Blood Flashcards
List the functions of blood
1) Transport
2) Regulation (Temperature, pH, Fluid volume)
3) Protection (preventing infection and blood loss)
Describe the composition and the physical characteristics of blood
55% plasma MOSTLY WATER 90%
1% leukocytes 4,800-10,800
44/45% RBC 4-6MILLION
Describe the composition of PLASMA
1) Electrolytes
2) Plasma proteins
- Albumin, contributes to the osmotic pressure, preventing edema produced by the liver, 60%
- Globulins 36%
- Alpha, Beta, produces by the liver, they are mostly transport proteins
- Gamma, antibodies released by plasma cells during immune response
3) Fibrinogen 4%
- Produced by the liver, forms fibrin threads during blood clotting
DESCRIBE THE FUNCTION OF RBC
functions as a oxygen/waste transporter
DESCRIBE THE STRUCTURE OF RBC
Made of the red heme pigment bound to the globin (2 alpha & 2 beta), each heme group bounds a iron ion, they can transport four oxygen molecules at the same time
WHAT IS THE HORMONE NEEDED FOR RBC PRODUCTION
Erythropoietin
FROM WHERE IS THE RBC PRODUCED
15 days
Hematopoietic stem cell - pro-erythroblast - basophilic erythroblast (ribosome synthesis & iron accumulation) - polychromatic erythroblast (Hemoglobin accumulation) - orthochromatic erythroblast (ejection of organelles and pinching of nucleus) - reticulocyte - erythrocyte
What is anemia
A condition where blood oxygen carrying capacity is too low to support normal metabolism
WHAT IS THE CHEMICAL COMPOSITION OF HEMOGLOBIN and how is it regulated
Made of heme and globin
After 120 days it gets engulfed by macrophages:
Globin is a protein which gets recycled into the body as amino acids
Heme is broken down into iron and bilirubin, where the iron is stored as ferritin or hemosiderin, and the liver transform bilirubin into bile which helps in digestion and gets excreted by the body
WHAT ARE THE DIFFERENT TYPE OF ANEMIA
1) hemorrhagic
2) iron-deficiency (microcytic rbc)
3) pernicious (macrocytic RBC)
4) renal
5) aplastic
WHAT IS HEMORRHAGIC ANEMIA
A type of anemia which results from the loss of blood
1) acute: rapid blood loss over a short period (treated by blood transfusion) for example from a stab
2) chronic: slight but persistent blood loss (hemorrhoids, bleeding ulcer, menstruation, etc)
WHAT IS IRON-DEFICIENCY ANEMIA
Usually a secondary effect of hemorrhagic-anemia, and can be due to the deficit of iron from the diet, producing microcytic RBC which can be treated by adding iron to the diet
WHAT IS PERNICIOUS ANEMIA
Autoimmune disease that mostly affects elderly people, where their immune system destroys their own stomach mucosa, which is responsible for the production of intrinsic factors responsible for the absorption of vitamin B12 which makes the growing erythrocytes unable to divide producing macrocytic RBC, the treatment involves regular intravascular vitamin B12 injections or vitamin B12 gel
WHAT IS RENAL ANEMIA
Due o the lack of EPO hormone, which accompanies renal diseases, can be treated by administrating EPO
WHAT IS APLASTIC ANEMIA
Due to the destruction/inhibition of the red marrow by certain drugs, chemicals, ionizing radiations & viruses, treatment must be by a transplant of stem cells, bone marrow, or umbilical cord
WHAT IS THALASSEMIS
A type of hemolytic anemia, of a deficiency in either the a or b globin chain of the hemoglobin, it is a inherited autosomal recessive where both parents must be carriers for it to occur in their child,
1) a-thalassemia
2) b-thalassemia, treated with iron chelation
Can have complications including:
1) iron overload
2) infection
3) bone deformities
4) enlarged spleen
5) slow growth rate
6) heart problems
WHAT IS SICKLE CELL ANEMIA
Caused by the abnormal hemoglobin S, which results from a change in one of the 146 amino acids, which causes the beta chains to link together under low oxygen conditions forming stiff rods, making the hemoglobin S spiky and sharp which can rupture easily and jam blood vessels, treated by blood transfusion, and patients can inhale nitric oxide to dilate their blood vessels
WHAT IS JAUNDICE
It is a sign of the accumulation of bilirubin in the blood which maybe due to:
Patients with hemolytic anemia
1) liver problems
2) blockage of the bile ducts from inflammation or tumor
3) hemolytic anemia
WHAT IS POLYCYTHEMIA
It is an abnormal excess of erythrocytes, which increases the bloods viscosity, which might lead into a heart stroke
WHAT IS POLYCYTHEMIA VERA
It is a bone marrow cancer, characterized by exceptionally high RBC count 8-11 million, which impairs the circulation. Treatment involves therapeutic phlebotomy (remind of blood)
WHAT IS SECONDARY POLYCYTHEMIA
Due to less availability of oxygen or due to the increase production of the EPO hormone, which usually occurs in people living in high altitudes where they have a RBC count of 6-8million
List all of the types of leukocytes
1) Granulocytes:
- Neutrophils
- Basophils
- Eosinophils
2) Agranulocytes:
-Monocytes
- Lymphocytes (T & B)
What is the structure of neutrophils
Multilobed nucleus, purple in color as it accepts both acidic and basic dyes
What is the structure of basophils
Bilobed nucleus, large purplish-black cytoplasmic granule, basophils are acidic and they accept basic dyes
What is the structure of eosinophil
Bilobed nucleus, red cytoplasmic granules, it is basic and it accepts acidic dyes
What is the structure of monocytes
U/kidney shaped nucleus, gray/blue cytoplasm
What is the structure of lymphocytes
Spherical nucleus, fills most of the pale blue cytoplasm
What is the function of neutrophils
Phagocytes bacteria
What is the function of basophils
Contains heparin (anticoagulant), releases histamine and other inflammatory mediators
What is the function of eosinophils
Kills parasitic worms, and has a role in allergy and asthma
What is the function of monocytes
Phagocytosis, developing into macrophages in the tissues
What is the function of T & B LYMPHOCYTES
Mount most of the immune response either by direct cell attack or via antibodies
WHAT IS THE HORMONE NEEDED FOR LEUKOCYTE PRODUCTION
Interleukins & colony-stimulating factors (CSFs), Hematopoietic factors released by supporting cells of the red bone marrow and mature WBC (which prompt the white blood cell precursors to divide and mature,
& enhance the protective potency of mature leukocytes)
HOW ARE NEUTROPHILS PRODUCED
Stimulated by the chemical messengers:
1) stem cell:
- Hematopoietic stem cell (hemocytoblast)
To - Myeloid stem cell
2) committed cells
- Myeloblast
3) development pathway:
- promyelocyte
- Neutrophilic myelocyte
- Neutrophilic band cells
- neutrophils
HOW ARE BASOPHILS PRODUCED
Stimulated by the chemical messengers:
1) stem cell:
- Hematopoietic stem cell (hemocytoblast)
To - Myeloid stem cell
2) committed cells
- Myeloblast
3) development pathway:
- promyelocyte
- basophilic myelocyte
- basophilic band cells
- basophils
HOW ARE EOSINOPHILS PRODUCED
Stimulated by the chemical messengers:
1) stem cell:
- Hematopoietic stem cell (hemocytoblast)
To - Myeloid stem cell
2) committed cells
- Myeloblast
3) development pathway:
- promyelocyte
- eosinophilic myelocyte
- Eosinophilic band cells
- Eosinophils
HOW ARE MONOCYTES PRODUCED
Stimulated by the chemical messengers:
1) stem cell:
- Hematopoietic stem cell (hemocytoblast)
To - Myeloid stem cell
2) committed cells
- Monoblast
3) development pathway:
- Promonocyte
- Monocyte
- Macrophages
HOW ARE T&B Lymphocytes PRODUCED
Stimulated by the chemical messengers:
1) stem cell:
- Hematopoietic stem cell (hemocytoblast)
To - Lymphoid stem cell
2) committed cells
- B lymphocyte precursor
- T lymphocyte precursor
3) development pathway:
- B lymphocytes some become plasma cells
- T lymphocytes some become effector T cells
What is leukopenia and when can it occur
Abnormally low white blood cells count due to glucocorticoids and anti-cancer drugs
What is leukemia and what are its types
It is the overproduction of abnormal white blood cells
1) Acute leukemias (derived from stem cells mainly in children)
2) chronic leukemia (occurs in adults, involves proliferation of later stages)
3) myeloid leukemia (involves myeloblast descendants)
4) lymphocytic leukemia (involves lymphocytes)
High WBC (abnormal)
Low RBC (anemia)
Low platelets (thrombocytopenia, bleeding disorders)
What is infection mononucleosis
The kissing disease
It is a highly contagious infection caused by Epstein-Barr virus, which has a symptom of excessive WBC count, tiredness, sore throat are normal consequences and there is no cure but patients needs bed rest and they will be fine in 4-6 weeks
What are platelets
They are cell fragments, produced from megakaryocytes
What is the function of platelets
It seals wound (blood clotting)
How is the platelet function regulated
1) intrinsic (rupture to the endothelium), prothrombin activator, prothrombin (plasma protein from the liver), thrombin, fibrinogen & fibrin stabilizing factor
2) extrinsic: (rupture of tissue cells), prothrombin activator, prothrombin (plasma protein from the liver), thrombin, fibrinogen & fibrin stabilizing factor
What are the major proteins involved in blood clotting
1) prothrombin: plasma protein synthesized in the liver, converted to thrombin, which converts fibrinogen to fibrin
2) Proconertin: plasma protein synthesized in the liver, involved in both intrinsic and extrinsic pathways
3) plasma thromboplastin component (PTC): plasma protein synthesized in the liver, and in its deficiency hemophilia B results
4) Stuart factor: plasma protein synthesized by the liver, its a common pathway
What is the process of clot formation
1) Vascular spasm, smooth muscle contracts, causing vasoconstriction
2) platelet plug formation (Injury to endothelium
lining the vessel exposes underlying collagen fibers; platelets adhere), Platelets release chemicals that make nearby platelets sticky; platelet plug forms
3) Coagulation, Fibrin proteins form a mesh that traps red blood cells and platelets, forming the clot
What are the factors limiting clot formation
1) nitric oxide
2) prostacyclin (prostaglandin)
What are the thromboembolic disorders
conditions that cause undesirable clot formation (undesirable intravascular clotting)
What are the types of anticoagulant drugs
1) Aspirin (Aspirin is an antiprostaglandin drug that inhibits thrornboxane A2 formation (blocking platelet aggregation and platelet plug formation))
2) Heparin (injectable form, is the anticoagulant most used in the hospital (for heart patients undergoing various procedures and to prevent or treat venous thrombosis))
3) Warfarin (Warfarin and direct oral anticoagulants are mainstays of outpatient treatment to reduce the risk of stroke in those prone to atrial fibrillation)
What is thrombocytopenia
Platelet deficiency, which interferes with the clotting mechanism
What is hemophilia A
The term hemophilia refers to several hereditary bleeding disorders that have similar signs and symptoms, Hemophilia A results from deficiency in factor VIII (anti hemophilia factor) most common
What is hemophilia B
It is the result of a deficiency of factor IX (plasma thromboplastin component)
What is hemophilia C
It is the hemophilia which results from the deficiency of plasma thromboplastin antecedent (PTA), least common
How does the impairment of liver function affects our bleeding
When the liver is unable to synthesize its usual supply of clotting factors, due to vitamin K deficiency (common in newborns) (and can be due to absorption problems), to nearly total impairment of liver function (as in hepatitis or cirrhosis),
What is Disseminated intravascular coagulation (DIC)
DIC involves both widespread clotting and severe bleeding, Clotting occurs in intact blood vessels and the residual blood becomes unable to clot. Blockage of blood flow accompanied by severe bleeding follows. DIC most commonly happens as a complication of pregnancy or a result of septicemia or incompatible blood transfusions
What happens if you abuse the use of the hormone EPO (erythropoietin)
EPO injections can increase your hematocrit value to 65% from 45% which makes the blood very viscous and when running severe dehydration occurs, making the blood sticky and sluggish which can cause clotting, stroke & heart failure
What is the hemolytic disease of newborn
When and only when the father is rhesus positive and the mother is rhesus negative given a rhesus positive fetus, and only after the first delivery where at the labor stage fetal and mother blood mixes the mother produces antibodies against her child which if she got pregnant again by a rhesus positive fetus the antibodies she developed may pass the placental barriers and destroys the baby’s RBC, this can be treated by Rhogam which is a serum containing anti-Rh antibodies
What is the transfusion reaction
It is a transfusion reaction resulted by mismatched blood infusion, where the recipient’s plasma antibodies attack the donor’s red blood cells, agglutination of the foreign red blood cells, clogs blood vessels throughout the body. During the next few hours, the clumped red blood cells begin to rupture or are destroyed by phagocytes, and their hemoglobin is released into the bloodstream.
Which hinder blood flow to tissues beyond those points. hemoglobin can escape into the blood stream. Circulating hemoglobin passes freely into the kidney tubules, causing cell death and kidney shutdown. If shutdown is complete (acute renal failure), the recipient may die, they can also cause fever, chills, low blood pressure, rapid heartbeat, nausea, vomiting, and general toxicity, treatment of transfusion reactions focuses on preventing kidney damage by administering fluid and diuretics to increase urine output, diluting and washing out the hemoglobin.
What blood group is considered as the universal donor
O-
What blood group is considered the universal recipient
AB+
What are the different blood tests
1) prothrombin time
2) platelet count
3) comprehensive metabolic panel (CMP)
4) complete blood count (CBC)
What are the clotting factors which are synthesized by vitamin K
1) prothrombin
2) proconvertin
3) plasma thromboplastin component (PTC)
4) Stuart factor
What is the difference between intrinsic and extrinsic clotting
The intrinsic pathway is activated through exposed endothelial collagen, and the extrinsic pathway is activated through tissue factor released by endothelial cells after external damage
what is PDGF
1) platelet derived growth factor, released by platelets
stimulates smooth muscle cells and fibroblasts to divide and rebuild the vessel wall
Mechanism of aspirin
- inhibit thromboxane A2
Mechanism of heparin
Injectable form for bed rest patient, receiving blood transfusion, cardiac surgeries
What is the mechanism of warfarin
Oral tabs which interferes with the action of vitamin K
What is the number of neutrophils, basophils, eosinophils, monocytes, lymphocytes, RBC, & platelets
Total 4,800-10,800
- Neutrophils: 3000-7000
- Eosinophils: 100-400
- Basophils: 20-50
- Lymphocytes: 1500-3000
- Monocytes 100-700
What is hemolytic anemia
Huge amount of RBC being destroyed, due to their lyses prematurely, hemoglobin disorders (thalassemia, sickle cell anemia), error in blood transfusions, bacterial or viral infection.
