Practical 1

Hematology

100

All of the parts of Hemoglobin

What is a Ferrous Ion, 2 alpha and 2 beta chains, Heme and globin molecules

200

The components and percentages of a Hct

What is 45% for RBC's on the bottom, <1% for WBC's in the middle "buffy coat", ~55% for Plasma on the top

300

Universal Donor and Universal Recipient

What is Type O and Type AB

400

A condition where a mother's antibodies attack the blood cells of a fetus because of a RBC surface antigen

What is Erythroblastosis Fetalis

500

The five leukocytes we learned, with proper categories and properties

Granulocytes: Neutrophil- first responder, most abundant, 3-5 lobed nucleus, stains purple/red, bacterial infection Eosinophil- 2-3 lobed nucleus, stains red, parasitic infection Basophil- 1 lobed nucleus, stains blue, allergic reaction Agranulocytes: Monocytes- 12uM in diameter, very large and phagocytic lymphocytes- 9um, B cells and T cells

Cardio

100

The Layers of the heart

Endocardium Myocardium Epicardium All covered by Pericardial Sac

200

A labeled EKG and what is happening in each part

P wave- atrial depolarization QRS complex- ventricular depolarization T wave- ventricular repolarization

300

The electrical conduction pathway of the heart

SA node-> AV node-> Bundle of HIS-> Bundle Branch (right or left)-> Purkinje Fibers-> muscle cells

400

A walkthrough of human circulation

What is Vena cava-> R. atrium-> Tricuspid valve-> R. Ventricle-> Pulmonary trunk-> Pulmonary artery-> lungs->Pulmonary vein->L.atrium -> Mitral Valve-> L. Ventricle-> aorta-> body

500

A walkthrough of Fetal circulation

Umbilican vein-> ductus Venosus-> Vena Cava-> R. Atrium-> Foramen Ovale-> L. Atrium-> L. Ventricle-> aortic arch-> head, neck, shoulders-> Superior V.C.-> R. Atrium-> Tricuspid valve-> Pulmonary Trunk-> Ductus Arteriosus-> Descending Aorta-> Umbilical Arteries (2)-> Placenta

Respiratory

100

normal volume of air exhaled ~.5L

What is Tidal volume

200

Boyle’s Law

What is PV=nRT

300

maximal amount of air exhaled beyond normal exhalation ~1L

Expiratory Reserve Volume (ERV)

400

The landmark that connects the Thyroid cartilage and the trachea

What is the cricoid cartilage

500

inflammation of the lungs caused by bacterium (Streptococcus pneumoniae), causes fever, cough, blood in phlegm, breathing difficulty

What is Pneumonia

Pig Parts

100

An immediate bifurcation off of the abdominal aorta that splits into each leg.

What is the external iliac artery

200

The names of the 3 segments of artery branching off of the left hose of the aortic arch.

What is left subclavian, axillary, brachial artery

300

Both of the branches off of the external iliac artery

What is femoral and deep femoral artery

400

a mid-aortic bifurcation into the splenic, hepatic and gastric arteries

What is celiac trunk

500

Supplies blood from a tiny branch off of the abdominal aorta to the large intestine.

What is the posterior mesenteric artery

Case Studies

100

A 14-year-old girl complained of fatigue and loss of stamina. Her appetite was marginal, as she was very conscious of maintaining her body weight at 96 pounds. Her monthly menstrual flow was always heavy and long from its onset at twelve years of age. Relevant laboratory findings included the following: Hematocrit (Hct) 28% Hemoglobin (Hgb) 9g/dL Iron 16ug/dL Bone marrow iron Absent Erythrocytes Small and pale Suggested treatment included ferrous sulfate or ferrous gluconate for six months orally between meals, since food may reduce absorption. A well-balanced diet was also suggested, as well as a gynecological examination. What is the primary disorder of this individual?

What is Iron-deficient anemia

200

A 28 year old female patient comes to your office complaining of chest pain. You listen to her heart with your stethoscope and hear an extra noise in the pattern: Lubb Dubb dah. Is this new sound an S1, S2, S3 or S4 murmur? What is it indicative of?

What is S3 murmur, indicative of heart failure. The sound is coming after the AV and SL valves close (S1 and S2) and now there is a flutter in the AV valves allowing blood to pool into the ventricles early because they are regurgitative.

300

A 19 year old male was was initially diagnosed with polycythemia because his hematocrit was 75% and his buffy coat was 5%. You read his chart and notice that his Sp02 values are normal, along with his erythropoeiten values. This tells you that it is not polycythemia 1 or 2, because the increase in RBC's is not due to a decrease in oxygen or an increase in the RBC producing hormone. After looking at the blood cells in the smear, you notice they are mostly immature and not fully functional. What is your diagnosis?

Elevated RBC and WBC counts mean that something is going awry in the bone marrow. An over-production of cells not caused by an increase in hormone must be caused by a mutation, or cancer. This disease is known as Leukemia, or Acute Myeloid Leukemia (AML).

400

A 62-year-old male complained of weakness, headache, light-headedness, and fatigue. Upon physical examination, the following information was available. Erythrocytes 8.5 million/cu mm Leukocytes 12,500/cu mm Thrombocytes 400,000/cu mm Hct 58% O2 Saturation (arterial) 94% Serum erythropoeitin Undetectable The erythrocytes and leukocytes were immature in the peripheral blood smear. The spleen was enlarged. The determined therapy of choice was phlebotomy, 300-500mL every other day, until the hematocrit was <45% with the possibility of myelosuppressive therapy, if needed. 1. What was the disorder of this individual? 2. Why are arterial O2 saturation and erythropoietin levels important in making this decision?

What is Polcythemia

500

A 30-year-old male developed flulike symptoms with fatigue, afternoon fever, night sweats, weight loss, abdominal cramping, and significant diarrhea. He had taken in very little water over the few days prior to admission to the hospital. Blood tests revealed the following: Hct 56% Leukocytes 1000/cu mm Serum Potassium 3.2 mEq/L CD4 T-cell counts <200/ uL of blood This individual was treated with antibiotics for infection and rehydrated with fluid containing potassium. The hematocrit reversed itself after the fluid was given and then the individual became anemic. 1. What is the diagnosis of this individual?

What is HIV/AIDS