Anatomy & Physiology & Other Syllabus Content Flashcards
Discuss hematopoiesis and blood cell maturation
Where does it occur?
Name 4 growth factors
Hematopoiesis
— Pelvis, ribs, sternum
— HSC in the bone marrow
Growth Factors
— Thrombopoietin: GP in liver and kidneys stimulate HSC to differentiate into megakaryocytes which speeds up maturation & fragmentation into platelets
— EPO: produced in kidneys and liver, stimulates HSC & myeloid progenitors to differentiate into erythrocytes
— GM-CSF (granulocyte macrophage): speed up maturation of monocytes, neutrophils, eosinophils and basophils
— G-CSF: induces myeloblasts > neutrophils
Production and function of cells produced by the bone marrow
Discuss which stem cell line
Which precursors
Cell function
See image
Discuss erythropoiesis
— Which hormone? Released from where?
Which nutrients needed to build an RBC?
Which specific molecule?
Hemoglobin production
Erythropoietin
— Released from renal cortex when fibroblasts sense low O2
— Stimulates erythroid progenitor cells by binding JAK2
(Mutations here lead to myeloproliferative disorders)
Essential nutrients
— Glucose for energy
— Iron
— Folate
— B12
2,3-BPG
— Formed in RBCs
— Improves O2 delivery to tissues by stabilising the T-state, decreasing hemoglobin’s affinity for O2 > forces O2 unloading
— Hypoxic conditions > increased 2,3-BPG production
Classify fluid component and formed elements of blood and identify their proportions in a blood sample: what are the components? What is in each component?
What is normal proportion of RBCs?
What does too high/too low indicate?
What is serum?
1. Plasma 55%
— 90% water
— 10% proteins (albumin), electrolytes & dissolved gasses, fibrinogen, globulins/antibodies
serum = plasma - clotting factors (i.eno fibrinogen)
serum is the liquid part of the blood after coagulation
2. Buffy coat <1% — platelets (megakaryocute in bone marrow) & leukocytes
— Neutrophils first responders 60%
— Eosinophils parasitic and basophils allergies : 2-5%.
— B & T cells, NK cells.
— Monocytes 5%
3. Erythrocytes — RBCs 45%
Proportion of RBCs in sample is hematocrit
Normal value is 45%
>45% — too many, dehydration, too many being made
<45% — too few, not enough made, or destroyed
Compare/contrast the composition of plasma and serum
Plasma - clotting factors (such as fibrinogen) = serum
— Serum is the liquid part of the blood after coagulation
— Plasma is the liquid treated with anticoagulants
Blood plasma also contains blood cells and clotting factors whereas blood serum does not
Discuss the steps of primary hemostasis and an important note about each step
Activation has 6 steps/important notes
Primary = platelet plug formation
— Endothelial injury: endothelin released > contraction
— Exposure: vWF comes in between endothelial cells, platelets bind via GP1B surface protein
— Adhesion: of platelets to vWF that is bound to collagen underneath endothelial cells
— Activation:
1. Activation of platelets when bound via GP1B to vWF > it changes shape
2. releases more vWF
3. releases serotonin = attracts more platelets, and Ca,
4. release ADP and thromboxane A2 which activate other platelets
5. Some platelets are inhibited from becoming activated by NO and prostaglandins
6. ADP and thromboxane A2 bind to platelets = expression of surface protein GPIIB/IIIA = fully activated platelet
— Aggregation: GPIIB/IIIA links to fibrinogen, which links to other platelets
In secondary hemostasis, fibrinogen will be cleaved into fibrin which forms a protein mesh
Recite/draw out the coagulation cascade
Discuss indications, product types, contraindications and complications of transfusions of blood products (see notes)
List and explain 5 types of blood products
List 7 complications
Whole blood
— donated form
PRBCs
— packed RBCs
— commonly used to raise Hgb
— 1 unit dose is 300mL, raises Hgb by 1g/dL
Platelets
— treats thrombocytopenia
— given prior to invasive surgery
— lasts 2-3 days
— when count is <10-20k
— 1 unit dose is 50mL
Fresh Frozen Plasma
— used from low fibrinogen levels
— adult dose is 5-10 units and kids is 1 unit by 10kg
Autologous non frozen RBCs
— elective surgery patient donates their own blood, can store up to 3 days
RISKS
— Incompatibility in the ABO system > hemolytic transfusion reaction
— Leukoagglutinin reactions : fever, chills, cough, pulmonary infiltrates
— Hypersensitivity reactions > urticaria, bronchospasms
— Contaminated blood/sepsis
— Graft vs Host Disease
— Transfusion Related Acute Long Injury: non-cardiogenic pulmonary edema
— TACO: volume overload, product transfused too quickly
Describe cancer staging and its utility
What does 2,3-BPG do?
Improved O2 deliver to tissues (forces unloading) by decreasing hemoglobin’s affinity for O2
Purpose of:
Neutrophils
Eosinophils
Basophils
Monocytes
B cells
T cells
NK cells
Which are granulocytes? Which are not?
Neutrophils — most common 60% fight infection
Eosinophils — parasitic infections
Basophils — allergies
Agranulocytes
Monocytes — phagocytise bacteria. They can enter the tissue.
B cells — adaptive, antibody production
T cells — memory
B and T cells are collectively known as lymphocytes
NK cells
Plasma makes up how much of the test tube?
What is in it?
Which protein?
What do you have if you take the fibrinogen out?
55%
Electrolytes, hormones, nutrients, O2 and CO2
Antibodies (globulins)
Albumin
Plasma - fibrinogen = serum?
When is the thymus most active?
When is it the largest?
What is its significance?
During the neonatal period
Largest during puberty then decreases in size — becomes more fatty
important in the maturation of T cells
What does the spleen do?
What is in the white and red pulp
Filters the blood
Refresh primary lymphoid organs and secondary lymphoid organs
See image
