Ap 1 - Ch 19 - Blood

Front 1

Describe the life cycle of RBCs (breakdown of hemoglobin to erythropoeisis).

Back 1

Hemoglobin is broken down into heme & globin. GLOBIN is broken into amino acids & recycled for protein synthesis. Iron is removed from heme as Fe3+ & transferrin transports it in bloodstream. Fe3+ is then stored inside ferretin in muscle, liver, spleen. On release transferrin carries it to red bone marrow for hemoglobin synthesis. HEME w/ no iron is converted to biliverdin (green) then bilirubin (yellow). Enters liver & released into small intestine w/ bile --> large intestine + bacteria = urobilinogen. Urobilin = urine. Sterlobilin = feces.

Front 2

What are 3 symptoms of anemia? What are 6 major causes?

Back 2

Symptoms - fatigue, intolerable to cold (low ATP), blue skin (low hemoglobin). Causes - iron deficiency, B12 & folic acid deficiency (megaloblastic anemia), insufficient hemopoiesis (pernicious anemia), RBC plasma membranes rupture prematurely (hemolytic anemia), deficient hemoglobin synthesis (thalassemia), red bone marrow destruction (aplastic anemia).

Front 3

How do the RBCs behave in a person w/ sickle-cell disease? Who does it affect? What are some symptoms & treatments?

Back 3

Contain Hb-S (abnormal hemoglobin). Forms rodlike structure that bend RBC & ruptures it easily. Inherited & affect ppl around malaria belt. Provides resistance to malaria. Symptoms - anemia, jaundice, pain, fatigue (tissue damage due to oxygen debt). Analgesics, hydration, oxygen, antibiotics, blood transfusion.

Front 4

Describe blood temp, pH, ECF%, amount in males/females.

Back 4

38º, 7.35-7.45 pH, 20% ECF, 5-6L male, 4-5L female

Front 5

What is a common site for venipuncture to draw a blood sample?

Back 5

Median cubital vein

Front 6

In a "settled" sample of blood, what are the 3 layers from top layer to bottom & their proportions?

Back 6

55% plasma, 1% buffy coat (WBC + platelets), 45% formed elements (RBC)

Front 7

% of total blood volume occupied by RBCs.

Back 7

Hematocrit

Front 8

What hormone stimulates erythropoietin (EPO) which triggers production of RBCs?

Back 8

Testosterone

Front 9

Below normal # of RBCs.

Back 9

Anemia

Front 10

Condition of abnormally high RBCs that raises viscosity of blood which increases blood flow resistance. Linked to high blood pressure & stroke. Causes: abnormal increase in RBC production, tissue hypoxia, dehydration, blood doping, use of EPO by athletes.

Back 10

Polycythemia

Front 11

In plasma, what is the ratio of water, solutes --> plasma proteins & other content?

Back 11

91.5% water, 8.5% solutes which breaks down into 7% plasma proteins & 1% other content.

Front 12

What are the 3 major plasma proteins (highest to lowest) & their functions?

Back 12

Albumin - most numerous (55%), lipid carrier, contributes to osmotic pressure. Globulin - carrier, type of antibody/immunoglobulin. Fibrinogen - blood clotting.

Front 13

Besides plasma proteins, what other substances are found in plasma solute?

Back 13

Gases, enzymes, hormones, electrolytes, nutrients, wastes.

Front 14

Process by which formed elements of blood develop.

Back 14

Hemopoiesis / hematopoiesis

Front 15

The amount of WBCs depends on what 2 factors?

Back 15

Invading pathogens, foreign antigens

Front 16

Where does hemopoiesis first occur before birth? What becomes the primary site of hemopoiesis in 3rd trimester & throughout life?

Back 16

Yolk sac --> liver, spleen, thymus, lymph nodes --> red bone marrow is primary site.

Front 17

Highly vascularized connective tissue found in spongy bone. Present chiefly in axial skeleton, pectoral/pelvic girdles, humerus, femur.

Back 17

Red bone marrow

Front 18

From which connective tissue do pluripotent stem cells develop?

Back 18

Mesenchyme

Front 19

Blood cells enter blood stream through ___, large leaky capillaries surrounding red bone marrow.

Back 19

Sinusoids (sinuses)

Front 20

Formed elements don't divide once they leave red bone marrow except for ___.

Back 20

Lymphocytes

Front 21

Pluripotent stem cells develop into what 2 stem cells?

Back 21

Myeloid, lymphoid stem cells

Front 22

Some myeloid stem cells differentiate into ___ which cannot reproduce themselves & give rise to more specific elements of blood.

Back 22

Progenitor cells

Front 23

What do the following progenitor cells eventually give rise to? CFU-E, CFU-Meg, CFU-GM?

Back 23

CFU-E (erythrocytes), CFU-Meg (megakaryocyte-->platelets), CFU-GM (granulocytes: neutrophils, monocytes)

Front 24

Generation after progenitor cells.

Back 24

Precursor cells (blasts)

Front 25

Draw blood cell chart (hemopoiesis).

Back 25

See p694 AP or AP1 notes.

Front 26

Hormone produced by kidneys that increase # of red blood cell precursors.

Back 26

Erythropoietin (EPO)

Front 27

Hormone produced by liver that stimulates platelet formation from megakaryocytes.

Back 27

Thrombopoietin (TPO)

Front 28

Oxygen-carrying protein that gives blood red colour.

Back 28

Hemoglobin

Front 29

Production & destruction of RBCs per second is at least ___.

Back 29

2 million

Front 30

What feature on a RBC increases surface area?

Back 30

Biconcave disc

Front 31

What are the benefits of a RBC being anucleated & without organelles?

Back 31

More room in cytosol for oxygen transport. No organelles = no ATP needed for cell metabolism = no oxygen consumed = maximum delivery of oxygen.

Front 32

What makes up a hemoglobin molecule? How many molecules of O2 can it transport?

Back 32

Globin - 4 polypeptide chains. Heme (nonprotein) in each of 4 chains. Iron ion in each heme which binds to 1 oxygen molecule = total 4 O2 molecules can be transported.

Front 33

Which part of hemoglobin does CO2 bind to?

Back 33

Globin

Front 34

What is the effect of nitric oxide binding to hemoglobin?

Back 34

Release of NO causes vasodilation to improve blood flow & oxygen delivery.

Front 35

What is the lifespan of a RBC?

Back 35

120 days - due to wear/tear & no organelles to repair.

Front 36

What type of cell phagocytize worn-out RBCs & where does it occur?

Back 36

Macrophages. Liver, spleen, red bone marrow.

Front 37

Transporter for Fe3+ in bloodstream.

Back 37

Transferrin

Front 38

Iron-storage protein.

Back 38

Ferretin

Front 39

Production of RBCs.

Back 39

Erythropoiesis

Front 40

What is the main stimulus for erythropoiesis?

Back 40

Decrease in oxygen-carrying capacity of blood (hypoxia)

Front 41

Condition of cellular oxygen deficiency that stimulates release of erythropoietin.

Back 41

Hypoxia

Front 42

Rate of erythropoiesis is measured by procedure called ___.

Back 42

Reticulocyte count

Front 43

Which leukocytes are granular vs. agranular?

Back 43

Granular - basophils, eosinophils, neutrophils. Agranular - monocytes, T-lymphocytes, B-lymphocytes, NK cells.

Front 44

Formed element that stains purple & is granular. Involved in inflammation/allergies & releases heparin, histamine, serotonin.

Back 44

Basophil

Front 45

Phagocyte that stains pink & is bilobed. Destroy antigen-antibody complexes, worms, & releases histaminase (counteracts basophil).

Back 45

Eosinophil

Front 46

Phagocyte that is multi-nuclear. 1st responder to bacteria tissue damage. Releases lysozyme, oxidants, defensins.

Back 46

Neutrophil

Front 47

Phagocyte with kidney/horseshoe shaped nucleus. "Finisher" - destroys microbes after neutrophils.

Back 47

Monocyte

Front 48

Increase of WBC above normal - protective response to invading microbes, strenuous exercise, anesthesia, surgery, etc.

Back 48

Leukocytosis

Front 49

Condition of abnormally low WBC & may be caused by radiation, shock, chemotherapeutic agents.

Back 49

Leukopenia

Front 50

Process by which WBCs leave bloodstream. What are the 3 steps in this process?

Back 50

Emigration (formerly diapedesis). Roll, stick, squeeze.

Front 51

Process by which phagocytes follow chemical signals to microbes or inflammed tissue.

Back 51

Chemotaxis

Front 52

Type of lymphocyte with adaptive immunity that releases plasma antibodies which are followed by ___ that destroy the pathogen. Memory function lets it remember past invaders.

Back 52

B-lymphocyte direct T-lymphocyte

Front 53

Type of lymphocyte with general immunity that attacks pathogens, microbes, tumors.

Back 53

NK Cells (natural killer)

Front 54

Type of formed element that develops from megakaryocytes that splinter into 2000 to 3000 fragments. Disc-shaped with many vesicles but no nucleus. Life span 5-9 days. Forms blood clot.

Back 54

Thrombocyte (platelet)

Front 55

Replacement of cancerous or abnormal red bone marrow w/ healthy red bone marrow.

Back 55

Bone marrow transplant

Front 56

How long does it take transplanted bone marrow to produce enough WBC for protection?

Back 56

2-3 weeks

Front 57

What are 3 drawbacks of bone marrow transplants?

Back 57

Donor T-cells may attack recipient's tissues, recipient's surviving T-cells may attack donor cells, patient must take immunosuppressive drugs for life which increase infection risk & other side effects.

Front 58

What are some advantages of cord-blood transplants?

Back 58

Stem cells are easily collected from umbilical cord before birth & can be stored indefinitely. Less likely to cause graft-versus-host disease.

Front 59

Sequence of responses that stops bleeding.

Back 59

Hemostasis

Front 60

Large amount of blood loss

Back 60

Hemorrhage

Front 61

What are the 4 main steps of hemostasis?

Back 61

1) Vascular spasm. 2) Platelet plug formation. 3) Clotting/coagulation 4) Clot retraction.

Front 62

First step in hemostasis when vasoconstriction occurs locally & blood flow decreases.

Back 62

Vascular spasm

Front 63

Hormone released by platelets that cause proliferation of vascular endothelial cells, vascular smooth mm fibers, fibroblasts to help repair.

Back 63

Platelet-derived growth factor (PDGF)

Front 64

Second step in hemostasis where platelet adhesion occurs, release reaction of ADP, serotonin, thromboxane-2 (last 2 are vasoconstrictors), & aggregration occurs (platelets group).

Back 64

Platelet plug formation

Front 65

Blood plasma minus clotting proteins is called ___.

Back 65

Serum

Front 66

Describe the extrinsic pathway of hemostasis.

Back 66

Occurs outside blood vessels in tissue & is the quicker process. Tissue protein called tissue factor/thromboplastin activates co-factor 10 & 5 to form enzyme prothrombinase.

Front 67

Describe the intrinsic pathway of hemostasis.

Back 67

Occurs locally in blood & is slower process. Factor 12 activates co-factor 10 & 5 to form enzyme prothrombinase.

Front 68

What marks the beginning of the common pathway of hemostasis?

Back 68

Synthesis of prothrombinase

Front 69

Describe the common pathway of hemostasis.

Back 69

Prothrombinase + Ca2+ convert prothrombin into thrombin. Thrombin + Ca2+ convert fibrinogen (soluble) into fibrin (insoluble).

Front 70

What are the 2 positive feedback effects of thrombin?

Back 70

It speeds up prothrombinase formation & activates platelets.

Front 71

Last step of hemostasis where fibrin clot is tightened.

Back 71

Clot retraction

Front 72

What vitamin is needed to synthesize clotting factors?

Back 72

Vitamin K

Front 73

System that dissolves inappropriate clots & clots at damage site once repaired. Breakdown of clot is called ___.

Back 73

Fibrinolytic system. Fibrinolysis.

Front 74

Inhibitor of platelet adhesion & release

Back 74

Prostacyclin

Front 75

Substances that delay, suppress, or prevent blood clotting such as antithrombin, heparin, activated protein C.

Back 75

Anticoagulants

Front 76

Clotting in an unbroken vessel is called ___. The clot itself is ___. Any type of debris transported in bloodstream is ___.

Back 76

Thrombosis. Thrombus. Embolus.

Front 77

Antigens on surface of erythrocytes composed of glycoproteins & glycolipids called ___. Blood plasma antibodies called ___.

Back 77

Agglutinogens (antigens). Agglutinins (antibodies).

Front 78

Blood groups are based on the presence or absence of various ___.

Back 78

Antigens

Front 79

How many blood groups & antigens are there?

Back 79

At least 24 blood groups. 100+ antigens.

Front 80

Antigen-antibody binding

Back 80

Agglutination

Front 81

Of the ABO blood types, which is the universal donor vs. recipient?

Back 81

Donor - O. Recipient - AB.

Front 82

Most common disease associated w/ Rh incompatibility in newborns. Occurs when maternal anti-Rh antibodies cross placenta & cause hemolysis of fetal RBCs. Can be prevented by giving Rh- women an injection of anti-Rh gamma globulin antibodies after delivery, miscarriage, abortion.

Back 82

Hemolytic disease of newborn (HDN)

Front 83

Why is the first born baby unlikely to have HDN?

Back 83

Mother is likely to going to make anti-Rh antibodies after baby is born so baby suffers no damage.

Front 84

Solutions that contain antibodies.

Back 84

Antisera

Front 85

Condition of bleeding spontaneously due to minor trauma. Treatment - transfusions of blood plasma or clotting factor. Drug desmopressin.

Back 85

Hemophilia

Front 86

Cancerous WBC interfering w/ WBC, RBC, platelet production. Oxygen deficiency, susceptible to infection, abnormal clotting. Treatment - chemo, radiation, stem cell transplant, interferon, antibodies, blood transfusion.

Back 86

Leukemia