Physiology: Chapter 32 Rbcs, Anemia And Polycythemia

Front 1

What buffers blood the most?

Back 1

hemoglobin is a powerful acid-base buffer because of charged amino acids that interact with ions

Front 2

What is the average RBC count/mL in a man? in a woman?

Back 2

5.2 mill
4.7 mill

Front 3

What is the upper limit that Hgb can be concentrated in 100mL of RBCs? What is normal Hgb concentration per 100mL of RBCs?

Back 3

1) 34 grams
2) 15 grams men and 14 grams woman

Front 4

In early embryonic life where are RBCs produced? in the middle trimester it switches to where? Then by last month gestation it switches to where?

Back 4

1) yolk sac
2) liver mostly, some in spleen and lymph nodes
3) bone marrow

Front 5

Prior to 5 which bones produce RBCs? When does the tibia turn to yellow marrow? Femur? Where are they continually produced?

Back 5

1) all
2) tibia shaft stops at 19 yrs
3) femur shaft stops at 24 yrs
4) vertebra produce most, then sternum, then rib throughout life

Front 6

What cell do all blood cells originate?

Back 6

pluripotential hematopoeitic stem cell

Front 7

What is a stem cell committed to becoming a erthryocyte called?

Back 7

CFU-E

Front 8

What is a major growth inducer of the blood cells?

Back 8

IL-3 promotes growth and reproduction of all the different types of committed stem cells

Front 9

What function do growth inducers not have?

Back 9

cannot cause differentiation

Front 10

What is the first cell that can be identified as belonging to the RBC series?

Back 10

proerythroblast

Front 11

what are the stages of RBC series?

Back 11

1) proerythroblast
2) basophil erythroblast
3) polychromophil erythroblast
4) orthoerythroblast
5) reticulocyte
6) erythrocyte

Front 12

At what stage in the RBC series do the cells begin to accumulate Hgb? what else occurs during the remaining stage?

Back 12

1) polychromaphilic erythroblast stage
2) nucleus condenses and is extruded as well as ER

Front 13

Why is the reticulocyte still slightly basophilic?

Back 13

it still contains some of the golgi, mitochondria and some other organelles

Front 14

Once a reticulocyte reaches the blood through diapedesis how long does it take to become a erythrocyte?

Back 14

1-2 days

Front 15

most of the EPO is made in the kidney. Where is the rest made?

Back 15

liver

Front 16

What stimulates EPO release from sites distant to the kidney?

Back 16

NE, epi and some prostaglandins

Front 17

Can the liver compensate for RBC production when the kidneys are removed?

Back 17

no

Front 18

What 2 vitamins are important for RBC production? Why are they important?

Back 18

1) vit B12 (cobalmin) and folic acid (B9)
2) they are needed to make TTP

Front 19

If large oval irregular RBCs are seen what is going on? How is it classified? Can they transport oxygen?

Back 19

1) lack of vit B12 or folic acid
2) causing macrocytic anemia
3) yes but they are flimsy and break easily

Front 20

Where is B12 absorbed?

Back 20

illeum still bound to IF

Front 21

How long can the residual supply of vit B12 last before anemia is seen?

Back 21

3-4 years

Front 22

over cooking food is likely to destroy what vit needed for RBC synthesis?

Back 22

folic acid

Front 23

Why are people with sprue prone to anemia?

Back 23

their intestinal mucosa is destroyed and they can't absorb enough B12 and folic acid

Front 24

IN What stage of RBC synthesis does Hgb production begin? when does it end?

Back 24

proerythroblast to reticulocyte

Front 25

What is hemoglobin A formed from?

Back 25

2 alpha and 2 beta chains

Front 26

How many hemes are in hemoglobin A? How many oxyens can bind?

Back 26

1) 4, 1 heme per globin and there are 4 globins
2) 4 one per heme

Front 27

What causes sickle cell?

Back 27

substitution of valine for glutamic acid in the beta chains

Front 28

What type of bond does oxygen have with heme?

Back 28

a coordination bond to Fe, which is a bond to a higher orbital of Fe not one of the ionic bonds

Front 29

What does Fe combine with to be transported in blood?

Back 29

apotransferrin + Fe is transported as transferrin in blood

Front 30

What does Fe combine with intracellularly?

Back 30

apoferritin + Fe is stored in blood as ferritin

Front 31

What are insoluble Fe stores called?

Back 31

hemosiderrin

Front 32

If someone is lacking transferrin what develops?

Back 32

microcytic hypochromic anemia

Front 33

woman should take approximately how much Fe per day?

Back 33

1.3mg/day to compensate for Fe loss

Front 34

where is Fe absorbed?

Back 34

in the small intestine

Front 35

How does apotransferrin reach the intestine?

Back 35

in the bile

Front 36

What forms of Fe can apotransferrin combine with?

Back 36

free Fe, Hgb, myoglobin

Front 37

What is the lifespan of an RBC?

Back 37

120 days

Front 38

Do RBCs have mitochondria?

Back 38

no

Front 39

What portion of Hgb is formed into bilirubin?

Back 39

the poryphorin ring

Front 40

After rapid blood loss when is the flood portion replaced?

Back 40

1-3 days

Front 41

After hemorrhage how long will it take the RBC concentration to increase?

Back 41

3-6 weeks whereas fluid is 1-3 days

Front 42

What is secondary polycythemia?

Back 42

physiologic polycythemia in which a person lives at high elevations

Front 43

In polycythemia is the cardiac output increased or decreased?

Back 43

about normal because the blood viscosity increases this slows venous return, however there is increased blood volume which increases venous return and in effect they cancel each other out and maintain normal CO

Front 44

What is the skin color of someone who has polycythemia vera?

Back 44

cyanotic because they have lots of deoxygenated Hgb in the superficial veins