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93 Cards in this Set
- Front
- Back
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What percentage of blood is plasma?
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60%
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What is the major component of plasma? What are the other components?
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Water…Electrolytes and proteins
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What are the proteins in plasma?
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Hemostatic…Complement…Immunoglobulins…Transport
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What are the three major types of blood cells?
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Erythrocytes…Leukocytes…Thrombocytes
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What are the thre categories of white blood cells (leukocytes)?
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Granulocytes…Lymphocytes…Monocytes
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What are the three types of granulocytes?
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Neutrophils…Esoinophils…Basophils
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What is the purpose of neutrophils?
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First line of defense in the inflammatory process.
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What is the purpose of esoinphils?
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Attack parasitic worms.
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What is the purpose of basophils?
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Contain amines such as histamine. Involved in infection and allergies.
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What are the two types of lymphocytes? Describe them.
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T-lymphocytes: cell-mediated immunity; produced by the thymus…B-lymphocytes: humoral immunity; produce antibodies.
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What is the role of monocytes? Where do they do their job?
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Matures into macrophages that remove debris, present antigens to T-cells. They circulate and then move into the tissue to work.
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How are platelets produced?
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The peripheral cytoplasm of megakaryocytes in bone marrow is fragmented.
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What are the functions of blood?
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Respiratory gas exchange…Transport of nutrients and waste…Thermoregulation…Hemostasis
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During embryogenesis, where are blood cells produced? Where does it occur after embryogenesis?
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Yolk sac mesoderm, liver, and spleen. Bone marrow.
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Where does hematopoiesis occur in infants to 4 year olds?
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In all marrow cavities.
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Where does hematopoiesis occur after 4 years of age?
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In parts of the marrow cavity; the marrow outgrows the need.
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From what cells are all blood cells derived?
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The "founder cell" is a pluripotent stem cell that divides indefinitely and can differentiate into daughter cells.
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What are the two stem cells that divide from the "founder cell"? What are they referred to as?
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Lymphoid stem cell…Myeloid stem cell…Multipotent stem cells.
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What are the two types of growth factors that influence hematopoiesis? What is the difference between the two?
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Non-lineage specific growth factors: act on pluripotent and multipotent stem cells; interleukin-3, granulocyte-monocyte colony stimulating factor (GM-CSF)…Lineage specific growth factors: erythropoietin, interleukin-5.
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What is the difference between aspiration and biopsy?
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Aspiration: a needle is inserted and a liquid sample is removed…Biopsy: a core of bone marrow is removed and examined.
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How long do erythrocytes live?
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Approximately 120 days.
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What is unique about the color of erythrocytes?
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1/3 of the diameter will have a palor.
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What organ responds to low blood oxygen levels? How so?
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The kidneys detect the condition and release erythropoetin into the blood.
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What is the role of erythropoetin?
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It travels to the bone marrow and stimulates an increase in the production of RBCs.
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What organ destroys damaged or old RBCs?
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The spleen.
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What are the three required hematopoetic growth factors?
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Interleukin-3 (IL-3)…granulocyte-monocyte colony stimulating factor (GM-CSF)…Erythropoetin (EPO).
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What are the growth factors that are important to the early stages of stem cell differentation?
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IL-3 and GM-CSF
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What is hematocrit?
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The amount of packed red blood cells in a sample of blood; a percentage.
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What is MCV?
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Mean Corpuscular Volume…The volume of an average RBC; measured in femtoliters (fL).
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What is MCH?
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Mean Corpuscular Hemoglobin…The average amount of hemoglobin in an RBC; measured in picograms (pg).
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What is MCHC?
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Mean Corpuscular Hemoglobin Concentration…The average amount of hemoglobin as a percentage of the volume of the RBC; measured in g/dL…Calculated using MCH/MCV x 100.
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What are the three morphological classifications of anemias?
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Normocytic…Microcytic…Macrocytic…Measurement based on MCV and MCHC.
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What is the iron carying part of the RBC called? What type of molecule is this?
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Heme…It is a porphyrin.
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What cyclic tetrapole is vital to DNA synthesis?
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Vitamin B12 and cobalt.
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What cyclic tetrapole is vital to photosynthesis?
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Chlorophyll and magnesium.
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What cyclic tetrapole is vital to oxygen transport in humans?
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Heme and ferrous iron (Fe2+)
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What is the composition of heme?
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Four pyrroles linked by methylene bridges to a central ferrous iron.
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What enzyme adds Fe to produce hemoglobin?
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Protoporphyrin IX
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What is the role of myoglobin?
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It is an oxygen storage molecule.
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Who recognized air as a requirement for life? When?
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Boyle…1660
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Who identified oxygen as the vital component of air? When?
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Lavoisier…1777
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Who name hemoglobin? When?
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Hoppe-Seyler…1864
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Who discovered the 3D shape of hemoglobin? When?
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Perutz…1936-59
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What is the general mutation that causes Hb function to diminish?
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An internal hydrophobic amino acid is exchanged for a hydrophilic amino acid, attracting water molecules and preventing oxygen from binding.
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What is bound to the proximal histadine?
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Fe2+ of the heme.
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What is bound to the distal histadine?
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Oxygen binds between this histadine and the Fe2+
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Where are the genes found for hemoglobin?
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They are found on chromosomes 11 and 16.
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What are the types of hemoglobin and which polypeptide bonds make them up?
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HgF (fetal): α2γ2…HgA2 (minor): α2δ2…HgA (major): α2β2
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How many amino acids are found in the α chain?
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141
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How many amino acids are found in the non-α chain?
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146
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What is the relationship between pH and oxygen binding capacity in heme?
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Hb binds oxygen efficiently in a high pH environment and releases it in a low pH environment.
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How is oxygen affinity modulated?
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2,3-diphosphoglycerate (2,3-DPG) decreases Hb affinity for oxygen.
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What is the affinity for oxygen for myoglobin? For hemoglobin?
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Myoglobin always has a higher affinity for oxygen than hemoglobin.
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What does 2,3-DPG do to Hb? How does it do this?
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It decreases it's affinity for oxygen. 2,3-DPG is hugely negative at blood pH and binds to the positive interior of the Hb, preventing oxygen from binding.
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What occurs in high altitude to adjust for the lower oxygen pressure?
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Ventilation rate increases…RBC production increases…2,3-DPG production increases to further lower the hemoglobin's affinity for oxygen.
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What are the differences from HbF and HbA?
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HbF has a higher affinity for oxygen and does not bind 2,3-DPG as readily
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What are the four stages of iron deficiency?
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Depletion…Deficiency without Anemia…Deficiency with Anemia…Advanced Iron Deficient Anemia
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What is the most common cause of iron deficiency?
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Blood loss
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What are the clinical signs of iron deficiency?
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Brittle nails, mouth sores, glossitis, pica
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What is the treatment for iron deficiency?
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Oral ferrous sulfate
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What are the major characteristics of megaloblastic anemia? What are the other hematologic presentations?
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Low reticulocyte count, Retardation of DNA synthesis…Anemia, Elevated MCV, Hypersegmented neutrophils
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What is the activity level of bone marrow in megaloblastic anemia?
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Hyperactive
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How long does it take for folate to be depleated? B12?
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4 months…10 years
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What does vitamin B12 do?
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It removes a methyl group from THF (tetrahydrofolate), activating the THF. The methyl is transferred to homocysteine.
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If B12 is missing, what is the effect?
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Myelin synthesis is diminished and neurological effects occur.
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What is the treatment for megaloblastic anemia due to folic acid deficiency?
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5 mg of folate for 4 months.
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What is the treatment for megaloblastic anemia due to vitamin B12 deficiency?
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6 doses of 100µg over 2-3 weeks.
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What occurs as RBCs age?
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Increased regidity, decreased concentration of 2,3-DPG
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If the lifespan of RBCs is decreased, what is this called?
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Hemolytic disorder
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How does the body combat hemolytic disorders? How long can it do this?
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It produces more RBCs by activating more bone marrow. Can make up for the extra RBC death until the average lifetime drops from 120 days to 15 days.
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What are the hereditary causes of hemolytic anemia?
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Red cell membrane defect…Red cell metabolism defect…Abnormal hemoglobin
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What are the causes of acquired hemolytic anemia?
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Inappropriate immune activation…Drug and chemical ingestion…Vasculitis…Infectious disease…Liver of kidney failure
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What are the clinical features of hemolytic anemia?
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Jaundice, tea colored urine, gallstones, ankle ulcers
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What is produced when RBCs are broken down?
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Bilirubin
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What is the treatment for hereditary spherocytic anemia?
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Splenectomy
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How is hereditary spherocytic anemia inherited?
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Autosomal dominant
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What is seen in the blood of a patient with hereditary spherocytic anemia after a splenectomy?
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Howell-Jolly bodies: small DNA fragments
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In which population is G6PD highly prevalent?
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African American males
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Where is G6PD located?
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X chromosomes
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What is thalassemia?
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A disorder characterized by a defective or absent globin chain
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What does hypochromic mean?
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Decreased hemoglobin
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What are the types of thalassemia? Where do they tend to occur?
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α-thalassemia: far east
β-thalassemia: Mediterranean Sea |
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What is the molecular basis of α thalassemia?
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Deletions in chromosome 11 and 16
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What is the molecular basis of β-thalassemia?
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Regulation of gene syntheis or single point mutations.
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What are the three types of β-thalassemia?
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β-thalassemia major: produces no β-globin chains and no HbA1
β-thalassemia intermedia: some β-globin and HbA1 is produced β-thalassemia minor |
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What occurs to the marrow in β-thalassemia major?
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Marrow becomes overactive and the skull can become deformed.
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What is agglutination? When does it occur?
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Since there are no β-chains for the α-chains to bind to, the α-chains do not form tetramers and eventually form Heinz Bodies
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What are the classifications of α-tahalassemia?
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Silent carrier (1 gene deletion)
α-thalassemia minor (2 gene deletion)…HbH disease (3 gene deletion)…hydrops fetalis (four gene deletion) |
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What are Hb Barts?
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Excess γ-chains build up in fetuses because there are no α-chains for it to bind with.
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What is the major cause of mortality in thalassemias? How is it treated?
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Iron overload…Low iron diet, Desferal
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What is the mutation that causes malaria resistence?
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Heterozygous for β globin chain mutation.
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What are the three gene mutations that cause sickle cell? What does this cause?
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HbS: β6 Glu to Val… HbC β6 Glu to Lys… Chapel Hill: α74 Asp to Gly…Causes a hydrophobic patch to appear that causes them to bind to one another.
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What drug based therapy is used for sickle cell?
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Induction of HbF formation with hydroxyurea.
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