PAT 401 FINAL EXAM QUESTIONS AND
ANSWERS
disorders involving erythrocytes? - Correct Answers -insufficient or excessive numbers
of RBC in circulation or normal levels with abnormal components
disorders involving leukocytes - Correct Answers -increased numbers of WBC in
response to infections or disorders like leukaemia or decreased WBC
increased wbc - Correct Answers -Leukocytosis
decreased WBC - Correct Answers -leukopenia
disorders involving platelets - Correct Answers -increase or decrease clotting in at least
one of the 3 major components of the clotting process, seen in many diseases
normal erythrocyte value - Correct Answers -4.2-6.1 x 10^12/L
hematocrit - Correct Answers -percentage of blood volume occupied by red blood cells
hematocrit value - Correct Answers -0.40-0.54 g/L
hyperglycemias in infants may indicate - Correct Answers -insulin resistance from
catecholamines and hydrocortisone secretion
when is hyperglycemias observed in infants in shock - Correct Answers -can be
observed in first 12-18 hours then go back to normal
critical illness hyperglycemias value in infants - Correct Answers -more than 10 mmol/L
critical illness hyperglycemias indicates what in infants - Correct Answers -linked to poor
survival
hemoglobin - Correct Answers -protein in red blood cells that carries oxygen for delivery
to cells
hemoglobin normal value - Correct Answers -7.4 - 11.2 mmol/L
,what is sickle cell disease - Correct Answers -blood disorder that causes the change in
the structure of the hemoglobin, making RBC sickled
triggers of the sickling of cells - Correct Answers -decreased PO2 of the blood,
increased hydrogen ion concentration in the blood causing acidosis, increased plasma
osmolarity with decreased volume and temp
decreased PO2 in blood - Correct Answers -hypoxemia
increased hydrogen ions in blood - Correct Answers -low pH, acidic
what is the abnormal hemoglobin in RBC during SCD - Correct Answers -hemoglobin S
or sickle hemoglobin (HbS)
severest form of SCD - Correct Answers -sickle cell anemia
polymerization in sickle cell disease - Correct Answers -sickled RBC stiffen and stretch
into elongated shape, go from flexible and beneficial to inflexible
inflexibility of RBC in SCD causes - Correct Answers -hypoxia and damage to tissues
does presence of sickle cell trait cause sickling - Correct Answers -no because pt also
produces the normal HbF and HbA which do not cause sickling
HbF - Correct Answers -fetal hemoglobin
HbA - Correct Answers -adult hemoglobin
HbF is present for - Correct Answers -120 days, thus anemia persists
hemoglobin structural alterations in SCD are stimulated by - Correct Answers -
deoxygenation
deoxygenation in SCD stimulates - Correct Answers -hemoglobin structural alterations
mutation of HbS - Correct Answers -HbA --> point mutation to HbS
how does HbS cause hemolysis - Correct Answers -normal RBC has deoxygenation
causing an influx of Ca and outflow of K and H2O, causing extensive membrane
damage, irreversible sickled cell, and hemolysis
hemolysis - Correct Answers -destruction of red blood cells
what happens if HbS causes deoxygenation ONLY - Correct Answers -influx of Ca,
efflux of K and H2O, membrane damage, sickled cell, hemolysis
,how does HbS cause microvascular occlusion - Correct Answers -deoxygenated RBC
becomes oxygenated again, dehydration and membrane damage, prolonged transit
times, occlusion
oxygenation of deoxygenated RBC can cause what - Correct Answers -either
microvascular occlusion or another cycle of deoxygenation
what happens when HbS deoxygenation becomes oxygenated - Correct Answers -
deoxygenation, damage to membrane, prolonged transit, occlusion
abnormal HbS in RBC causes what triggers - Correct Answers -hypoxemia, decreased
pH, low temp, decreased plasma volume
how does sickling of RBC occur - Correct Answers -persistent hypoxemia from HbS,
reducing of PO2 in circulation, sickling
how may sickled cells become normal - Correct Answers -reversal of hypoxemia,
reoxygenation, rehydration causing them to regain shape and resume function
two ways sickling can increase - Correct Answers -slow blood flow, hypoxemia OR low
pH decreased hemoglobin affinity to O2, decreasing PO2
what do sickled cells do to vessels - Correct Answers -clog
HbS to sickling - Correct Answers -membrane derangements as HbS grows and
protrudes through membrane, changing RBC shape, influx of Ca and efflux of K and
H2O, damaged cells are stiff and irreversibly sickled
pathophysiology of SCD - Correct Answers -inflammatory reaction, mediators released,
prevents RBC movement, adhesion molecules further prevents movement of sickled
cells, sluggish RBC in vessels, low oxygen, sickling, lysed sickle cells release
hemoglobin, inactive nitric oxide causing platelet aggregation, decrease in pH, low
affinity to O2, PO2 drops
inflammatory reaction, release of leukocyte mediators - Correct Answers -increased
adhesion molecules preventing RBC movement
sickle RBC express adhesion molecules - Correct Answers -further prevents movement
of sickled RBC
sluggish and stagnant RBC within inflamed vascular vessels - Correct Answers -
extended exposure to low O2, sickling, and obstruction
lysed sickle cells release hemoglobin - Correct Answers -free hemoglobin inactivates
nitric oxide, inhibiting platelet aggregation
, decrease in blood pH reduces hemoglobin affinity for O2 - Correct Answers -increasing
deoxygenated HbS and predisposition to sickling
less O2 taken by hemoglobin in lungs - Correct Answers -PO2 drops, sickling
how many SCD crises - Correct Answers -4
SCD crises - Correct Answers -vaso-occlusive, aplastic, sequestration, and
hyperhemolytic crisis
vaso-occlusive crises - Correct Answers -most common, sickling is in circulation, painful
and symmetric, swelling
what causes severe pain in vasooclusive crises - Correct Answers -hypoxic injury and
infarction causing pain crises
pain crises - Correct Answers -vaso-occlusive
hand-foot syndrome - Correct Answers -hands and feets have painful swelling in vase-
occlusive crises
acute chest syndrome - Correct Answers -cells get trapped in inflamed lungs and fail to
be oxygenated in vase-occlusive crises
aplastic crisis - Correct Answers -transient cessation in RBC production, occurring after
viral infection
sequestration crises - Correct Answers -large amount of blood pools in spleen and liver
causing hypovolemia and shock
hyperhemolytic crises - Correct Answers -rate of RBC destruction increases
what is responsible for most serious and urgent manifestations in SCD - Correct
Answers -microvascular occlusion
key attributes contributing to presentation of SCD - Correct Answers -chronic disease
with acute exacerbation, condition affecting RBC supplying O2 to cells and body, can
impact any part of body
when do symptoms of SCD appear - Correct Answers -until at least 6 months of age
why do SCD symptoms not appear until 6 months of age - Correct Answers -postnatal
concentration of HbF decreases causing increased HbS
hemolytic anemia - Correct Answers -hyperhemolytic crises, destruction of RBC cells
ANSWERS
disorders involving erythrocytes? - Correct Answers -insufficient or excessive numbers
of RBC in circulation or normal levels with abnormal components
disorders involving leukocytes - Correct Answers -increased numbers of WBC in
response to infections or disorders like leukaemia or decreased WBC
increased wbc - Correct Answers -Leukocytosis
decreased WBC - Correct Answers -leukopenia
disorders involving platelets - Correct Answers -increase or decrease clotting in at least
one of the 3 major components of the clotting process, seen in many diseases
normal erythrocyte value - Correct Answers -4.2-6.1 x 10^12/L
hematocrit - Correct Answers -percentage of blood volume occupied by red blood cells
hematocrit value - Correct Answers -0.40-0.54 g/L
hyperglycemias in infants may indicate - Correct Answers -insulin resistance from
catecholamines and hydrocortisone secretion
when is hyperglycemias observed in infants in shock - Correct Answers -can be
observed in first 12-18 hours then go back to normal
critical illness hyperglycemias value in infants - Correct Answers -more than 10 mmol/L
critical illness hyperglycemias indicates what in infants - Correct Answers -linked to poor
survival
hemoglobin - Correct Answers -protein in red blood cells that carries oxygen for delivery
to cells
hemoglobin normal value - Correct Answers -7.4 - 11.2 mmol/L
,what is sickle cell disease - Correct Answers -blood disorder that causes the change in
the structure of the hemoglobin, making RBC sickled
triggers of the sickling of cells - Correct Answers -decreased PO2 of the blood,
increased hydrogen ion concentration in the blood causing acidosis, increased plasma
osmolarity with decreased volume and temp
decreased PO2 in blood - Correct Answers -hypoxemia
increased hydrogen ions in blood - Correct Answers -low pH, acidic
what is the abnormal hemoglobin in RBC during SCD - Correct Answers -hemoglobin S
or sickle hemoglobin (HbS)
severest form of SCD - Correct Answers -sickle cell anemia
polymerization in sickle cell disease - Correct Answers -sickled RBC stiffen and stretch
into elongated shape, go from flexible and beneficial to inflexible
inflexibility of RBC in SCD causes - Correct Answers -hypoxia and damage to tissues
does presence of sickle cell trait cause sickling - Correct Answers -no because pt also
produces the normal HbF and HbA which do not cause sickling
HbF - Correct Answers -fetal hemoglobin
HbA - Correct Answers -adult hemoglobin
HbF is present for - Correct Answers -120 days, thus anemia persists
hemoglobin structural alterations in SCD are stimulated by - Correct Answers -
deoxygenation
deoxygenation in SCD stimulates - Correct Answers -hemoglobin structural alterations
mutation of HbS - Correct Answers -HbA --> point mutation to HbS
how does HbS cause hemolysis - Correct Answers -normal RBC has deoxygenation
causing an influx of Ca and outflow of K and H2O, causing extensive membrane
damage, irreversible sickled cell, and hemolysis
hemolysis - Correct Answers -destruction of red blood cells
what happens if HbS causes deoxygenation ONLY - Correct Answers -influx of Ca,
efflux of K and H2O, membrane damage, sickled cell, hemolysis
,how does HbS cause microvascular occlusion - Correct Answers -deoxygenated RBC
becomes oxygenated again, dehydration and membrane damage, prolonged transit
times, occlusion
oxygenation of deoxygenated RBC can cause what - Correct Answers -either
microvascular occlusion or another cycle of deoxygenation
what happens when HbS deoxygenation becomes oxygenated - Correct Answers -
deoxygenation, damage to membrane, prolonged transit, occlusion
abnormal HbS in RBC causes what triggers - Correct Answers -hypoxemia, decreased
pH, low temp, decreased plasma volume
how does sickling of RBC occur - Correct Answers -persistent hypoxemia from HbS,
reducing of PO2 in circulation, sickling
how may sickled cells become normal - Correct Answers -reversal of hypoxemia,
reoxygenation, rehydration causing them to regain shape and resume function
two ways sickling can increase - Correct Answers -slow blood flow, hypoxemia OR low
pH decreased hemoglobin affinity to O2, decreasing PO2
what do sickled cells do to vessels - Correct Answers -clog
HbS to sickling - Correct Answers -membrane derangements as HbS grows and
protrudes through membrane, changing RBC shape, influx of Ca and efflux of K and
H2O, damaged cells are stiff and irreversibly sickled
pathophysiology of SCD - Correct Answers -inflammatory reaction, mediators released,
prevents RBC movement, adhesion molecules further prevents movement of sickled
cells, sluggish RBC in vessels, low oxygen, sickling, lysed sickle cells release
hemoglobin, inactive nitric oxide causing platelet aggregation, decrease in pH, low
affinity to O2, PO2 drops
inflammatory reaction, release of leukocyte mediators - Correct Answers -increased
adhesion molecules preventing RBC movement
sickle RBC express adhesion molecules - Correct Answers -further prevents movement
of sickled RBC
sluggish and stagnant RBC within inflamed vascular vessels - Correct Answers -
extended exposure to low O2, sickling, and obstruction
lysed sickle cells release hemoglobin - Correct Answers -free hemoglobin inactivates
nitric oxide, inhibiting platelet aggregation
, decrease in blood pH reduces hemoglobin affinity for O2 - Correct Answers -increasing
deoxygenated HbS and predisposition to sickling
less O2 taken by hemoglobin in lungs - Correct Answers -PO2 drops, sickling
how many SCD crises - Correct Answers -4
SCD crises - Correct Answers -vaso-occlusive, aplastic, sequestration, and
hyperhemolytic crisis
vaso-occlusive crises - Correct Answers -most common, sickling is in circulation, painful
and symmetric, swelling
what causes severe pain in vasooclusive crises - Correct Answers -hypoxic injury and
infarction causing pain crises
pain crises - Correct Answers -vaso-occlusive
hand-foot syndrome - Correct Answers -hands and feets have painful swelling in vase-
occlusive crises
acute chest syndrome - Correct Answers -cells get trapped in inflamed lungs and fail to
be oxygenated in vase-occlusive crises
aplastic crisis - Correct Answers -transient cessation in RBC production, occurring after
viral infection
sequestration crises - Correct Answers -large amount of blood pools in spleen and liver
causing hypovolemia and shock
hyperhemolytic crises - Correct Answers -rate of RBC destruction increases
what is responsible for most serious and urgent manifestations in SCD - Correct
Answers -microvascular occlusion
key attributes contributing to presentation of SCD - Correct Answers -chronic disease
with acute exacerbation, condition affecting RBC supplying O2 to cells and body, can
impact any part of body
when do symptoms of SCD appear - Correct Answers -until at least 6 months of age
why do SCD symptoms not appear until 6 months of age - Correct Answers -postnatal
concentration of HbF decreases causing increased HbS
hemolytic anemia - Correct Answers -hyperhemolytic crises, destruction of RBC cells
