Advanced Pathophysiology – Exam 2, Graduate Nursing Course, Comprehensive Study Guide
and System-Based Review
Overview of the Blood - ✔✔•Blood
•5000ml
•Plasma
•3000ml
Hematocrit defined - ✔✔- % of RBCs
[higher value = higher viscosity = thicker blood)
- Example: Polycythemia may have Hct of 60-70%
Types of Blood Cells
- Erythrocytes [RBCs) - ✔✔- Transport O2
- Small disc shape
- Lifespan = 120 days
- Carry Hgb [ferrous oxide, also an acid/base buffer)
- Made in the bone marrow - Iliac crest for sample in leukemia
[after age 20 in the vertebrae, sternum, ribs, iliac)
- Hgb Levels: 14-16g/dL in males / 12-14g/dl females
Cytic vs Chromic - ✔✔Cytic = Size of RBCs
Chromic = Amount of Hgb
MCV and MCHC - ✔✔MCV: Mean corpuscular volume - [average size rbc]
,MCHC: normal Mean corpuscular Hgb concentration - [average amount of hemoglobin in the
RBCs compared to the average size of the RBCs. The amount of hemoglobin that was there
Morphology Size or Erythrocyte Volume Cytic Values - ✔✔- Normocytic: Normal RBC size
[MCV = 83-99)
- Microcytic: Small RBC size
[MCV = 50-82)
- Macrocytic: Large RBC size
[MCV is > 100)
Chromic Values
[Hgb content) - ✔✔- Normochromic: Normal amount of Hgb [MCHC -Average amount of
hemoglobin in the RBCs compared to the average size of the RBCs.
[MCHC = 32-36)
- Hypochromic: Low amount of Hgb
[MCHC is < 32)
- Hyperchromic: Increased amount of Hgb
[MCHC is > 36)
Leukocytes
[WBCs) - ✔✔- Defend the body against foreign proteins
- Made in the bone marrow
- 9,000/mm^3
- CBC w/ Diff shows: Leukocytes broken down into:
Neutrophils, Basophils, PMNs [polymorphonulcear), Bands
Bands - {Infective process - ✔✔-Immature Leukocytes
,- Indicate an infective process
- Increase in bands = 12 to 20 or more = shift to the left indicating a bacterial infection
- If bands are not increased it is a shift to the right and a viral infection
Alterations of Leukocytes
Quantitative:
1. Bone marrow dysfunction
2. Premature destruction of cells
a. May originate in lymphoid organs secondary to infectious process - ✔✔Leukocytosis equals
increase WBC's
Leukopenia Equals decreased wbc's
Types of Leukocytes:
- Granular - ✔✔- Categorized according to the presence or absence of granules in the cell
cytoplasm
- *Granular Leukocytes*:
- PMNs - Polymorphonuclear leukocytes[2 or more lobes to the granular site)
- Neutrophils
- Eosinophils - Allergic reaction or parasites
- Basophils
Types of Leukocytes:
- Non-granular - ✔✔*Non-granular* Leukocytes :
- Lymphocytes
- Monocytes
- platelets or thrombocytes
, WBC Morphology/Fx
[Shape and function] - ✔✔- Total WBC count increases with infection
- As % of 1 increases, the %s of the others will decrease
[shift in %) = Shift to the left or shift to the right
- Bands = immature neutrophils aka stabs
[German for rods due to shape)
WBC Morphology/Fx - ✔✔- Bands being immature with infection there is an increase in
production
= shift to the left
- Neutrophils = segs or polys = mature polymorphonuclearcytes and segmented
WBC's and bands - ✔✔Should tell you right away that when you have an infection and the
WBCs are called on to replicate and attend to this infection, that the faster they do it the more
immature cells they have so the more bands produced.
How to tell if an infection is viral or bacterial?
- If there is a shift to the left [increase in bands) it is bacterial - ✔✔- This is because of the way
the differential used to be displayed [Shift to the left then you would see the WBCs going up,
the bands going up, the neutrophils or segs rising as well and the other percentages going down
[lymphocytes and monocytes in particular]
Response to infections - ✔✔- Neutrophils are released
- Many are immature or "bands"
and System-Based Review
Overview of the Blood - ✔✔•Blood
•5000ml
•Plasma
•3000ml
Hematocrit defined - ✔✔- % of RBCs
[higher value = higher viscosity = thicker blood)
- Example: Polycythemia may have Hct of 60-70%
Types of Blood Cells
- Erythrocytes [RBCs) - ✔✔- Transport O2
- Small disc shape
- Lifespan = 120 days
- Carry Hgb [ferrous oxide, also an acid/base buffer)
- Made in the bone marrow - Iliac crest for sample in leukemia
[after age 20 in the vertebrae, sternum, ribs, iliac)
- Hgb Levels: 14-16g/dL in males / 12-14g/dl females
Cytic vs Chromic - ✔✔Cytic = Size of RBCs
Chromic = Amount of Hgb
MCV and MCHC - ✔✔MCV: Mean corpuscular volume - [average size rbc]
,MCHC: normal Mean corpuscular Hgb concentration - [average amount of hemoglobin in the
RBCs compared to the average size of the RBCs. The amount of hemoglobin that was there
Morphology Size or Erythrocyte Volume Cytic Values - ✔✔- Normocytic: Normal RBC size
[MCV = 83-99)
- Microcytic: Small RBC size
[MCV = 50-82)
- Macrocytic: Large RBC size
[MCV is > 100)
Chromic Values
[Hgb content) - ✔✔- Normochromic: Normal amount of Hgb [MCHC -Average amount of
hemoglobin in the RBCs compared to the average size of the RBCs.
[MCHC = 32-36)
- Hypochromic: Low amount of Hgb
[MCHC is < 32)
- Hyperchromic: Increased amount of Hgb
[MCHC is > 36)
Leukocytes
[WBCs) - ✔✔- Defend the body against foreign proteins
- Made in the bone marrow
- 9,000/mm^3
- CBC w/ Diff shows: Leukocytes broken down into:
Neutrophils, Basophils, PMNs [polymorphonulcear), Bands
Bands - {Infective process - ✔✔-Immature Leukocytes
,- Indicate an infective process
- Increase in bands = 12 to 20 or more = shift to the left indicating a bacterial infection
- If bands are not increased it is a shift to the right and a viral infection
Alterations of Leukocytes
Quantitative:
1. Bone marrow dysfunction
2. Premature destruction of cells
a. May originate in lymphoid organs secondary to infectious process - ✔✔Leukocytosis equals
increase WBC's
Leukopenia Equals decreased wbc's
Types of Leukocytes:
- Granular - ✔✔- Categorized according to the presence or absence of granules in the cell
cytoplasm
- *Granular Leukocytes*:
- PMNs - Polymorphonuclear leukocytes[2 or more lobes to the granular site)
- Neutrophils
- Eosinophils - Allergic reaction or parasites
- Basophils
Types of Leukocytes:
- Non-granular - ✔✔*Non-granular* Leukocytes :
- Lymphocytes
- Monocytes
- platelets or thrombocytes
, WBC Morphology/Fx
[Shape and function] - ✔✔- Total WBC count increases with infection
- As % of 1 increases, the %s of the others will decrease
[shift in %) = Shift to the left or shift to the right
- Bands = immature neutrophils aka stabs
[German for rods due to shape)
WBC Morphology/Fx - ✔✔- Bands being immature with infection there is an increase in
production
= shift to the left
- Neutrophils = segs or polys = mature polymorphonuclearcytes and segmented
WBC's and bands - ✔✔Should tell you right away that when you have an infection and the
WBCs are called on to replicate and attend to this infection, that the faster they do it the more
immature cells they have so the more bands produced.
How to tell if an infection is viral or bacterial?
- If there is a shift to the left [increase in bands) it is bacterial - ✔✔- This is because of the way
the differential used to be displayed [Shift to the left then you would see the WBCs going up,
the bands going up, the neutrophils or segs rising as well and the other percentages going down
[lymphocytes and monocytes in particular]
Response to infections - ✔✔- Neutrophils are released
- Many are immature or "bands"
