
Macrocytic-normochromic anemias
o Also termed megaloblastic anemias
o Characterized by unusually large stem cells
o Result of defective DNA synthesis
Caused by deficiencies in vitamin B12 or folate
Coenzymes for nuclear maturation and the DNA synthesis
pathway
o Pernicious anemia
Caused by a lack of intrinsic factor from the gastric parietal cells
Required for vitamin B12 absorption
Results in vitamin B12 deficiency
o Pernicious anemia (Cont.)
Early symptoms nonspecific and vague
When hemoglobin at 7-8 g/dl:
, Weakness
Fatigue
Paresthesia’s
Difficulty walking
Loss of appetite
Abdominal pain
Weight loss
o Neurologic manifestations – result from nerve demyelination that produce
neuronal death
o Treatment
Parenteral (injections) or high oral doses of vitamin B12
Lifelong
o Folate deficiency anemia
Absorption of folate occurs in the upper small intestine
Not dependent on any other factor
Similar symptoms to pernicious anemia except neurologic
manifestations generally not seen
Treatment requires daily oral administration of folate
Types of Anemias – Normocytic-normochromic
o Reduction in the total number of erythrocytes in the circulating blood or in
the quality or quantity of hemoglobin
Impaired erythrocyte production
Acute or chronic blood loss
Increased erythrocyte destruction
Combination of the above
o Normocytic-normochromic
Characterized by red cells that are relatively normal in size and
hemoglobin content but insufficient in number
Aplastic - damage to bone marrow erythropoiesis
Post hemorrhagic – acute blood loss
Acquired hemolytic – immune destruction of erythrocytes
Hereditary hemolytic – such as sickle cell disease
Anemia of chronic inflammation – multiple causes
Polycythemia vera
o Polycythemia vera (PV) – characterized by an abnormal uncontrolled
proliferation of RBCs
JAK2 mutation
o Abnormal, uncontrolled proliferation of RBCs, WBCs, and platelets
o Manifestations due to increased red cell mass and hematocrit
Increased blood viscosity
Hyper coagulopathy
Infectious mononucleosis
, o Acute, self-limiting infection of B lymphocytes transmitted by saliva
through personal contact
o Commonly caused by the Epstein-Barr virus (EBV)—85%
B cells have an EBV receptor site
o Symptoms:
Fever
Sore throat
Swollen cervical lymph nodes
Increased lymphocyte count
Atypical (activated) lymphocytes
o Serious complications are rare
Splenic rupture is the most common cause of death
Leukemia signs and symptoms
o Most common malignancy of childhood
o 80% to 85% are acute lymphoblastic leukemia (ALL); remainder acute
myelogenous leukemia (AML)
o Result of Eco genetics (genetic traits related to the response to
environmental substances)
o Manifestations of pallor, fatigue, purpura, and fever
o Blast cell is hallmark of acute leukemia
o 5-year survival rate is 80%
Signs and symptoms
o Fatigue
o Bleeding
Petechiae
Ecchymosis
o Fever
o Weight loss
o Bone pain
o Elevated uric acid
o Liver, spleen, and lymph node enlargement
o Infections
o Neurologic manifestations
Hodgkin lymphoma
o Characterized by the presence of Reed-Sternberg cells (B cells) in the
lymph nodes
Reed-Sternberg cells are necessary for diagnosis, but they are not
specific to Hodgkin lymphoma. a large multinucleated or multilobed
cell surrounded by a halo of clear nucleoplasm
o Physical findings
Adenopathy, mediastinal mass, splenomegaly, and abdominal mass
Composition of Blood – Granulocytes
o Granulocytes mature in the bone marrow
Membrane-bound granules in their cytoplasm
The granules contain enzymes capable of destroying
microorganisms
Inflammatory and immune functions
Capable of ameboid movement (diapedesis) – the migration
through vessel walls to the sites where their action is needed
Natural Killer Cells (NK)
o kill some types of tumor cells and some virus-infected cells
Regulation of Erythropoiesis
o Numbers of circulating red cells in healthy individuals remain constant
o The peritubular cells of the kidney produce erythropoietin
o Hypoxia stimulates the production and release of erythropoietin
Control of Hemostatic Mechanisms – Pulmonary Embolism
o Clot retraction
Fibrin strands shorten; become denser and stronger to approximate
the edges of the injured vessel and site of injury
Facilitated by large numbers of platelets within the clot
o Lysis (breakdown) of blood clots carried out by:
Fibrinolytic system
Plasminogen converted to plasmin (an enzyme that
dissolves clots, a process called fibrinolysis)
The dissolved products are termed fibrin degradation
products (FDP). The major FDP are D-dimers.
Clinical note: measurement of the levels of circulating D-
dimer has been used for diagnosis of DVTs and PEs.
Macrocytic-normochromic anemias
o Also termed megaloblastic anemias
o Characterized by unusually large stem cells
o Result of defective DNA synthesis
Caused by deficiencies in vitamin B12 or folate
Coenzymes for nuclear maturation and the DNA synthesis
pathway
o Pernicious anemia
Caused by a lack of intrinsic factor from the gastric parietal cells
Required for vitamin B12 absorption
Results in vitamin B12 deficiency
o Pernicious anemia (Cont.)
Early symptoms nonspecific and vague
When hemoglobin at 7-8 g/dl:
, Weakness
Fatigue
Paresthesia’s
Difficulty walking
Loss of appetite
Abdominal pain
Weight loss
o Neurologic manifestations – result from nerve demyelination that produce
neuronal death
o Treatment
Parenteral (injections) or high oral doses of vitamin B12
Lifelong
o Folate deficiency anemia
Absorption of folate occurs in the upper small intestine
Not dependent on any other factor
Similar symptoms to pernicious anemia except neurologic
manifestations generally not seen
Treatment requires daily oral administration of folate
Types of Anemias – Normocytic-normochromic
o Reduction in the total number of erythrocytes in the circulating blood or in
the quality or quantity of hemoglobin
Impaired erythrocyte production
Acute or chronic blood loss
Increased erythrocyte destruction
Combination of the above
o Normocytic-normochromic
Characterized by red cells that are relatively normal in size and
hemoglobin content but insufficient in number
Aplastic - damage to bone marrow erythropoiesis
Post hemorrhagic – acute blood loss
Acquired hemolytic – immune destruction of erythrocytes
Hereditary hemolytic – such as sickle cell disease
Anemia of chronic inflammation – multiple causes
Polycythemia vera
o Polycythemia vera (PV) – characterized by an abnormal uncontrolled
proliferation of RBCs
JAK2 mutation
o Abnormal, uncontrolled proliferation of RBCs, WBCs, and platelets
o Manifestations due to increased red cell mass and hematocrit
Increased blood viscosity
Hyper coagulopathy
Infectious mononucleosis
, o Acute, self-limiting infection of B lymphocytes transmitted by saliva
through personal contact
o Commonly caused by the Epstein-Barr virus (EBV)—85%
B cells have an EBV receptor site
o Symptoms:
Fever
Sore throat
Swollen cervical lymph nodes
Increased lymphocyte count
Atypical (activated) lymphocytes
o Serious complications are rare
Splenic rupture is the most common cause of death
Leukemia signs and symptoms
o Most common malignancy of childhood
o 80% to 85% are acute lymphoblastic leukemia (ALL); remainder acute
myelogenous leukemia (AML)
o Result of Eco genetics (genetic traits related to the response to
environmental substances)
o Manifestations of pallor, fatigue, purpura, and fever
o Blast cell is hallmark of acute leukemia
o 5-year survival rate is 80%
Signs and symptoms
o Fatigue
o Bleeding
Petechiae
Ecchymosis
o Fever
o Weight loss
o Bone pain
o Elevated uric acid
o Liver, spleen, and lymph node enlargement
o Infections
o Neurologic manifestations
Hodgkin lymphoma
o Characterized by the presence of Reed-Sternberg cells (B cells) in the
lymph nodes
Reed-Sternberg cells are necessary for diagnosis, but they are not
specific to Hodgkin lymphoma. a large multinucleated or multilobed
cell surrounded by a halo of clear nucleoplasm
o Physical findings
Adenopathy, mediastinal mass, splenomegaly, and abdominal mass
