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Download ADVANCED PATHO EXAM 2 QUESTIONS WITH CORRECT DETAILED ANSWERS VERIFIED A+ ALREADY GRADED and more Exams Pathophysiology in PDF only on Docsity!
Hematopoiesis - correct answers-production of blood cells Where does hematopoiesis occur in adults? - correct answers-bone marrow Where does hematopoiesis occur in the fetus? - correct answers-spleen and liver What are the two stages of hematopoiesis? - correct answers-Mitosis (proliferation) Maturation (differentiation) In infants at birth, what is normal to see regarding WBCs and RBCs? - correct answers-it is normal to see increased WBC and RBC in infants at birth What does red bone marrow produce? - correct answers-red blood cells does yellow bone marrow produce red blood cells? - correct answers-yellow does not produce red blood cells Factors that increase hematopoiesis - correct answers-conversion of yellow bone marrow, which does not produce blood cells, to hematopoietic red marrow by the actions of erythropoietin faster differentiation of progenitor cells faster proliferation of stem cells into progenitor cells Bone marrow may also be defined as - correct answers-Myeloid tissue What do all committed immature cells end in? - correct answers-- blast lymphoblasts develop into - correct answers-develop into lymphocytes pro erythroblasts develop into - correct answers-develop into erythrocyte Within the peripheral blood, what percentage of granulocytes are functional/stored? - correct answers- 50% functional / 50% stored Within the peripheral blood, what percentage of thrombocytes are functional/stored? - correct answers- 70% functional / 30% stored Within the peripheral blood, what percentage of erythrocytes are functional/stored? - correct answers- 100% functional / 0% stored What is erythropoiesis? - correct answers-production of red blood cells Erythropoiesis steps - correct answers-stimulates stem cells to form pro-erythroblasts, which are committed into producing erythroid cells - which promotes release of reticulocytes Erythropoietin - correct answers-Hormone released by the kidney in response to low renal oxygenation Where is erythropoietin always present? - correct answers-In the plasma What does a reticulocyte count indicate? - correct answers-indicates whether new RBCs are being produced What is a reticulocyte count a good indicator of? - correct answers-erythropoiesis What is hemoglobin? - correct answers-an oxygen-carrying protein of the erythrocyte How many hemoglobin molecules can a single erythrocyte contain? - correct answers-can contain as many as 300 hemoglobin molecules What is iron absorption inhibited by? - correct answers-carbonates, tannate (tea), oxalate (spinach, rhubarb) phosphates (veggies) and clay Where do thrombocytes develop from? - correct answers-megakaryocyte progenitor cells In platelets - what do glycoproteins do on the surface of the cell membrane? - correct answers-repulse adherence to "normal" endothelium AND promote adherence to injured endothelium What are the functions of platelets? - correct answers-inducing vasoconstriction formation of a platelet plug Activate the coagulation (or clotting) cascade Initiate repair processes 4 step process of hemostasis - correct answers-1. local constriction 2. formation of platelet plug 3. formation of blood clot 4. would repair with formation of fibrous tissue What does thromboxane A2 do? - correct answers-stimulates activation of new platelets increases platelet aggregation causes vasoconstriction What does ADP do? - correct answers-platelet activation von Willebrand factor - correct answers-acts as bridging molecule at sites of vascular injury for normal platelet adhesion After an injury, what does intravascular smooth muscle do? - correct answers-smooth muscle contracts, reducing blood flow After an injury, what are platelets responsible for? - correct answers-much of the vasoconstriction as a result of thromboxane A2 What is necessary for platelet adhesion? - correct answers-Von Willebrand factor What is Factor I? - correct answers-Fibrinogen What is Factor II? - correct answers-Prothrombin What is factor III? - correct answers-tissue thromboplastin What is Factor IV? - correct answers-Calcium Which factor is required throughout the entire clotting sequence? - correct answers-Factor IV (Calcium) What is the carrier for Factor VIII? - correct answers-Von Willebrand factor What is required in multiple steps in the process to activate clotting factors? - correct answers-Calcium What is essential in the synthesis of certain clotting factors in the liver? - correct answers-Vitamin K Sequence of events for blood clots - correct answers-1. Injury induces the formation of a prothrombin activator 2. Prothrombin activator changes prothrombin to thrombin 3. Thrombin changes fibrinogen to fibrin 4. Clot retraction When is the Extrinsic pathway activated? - correct answers-it is activated when the tissue factor (tissue thromboplastin) is released by damaged endothelial cells. Hypoxic intrauterine environment stimulates erythropoietin production. What does this result in? - correct answers-Polycythemia of the newborn Polycythemias - correct answers-Too many cells Anemias - correct answers-Too few cells Anisocytosis - correct answers-Red blood cells (RBCs) are present in various sizes. Paikilocytosis - correct answers-RBCs are present in various shapes What are the 3 microcytic hypo-chromic anemias? - correct answers-1. iron deficiency anemia 2. sideroblastic anemia 3. Thalassemia What is the most common physiologic cause of IDA? - correct answers-menstruation Men and postmenopausal women with IDA is a good indicator of what? - correct answers-malignancy What is the most sensitive test for IDA? - correct answers-ferritin Saturation is typically measured indirectly by assessing what? - correct answers-total iron binding capacity (TIBC) What does total iron binding capacity (TIBC) measure? - correct answers-Measures available transferrin that is left unbound to iron If you have low transferrin, is your TIBC high or low? - correct answers-high, more capacity to bind or high Total iron binding capacity In iron deficiency would the ferritin be high or low? - correct answers-low What would happen to the total iron binding capacity in iron deficiency? - correct answers-it would be high In IDA is initial reticulocyte count high or low? - correct answers-low IDA labs - correct answers-low MCV low MCH low ferritin low iron high TIBC What is koilonychia? - correct answers-Spoon shaped nails often seen in iron-deficiency anemia What is sideroblastic anemia? - correct answers-defect in mitochondrial hemesynthesis What is Thalassemia? - correct answers-Autosomal recessive blood disorder What does Thalassemia result from? - correct answers-mutation that causes loss of one or both ofalpha globin chains or one or both of beta globin chains What diagnostic test is used in thalassemia? - correct answers-hemoglobin electrophoresis What kind of cells may be seen in thalassemia? - correct answers-"target cells" may be seen What are the 3 Macrocytic-Normochromic Anemias? - correct answers-1. Vitamin B12 deficiency 2. Pernicious 3. Folate deficiency A person is admitted with an autoimmune diseasedirected against the hematopoietic stem cells. The nurseknows this will produce: 1. Aplastic anemia 2. lron-deficiency anemia 3. Sideroblastic anemia 4, Fanconi anemia - correct answers-1. Aplastic anemia G6PD deficiency is - correct answers-X-linked recessive What precipitant is formed in G6PD deficiency? - correct answers-Heinz bodies G6PD deficiency signs and symptoms - correct answers-Hemolysis only with oxidative stress Sickle Cell Anemia is a - correct answers-Autosomal recessive Those homozygous for mutation of the B globin chain of Hgb - correct answers-have sickle cellanemia (also noted as HbSS) Those heterozygous for mutation of the B globin chain of Hgb - correct answers-have sickle cell trait(also noted as HbAS)t Sickle cell anemia peripheral smear findings - correct answers-Sickled cells Target cells Howell-Jolly bodies How is sickle cell diagnosis confirmed? - correct answers-Dx confirmed by Hgb electrophoresis What happens to the RBCs in Paroxysmal Nocturnal Hematuria? - correct answers-Red blood cells become sensitive to complement, which causes lysis Anemia of chronic disease is caused by: 1. Immunoglobulin G (IgG) binding to erythrocytes atnormal body temperatures 2. Autoantibodies against erythrocyte surface antigens 3. Reduced response to erythropoietin 4, Paroxysmal nocturnal hemoglobinuria - correct answers-3. Reduced response to erythropoietin What is polycythemia vera? - correct answers-is a myeloproliferative disease that increases production of RBCs What is the patho of polycythemia vera? - correct answers-Is an acquired mutation in Janus kinase 2 (JAK2) Negates the self-regulatory activity of JAK2 that allows the erythropoietin receptor to be constitutively active, regardless of the level of erythropoietin. Is erythropoietin high or low in polycythemia vera? - correct answers-EPO level is lowin PV. Is erythropoietin elevated or decreased in secondary polycythemia? - correct answers-Elevated Erythropoietin (EPO) EPO increased if there is an ectopic source of EPO or if polycythemia is secondary to hypoxia hypocoaguable state - correct answers-Excessive bleeding hypercoaguable state - correct answers-Excessive clotting What can cause a hypercoaguable state? - correct answers-Excess of platelets or deficiency of anti- thromboticproteins (protein C, S, Antithrombin III) What causes hypocoaguable states? - correct answers-Arise from either deceased coagulation factors , decreased platelet function, or decreased platelet number (thrombocytopenia) What is DIC the result of? - correct answers-DIC is the result of increased protease activity in the blood caused by unregulated release of thrombin with subsequent fibrin formation and accelerated fibrinolysis .Clotting factors become depleted. What is Factor V Leiden? - correct answers-Mutation of factor V Causes factor V to be unable to be inactivated by protein C Clotting is encouraged Factor V Leiden is a - correct answers-Autosomal dominant disorder Where is excessive clotting almost always restricted to? - correct answers-Excessive clotting is almost always restricted to the veins What are you at increased risk for in Protein C deficiency? - correct answers-Increased risk of venous thromboembolism In Protein C deficiency is there an association with arterial thrombotic disease? - correct answers-No association with arterial thrombotic disease What is commonly seen in newborns with Protein C deficiency? - correct answers-Purpura fulminans What can Protein § deficiency lead to ? - correct answers-Deficiency leads to impaired function/activity of protein S and ultimately decreased degradation of these factors How are Leukocytes classified? - correct answers-Classified by structure and function What are the four types of Granulocytes: Phagocytes? - correct answers-Neutrophils, basophils, eosinophils and mast cells What are the three types of Agranulocytes? - correct answers-Monocytes and macrophages: Phagocytes Lymphocytes: Immunocytes What do neutrophils do? - correct answers-Serve as phagocytes in earlyinflammation. What do Eosinophils do? - correct answers-Ingest antigen-antibody complexes andviruses. Release cytokines and leukotrienes thataugment the inflammatory response. Increase in type | hypersensitivity allergicreactions and asthma. Increase and attack parasitic infections. What do Basophils contain? - correct answers-histamine What do Basophils do? - correct answers-Increase at the sites of allergic inflammatoryreactions and parasitic infection, particularlyexoparasites (e.g., ticks). What do Basophils contribute to? - correct answers-Contribute to the local inflammatory response. Where are mast cells located? - correct answers-in the tissues What cells are the central cells in inflammation? - correct answers-Mast cells What are lymphocytes? - correct answers-Are mature T, B, and plasma cells What is the function of Natural killer (NK) cells? - correct answers-Kill tumor cells and virally infected cells Do Natural killer (NK) cells have to be induced by antigens? - correct answers-Do not have to be induced by antigens What is the function of Monocytes and macrophages? - correct answers-Provide the main line of defense against bacteria in the bloodstream Which two cells initiate immune responses? - correct answers-Macrophages and Dendritic cells The characteristic vascular changes at the site of an injury produce: A.Blood vessel constriction after dilation B.Increased permeability and leakage C.Tightening of the capillary endothelial cell junctions D.Pallor and swelling where the injury occurred - correct answers-B.Increased permeability and leakage What is the function of the Kinin system? - correct answers-Causes dilation of blood vessels, pain, smooth muscle contraction, vascular permeability, and leukocyte chemotaxis Which cells are the most important activator of inflammation? - correct answers-Mast cells What is the function of Dendritic cells? - correct answers-These cells connect the innate and adaptiveimmune responses What are Biochemical mediators responsible for? - correct answers-Are responsible for vascular changes. What do Biochemical mediators include? - correct answers-histamine When is the inflammatory response initiated? - correct answers-the inflammatory response is initiated when tissue injury occurs or when PAMPs are recognized byPRRs on cells of the innate immune system. What do Chemokines or cytokines regulate? - correct answers-Regulate innate or adaptive resistance by affecting other neighboring cells. What is the important function of Interleukins? - correct answers-enhancement of acquired immune response What is the function of Interferon? - correct answers-To protects against viral infections Do interferons kill viruses? - correct answers-Does not directly kill viruses but prevents them from infecting additional healthy cells What is the function of Chemokines? - correct answers-Attract leukocytes to site of inflammation What is the role of platelets in inflammation? - correct answers-Release a number of mediators that promote and control inflammation What are B lymphocytes are responsible for? - correct answers-B lymphocytes are responsible for humoral immunitythat is mediated by circulating antibodies What are T lymphocytes responsible for? - correct answers-T lymphocytes are responsible for cell- mediated immunity What is the function of Humoral immunity? - correct answers-Produce immunoglobulins (antibodies) by activating B cells and creating plasma cells What is the function of Cellular immunity? - correct answers-Kill target directly Does Cellular immunity produce memory cells? - correct answers-yes Does Humoral immunity produce memory cells? - correct answers-yes What is an Antigenic determinant (epitope)? - correct answers-precise recognition portion What is an Antigenic binding site (paratope)? - correct answers-matching portion What are Haptens? - correct answers-antigens too small to induce immune response but can in combo with larger molecules that function as carries Why is the secondary response to an antigen so much faster than the primary response? - correct answers-Rapidity is caused by the presence ofmemory cells that do not have todifferentiate 
