HEMATOLOGY STUDY GUIDE ASSURED SUCCEED
The hematologic system consists of blood and blood-forming
tissue like the bone marrow, blood, spleen, and lymph
system.
You may recall the term reticuloendothelial system, which is
comprised of this network of cells and tissues found throughout
the body, (in blood, general connective tissue, spleen, liver,
lungs, bone marrow, and lymph nodes) that are concerned with
blood cell formation and play a role in inflammation and
phagocytosis.
Hematopoiesis
• All 3 types of blood cells (RBC, WBC & platelets) develop
from common hematopoietic stem cells within the bone
marrow.
• It matures and differentiates based on a negative feedback system
in the body (Cytokines such as erythropoietin, thrombopoietin, &
granulocyte colony-stimulating factor).
Blood
• An average adult has between 5-6 liters of blood.
• Blood is a type of connective tissue that functions in
transportation, regulation, and protection.
• It is an aqueous mixture consisting of plasma and blood cells.
Plasma
• A straw-colored liquid consisting of approximately 90% water and 10%
proteins.
• The proteins are albumin, globulins, and fibrinogen, other factors
needed for clotting.
• Other components of plasma are electrolytes, waste products, and
nutrients.
• About 55% of blood volume is plasma.
Red Blood Cells
• Also called erythrocytes, these are the most numerous blood cells in
the body.
• Generally live 120 days.
,• RBCs in conjunction with the respiratory and circulatory systems
oxygenate body tissues.
• Composed of hemoglobin which binds with gases (oxygen and carbon
dioxide).
• Oxyhemoglobin is oxygen-bound hemoglobin.
• Hemoglobin also acts as a buffer to help regulate acid-base balance.
• Erythropoiesis is stimulated by hypoxia and controlled by
erythropoietin.
• An immature RBC is called a reticulocyte. The reticulocyte count
measures the rate at which news RBCs appear in circulation.
• Hemolysis is the destruction of RBCs. The liver conjugates and
excretes all bilirubin if hemolysis occurs normally.
• Hematocrit (HCT) is the percentage of RBC in a volume of blood.
Increased HCT with loss of plasma dehydration and increased
production of RBC. Decreased HCT with overhydration or low
number of RBC.
White Blood Cells
• Also called leukocytes; these fight infections and assist with
immunity. Live from days to years, depending on type. See Fig 30-1
Blood cells for types. Leukocytes are divided by appearance into
granulocytes and agranulocytes. These are further divided by function.
• Granulocytes:
• Neutrophil:
• greatest number.
• First responder with the inflammatory process.
• Responsible for phagocytosis.
• Mature = segmented neutrophils or “segs”.
• Immature = band.
• Eosinophils:
• Less number.
• Active in an allergic response.
• Defends against parasites.
• Basophils:
• Least number.
, • Chemical mediators.
• Agranulocytes:
• Lymphocytes:
• foundation of cellular and humoral response.
• B cells, T cells, & natural killer cells.
• Monocytes:
• potent phagocytes
Platelets
• Platelets (thrombocytes) are non-nucleated, granular, ovoid, or
spindle-shaped cell fragments that are active in the clotting
mechanism of the body.
• Live 8-11 days. One-third are in the spleen.
Pharm Review
• Three drugs to be familiar with:
• filgrastim (Neupogen); pegfilgrastim (Neulasta):
• stimulates the production of neutrophils
• epoetin alfa (Epogen, Procrit):
• stimulates RBC production
• oprelvekin (Neumega):
• stimulates the production of platelets
Normal Clotting Mechanisms p. 616
• Review hemostasis.
• Four components:
• Vascular response to injury: vasoconstriction to reduce
leakage that may last 20-30 minutes. Triggers platelet
response and activates plasma clotting factors.
• Platelet plug formation: Platelets stick together and clump
(aggregation).
Causes the release of several substances that enhance
coagulation.
• The development of fibrin clots on the platelet plug by plasma
, clotting factors indicates the coagulation process is complete.
Completion of complex series of reactions between clotting
factors. See Fig 30-4 p. 617. Either intrinsic or extrinsic
pathways are involved. The final pathway of the clotting
cascade occurs with both. This final pathway involves
thrombin converting fibrinogen to fibrin.
• Lysis of the clot. Some blood elements counterbalance
coagulation by interfering with coagulation (anticoagulants).
This keeps blood in its fluid state. Antithrombin antagonizes
thrombin. Fibrinolysis dissolves clots is initiated when
plasminogen is activated to plasmin SEE Fig 30-5. Plasmin
attacks fibrin or fibrinogen.
Complete Blood Count
• RBC:
• # of RBCs in a microliter of blood.
• Norm Male = 4.3-5.7 Female 3.8=5.1
• Increased with polycythemia vera.
• Decreased in hemorrhage, hemolytic anemia, and with chemo.
• Hgb:
• transports O2.
• Norm Male 13.2 – 17.3. Female = 11.7-16.
• Increased with burns and polycythemia vera.
• Decreased with hemolysis, fluid retention, anemia, and blood
loss.
• Hct:
• % of RBC in a volume of blood.
• Norm Male 39%-50% Female 35% - 47%.
• Increased with dehydration and polycythemia.
• Decreased with overhydration, anemia, or blood loss.
• RBC indices (cell differential)
• Mean Corpuscular Volume (MCV):
• measures cell size.
• Norm = 80-100
The hematologic system consists of blood and blood-forming
tissue like the bone marrow, blood, spleen, and lymph
system.
You may recall the term reticuloendothelial system, which is
comprised of this network of cells and tissues found throughout
the body, (in blood, general connective tissue, spleen, liver,
lungs, bone marrow, and lymph nodes) that are concerned with
blood cell formation and play a role in inflammation and
phagocytosis.
Hematopoiesis
• All 3 types of blood cells (RBC, WBC & platelets) develop
from common hematopoietic stem cells within the bone
marrow.
• It matures and differentiates based on a negative feedback system
in the body (Cytokines such as erythropoietin, thrombopoietin, &
granulocyte colony-stimulating factor).
Blood
• An average adult has between 5-6 liters of blood.
• Blood is a type of connective tissue that functions in
transportation, regulation, and protection.
• It is an aqueous mixture consisting of plasma and blood cells.
Plasma
• A straw-colored liquid consisting of approximately 90% water and 10%
proteins.
• The proteins are albumin, globulins, and fibrinogen, other factors
needed for clotting.
• Other components of plasma are electrolytes, waste products, and
nutrients.
• About 55% of blood volume is plasma.
Red Blood Cells
• Also called erythrocytes, these are the most numerous blood cells in
the body.
• Generally live 120 days.
,• RBCs in conjunction with the respiratory and circulatory systems
oxygenate body tissues.
• Composed of hemoglobin which binds with gases (oxygen and carbon
dioxide).
• Oxyhemoglobin is oxygen-bound hemoglobin.
• Hemoglobin also acts as a buffer to help regulate acid-base balance.
• Erythropoiesis is stimulated by hypoxia and controlled by
erythropoietin.
• An immature RBC is called a reticulocyte. The reticulocyte count
measures the rate at which news RBCs appear in circulation.
• Hemolysis is the destruction of RBCs. The liver conjugates and
excretes all bilirubin if hemolysis occurs normally.
• Hematocrit (HCT) is the percentage of RBC in a volume of blood.
Increased HCT with loss of plasma dehydration and increased
production of RBC. Decreased HCT with overhydration or low
number of RBC.
White Blood Cells
• Also called leukocytes; these fight infections and assist with
immunity. Live from days to years, depending on type. See Fig 30-1
Blood cells for types. Leukocytes are divided by appearance into
granulocytes and agranulocytes. These are further divided by function.
• Granulocytes:
• Neutrophil:
• greatest number.
• First responder with the inflammatory process.
• Responsible for phagocytosis.
• Mature = segmented neutrophils or “segs”.
• Immature = band.
• Eosinophils:
• Less number.
• Active in an allergic response.
• Defends against parasites.
• Basophils:
• Least number.
, • Chemical mediators.
• Agranulocytes:
• Lymphocytes:
• foundation of cellular and humoral response.
• B cells, T cells, & natural killer cells.
• Monocytes:
• potent phagocytes
Platelets
• Platelets (thrombocytes) are non-nucleated, granular, ovoid, or
spindle-shaped cell fragments that are active in the clotting
mechanism of the body.
• Live 8-11 days. One-third are in the spleen.
Pharm Review
• Three drugs to be familiar with:
• filgrastim (Neupogen); pegfilgrastim (Neulasta):
• stimulates the production of neutrophils
• epoetin alfa (Epogen, Procrit):
• stimulates RBC production
• oprelvekin (Neumega):
• stimulates the production of platelets
Normal Clotting Mechanisms p. 616
• Review hemostasis.
• Four components:
• Vascular response to injury: vasoconstriction to reduce
leakage that may last 20-30 minutes. Triggers platelet
response and activates plasma clotting factors.
• Platelet plug formation: Platelets stick together and clump
(aggregation).
Causes the release of several substances that enhance
coagulation.
• The development of fibrin clots on the platelet plug by plasma
, clotting factors indicates the coagulation process is complete.
Completion of complex series of reactions between clotting
factors. See Fig 30-4 p. 617. Either intrinsic or extrinsic
pathways are involved. The final pathway of the clotting
cascade occurs with both. This final pathway involves
thrombin converting fibrinogen to fibrin.
• Lysis of the clot. Some blood elements counterbalance
coagulation by interfering with coagulation (anticoagulants).
This keeps blood in its fluid state. Antithrombin antagonizes
thrombin. Fibrinolysis dissolves clots is initiated when
plasminogen is activated to plasmin SEE Fig 30-5. Plasmin
attacks fibrin or fibrinogen.
Complete Blood Count
• RBC:
• # of RBCs in a microliter of blood.
• Norm Male = 4.3-5.7 Female 3.8=5.1
• Increased with polycythemia vera.
• Decreased in hemorrhage, hemolytic anemia, and with chemo.
• Hgb:
• transports O2.
• Norm Male 13.2 – 17.3. Female = 11.7-16.
• Increased with burns and polycythemia vera.
• Decreased with hemolysis, fluid retention, anemia, and blood
loss.
• Hct:
• % of RBC in a volume of blood.
• Norm Male 39%-50% Female 35% - 47%.
• Increased with dehydration and polycythemia.
• Decreased with overhydration, anemia, or blood loss.
• RBC indices (cell differential)
• Mean Corpuscular Volume (MCV):
• measures cell size.
• Norm = 80-100
