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PHGY 209 > Blood > Flashcards

Blood Flashcards

1
Q

Three main functions of blood

A

Transport, acid base balance and protection

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2
Q

What does blood transport

A

Nutrition, respiratory gases, excretion of wastes, hormone transport, temperature regulation

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3
Q

What is the normal pH of blood and what happens when pH changes

A

7.30-7.45
Changes cause protein structure changes

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4
Q

What part of the blood is used for protection

A

White blood cells and plasma proteins

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5
Q

What is the composition of blood

A

55% plasma, 45% RBCs and <1% WBCs

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6
Q

What kinds of fluids does blood contain

A

ECF (plasma) and ICF (fluid inside blood cells)

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7
Q

Blood accounts for how much of body mass

A

Around 7% body mass (around 5L)

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8
Q

What does normovolemia mean

A

Normal blood volume

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9
Q

What does hypovolemia mean

A

Lower blood volume

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10
Q

What does hypervolemia mean

A

Higher blood volume

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11
Q

What is hematocrit (Ht), what is the formula

A

Percentage of blood volume occupied by RBCs
Height of RBC column / height of whole blood column *100
Normal value = 45%

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12
Q

What is the composition of plasma

A
  1. > 90% water
  2. Ions: Na+ Cl- mostly (close to saline 0.9% NaCl)
  3. Nutrients, respiratory gases, wastes (glucose, amino acids, lipids, O2, CO2, urea, lactic acid)
  4. Proteins (albumins, globulins, fibrinogen)
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13
Q

Different methods of separating plasma proteins

A

Differential precipitation by salts
Sedimentation in ultracentrifuge
Immunological characteristics
Electrophoretic mobility ***

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14
Q

What is electrophoresis

A

Fractionation method based on movement of charged particles along a voltage gradient

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15
Q

What is rate of migration in electrophoresis influenced by

A

The number and distribution of charged and by the molecular weight of each protein (each protein migrates at its own characteristic rate)

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16
Q

Which direction do proteins move in in electrophoresis

A

Proteins migrate towards positive pole as proteins are negative

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17
Q

Which proteins will move closest to the positive pole and which will move more to negative pole

A

Albumin, alpha 1 and 2, beta, fibrinogen, gamma (positive to negative)

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18
Q

What does the size of band refer to in electrophoresis

A

How much of that particular protein is present

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19
Q

Why do we use serums in electrophoresis instead of concentrate plasma

A

Much easier to work with, serum is plasma without the clotting factor

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20
Q

What is the origin of albumin, fibrinogen, a1, a2, B globulins and gamma globulin plasma proteins

A

Albumin, fibrinogen, a1, a2, b globulins = liver
Gamma globulins = lymphoid tissue

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21
Q

What happens to electrophoretic pattern in renal disease

A

Too much permeability, albumin flows out in urine (less albumin on strip)

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22
Q

What is the electrophoretic pattern in bacterial infection

A

Lots of antibodies form meaning a peak in gamma globulins

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23
Q

What is the major role of plasma proteins and how do they do it

A

Determining the distribution of fluid between the plasma and the ISF compartments by controlling transcapillary dynamics

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24
Q

What must there be in order for there to be a net flow of water between ISF and Plasma and why

A

A difference in osmotic pressure because they otherwise have the same characteristics (same mOsm, % NaCl etc)

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25
Q

What kind of solutes contribute to the effective osmotic pressure of a solution and why

A

Non diffusible solutions because diffusible solutions do not contribute because they become equally distributed on both sides of the membrane

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26
Q

Can plasma proteins exert an osmotic effect?

A

Yes because they are non-diffusible

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27
Q

What is the effect of non-diffusible solute on osmotic pressure known as

A

Colloidal osmotic pressure (C.O.P.) of plasma

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28
Q

What happens if C.O.P increases in plasma

A

More water will flow into plasma

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29
Q

What happens if C.O.P. D ecreases in plasma

A

More water will flow into ISF

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30
Q

Across the capillary wall is there protein diffusion

A

No

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31
Q

Why do proteins make a major contribution to the C.O.P. Of a solution

A

There is no protein diffusion across the capillary wall

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32
Q

What are the two major forms of fluid transport across the capillary wall

A

Filtration and osmotic flow

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33
Q

What is bulk flow

A

Flow of molecules subjected to a pressure difference (ex: opening a tap)

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34
Q

What is the difference between diffusion and starling forces

A

D: exchange of nutrients, gases and wastes across the capillary wall
SF: determine the distribution of ECF volume between plasma and ISF

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35
Q

What does bulk flow depend on

A

Hydrostatic pressure difference

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36
Q

What is filtration

A

Bulk flow across a porous membrane which acts as a sieve withholding some particles

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37
Q

What are the key mechanisms for transport across capillaries

A

Filtration: fluid in blood vessel is under pressure, tends to push out fluid from inside the capillaries to ISF
Osmotic flow: plasma proteins tend to pull in to get fluid inside the capillaries

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38
Q

What occurs in the capillary bed

A

Exchanges between plasma and ISF

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39
Q

Where does net filtration occur in blood vessels

A

Arteries

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40
Q

Where does net absorption occur in blood vessels

A

Veins

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41
Q

How is net filtration or absorption calculated

A

Filtration - C.O.P.

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42
Q

What moves by simple diffusion

A

Oxygen, carbon dioxide, nutrients, wastes

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43
Q

What are the main capillary exchanges

A

Simple diffusion and starling’s transcapillary dynamics (filtration and osmotic flow)

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44
Q

What do Starling’s Transcapillary dynamics do

A

Determine the distribution of ECF volume between Plasma and ISF (movement of water)

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45
Q

Difference between filtration and osmotic flow

A

Filtration pushes fluid out of capillaries osmotic flow pulls in fluid to capillaries

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46
Q

What happens to the proteins escaped through ISF

A

They are brought back by the lymphatic system

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47
Q

Which is more permeable capillaries or the lymphatic system

A

Lymphatic system

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48
Q

What percentage of fluid is not reabsorbed back into capillaries

A

10% into lymphatic vessels

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49
Q

What does the osmotic pressure of a solution depend on

A

The number of osmotically active particles / unit volume

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50
Q

What does the osmotic pressure of a solution not depend on

A

Size, configuration, charges

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51
Q

What does the protein fraction’s osmotic pressure directly relate to

A

The protein fraction’s concentration in the plasma

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52
Q

What is each protein fraction that exerts an osmotic pressure inversely related to

A

The molecular weight of that protein

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53
Q

What are the factors in transcapillary dynamics

A
  1. Hydrostatic pressure
  2. C.O.P.
  3. Capillary permeability
  4. Lymphatic drainage
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54
Q

What is edema

A

Accumulation of excess fluid in the interstitial spaces

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55
Q

What are conditions that lead to edema

A
  1. Increased hydrostatic pressure (high BP)
  2. Decreases plasma protein (C.O.P.)
  3. Increased capillary permeability
  4. Obstruction of lymphatic drainage
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56
Q

What does increased hydrostatic pressure mean for net filtration and net absorption

A

Net absorption is 0 or close to 0 filtration is higher than normal

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57
Q

What does decreased C.O.P. do to net filtration and absorption

A

Net filtration higher net absorption close to 0

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58
Q

What is an extreme example of edema due to decreased C.O.P.

A

Failure to synthesize plasma proteins

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59
Q

What are the effects of increased capillary permeability

A

Normally there is very little protein in ISF. If the capillary wall becomes more permeable, some plasma proteins escape into ISF where they can exert an onconic effect

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60
Q

What happens in reduced lymphatic drainage

A

Leftover proteins accumulate in ISF instead of being drained by lymphatic system

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61
Q

What are the roles of plasma proteins

A
  1. Determining the distribution of fluid between the plasma and the ISF compartments by Starling Forces controlling transcapillary dynamics
  2. Contribute to viscosity of plasma (which contributes to BP)
  3. Contributes to buffering power of plasma (pH)
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62
Q

What are the proteins essential for clotting

A

Fibrinogen and globulins

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63
Q

What is the function of y-globulins

A

Immunoglobulins: provide specific resistance to infection

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64
Q

What proteins act as carriers for lipids, minerals and hormones

A

Albumin and some globulins

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65
Q

What is hematopoiesis

A

All blood cells are derived from a common, multi potential (pluripotential) hematopoietic stem cell (can give rise to multiple different blood cells)

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66
Q

What is erythropoiesis

A

Production of red blood cells

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67
Q

What is thrombopoiesis

A

Production of platelets

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68
Q

What is leukopoiesis

A

Production of white blood cells

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69
Q

What are cytokines

A

Substances which are released by one cell and affect the growth, development and activity of another call

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70
Q

What are Hematopoietic Growth factors (HGFs)

A

Cytokines that influence the proliferation and differentiation of blood cell precursors

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71
Q

What is the general pattern of hematopoiesis

A

Division and differentiation if an inducer and a stimulant

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72
Q

What are the sites of hematopoiesis (prenatal)

A
  1. Yolk sack
  2. Liver and spleen
  3. Bone marrow
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73
Q

Where will hematopoiesis occur mainly after birth

A

Bone marrow (Distal long bones until 25)

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74
Q

What is the function of red blood cells

A

Facilitate transport of respiratory gases (mainly oxygen)

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75
Q

Why are RBCs shaped like a biconcave disk

A

Presence of spectrum, a fibrous protein forming a flexible network linked to cell membrane

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76
Q

What is the advantage of the shape of an RBC

A

Maximal surface area and minimal diffusion distance (increases efficiency of oxygen and carbon dioxide) *fick’s law
High degree of flexibility (Allows red blood cells to squeeze through narrow capillaries)

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77
Q

What makes up the CBC (complete blood count)

A

RBC, WBC, platelet count, hematocrit, Hb concentration

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78
Q

What is a cell called when it is normal sized

A

Normocytic cell

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79
Q

What is it called when a cell is smaller than normal

A

Microcytic

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80
Q

What would a cell that is larger than normal be called

A

Macrocyclic

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81
Q

What is a red blood cell that is deflated called

A

Sickle cell

82
Q

What is a red blood cell called when it is over inflated

A

Spherocyte

83
Q

What is the relationship between production and destruction of RBCs

A

Rate of production = rate of destruction

84
Q

What differs RBCs from normal cells

A

No sub cellular organelles

85
Q

What is the composition of RBCs

A

Mostly water, then hemoglobin, then lipids, proteins and ions

86
Q

What do RBCs have instead of mitochondria and was is their function

A

Glycolysis enzymes that generate energy anaerobically

87
Q

What is responsible for the facilitation of CO2 transport in RBCs

A

Carbonic anhydrase

88
Q

How many oxygen molecules can HB bind at most

A

4

89
Q

What is HbO2

A

Hemoglobin combined with oxygen

90
Q

What is deoxyHB

A

When oxygen is released from Hb

91
Q

What is the structure of hemoglobin

A

4 protein chains, each chain has a heme region with an iron bound which is where O2 binds (2 alpha chains and 2 beta chains)

92
Q

When does hemoglobin appear bight red

A

In lungs when Hb becomes saturated with O2

93
Q

When does hemoglobin appear dark red

A

In tissues O2 dissociates from Hb

94
Q

What is the function of hemoglobin

A

Transport O2 main source of high O2 solubility
Transport of CO2
Acts as a buffer

95
Q

Why is Hb inside the RBC instead of dissolved in the plasma

A
  1. Plasma viscosity would increase
  2. Plasma C.O.P. Increases
  3. plasma would be lost via the kidney
96
Q

What are the factors that affect the ability of Hb to bind and release O2

A
  1. Temp
  2. Ionic composition
  3. pH
  4. pCO2 (amount of CO2 dissolved)
  5. Intracellular enzyme concentration
97
Q

What are the two stages of RBC production

A
  1. Division and Differentiation (3-5 days)
  2. Reticulocyte to RBC (24 hours)
98
Q

What is the process of Red blood cell precursor proliferation (development)

A
  1. Decrease in size
  2. Loss of nucleus and organelles
  3. Accumulation of Hb
99
Q

What are Reticulocyte

A

Immature RBCs with ribosomes still left

100
Q

What is the normal Reticulocyte count

A

Less than 1%

101
Q

What is the Reticulocyte index

A

Reflects the amount of effective erythropoiesis in the bone marrow

102
Q

What are the factors that determine the amount of RBCs

A

Oxygen requirements and availability

103
Q

Are there more or less RBCs at a higher altitude

A

More

104
Q

What is erythropoietin and where is it produced

A

A glycoprotein hormone/cytokine produced mainly by the kidney

105
Q

What is the stimulus for the release of erythropoietin

A

Hypoxia (low oxygen)

106
Q

What could cause hypoxia

A
  1. Decreased RBC count
  2. Decreased availability of O2 to blood
  3. Increase tissue demand for O2
107
Q

What is the function of the kidney in regulation of erythropoiesis

A

Senses hypoxia and increases the release of erythropoietin in plasma

108
Q

What is the effect of increased erythropoietin in the plasma

A

Stimulates RBC production in bone marrow which increases RBC production

109
Q

What is the effect on increased RBC production

A

Increased oxygen in plasma

110
Q

What is the effect of increased oxygen in plasma

A

Kidney senses increased oxygen and decreases the release of erythropoietin

111
Q

What kind of process is the regulation of erythropoiesis

A

Negative feedback process

112
Q

What does the regulation of erythropoiesis maintain

A

Homeostasis

113
Q

What is the process for erythropoietin action

A

A pluripotent stem cell becomes a committed stem cell (EPO stimulates proliferation)
(EPO accelerates maturation)
Committed stem cell becomes a reticulocyte which becomes a mature RBC

114
Q

What is the effect of testosterone on erythropoietin

A
  1. Increases release of erythropoietin
  2. Increases sensitivity of RBC precursors to Erythropoietin
115
Q

What is the effect of estrogen on erythropoietin

A
  1. Decreases release of erythropoietin
  2. Decreases sensitivity of RBC precursors to erythropoietin
116
Q

Why do males have more RBCs than females

A

Because of the effects of testosterone on erythropoietin

117
Q

What is the lifespan of RBCs

A

120 days

118
Q

What prolongs the RBC lifespan

A

Nothing

119
Q

How are old RBCs gotten rid of

A

They are recognized and removed from circulation by highly phagocytize cells (macrophages) (in the liver or spleen)

120
Q

Why is the lifespan so short and final of RBCs

A

They have no sub cellular structures to replenish itself

121
Q

What is another function of the macrophage aside from engulfing the old RBC

A

Recycles useful raw materials of RBC into cytoplasm

122
Q

What are the components of RBCs that are recycled by macrophages

A

Globin, Iron and Hemoglobin

123
Q

What does recycled globin produce

A

Amino acid pool

124
Q

What does recycled hemoglobin produce

A

Heme which then produces bilirubin (yellow) which is excreted through the liver and intestinal tract

125
Q

What does recycled iron produce

A

Transferrin which carries iron the ferritin storage i the liver, spleen and gut

126
Q

What is the function of transferrin

A

Transport iron to ferritin and the once again from storage to bone marrow to be put back in an RBC

127
Q

What causes jaundice

A

Excess of bilirubin in plasma

128
Q

What causes excess billirubin in plasma

A

Excess hemolysis (breakdown of RBC) which produces excess Hb, heme and ultimately bilirubin

Liver damage (no excretion of bilirubin)

Bile duct obstruction (gall stones) which prevents billirubin from exiting the liver and entering the intestinal tract

129
Q

What is polycythemia

A

Production of RBCs is greater than destruction

130
Q

What is anemia

A

Production of RBCs is less than destruction

131
Q

How do we measure RBC dynamics

A
  1. Number of RBCs
  2. Amount of Hb
  3. Hematocrit
132
Q

What is hematocrit

A

The percentage of blood volume occupied by red blood cells

133
Q

What are potential causes for a higher hematocrit

A

Polycythemia or dehydration

134
Q

Hat are causes for a lower hematocrit

A

Anemia or fluid retention in the ISF compartment

135
Q

What is the cause of relative polycythemia

A

Decreased plasma volume

136
Q

What is the cause of absolute polycythemia

A

Physiological or pathological

137
Q

What is physiological polycythemia

A

Secondary effect that occurs due to higher oxygen needs or lower oxygen availability

138
Q

When can physiological polycythemia occur

A

At high altitude
Increased physical activity
Chronic lung disease
Heavy smoking

139
Q

What is pathological polycythemia and why can it occur

A

A primary effect that can occur due to tumours of cells producing EPO or unregulated RBC production by bone marrow

140
Q

Why is polycythemia a problem

A
  1. Increases blood viscosity
  2. Slow blood flow can lead to blood clots
141
Q

What is anemia

A

A decrease in the oxygen-carrying capacity of blood

142
Q

What are signs of anemia

A

Decreased RBC count and decreased Hb content

143
Q

What are the different sizes of anemias

A

Microcytic, normocytic and macrocytic
(Normocytic is 90-94)

144
Q

What are the different colours of anemias

A

Normochromic (33% Hb) and hypochromic

145
Q

What are the possible causes of anemias

A
  1. Diminished production of RBCs
  2. Ineffective maturation
  3. Increased RBC destruction/reduced RBC survival
146
Q

What are the causes of diminished RBC production

A
  1. Abnormality at site of production
  2. Inadequate stimulus
  3. Inadequate raw materials
147
Q

What is the type of anemia with abnormality at the site of production called and what is its ethology and classification

A

Aplastic (hypoplastic) anemia
E: unknown, exposure to radiation, chemicals or drugs
C: normocytic or normochromic

148
Q

What is the type of anemia with inadequate stimulus called and what is its ethology and classification

A

Stimulation failure anemia
E: renal disease (less EPO production)
C: Normocytic, normochromic

149
Q

What is the type of anemia with inadequate raw materials called and what is its ethology and classification

A

Iron deficiency anemia (most common)
E: increased requirement for Fe or inadequate supply of fe
C: microcytic, hypochromic

150
Q

How much iron is there in the body and where is it primarily located

A

4g (Hb and stored)

151
Q

Which sex absorbs more iron from the gut

A

Females (who menstruate) because they lose more blood (twice as much)

152
Q

What is the anemia related to ineffective maturation, what is its etiology and what is its classification

A

Maturation failure anemia
E: deficiencies of vitamin B12 and folic acid (required for DNA synthesis) an inadequate supply of Fr
C: maccrocytic and normochromic

153
Q

Why could someone have a vitamin B12 deficiency

A

Failure of absorption

154
Q

Why could someone have a deficiency in folic acid

A

Absence in diet or overcooking of veggies

155
Q

How does the intrinsic factor work in vitamin B12 absorption

A

It binds to vitamin B12 and allows it to be carried to the small intestine for absorption rather than be digested in the stomach

156
Q

What does intrinsic factor deficiency lead to

A

Pernicious anemia

157
Q

What is an anemia of RBC survival disorders and what is its etiology

A

Hemolytic anemias (may be accompanied by jaundice)
E; congenital or acquired

Acquired by: abnormal RBC membrane structure, enzyme systems and Hb structure)

158
Q

What are the two types of blood loss

A

External and internal (into tissues)

159
Q

What is the stopping of bleeding called

A

Hemostasis

160
Q

What is primary hemostasis

A

Begins within seconds on injury, lasts only minutes and includes vascular and platelet response

161
Q

What is secondary hemostasis

A

Clot formation, only part that is visible and takes longer

162
Q

What are the steps of hemostasis

A
  1. Vascular injury (1)
  2. Vasoconstriction (1)
  3. Platelet plug formation (temporary) (1)
  4. Blood clot formation (2)
163
Q

How does the vascular response work in hemostasis

A

Smooth muscle cells in vessel wall respond to injury by contracting and opposed endothelial cells stick together

164
Q

Does the vascular response (vasoconstriction) block blood flow entirely

A

No

165
Q

What is the platelet response

A

A platelet plug (white thrombus) is formed that stops blood flow entirely

166
Q

What is the platelet structure

A

Cell fragments, no nucleus, very small, many granules (factors for vasoconstriction, platelet aggregation, clotting, growth, etc)

167
Q

What is the lifespan of platelets

A

7-10 days

168
Q

What is the hematopoiesis lineage

A

A pluripotent hematopoietic stem cell makes lymphoid and myeloid stem cells

Lymphoid makes lymphocyte and myeloid makes everything else including megakaryocyte which makes platelets

169
Q

What is the process of platelet production

A
  1. Pluripotent cell becomes
  2. Myeloid cell
  3. Thrombopoietin (mostly from liver ) is added to form
  4. Megakaryocyte in bone marrow with granules which turn into
  5. Platelets in the blood stream
170
Q

What cells make up the vessel wall

A

Endothelial cells

171
Q

What do endothelial cells contain that prevent things from sticking to the vessel wall

A

Prostacyclin and nitric oxide (vasodilators)

172
Q

What is the role of collagen in endothelial cells

A

They are exposed when the vessel wall is damaged which allows for the platelets to stick (binds and activates platelets)

173
Q

What are the steps of platelet plug formation

A
  1. Adhesion
  2. Activation and release of cytokines
  3. Aggregation
  4. Consolidation
174
Q

What compounds are involved in the process of adhesion to aggregation

A

Von willerbrand factor, TXA2, ADP, serotonin and PF3

175
Q

What is the role of thrombin in platelet plug formation

A

Important for production of blood clots

176
Q

What do platelet factors do

A

They are released and attract more platelets

177
Q

What do platelet factors promote

A

Coagulation scheme

178
Q

What are platelet functions

A
  1. Release vasoconstricting agents / cytokines
  2. Form platelet plug (red thrombus)
  3. Release clotting factors
  4. Participate in clot retraction
  5. Promote maintenance of endothelial integrity
179
Q

What is petechia and what is it caused by

A

Small red dots caused by clearing into the skin due to capillaries and platelets not functioning properly

180
Q

What does abnormal primary hemostasis response lead to

A

Prolonged bleeding

181
Q

What can cause abnormal primary hemostasis response

A
  1. Failure of blood vessel to constrict
  2. Platelet deficiencies

Numerical or functional (congenital or acquired)

182
Q

What is a thrombus

A

Blood clot

183
Q

What cells are not required in blood clot formation

A

RBCs and WBCs

184
Q

What is clotting initiated by and what does it result in

A

Injury to blood vessel wall

Sequential activation and interaction of a group of plasma proteins/clotting factors in the presence of Ca2+ and some phospholipid agents

185
Q

Clot formation is a function of what part of the blood

A

Plasma

186
Q

What takes longer the intrinsic pathway to extrinsic pathway of clot formation

A

Intrinsic

187
Q

What is the intrinsic pathway

A
  1. Damage to blood vessel
  2. Releases interacting plasma factors plus Ca2+ and PF3 which contributes to the reaction of prothrombinase to
  3. Convert prothrombin to thrombin which help with the reaction of
  4. Fibrinogen to Fibrin which cross links to form a
  5. Blood clot
188
Q

What is the extrinsic pathway

A
  1. Damage to tissue outside vessel
  2. Releases interacting plasma factors plus Ca2+ and PF3 which contributes to the reaction of prothrombinase to
  3. Convert prothrombin to thrombin which help with the reaction of
  4. Fibrinogen to Fibrin which cross links to form a
  5. Blood clot
189
Q

Where are small amounts of thrombin generated rapidly and what can they trigger

A

Extrinsic pathway

Sufficient to trigger strong positive feedback effects to generate large quantities of thrombin in the intrinsic pathway

190
Q

What are the factors in coagulation

A

Ca2+, phospholipids and protein plasma factors (limiting)

191
Q

How is clotting kept in check

A

Inhibitors of platelet adhesion
Anticoagulants

192
Q

What are anticoagulants and what do they do

A

Naturally occurring chemicals that block one or more of the reactions of the coagulation scheme

193
Q

What are congenital clotting factors deficiencies

A

Single-factor hereditary deficiencies (hemophilia)

194
Q

What are acquired clotting factor deficiencies

A

Multi-factor deficiencies (liver disease and vitamin k deficiency , vitamin k is a cofactors in synthesis of prothrombin)

195
Q

What does clot retraction required

A

A contractile protein released by platelets (damaged endothelial cells are sticky, normal ones prevent stickiness)

196
Q

What factors make up the plasminogen activator

A

Intrinsic Proactivators (endothelial cell factors) and extrinsic proactivators (tissue factors)

197
Q

What is the path from plasminogen to fibrin fragments

A

Plasminogen
Plasminogen activator which helps make
Plasmin which helps make
Fibrin
Fibrin fragments

198
Q

What does aspirin do

A

Inhibits platelet adhesion

199
Q

What are the types of anticoagulant drugs and what do they do

A

Interfere with clot formation
Coumarin: blocks synthesis of functional prothrombin
Heparin: inhibits thrombin activation and action

200
Q

What are the types of thrombocytes drugs and what do they do

A

Promote clot lysis
Tissue plasminogen activator
Streptokinase

PHGY 209 (4 decks)

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