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66 Cards in this Set
- Front
- Back
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What are the three functions of Blood?
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Distribution of Oxygen, nutrients, wastes, and hormones
Regulation of Temperature, pH, and fluid volume Protection from fluid loss (clotting), and infection (immunity) |
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What are the two major categories of blood components?
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Plasma and Formed Elements (blood cells)
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What are the three sub-categories of blood components
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Red Blood Cells, White Blood Cells, Platelets
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Name the general five components of Plasma
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Water, *Proteins, Hormones, Nutrients, and Electrolytes
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What are platelets?
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Cell fragments without nuclei that cluster to form blood clots
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What is plasma?
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The fluid fraction of blood
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What is Serum?
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The fluid fraction of blood after coagulation
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What are the 3 general categories of White Blood cells?
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Granulocytes, Macrophages, Lymphocytes: B-cells make antibody (plasma cells) and T-cells: helper and cytotoxic
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How many proteins exist in plasma?
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Over 300, ~7% of blood
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What are four biochemical roles of plasma proteins
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Maintenance of oncotic pressure, Transport, Defense reactions, Coagulation and fibrinolysis
Some appear as a result of the disease: intracellular enzymes and tumor markers |
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Function of albumin
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Maintenance of oncotic pressure, nonspecific transport protein
Liver ~60% of plasma protein content, short half-life |
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Function of Immunoglobulins
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Humoral Immunity
Plasma Cells ~ 18% of plasma protein content |
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Function of Fibrinogen
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Blood Coagulation
Liver ~4% of blood volume |
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Function of Serpins (Serine Protease Inhibitors)
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Control coagulation and inflammation
Liver |
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Function of Haptoglobulin
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Binds hemoglobin
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Function of Hemopexin
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Highest binding affinity to heme
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Transferring
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Iron transport protein
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Ferritin
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Iron storage protein
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Ceruloplasmin
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Converts ferrous iron into ferric form
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Thyroid binding globulins
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Thyroid hormone transport proteins
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Function of Steroid-binding globulins
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Steroid hormone transport
Liver |
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Function of Enzymes
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Coagulation, complement
Liver |
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Function of Acute phase proteins
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Binds to bacterial polysaccharides
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Funciton of Alpha 1-antitrypsin (serpin)
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Protects from enzymes of inflammatory cells
1.5-3.5 gram/liter Liver |
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Where is Albumin produced and what is the half-life
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in the liver and ~20 days
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What are the four functions of Albumin
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1.Maintains blood oncotic pressure
2.Transport of FFA, unconjugated bilirubin, metal ions: (Ca2+, Fe2+, and Cu2+) Drugs, thyroid, and steroid hormones 3.Free radical scavenging (sulfydryl groups) - important free radical scavenger in sepsis 4.Buffer because of its abundance |
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What are the four causes of hypoalbuminemia
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Liver disease
Starvation (malnutrition, low protein) Excess excretion by the kidneys (nephrotic syndrome) Sepsis |
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What is hyperalbuminemia a sign of?
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Severe dehydration
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What is the main force bringing water back from the tissues?
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The osmotic pressure of plasma proteins
= oncotic pressure |
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What is Kwashiorkor?
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childhood protein malnutrition caused by decreased concentration of plasma proteins. That caused decreased osmotic pressure of blood. The fluid is not drawn back into the blood and accumulates in interstitial space causing edema (swollen belly)
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What is the basic description of Nephrotic Syndrome?
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Damage of the glomerular basement membrane in nephritis results in leaking albumin. Damage results in loss of immunoglobins and complement.
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What is the classic triad of nephrotic syndrome?
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Hypoalbuminemia, proteinuria, edema
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What does Haptoglobin do?
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binds to hemoglobin released from hemolyzed RBC's
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What are three specific functions of haptoglobin
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Inhibits oxidative activity
prevents losses of iron through the kidney prevents kidney damage by hemoglobin |
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What causes haptoglobin levels to decrease?
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hemolytic anemias
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What system removes the hemoglobin-haptoglobin complex?
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Reticuloendothelial system
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What does Hemopexin bind?
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Free heme released from hemoglobin
-heme-hemopexin complex is taken up by liver cells, in liver released iron binds to ferritin |
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Why is Free Heme potentially highly toxic?
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Intercalation into membranes, and it produces free radicals
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What is depletion of unsaturated hemopexin is an indicator of?
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Intravascular hemolysis
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What does Transferring protect against?
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effects of free iron
Transferrin is a glycoprotein transports iron, called apotransferrin when not bound to iron |
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Normal 30% saturation with Fe3+. What is increased saturation and decreased saturation indicative of?
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Increased - iron overload
Decreased - iron deficiency |
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Ferritin is the main _______
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Intracellular iron storage protein
It keeps iron in soluble and nontoxic form |
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What is iron-free ferritin and what is it used for?
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apoferritin and it is used to measure the total amount of iron stored in the body
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What is Hemosiderin?
Where is it always found? When is it found? |
another iron-storage complex
WITHIN CELLS (as opposed to circulating blood) situations following hemorrhages |
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T/F Humans have a mechanism to excrete the excess of iron
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F
We do not |
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What can be the consequences of Iron overload?
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Hindered Immune System
Pancreases can cause diabetic complicatons Heart Problems - Angina and Poor heart rhythm Liver through cirrhosis and cancer Depression (brain) and infertility |
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How often and for how long can therapeutic phlebotomy treatment
(for iron overload) |
once or twice a week for 6 months to three years
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What is used for chelation therapy in case of extreme anemia?
(for iron overload) |
Desferal (desferoxomine)
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What is Ceruloplasmin?
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The major copper transport protein
Carries ~90% of the copper in plasma It regulates redox transport and utilizaiton of iron from ferrous into ferric form |
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When are concentrations of Ceruplasmin elevated? Decrease levels?
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liver disease of tissue damage, OCD, metabolic syndrome
Wilson's disease |
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What are some symptoms of Wilson's disease?
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Jaundice, abdominal pain, enlarged liver, drowsiness with behavior disturbances (liver issues)
increased urinary excretion of copper decreased ceruloplasmin & serum copper |
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What is the hereditary pattern of Wilson's disease?
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autosomal recessive
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Major blood transport proteins & their ligands
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Thyroid binding globulins:
TBG- transports thyrosine TTR- transports thryosine & retinol Alubumin Steriod binding globulins: Transocortin- transports corticosteriod SHBG- transports testosterone & estradiol |
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biochemical mechanism of iron accumulation
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-immature crypt cells sense body iron requirements through the uptake of circulating transferrin-bound iron
-transferrin bound iron is mediated through interaction btwn transferrin receptor & HFE gene product (HFE) |
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biochemical mechanism of iron deficiency
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-HFE unable to interact w/ transferrin receptor
-prevents circulation iron from being taken up by crypt cells -leads to relative intracellular iron deficiency -DMT1 is expressed via enterocytes & ferroprotin presumes iron deficiency & increases iron absorption -leads to iron overload |
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biochemical mechanism of copper accumulation
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- copper in complex w/ albumin transported into liver via hCTr1
-copper chaperons deliver copper to ATP7B -spits into bilary copper and combines with apoceruloplasm to form ceruloplasmin complex -biliary copper transports to bile in canaliculus -ceruplasmin is secreted into circulation |
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biochemical mechanism of copper deficiency
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-ATP7b does not function in deficiency
-no biliary copper can be delivered to bile canaliculus -ceruloplasmin complex not formed or secreted into circulation |
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Defects and symptoms of hemochromatosis
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-defects in proteins regulating iron absorption lead to iron overload
-symptoms include diabetic complications, infections/ illness, angina & arythmia, cirrhosis & cancer, depression, infertility |
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major acute response proteins & functions
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C-reactive protein (CRP):
-marks inflammation -mediates binding of foreign polysaccharides & activation of complement system Alpha 1-Antitrypsin (AAT): -inhibits elastase Alpha 1-Antichymotrypsin (ACT): -inhibits chymotryspin |
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Events that take place during an acute phase response
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A set of nonspecific host responses to cytokines released in response to:
-tissue injury -infection -inflammation leads to: -increased synthesis of acute phase proteins -decreased albumin synthesis |
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tetrad of multiple myeloma
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*type of cancer of plasma cells, hematological malignancy
Tetrad: C-hypercalcemia R-renal failure A-anemia B-bone lesion |
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What are the blood coagulation factor deficiencies of hemophilia A and E?
(both X linked ) |
hemophilia A- factor VIII deficiency
(more common) hemophilia E- factor IX deficiency (Christmas factor) *severe moderate and mild forms of each |
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blood enzymes w/ diagnostic valvues
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alpha-amylase: pancreatitis, trauma, mumps
prostatic acid phosphatase (PAP or PSA): prostate cancer CRP: cardiovscular disease, pregnancy (birth control) ACT: crohn's disease, ulcerative colitis/burn injuries, inflammatory conditions (associated w/ alzheimers) |
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Different types of immunoglobins, function, & location
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IgG-long term immunity
IgA- secretory antibody IgM- first response IgD- B cell receptor IgE- allergy & infection |
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What leads to elevated troponin?
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-MI (up to 2 wks after)
-high BP -pulmonary embolism (blockage) -coronary heart spasm -myocarditis -supraventricular tachycardia -trauma, strenuous exercise -cardiomyopathy |
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Disorders of alpha 1-antitrypsin (AAT)
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Emphysema
chronic obstructive pulmonary disease (COPD) -unchecked elastase leads to extensive destruction of connective tissue |
