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201 Cards in this Set
- Front
- Back
blood clot/gas bubble floating in blood
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embolus
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factors interfere with normal clotting
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1. prothrombin III - deactivates thrombin
2. protein C - inhibits clotting Factors 3. heparin - inhibits thrombin; prevents adherence of platelets to injured site |
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undesirable clotting
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Thromboembolytic Disorders
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blood clot in normal blood vessel
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thrombus
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can dissolve a clot
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TPA, streptokinase
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inhibits Thromboxane formation
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aspirin
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inhibits thrombin & platelet deposit
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heparin
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anticoagulant, blocks Vitamin K
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dicumarol
|
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reduced platelet count; generally below 50,000 per cubic millimeter; can cause excessive bleeding from vascular injury
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thrombocytopenia
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impaired liver function - lack of (Clotting Factors) that are made in liver
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procoagulants
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essential for liver to make Clotting Factors for coagulation
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vitamin K
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hereditary bleeding disorders that occur almost exclusively in males
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hemophilias
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hemophilias
defective Factor VIII (83%) |
hemophilia A
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hemophilias
defective Factor IX (10%) |
hemophilia B
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hemophilias
now produces genetically engineered TPA and Factor VIII; patients do not need transfusions as often |
Genentech. Inc.
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all cells and plasma; anticoagulants (citrate and oxalate salts) used
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whole blood transfusion
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most of the plasma has been removed prior to transfusion
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packed red blood cells
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glycoproteins on the surface of blood cells; causes "agglutination" (clumping)
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agglutinogens
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determined by presence or absence of Type A and Type B agglutinogen proteins on cell membrane
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ABO Blood Groups
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NO Rh factor
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Rh negative (Rh-)
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an Rh factor is present
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Rh positive (Rh+)
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type A blood
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GENES: A/A, A/O, O/A
PEOPLE: (30-40%) Antibodies: Anti-B Receive Blood from: A, O |
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type B blood
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GENES: B/B, B/O, O/B PEOPLE: (l0-30%)
Antibodies: Anti-A Receive Blood from: B,O |
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type AB blood
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GENES: A/B or B/A PEOPLE: (3-5%)
Antibodies: none Receive Blood from: A, B, AB, O |
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type O blood
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GENES: no A or B PEOPLE: (40-50%)
Antibodies: Anti-A, Anti-B Receive Blood from: O only |
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Diagnostic Blood Tests
blood glucose level |
diabetes
|
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antibodies against either A or B agglutinogen (whichever is not present)
a. transfusion reaction - patient's antibodies attack the donor blood |
agglutinins
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transfusion reaction - patient's antibodies attack the donor blood
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A (anti-B) receives A,O (not B)
B (anti-A) receives B,O (not A) AB (none) receives A, B,AB,O (universal recipient) O (anti-A,anti-B) receives O (universal donor) |
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antibodies against either A or B agglutinogen (whichever is not present)
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agglutinins
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when incorrect blood transfused, antibodies will "clump" new blood
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agglutination
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after clumping, RBCs may rupture, releasing hemoglobin, harming kidney
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hemolysis
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hemolysis, treatment for:
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dilute hemoglobin, administer diuretics
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a different group of agglutinogens
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Rh factor
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delayed and less severe than in ABO confrontation
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transfusion reaction
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directly from the mother (Rh-) to the newborn (Rh+)
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exchange transfusion
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Rh- mother antibodies attack Rh+ of older newborn; results in anemia and low oxygen levels (hypoxia)
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erythroblastosis fetalis
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Diagnostic Blood Tests
lipidemia |
high in fat; yellowish plasma
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serum with anti-Rh agglutinins which will clump the Rh factor, blocking the reaction of mothers antibodies
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RhoGAM
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mixing Donors Blood with Recipient Antibodies (Anti-A, Anti-B, anti-Rh) in order to identify agglutination
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Blood Typing
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Diagnostic Blood Tests
generally higher WBC count |
infection
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Diagnostic Blood Tests
significantly higher WBC count |
leukemia
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Ways of Expanding Blood Volume to Avoid Shock
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1. pure plasma without antibodies
2. plasma expanders - purified human serum albumin, plasminate, dextran 3. isotonic saline - normal electrolyte solution isotonic to blood plasma (Ringer's Solution) |
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Diagnostic Blood Tests
anemia |
low hematocrit (below 35%)
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Diagnostic Blood Tests
counts % of each of the different leukocytes (helps diagnose) |
differential WBC count
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Diagnostic Blood Tests
time for clotting to occur |
prothrombin time
|
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Diagnostic Blood Tests
diagnose thrombocytopenia |
platelet count
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Diagnostic Blood Tests
overall blood review |
complete blood count
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Factors Limiting Growth and Formation of Clots
Limiting Normal Clot Growth |
a. blood moves too fast to allow procoagulants
b. factors interfere with normal clotting |
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Clot Eradication (Fibrinolysis)
healing occurs over ? days |
healing occurs over 2 - 10 days
|
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Clot Eradication (Fibrinolysis)
causes the activation of plasminogen |
tissue plasminogen activator (TPA)
|
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Clot Eradication (Fibrinolysis)
plasminogen--> ? |
plasmin
|
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Clot Eradication (Fibrinolysis)
? degrades proteins within the clot |
plasmin
|
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the actual cellular components of blood (special connective tissue)
|
formed elements
erythrocytes leukocytes platelets |
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complex non-cellular fluid surrounding formed elements; protein & electrolytes
|
blood plasma
|
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Separation of Components in a Centrifuge
VOLUME LAYER 55% top |
clear/yellowish PLASMA
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Separation of Components in a Centrifuge
VOLUME LAYER <1% middle |
thin/whitish buffy coat
with LEUKOCYTES & PLATELETS |
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Separation of Components in a Centrifuge
VOLUME LAYER 45% bottom |
reddish mass - ERYTHROCYTES
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red blood cells
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erythrocytes
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white blood cells
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leukocytes
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cell fragments for clotting
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platelets
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percentage by VOLUME of erythrocytes when blood is centrifuged (normal = 45%)
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hematocrit
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Characteristics of Blood
bright red |
oxygenated
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Characteristics of Blood
dark red/purplish |
unoxygenated
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Characteristics of Blood
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1. much more dense than pure water
2. pH range from 7.35 to 7.45 (slightly alkaline) 3. slightly warmer than body temperature 100.4 F 4. typical volume in adult male 5-6 liters 5. typical volume in adult female 4-5 liters 6. typically 8% of body weight |
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Distribution & Transport
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a. oxygen from lungs to body cells
b. carbon dioxide from body cells to lungs c. nutrients from GI tract to body cells d. nitrogenous wastes from body cells to kidneys |
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Regulation (maintenance of homeostasis)
maintenance of normal body pH |
blood proteins (albumin) & bicarbonate
|
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Regulation (maintenance of homeostasis)
maintenance of circulatory/interstitial fluid |
electrolytes aid blood proteins (albumin)
|
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Regulation (maintenance of homeostasis)
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maintenance of temperature (blushed skin)
|
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Protection
"seal" vessel damage |
platelets and proteins
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Protection
leukocytes, antibodies, complement proteins |
protection from foreign material & infections
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Erythrocytes (red blood ells; RBCs)
Structure diameter / thickness |
7.5 micron diameter; 2.0 micron thick
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Erythrocytes (red blood ells; RBCs)
Structure ideal for gas exchange |
biconcave disk shape
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Erythrocytes (red blood ells; RBCs)
Structure elastic protein; allows shape change |
spectrin
|
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Erythrocytes (red blood ells; RBCs)
Structure anucleate (no nucleus) |
mature cells
|
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Erythrocytes (red blood ells; RBCs)
Structure very few organelles; mainly a hemoglobin carrier |
hemoglobin 33% of cell mass; carries oxygen
|
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Erythrocytes (red blood ells; RBCs)
Structure only anaerobic respiration |
no mitochondria
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Erythrocytes (red blood ells; RBCs)
Structure ratio erythrocytes:leukocytes |
800:1
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Erythrocytes (red blood ells; RBCs)
Structure red blood cell count: # cells per cubic millimeter i. normal male count |
5.1 to 5.8 million
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Erythrocytes (red blood ells; RBCs)
Structure red blood cell count: # cells per cubic millimeter i. normal female count |
4.3 to 5.2 million
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large molecules with globin and hemes
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hemoglobin
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complex protein with 4 polypeptides (2 alpha and 2 beta polypeptides)
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globin
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IRON containing pigment part of hemoglobin to which oxygen binds
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heme group
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each polypeptide has
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one heme group
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each heme carries
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one O2
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normal hemoglobin levels (grams/l00 ml blood)
infants |
14-20 grams/l00 ml
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normal hemoglobin levels (grams/l00 ml blood)
adult female |
12-16 grams/100 ml
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normal hemoglobin levels (grams/l00 ml blood)
adult male |
13-18 grams/l00 ml
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when oxygen is bound to IRON
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oxyhemoglobin
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no oxygen bound to IRON
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deoxyhemoglobin
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when carbon dioxide bound (to polypeptide chain)
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carbaminohemoglobin
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the maturation, development and formation of blood cells
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hematopoiesis (hemopoiesis)
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location of hematopoiesis; in blood sinusoids which connect with capillaries; mainly in axial skeleton and heads of femur & humerous
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red bone marrow (myeloid tissue)
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the mitotic precursor to blood cells before differentiation
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hemocytoblast (stem cell)
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maturing cell becomes "committed" to being certain type blood cell
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differentiation
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the maturation, development, and formation of Red Blood Cells (erythrocytes)
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erythropoiesis
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erythropoiesis
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hemocytoblast ->
proerythroblast -> early (basophilic) erythroblast -> late (polychromatophilic) erythroblast-> (hemoglobin) normoblast -> (nucleus ejected when enough hemoglobin) reticulocyte -> (retaining some endoplasmic reticulum) ERYTHROCYTE |
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3-5 DAYS
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hemocytoblast -> reticulocyte
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2 DAYS (in blood)
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reticulocyte -> ERYTHROCYTE
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100-120 DAYS
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ERYTHROCYTE lifespan
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ERYTHROCYTE death
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(primarily destroyed by macrophages in the spleen)
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Regulation of Erythropoiesis
hormonal controls hormone that stimulates RBC production |
erythropoietin
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Regulation of Erythropoiesis
hormonal controls DECREASED oxygen level in blood causes |
KIDNEYS to increase release of erythropoietin
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DECREASED oxygen level in blood
causes |
1. Less RBCs from bleeding
2. Less RBCs from excess RBC destruction 3. Low oxygen levels (high altitude, illness) 4. Increased oxygen demand (exercise) |
|
Eythropoietin now genetically engineered and synthesized by
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AMGEN of Thousand Oaks
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Testosterone can also mildly stimulate production of
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RBCs in humans
|
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essential for hemoglobin to carry oxygen
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Iron
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65% of Fe in body is in
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hemoglobin
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liver and spleen store most excess Fe bound to
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ferritin and hemosiderin
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Fe in blood bound to
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transferrin
|
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daily Fe loss:
|
0.9 mg men/l.7 mg women
|
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women also lose Fe during
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menstrual flow
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essential for DNA synthesis in early mitotic divisions leading to erythrocytes
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B-complex Vitamins - Vitamin B12 and Folic Acid
|
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a symptom that results when blood has lower than normal ability to carry oxygen
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Anemias
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loss of blood from bleeding (wound, ulcer, etc.)
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hemorrhagic anemia
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erythrocytes rupture (hemoglobin/transfusion problems, infection)
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hemolytic anemia
|
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red marrow problems (cancer treatment, marrow disease, etc.)
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aplastic anemia
|
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Decrease in Hemoglobin
low Iron levels (diet; absorption, bleeding, etc.) |
iron-deficiency anemia
|
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Decrease in Hemoglobin
low Vitamin B12 (diet, intrinsic factor for Vit B absorption) |
pernicious anemia
|
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Abnormal Hemoglobin (usually genetic)
easily ruptured RBCs (Greek & Italian genetic link) |
thalassemia
|
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Abnormal Hemoglobin (usually genetic)
sickle-shaped RBCs (genetic Africa, Asia, southem Europe link) |
sickle-cell anemia
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excess RBC count, causes thick blood
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Polycythemia
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bone marrow problem; hematocrit may jump to 80%
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polycythemia vera
|
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high altitude (normal); or too much erythropoietin release
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secondary polycythemia
|
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RBCs previously withdrawn are transfused before an event; more RBCs, more oxygen delivery to the body
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blood doping in athletes
|
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Leukocytes (white blood cells; WBCs)
General Structure and Function protection from |
microbes, parasites, toxins, cancer
|
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Leukocytes (white blood cells; WBCs)
General Structure and Function ?% of blood volume; ? per cubic mm blood |
1% of blood volume; 4-11,000 per cubic mm blood
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Leukocytes (white blood cells; WBCs)
General Structure and Function can "slip between" capillary wall |
diapedesis
|
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Leukocytes (white blood cells; WBCs)
General Structure and Function movement through the body |
amoeboid motion
|
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Leukocytes (white blood cells; WBCs)
General Structure and Function moving in direction of a chemical |
chemotaxis
|
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Leukocytes (white blood cells; WBCs)
General Structure and Function increased "white blood cell count" in response to bacterial/viral infection |
leukocytosis
|
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Leukocytes (white blood cells; WBCs)
General Structure and Function contain membrane-bound granules (neutrophils, eosinophils, basophils) |
granulocytes
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Leukocytes (white blood cells; WBCs)
General Structure and Function NO membrane-bound granules (lymphocytes, monocytes) |
agranulocytes
|
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granules in cytoplasm can be stained with Wright's Stain; bilobar nuclei; 10-14 micron diameter; all are phagocytic cells (engulf material)
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Granulocytes
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destroy and ingest bacteria & fungi (polymorphonuclear leuks.; "polys")
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neutrophils
|
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a. most numerous WBC
b. basophilic (blue) & acidophilic (red) c. defensins - antibiotic-like proteins (granules) d. polymorphonuclear - many-lobed nuclei e. causes lysis of infecting bacteria/fungi f. HIGH poly count --> likely infection |
neutrophils
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lead attack against parasitic worms
|
eosinophils
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a. only 1-4% of all leukocytes
b. two-lobed, purplish nucleus c. acidophilic (red) granules with digest enzymes d. phagocytose antigens & antigen / antibody complex e. inactivate chemicals released during allergies |
eosinophils
|
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releases Histamine which causes inflammation, vasodilation, attraction of WBCs
|
basophils
|
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a. RAREST of all leukocytes (0.5%)
b. deep purple U or S shaped nucleus c. basophilic (blue) granules with HISTAMINE d. related to "mast cells" of connective tissue e. BOTH release Histamine with "IgE" signal f. antihistamine - blocks the action of Histamine in response to infection or allergic antigen |
basophils
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WBCs without granules in cytoplasm
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C. Agranulocytes
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(thymus) respond against virus infected cells and tumor cells
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T lymphocytes
|
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(bone) differentiate into different "plasma cells" which each produce antibodies against different antigens
|
B lymphocytes
|
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lymphocytes primarily in
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lymphoid tissues
|
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lymphocytes nucleus
|
very large basophilic (purple) nucleus
|
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small lymphocytes in blood ? microns
|
5-8 microns
|
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larger lymphocytes in lymph organs
? microns |
10-17 microns
|
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differentiate to become macrophages; serious appetites for infectious microbes
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monocytes
|
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largest of all lymphocytes (18 microns)
dark purple, kidney shaped nucleus |
monocytes
|
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the production, differentiation, and development of white blood cells
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leukopoiesis
|
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hematopoietic hormones that promote leukopoiesis
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colony stimulating factors (CSF)
|
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M-CSF
|
macrophage-monocyte CSF
(colony stimulating factors) |
|
G-CSF
|
granulocyte CSF
|
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GM-CSF
|
granulocyte-macrophage CSF
|
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multi CSF
|
multiple lymphocyte action
|
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IL-3
|
interleukin 3 (general lymphocytes)
|
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all cells derived from hemocytoblast
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leukopoiesis
|
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EOSINOPHIL
NEUTROPHIL BASOPHIL lifespan? |
0.5 to 9 day lifespan
|
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abnormally low WBC count
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leukopenia
|
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leukopenia
causes |
HIV infection, glucocorticoids, chemotherapy
|
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cancerous condition of "line" of WBCs
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leukemia
|
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myelocytic leukemia
|
myelocytes
|
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lymphocytic leukemia
|
lymphocytes
|
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acute leukemia
|
cancer spreads rapidly
|
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chronic leukemia
|
cancer progresses slowly
|
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caused by Epstein-Barr virus, excessive monocytes and lymphocytes; fatigue, sore throat, fever; 3 week course
|
infectious mononucleosis
|
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thrombocytes - "clotting"
|
Platelets
|
|
Platelets (thrombocytes - "clotting")
size? |
very small, 2-4 microns in diameter
|
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Platelets (thrombocytes - "clotting")
approximately ? per cubic millimeter |
approximately 250-500,000 per cubic millimeter
|
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Platelets (thrombocytes - "clotting")
essential for ? of damaged vasculature |
essential for clotting of damaged vasculature
|
|
regulates platelet production
|
thrombopoietin
|
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hemocytoblast->
myeloid stem cell-> megakaryoblast-> promegakaryocyte-> megakaryocyte-> (large multilobed nucleus) platelets (anucleated parts of megakaryocyte cytoplasm) |
Formation of Platelets
|
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plasma makes up ?% of normal blood by volume
|
plasma makes up 55% of normal blood by volume
|
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water is ?% of the plasma by volume
|
water is 90% of the plasma by volume
|
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different SOLUTES in the plasma
|
albumin
globulins clotting proteins other proteins nutrients electrolytes |
|
pH buffer & osmotic pressure
|
albumin
|
|
binding proteins & antibodies
|
globulins
|
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clotting proteins
|
prothrombin & fibrinogen
|
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other proteins
|
enzymes, hormones, others
|
|
glucose, fatty acids, amino acids, cholesterol, vitamins
|
nutrients
|
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Na+, K+, Ca++, Mg++, Cl-, phosphate, sulfate, bicarbonate, others
|
electrolytes
|
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stoppage of blood flow after damage
|
Hemostasis
|
|
Hemostasis
General Characteristics |
1. vascular spasms (vasoconstriction at injured site)
2. platelet plug formation (plugging the hole) 3. coagulation (blood clotting - complex mechanism) |
|
first response to vascular injury
|
Vascular Spasms / VASOCONSTRICTION
|
|
VASOCONSTRICTION is stimulated by:
|
a. compression of vessel by escaping blood
b. injury "chemicals" released by injured cells c. reflexes from adjacent pain receptors |
|
Formation of a Platelet Plug
|
1. damage to endothelium of vessel
2. platelets become spiky and sticky in response 3. platelets attach to damaged vessel wall to plug it 4. platelets produce thromboxane A2 - granule release 5. serotonin release enhances vascular spasm 6. ADP - attracts and stimulates platelets at site 7. prostacylin - inhibits aggregation at other sites |
|
Coagulation
|
blood clotting
|
|
General Events in Clotting
|
platelet cells activated by damage->
PF3 and/or Tissue Factor produced by platelet cells-> Factor X activated-> prothrombin activator (enzyme)produced-> prothrombin conversion -> thrombin (another enzyme) thrombin stimulates: fibrinogen----> fibrin mesh |
|
chemical that inhibits clotting
|
anticoagulant
|
|
chemical that promotes clotting
|
procoagulant
|
|
pathway - within the damaged vessel
|
intrinsic pathway
|
|
a. more procoagulants needed (I-XIII) toward PF3 and Factor X
b. allows more "scrutiny" before clotting occurs |
intrinsic pathway
|
|
pathway in outer tissues around vessel
|
extrinsic pathway
|
|
skips intrinsic steps straight to PF3 and Factor X
|
tissue thromboplastin (Tissue Factor)
|
|
a. tissue thromboplastin (Tissue Factor) - skips intrinsic steps straight to PF3 and Fac X
b. allows rapid response to bleeding out of vessel (clot can form in 10 to 15 seconds) |
extrinsic pathway - in outer tissues around vessel
|
|
After activation of Factor X, common pathway:
|
Factor X, PF3 (thromboplastin), Factor V, Ca++ -->
prothrombin activator -> prothrombin converted -> thrombin (active enzyme) thrombin stimulates: fibrinogen -> fibrin (meshwork) Ca++ & thrombin -> Factor XIII (fibrin stabilizer) |
|
shrinking of clot
|
Clot Retraction
|
|
Clot Retraction (shrinking of clot)
causes contraction of platelets |
actomyosin
|
|
Clot Retraction (shrinking of clot)
plasma WITHOUT clotting Factors |
blood serum - plasma WITHOUT clotting Factors
|
|
Clot Retraction (shrinking of clot)
stimulates fibroblast migration and endothelial growth |
platelet-derived growth factor (PDGF)
|
|
Clot Eradication
|
Fibrinolysis
|
|
1. anemia, fever, weight loss, bone pain
2. death from internal hemorrhage or infection 3. chemotherapy & radiation therapy used to treat |
leukemia
|