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162 Cards in this Set

  • Front
  • Back
What is plasma made of?
water, electrolytes, oxygen, co2, glucose, amino acids, antibodies, hormones, cells
What are the cells in plasma? Name them.
platelets, leukocytes, RBC
Blood is the body's what.
Blood is the body’s only fluid tissue?
What are formed elements?
platelets, leukocytes, RBC
What is Hematocrit?
The percentage of RBCs out of the total blood volume
When is blood red?
When it is oxyginated
What is the average pH of blood.
The pH of blood is 7.35–7.45
What is acidosis?
What is alkadosis?
pH below 7.35 = acidosis.
pH above 7.45 = alkadosis
What of is the temp of blood?
38 degrees Celsius
How much does blood weight?
Blood accounts for 8% of body weight
How much volume of blood does a male and female have?
5-6 liters for male 4-5 liters for females
What are the functions of blood in general?
-Substance distribution
-Regulation of blood levels of particular substances
-Body protection
What is the function of blood?
distribute, regulate, protectes from extreme temps, transports oxygen and hormones, wastes ,
What does the liver make?
urea, albumin, FIND OUT~!
How does the body prevent blood loss?
Initiating clot formation when a vessel is broken
How does blood prevent blood loss?
- Activating plasma proteins and platelets
- Initiating clot formation when a vessel is broken
How does the blood prevent infection?
- Synthesizing and utilizing antibodies
- Activating complement proteins
- Activating WBCs to defend the body against foreign invaders
Why are the WBC the only complete cells?
They are the only ones that have a nucleus.
Why are RBC not complete?
They dont have a nucleus.
Do RBC's undergo mitosis?
No. The bone marrow has stem cells that makes new cells.
How long do formed elements survive?
Most formed elements survive in the bloodstream for only a few days.
What else does RBC have?
Contain the plasma membrane protein spectrin and other proteins.
How does the RBC's shape and characteristic contribute to its function?
- Biconcave shape has a huge surface area relative to volume
- Erythrocytes are more than 97% hemoglobin
- ATP is generated anaerobically, so the erythrocytes do not consume the oxygen they transport
What is hemoglobin composed of?
Hb is composed of the protein globin, made up of two alpha and two beta chains, each bound to a heme group
Which group has the O2 attached to it?
Iron on the heme group.
How many oxygens can a hemoglobin carry?
4
What is hematopoiesis?
blood cell formation
Where does hematopoiesis occur?
- Flat irregular bones, ribs vertebrae, sternum and pelvis (iliac crest common site for bone marrow aspiration)
- Epiphyses of the humerus and femur
What is the stem cell that all formed elements made from?
Pluripotent hematopoietic
Very low O2 level and high CO2 will activate...
chemoreceptors from which erythropoietin hormone is secreted and targets bone marrow to make more RBC.
What kinds of bones produce RBC?
Flat bones – all bones of the skull (compact at two ends with spongy in the middle)

Epiphysis (the head) makes RBC

Irregular (some)

Sternum

Iliac crest is used for bone marrow transplant (edge of the illium)

Long bone has compact bone
What is erythropoiesis?
Production of RBCs.
What are the 3 phases of developmental pathway of erythropoiesis?
1 – ribosome synthesis in early erythroblasts
2 – hemoglobin accumulation in late erythroblasts and normoblasts
3 – ejection of the nucleus from normoblasts and formation of reticulocytes
What is erythrocyte a mature form of?
Reticulocytes
What gives the RBC the ability to bend and move through the smallest cappilaries?
Spectrin; it is a protein in the plasma membrane of RBCs
What kind of bond does hemoglobin have with O2?
Coordinate bond; can be easily broken.
How is ATP generated in RBCs?
anaerobicly so as to not use the O2 that it is carrying.
What is so significant about the porphyrin ring?
It is the portion of the hemoglobin that O2 gets attached to.
When do RBCs enter the blood?
After they are matured. You will not find them (under normal conditions) in immatures.
RBCs count is almost always a constant
okay.
As soon as an RBC dies, it is replaced by...
stem cells.
What do too few RBCs cause?
hypoxia
Too many RBCs causes? What are some problems associated with this?
Undesirable blood viscosity; makes it harder for the heart to pump (hypertrophy of the heart).
What does folic acid do?
Causes RBCs to multiply
What is the release of erythropoeitin triggered by?
hypoxia
What are the requirements of the production of RBCs?
Proteins, lipids, carbohydrates
Iron, vitamin B12, and folic acid
How long does it take the body to make erythropoetin?
10 days for the body to realize and about a month to create.
Where in the body other then Hb is Iron stored?
The liver, spleen, and bone marrow.
Where is intracellular iron stored?
Intracellular iron is stored in protein-iron complexes such as ferritin and hemosiderin
Why does Iron exist in complexes and not free floating?
oxidation cause literally cause rust of the organs and ceases function
What is blood doping? What are the problems with this?
Injecting blood into you before a race?

Can cause stroke and heart problems.
Where is circulating iron stored?
Circulating iron is loosely bound to the transport protein transferrin
What is the name of the genetic disorder that you get with rusting of the organs?
Hemocramatosis
What is the prevention or treatment of hemocramatosis?
Draining the blood out.

Take out the blood, help you use the iron to make new RBC, go back, drain some more blood.
What is the fate and destruction of erythrocytes?
they break down. Hb is separated into heme and globin. Globin breaks down into amino acid and they are recycled.

Heme is broken into Iron and other parts of heme are converted by liver to bilirubin .
What is the process by which heme is broken down. Give all steps.
1. Heme is degraded into bilirubin (unconjugated)
2. It becomes conjugated in the liver by glucuronide (conjugated=water soluble)
3. Liver dumps bilirubin into bile.
4. Bilirubin is metabolized (intestines) into Urobilinogen
5. Urobilinogen leaves the body in feces as Stercobulin
What is hemocramatosis? What kind of a disorder is it?
When you have too much Iron in your body. It is a genetic disorder.
What captures hb to break it down?
haptoglobin.
Where is Iron returned to; which part of the body?
Liver and Bone Marrow.
What is the fate of the excess Iron that is not used in the creation of RBCs?
It is bound to Ferritin or Hemosiderin in the liver.
What is the normal level of WBC count? What could a shift to the left in the levels indicate?
Normall around 11,000.

Above (shift to the left) 11,000 means you have some sort of viral or bacterial infection.
What does a Differencial Blood Count do?
Tells you if you have a viral or bacterial infection. It gives you the numbers of each leukocyte.
With a bacterial infection, what would you see more of in the blood?
With bacterial infections you see more of immature neutrophils (called bands)
Give the correct percentages of Granulocytes and Agranulocytes.
Neutrophils - 50-70
Eosinophil - 2-4
Basophils - 0.5-1

Lympocytes - 25-45
Monocytes - 3-8
What are the characteristics of Granulocytes?
1. Staining of cytoplasmic granules
2. Larger than RBCs
3. Live short than RBCs
4. Lobed nuclie
5. All are phagocytic
What are the three things in Neutrophils that help you kill bacteria?
Peroxidases, Hydrolytic Enzymes, and Defensins (anti bacterial protiens)
What are three other names for Neutrophils?
Seg, PMNs, and Polys
Basophils are...

They make...
...mast cells

...histamine and heparin
What is heparin?
A blood thinner
Which is the largest leukocyte?
Monocytes
What are some characteristics of Monocytes?
1. They differentiate into macrophages.
2. First line of defense
3. They become APCs
4. Activation of T and B cells.
What is Leukopoiesis?
Production of WBCs.
What two things stimulate Leukopoiesis?
Interlukin (named with numbers)
CSF (named with the thing it is stimulating)
What are the two most important sources for cytokines.
Macrophages and T Cells.
What do cytokines do?
Proliferation of WBC to an area.
What do platelets do?
They initiate clot formation. Key word INITIATE, not completely form.
So what actually forms the clot?
Prothrombin and Fibrinogen
Prothrombin and Fibrinogen are in what form floating around in your blood? Why?
Inactive. So you don't randomly form a clot.
What are the two factors called that also initiate the clot?
Intrinsic and Extrinsic factors
What are the intrinsic factors?
What are the extrinsic factors?
Intrinsic - Endothelials getting damage
Extrinsic - Tissue factors
What are the steps to clotting?
Taking away the "pro" part of "prothrombin" to form Thrombin

Throbmin activates Firbrinogen to become Fibrin, and Fibrin is the one that forms the clot and prevents the the blood from getting out via the Fibrin Mesh.
What is hemostatis?
What are the three steps?
Stopping bleeding

1. Vasoconstirction (vascular spasm) - so you dont bleed to death.
2. Platelet plug formation
3. Coagulation – clot formation
Intrinsic and extrinsic pathways
What are cappilaries made up of?
Connective tissue on the outside (collagen fibers) and endothelials on the inside.
What do the collagen fibers do?
When you get a cut the collagen fibers are hanging out. They start secreting certain factors that attract platelets. Once the platelets adhere to it, they start forming the plug temporarily.
What is the permamnet seal made by?
The intrinsic and extrinsic factors.
Why is Calcium so important in clot formation?
Calcium is important in the clotting process because it is required from both Intrinsic and Extrinsic pathways.
What is the process of the formation of the clot?
1. Platlets activate Prothrombin Activator
2. Prothrombin Activator activates Prothrombin
3. Prothrombin is activated into Thrombin
4. Thrombin converts Fibrinogen into Fibrin
5. Fibrin creates the Fibrin Mesh.
Where does Heparin's function come into play here?
Heparin's function is prevention of Prothrombin Activator from activating Thrombin from Prothrombin.
What is a medication that acts similar to Heparin?
Warfarin.
What Vitamin is required for clotting?
K
When does Heparin work?
Prevents from FORMING the clot. If you already have a clot, it does nothing.

Heparin is not going to do anything with a person who has had a TIA.

It only prevents FUTURE clots.
What do you then do if you have a clot that you need to break down?
Take TPA. TPA is Thrombolytics (Streptokinase)
How does TPA work?
By activating Plasmin.
Plasminogen breaks down clots. So if you can activate the Plasminogen into Plasmin, you can break down clots.
If you have a TIA (hypoxia to the brain), what do you do?
You give the person TPA.
What does ASA do?
Prevents the platelets from sticking together.
What two things block the conversion of Prothrombin to Thrombin?
Antithrombin III and Heparin (released by Basophils)
Heparin only does what?
It does NOT dissolve clot, but PREVENTS it from GROWING. If a clot is already formed its not gonna work.
With newly formed clots, you give what? Why?
Plasminogen activator (tPA) and streptokinase
You give them this because they breakdown clots.
To whom do you give TPAs and Sre
Used in heart attack and stroke patients.
How do you know if a person has a clotting disorder? What are these tests called and what do they do?
Bleeding Time Test (measures platelet function)

PT - prothrombin time. It sees how fast Prothrombin is converted into Thrombin. Measures extrinsic pathway.

PTT - partial thromboplastin time.
What is platelet adhesion is prevented by?
1. Smooth endothelial lining of blood vessels

2. Antithrombic substances (eg, nitric oxide) and prostacyclin secreted by endothelial cells

3. Vitamin E (anticoagulant and antioxidant)
Why would you have clotting problems?
Maybe not enough fibrinogen (made in liver). So this means you might have liver problems.

Not enough calcium or Vitamin K (make in the Colon by bacteria). This could be because of Ulcerative Colitis (inflammation of the colon prevents production of good bacteria)
What is a thrombus?
It is a clot that develops and persists in an unbroken blood vessel
What can thrombus cause?
It can block circulation, leading to tissue death.
What is an Embolus?
It is a thrombus floating freely in the blood stream.
What can an embolus cause?
It impairs the ability of the body to obtain oxygen. It can cause strokes (cerebral embolus)
Aspirin is an ______________ that inhibits ______________.
Aspirin is an antiprostaglandin that inhibits thromboxane A2.
Heparin is an ___________ used clinically for ____ & __________ _____ care.
Heparin is an anticoagulant used clinically for pre- and postoperative cardiac care
On whom is Warfarin used for (think heart)
Used for those prone to atrial fibrillation.
What is DIC?
Disseminated Intravascular Coagulation
DIC is what...
Widespread clotting blocks intact blood vessels.
DIC is more common in...
Pregnancy, septicemia, or incompatible blood transfusions
Explain organ failure in light of DIC with release of tissue thromboplastin.
The thromboplastin can trigger the clotting process. This triggering causes the activation of plasmin which initiates fibrinolysis which causes excessive bleeding and hemorrhaging. This can cause organ failure.
Explain organ failure in light of DIC with extensive endothelial damage.
1. The clotting process is initiated. This can cause many thrombi to form. This causes Ischemia and multiple infarctions

2. The thrombi activation can cause aggregation of platelets which can cause ischemia and multiple infarctions.

3. The many thrombi formations can use up all the clotting factors which can decrease serum fibrinogensis. This causes Ischemia and multiple infarctions.

4. The many thrombi can cause platlet aggregation which causes thrombocytopenia which causes Ischemia and multiple infarctions.
What is Thrombocytopenia?
deficient number of circulating platelets
With thrombocytopenia, there appears spontaneous, widespread hemorrhaging as small dots. What is this called?
Petechiae
What is a cause of thrombocytopenia? Give an example.
Suppression or destruction of bone marrow (e.g., malignancy, radiation)
What is the platelet count with someone with thrombocytopenia?
Platelet count <50,000/mm3 is diagnostic
How is thrombocytopenia treated?
Treated with transfusion of concentrated platelets
How can liver impairment cause a bleeding disorder?
1. Cannot synthesize procoagulants, impaired fat and Vitamin K absorption
What liver diseases can cause thrombocytopenia? Two examples.
hepatitis and cirrhosis
What are the different kinds of Hemophelia? Give descriptions about what deficiency in what factor they have.
Hemophilia A: most common type (77% of all cases); due to a deficiency of factor VIII

Hemophilia B: deficiency of factor IX

Hemophilia C: mild type; deficiency of factor XI
What are the symptoms of hemophelia?
prolonged bleeding, especially into joint cavities
How do you treat Hemophelia?
1. Treated with plasma transfusions

2. Injection of missing factors
Hemophilia is a genetic disorder. It is a(n) ____ linked disorder..
X
What are the percentages of affected and unaffected children if the father is normal and the mother a carrier of hemophilia.
Female child: 50% Normal - 50% Carrier

Male child: 50% Normal - 50% Affected
How can a girl have hemophilia ?
With an affected father and a carried mother.
What are the percentages of affected and unaffected children if the father is affected and the mother a normal.
Female child: 50% Carrier - 50% Affected

Male child: 50% Normal - 50% Affected
When are whole-bood transfusions used?
Whole-blood transfusions are used when blood loss is substantial.
What are packed red cells used for?
Packed red cells (plasma removed) are used to restore oxygen-carrying capacity.
What is Anemia?
Anemia is where the blood has abnormally low O2-carrying capacity.
Anema is a _____ rather than the disease itself.
Sign
What are some symptoms of anemia?
1. fatigue
2. paleness
3. shortness of breath
4. chills
What can cause Anemia?
Insufficient erythrocytes
What can cause insufficient erythrocytes? Explain them.
Hemorrhagic anemia - acute or chronic loss of blood

Hemolytic anemia - RBCs rupture for some reason.

Aplastic anemia - destruction or inhibition of red bone marrow
(This is a side effect as a treatment of another disease (chemotherapy))
What is another kind of anemia regarding hb?
Low hemoglobin content
Why would you have low hb count?
Iron deficiency
Why would you have Iron deficiency?
1. hemorrhagic anemia
2. low intake of iron
3. impaired iron absorption
What is Pernicious anemia?
Not enough vitamin b12 (cheese, milk, meat)
What do you need to have for B12 absorption?
Intrinsic Factor
What secretes intrinsic factor?
Parietal cells (also secretes acid)
Once the Intrinsic Factor binds to vitamin b12, where is it absorbed?
Illium
What if you are not making Intrinsic factor?
You make huge cells called Megalocytes which are immature RBCs.
What else is Vitamin B12 needed for?
Mylenation; without it you have improper nerve conduction.
How do you treat Pernicious anemia?
Treated by intramuscular injection of B12 or application of Nascobal
Explain the process of vitamin B12 deficiency.
1. Vitamin B12 is ingested
2. Antibody reaction causes atrophy of the gastric mucosa (thus no intrinsic factor)
3. No absorption in ilium
4. Vitamin B12 is excreted
5. Lack of B12 causes the bone marrow to make Megaloblastic erythrocytes.
Besides Hb deficiency, what other kind of Hb issues cause anemia?
Abnormal hemoglobin. Specifically Thalassemias
What is Thalassemias?
It is where you have a missing globin chain or faulty beta chain of hemoglobin.
What is the cause of Thalassemias?
Mutation
Which is more dangerous, Alpha or Beta chain.
Beta
What is Sickle-cell anemia?
A defective gene that codes for the Hb which causes RBCs to become sickle shaped in low-oxygen situations.
What does Valien 6 have to do with sickle cell anemia?
Position 6 (valien) is the amino acid that causes the hemoglobin to fold differently and causes the mutation.
What does sickle cell anemia do to the blood vessels?
It causes occulusion.
What does occulsions do?
Occlusions cause:
1. Tissue damage
2. Multiple Infractions
3. Pain
4. Loss of function
In addition to occlusions what doe ssickel cell anemia cause?
It causes hemolysis of RBC's in spleen and severe anemia and hyperbilirubenia.
Two parents, one with the trait for sickle cell anemia and the other normal. What is the percentage of the child having sickle cell traits.
50%
Two parents: both with the sickle cell trait. What is the percentage that the children/child is anemic and so on?
25% normal
25% with sickle cell anemia
50% with sickle cell trait
Two parents: parent with sickle cell anemia and one normal. What are the changes that the children are anemic?
100% anemic
What is polycythemia....
excess of RBCs that increase blood viscosity
What is the cause of polycythemia...
1. Polycythemia vera - bone marrow cancer
2. Secondary polycythemia (low O2, high EPO)
3. Blood doping
Leukopenia is...
Abnormally low WBC count
How can leukopenia is caused by...
drugs. It can be drug induced (inhibition of bone marrow)