Blood Flashcards

1
Q

What are the functions of blood?

A

FUNCTIONS OF BLOOD
Transportation: of nutrients and proteins (fragments and specialised cells)
Regulation: of temperature/calcium levels/body fluids/pH levels
Protection: blood clotting - platelets, immunity - white blood cells

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2
Q

Blood is a connective tissue composed of…

A

Blood is a connective tissue composed of…

  • Blood plasma (liquid extracellular matrix)
  • Various cells & cell fragments (dissolved & suspended in blood plasma)
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3
Q

What are the components of blood?

A

COMPONENTS OF BLOOD

  • 55% blood plasma (watery liquid extracellular matrix containing dissolved substances)
  • 45% formed elements (99% of these are red blood cells & 1% of these are white blood cells & platelets
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4
Q

What is blood plasma made up of?

A

BLOOD PLASMA
91.5% is water
7% is proteins (half of which are albumins)
1.5% is other solutes - electrolytes, nutrients, gases, enzymes, hormones, vitamins, waste products (urea, bilirubin)

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5
Q

Red blood cells are called?

A

Red blood cells are called erythrocytes

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6
Q

What are erythrocytes?

A

Erythrocytes are red blood cells

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7
Q

What is hemoglobin?

A

Hemoglobin is in erythrocytes (RBCs) and is an oxygen carrying protein, which is a pigment that gives blood its red colour.

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8
Q

Characteristics of RBCs

A
- Membrane contains glycolipoproteins 
 ABO and Rh
 - Contains hemoglobin (oxygen carrying protein - pigmented, gives RBCs their colour)
- Lack nucleus & other  organelles
- Cannot reproduce
- Have a biconcave shape
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9
Q

What is the make up of RBCs?

A
  • Each RBC contains about 280 million Hb molecules. Hb = hemoglobin
  • Each Hb molecule can carry 4 oxygen molecules
  • Heme - Iron ion (Fe2+)
  • Globin - Protein - four polypeptide chains (2 alpha, 2 beta)
  • Nitric Oxide (NO) bound to Hb
    produced by endothelial cells
    Release of NO > vasodilation> increased blood flow > enhanced delivery of O2, nutrients and removal of wastes
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10
Q

How long does a red blood cell live for?

A

Lives only about 120 days. Ruptured RBC’s are removed from circulation
destroyed by phagocytic macrophages in spleen & liver
Breakdown products are recycled

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11
Q

What is hemopoiesis (or hematopoiesis)?

A

Hemopoiesis is the formation of blood cells from hemopoietic stem cells in red bone marrow

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12
Q

What am I?

  • Highly vascularised
  • 0.05-1% of the cells are derived from mesenchyme and are called pluripotent stem cells (capacity to develop into many different type of cells)
  • Sinusoids are entry points of formed blood cells into circulation
A

Red bone marrow

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13
Q

What are Hemopoietic Growth Factors?

A

Hormones that regulate differentiation & proliferation of particular progenitor cells

  • Erythropoietin (EPO) - Is produced primarily in the kidneys and increases number of RBC precursors
  • Thrombopoietin (TPO) - Produced by the liver and stimulates thrombocyte (platelet) formation
  • Cytokines - Typically produced
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14
Q

What is Erythropoiesis?

A

Erythropoiesis is the production of RBC’s.
- Precursor cell called proerythroblast, ejects its nucleus causing cell to indent –> biconcave shape – now called reticulocyte.
Still retain some mitochondria, ribosomes, E.R.
Squeezes between endothelial cells of blood capillaries from red bone marrow into the blood stream.
- Reticulocytes take 1-2 days to mature in the blood stream > now called erythrocyte

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15
Q

What is the stimulus for Erythropoiesis?

A

STIMULUS FOR ERYTHROPOIESIS:

  • Hypoxia: due to high altitude, blood disorder etc. Hypoxia stimulates the kidneys to stimulate the release of erythropoietin –> speeds up the development of proerythroblasts into reticulocytes. Increased RBCs = Increased oxygen delivery
  • Low levels of atmospheric O2
  • Increase in exercise
  • Hemorrhaging
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16
Q

Please describe erythrocyte homeostasis….

A

ERYTHROCYTE HOMEOSTASIS
Classic negative feedback control:
drop in RBC count causes hypoxemia to kidneys.
Erythropoietin ↑ > stimulation of bone marrow
RBC count ↑ in 3-4 days

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17
Q

What are leukocytes (leuko=white)

A

Leukocytes are white blood cells

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18
Q

How are white blood cells classified?

A

WBCs are classified according to their microscopic appearance upon dye injection:

  • Granular leukocytes
  • Agranular leukocytes

WBCs have a nuclei

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19
Q

What are the names of the granular leukocytes (WBCs)?

A

Granular WBCs

  • Eosinophils: 2-4% of all WBC’s
  • Basophils: 0.5-1% of all WBC’s
  • Neutrophils: 60-70% of all WBC’s
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20
Q

What are the names of the agranular leukocytes (WBCs)?

A

Lymphocytes: 20-25% of all WBC’s - includes T cells, B cells, Natural Killer (NK) Cells
Monocytes: Enlarge & differentiate into fixed and wandering macrophages (=large eaters) in tissues

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21
Q

What are Major Histocompatibility (MHC) Antigens?

A
Major Histocompatibility (MHC) Antigens are proteins protruding from plasma membrane into ECF. MHC antigens are found in all WBC’s and other nucleated cells in body 
MHC Antigens are “Cell identity markers” and unique for each person
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22
Q

WHat are the functions of leukocytes (WBCs)?

A

WBC FUNCTIONS:
- Destroy invading pathogens: by phagocytosis, by immune responses
Note: they may have to leave blood stream to do so…
- Leukocytosis (increase in numbers of WBC’s above 10,000/uL)
- Leukopenia (abnormal low level of WBC’s below 5000/uL)

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23
Q

Which WBCs are active in phagocytosis?

A

Neutrophils & Macrophages are active in phagocytosis - including ingestion & digestion of bacteria, disposal of dead matter

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24
Q

What are phagocytes?

A

Phagocytes are the white blood cells that protect the body by eating (phagocytosing) dirt, bacteria and dead or dying cells. They are important for fighting infections. They are also important for becoming immune.

The professional phagocytes are neutrophils, monocytes, macrophages, dendritic cells, and mast cells. The reason they are called professional phagocytes is because they have receptors on their surfaces that can detect harmful objects, such as bacteria. Phagocytes are very important in fighting infections and in getting rid of dead and dying cells

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25
Q

What is chemotaxis?

A

CHEMOTAXIS

Chemicals released by microbes & inflamed tissues which attract phagocytes (WBCs neutrophils and macrophages).

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26
Q

Why is the detection of changes in numbers of circulating WBCs (percentages of each type) important?

A

Detection of changes in numbers of circulating WBCs is important as percentages of each type indicate infection, poisoning, leukemia, chemotherapy, parasites or allergy reaction

Normal WBC counts

  • neutrophils 60-70% (up if bacterial infection)
  • lymphocyte 20-25% (up if viral infection)
  • monocytes 3- 8 % (up if fungal/viral infection)
  • eosinophil 2-4 % (up if parasite/ allergy reaction)
  • basophil <1% (up if allergy or hypothyroid)
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27
Q

Why are leukocytes called “major soldiers”?

A

Leukocytes are “Major soldier” in immune system battles as they continually move between blood, lymph tissue & lymph.

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28
Q

How do B-cells assist in immunity?

A

B-cells: destroy bacteria & inactivate their toxins

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29
Q

How do T-cells assist in immunity?

A

T-cells attack viruses, fungi, transplanted cells, cancer cells…

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30
Q

How do Natural Killer (NK) cells assist in immunity?

A

NK-cells: attack wide variety of infectious microbes

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31
Q

What is Blood Type Incompatibility caused by?

A

Blood type incompatibility is due to:

  • The presence of Agglutinogens – antigens on RBC plasma membrane composed of glycoproteins & glycolipids
  • The presence of Agglutinins – corresponding specific antibodies in blood plasma
  • Presence or absence of antigens genetically determined – blood type is inherited
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32
Q

What are the two main blood groups called?

A

Two main blood groups
ABO
RH

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33
Q

What is agglutinogens?

A

Agglutinogens are antigens

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34
Q

What are agglutinins?

A

agglutinins are antibodies

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35
Q

If type A blood is infused into a patient with type O blood, which of the following adverse reactions would you expect to observe in the patient?

A

ADVERSE RECTIONS WITH TYPE A BLOOD IS INFUSED IN PATIENT WITH TYPE O BLOOD:

  • Agglutination (clumping) of the transfused blood cells. A- antibodies in the recipient’s blood (typeO) would bind to A- antigens on the donated RBC’s (Type A) causing clumping of RBC’s.
  • Complement-induced haemolysis of the transfused blood cells. A-antigen- A-antibody complexes form that activate complements that lead to RBC’s leaking haemoglobin into the blood plasma.
  • Released haemoglobin clogging the filtration membrane of the kidneys. The liberated haemoglobin may cause kidney damage by clogging the kidney filtration membranes.
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36
Q

What type of antibodies (or agglutinin) does a type B person contain in their plasma?

A

Blood type B has B antigens on its RBC surface and consequently anti- A antibodies (also called agglutinins) in the blood. Thus a person with blood type B contains only anti-A agglutinin in their plasma.

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37
Q

Hematocrit

A

The percentage of RBCs in blood

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38
Q

Polycythemia

A

A disorder characterised by above average hematocrit (above 55%) eg hypertension, thrombosis, hemorrhaging.

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39
Q

What are stem cells?

A

Stem cells are are cells that are unspecified

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40
Q

What are pluriopotent cells?

A

Pluriopotent are stem cells that can form into red blood cells

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41
Q

What is erthropoiesis?

A

Erythropoiesis is the formation of red blood cells.

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42
Q

A person has antibodies for any antigens that their RBC’s lack, eg blood type O would have both A and B antibodies. Blood type A has A antigens on its RBC surface.
WHAT ANTIBODIES & ANTIGENS WOULD BLOOD TYPE O HAVE?

A

BLOOD TYPE O: You would find the following antibodies in the plasma: Anti A and Anti B. Type O blood has no antigens on the surface of its RBC’s hance the presence of both antibodies in the blood.

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43
Q

What role does iron play in hemoglobin?

A

Iron attaches itself to an iron-storage protein called ferritin in liver cells. Globin is the non- iron portion of a hemoglobin molecule. Biliverdin is produced from the breakdown of the non-iron portion of heme

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44
Q

What is anemia?

A

Oxygen delivery may fail due to anaemia (a condition in which the oxygen-carrying capacity of blood is reduced) leading to hypoxia (cellular oxygen deficiency) in the kidneys which triggers the formation of RBC’s (erythropoiesis).

45
Q

What is hypoxia?

A

HYPOXIA (cellular oxygen deficiency): in the kidney leads to secretion of erythropoietin, which targets proerythroblasts in red bone marrow to mature into reticulocytes, which enter circulation to become red blood cells thus increasing the oxygen-carrying capacity of blood.

46
Q

What role does biliverdin play in the formation and destruction of red blood cells?

A

Biliverdin is produced from the breakdown of the non-iron portion of heme.

47
Q

What is a monocyte?

A

MONOCYTES are an agranular leukocyte that leaves the blood and becomes a wandering macrophage.

48
Q

What do the agranular leukocytes, basophils, develop into?

A

BASOPHILS develop into mast cells that liberate heparin, histamine, and serotonin in allergic reactions that intensify the inflammatory response

49
Q

Blood functions include…

A

Blood functions include:

  • transportation of heat
  • protection against infectious disease
  • transportation of nutrients
  • regulation of blood pH
50
Q

What is in the blood, that flows through our vessels?

A

The blood that flows in our blood vessels consists of: plasma, erythrocytes (RBCs), leukocytes (WBCs) and platelets.

51
Q

What is the role of vitamin K in clotting?

A

Although vitamin K is not involved in the actual clotting it is required for synthesis of four clotting factors. Vitamin K deficiency can cause uncontrolled bleeding as people suffering from disorders with slow absorption of lipids have an inadequate release of bile to the small intestine. When absorption of lipids is normal, vitamin K (a fat soluble vitamin) can be absorbed through the lining of the intenstine and into the blood.

52
Q

What happens if a Rh- person has a transfusion from a Rh+ person?

A

Normally blood plasma does contain anti-Rh antibodies, however if blood donation occurs from Rh+ person to Rh- person, the Rh- person’s immune system makes anti-Rh antibodies in response. Minimal reaction first time. Second transfusion: massive agglutination and hemolysis of donated RBC’s.

53
Q

What is hemolytic disease of newborns?

A

Hemolytic disease of the newborn (HDN)

is when Mother Rh-, Foetus is Rh+ which causes problems with the second child.

54
Q

What is the structure and function of platelets (thrombocytes)?

A

Under the Platlets contain chemicals, that once release, promote blood clotting. Platelets cause blood clotting in damaged blood vessels by forming a ‘platelet plug’. Platlets live 5-9 days only. Macrophages in the spleen or liver remove old platlets.

55
Q

What is the structure, function and production of leukocytes (WBCs)?

A

WBCs contain no hemoglobin - yet have a nuclei and organelles. They are granular (neutrophils, eosinophils, basophils) or agranular (lymphocytes - T/B/NK cells + monocytes).

WBCs have major histocompatibility (MHC) antigens protruding from plasma membrane - identity markers, unique for each person. RBCs dont have MHC antigens.

WBCs combat pathogens by phagocytosis or immune responses.
To do this WBCs leave the bloodstream and collect at site of pathogen invasion or inflammation. Granular leukocytes - and monocytes - never return, however lymphocytes continually circulate (blood > interstitial spaces of tissues > lympathic fluid > blood). 98% of leukocytes are in lympatic fluid and organs (such as skin, lungs, lymph nodes, spleen).

56
Q

Lifecycle of red blood cells

A

LIFCYCLE OF RED BLOOD CELLS
Ruptured blood cells are removed from circulation and destroyed by fixed phagocytic macrophragesin the spleen and liver.The breakdown products are recycled and used in metabolic processes (incl formation of new RBCs). Recycling:
- Heme & Globin split.
- Globin broken down by aminos, reused to synthesize other proteins.
- Iron removed from heme and associate with transferrin (transporter for Fe3+ in bloodstream).
- In spleen & liver, Fe3+then detaches from transferrin and attaches to iron-storage protein ferritin
- Then again reattaches to transferrin and carries to red bone marrow, where RBC precursor cells take it up through receptor mediated endocytosis for use in hemoglobin synthesis.
- Erythropoiesis in red blood marrow results in production of RBCs, released into curculation

  • When iron is removed from heme, the non-iron portion is converted to bilirudin (green pigment) and then bilirubin (yellow-orange pigment).
  • Bilirubin enters blood and is transported to liver.
  • In the liver, bilirubin released by liver cells into bile (which passes from small intestine to large intestine).
  • In large intenstine bilirubin becomes urobilin.
  • most urobilinogen is eliminated in faeces (brown pigment called stercobilin)
  • some bilirubinogen absorbed back into blood, converted to yellow pigment urobilin - and excreted in urine.
57
Q

What is an antigen (Ag)?

A

Antigens (Ag) are substances that have immunogenicity (the ability to evoke an immune response) and reactivity (the ability to react with the antibodies or cells that result from an immune response).

58
Q

What is an antibody?

A

An antibody is a protein produced by plasma cells in response to a specific antigen. The antibody combines with the antigen to neutralise, inhibit or destroy it. Ig = immunoglobulin

59
Q

What antigens are present for ABO blood types?

A

Based on two glycolipid antigens called antigen A and B.
A - Have only A antigens, has anti-B antibody.
B - Have only B antigens, has anti-A antibodies
AB - Have both A and B, and neither antibodies.
O - Have neither antigen, and both anti-A and anti-B antibodies.

60
Q

Blood plasma contains agglutinins – antibodies which, if mixed, react with antigen A or B.

A

Anti-A antibody: reacts with antigen A.
Anti-B antibody: react with antigen B.
Note: Blood does not have antibodies that react with antigens of one’s own blood but antibodies for any antigens your RBC’s lack

61
Q

Which blood type is called the universal recipient?

A

Blood Type AB

62
Q

Which blood type is known as the universal donor?

A

Blood Type 0

63
Q

What is the blood type Rhesus?

A
  • Individuals with Rh antigens on RBC membrane referred to as Rh+ (positive)
  • Individuals who lack Rh antigens on RBC membrane referred to as Rh – (negative)
64
Q

What makes someone RH+?

A

If someone’s RBCs have Rh antigens they are considered Rh+.

65
Q

What makes someone Rh-?

A

Those who lack Rh antigens are considered Rh-.

66
Q

What is hemolysis?

A

Hemolysis is the rupture of RBCs and the release of hemoglobin into the blood plasma. The free hemoglobin may cause kidney damage by clogging filtration membranes.

67
Q

What s leukopenia?

A

Leukopenia is an abnormally low number of WBCs (can be caused by radiation, shock, and certain chemotherapeutic agents.

68
Q

What is leukocytosis?

A

Leukocytosis is an increase in the number of WBCs (above normal range of 5000-1000 microlitres. Leukocytosis is a normal protective response to invading microbes, strenuous exercise, anesthesia and surgery.

69
Q

How do WBCs leave the blood stream?

A

WBCs leave the blood stream by a process called emigration (or diapedeisis) whereby WBCs roll along the endothelium, stick to it, then squeeze between endothelial cells.

70
Q

What are neutrophils?

A

Neutrophils are the smallest of the granular leukocytes (WBCs). Neutral loving and active in phagocytosis.
A high count of neutrophils may indicate a bacterial infection, burns, stress, inflammation. A low count of neutrophil may indicate radiation exposure, drug toxicity, vitamin B12 deficiency, systemic lupus.

71
Q

What are lymphycytes?

A

Lymphocyes are agranular leukocytes (WBCs). A high count may indicate a viral infection or leukemia. Low count could mean long illness, immunosuppression, treatment with cortisol.

72
Q

What are monocytes?

A

Monocytes are agranular leukocytes (WBCs) which migrate from blood to the tissues where they enlarge and differentiate into macrophages. A high count of monocytes may indicate viral or fungal infections, tuberculosis, some leukemias, chronic illness. A low count of monocytes may indicate bone marrow suppression, treatment with cortisol.

73
Q

What is a fixed macrophage? What is a wandering macrophage?

A

A fixed macrophage resides in a particular tissue eg alveolar macrophages (lungs). A wandering macrophage has the ability to move throughout the tissue - gathering at sites of infection or inflammation, to carry out phagocytosis.

74
Q

What is a macrophage?

A

Macrophages develop from monocytes (a types of leukocyte - WBC). Macrophages engulf bacteria and cellular debris, they carry out phagocytosis.

75
Q

What do hemopoietic (immature) stem cells differentiate into?

A

Hemopoietic stem cells can differentiate into erythrocytes (RBCs), leukocytes (WBCs) - or cells that produce thrombocytes (platelets).

76
Q

What is hemostasis?

A

Hemostasis is the sequence of events that stops bleeding. Three mechanisms reduce blood loss - vascular spasm, platelet plug formation & blood clotting.

77
Q

What is coagulation?

A

Coagulation is blood clotting?

78
Q

What is vascular spasm?

A

Vascular spam: When arteries or arterioles rupture the circularly arranged smooth muscle contracts to prevent blood loss (for several minutes/hours, whilst hemeostasis takes place). Vascular spasm is probably caused by substance released by platelet, and activated by reflexes of pain receptors.

79
Q

What is blood serum?

A

Blod plasma minus clotting factors. Serum is the liquid component (seperated from gel) once drawn from the body. Blood remains in liquid form within vessels. The get component is called gel.

80
Q

What happens if blood clots too quickly?

A

Thrombosis

81
Q

What is thrombosis?

A

Thrombosis is when blood clots too quickly?

82
Q

What is a hemorrhage?

A

A hemorrhage is when blood takes too long to clot.

83
Q

What are blood clotting factors?

A

Blood clotting factors include calcium ions, several inactive enzymes that are sythesized by hepatocytes (liver cells) and released into the blood stream, and various molecules associated with platelets or released by damaged cells.

84
Q

What is a clot?

A

A clotting is a network of insoluble protein fibers (fibrin) in which formed elements of the blood are trapped. Formed elements are erythrocytes (RBCs), leukocytes (WBCs) and thrombocytes (platelets).

85
Q

Blood constitutes approximately 8% of body weight. What is the average amount in adults?

A

The average adult has 4-6litres of blood in their body.

86
Q

What do myeloid stem cells?

A

Myeloid cells form RBCs, platelets, granulocytes and monocytes. Lymphoids give rise to lymphocytes.

87
Q

What is the function of hemoglobin?

A

The function of hemoglobin is to transport oxygen and some carbon dioxide.

88
Q

What happens after phagocytosis of aged RBCs by macrophages?

A

After macrophages undertake phagocytosis on erythrocytes), hemoglobin is recycled.

89
Q

What is the general function of WBCs?

A

WBCs fight infection and inflammation. Neutrophils and macrophages (which develop from monoctyes) combat infection and inflammation through phagocytosis.

90
Q

What is the purpose of the granular leukocyte (WBC), eosinophils?

A

Eosinophils combat the reaction of histamine in allergic reactions, phagocytize antigen-antibody complexes and combat parasitic worms.

91
Q

What is the purpose of the granular leukocyte (WBC), basophils?

A

Basophils liberate hiparin, histamine and serotonin in allergic reactions that intensify the reaction.

92
Q

How long do leukocytes WBCs live for?

A

With the exception of lymphocytes, leukocytes (WBCs) live for only a few hours or a few days.

93
Q

What do the agranular leukocyte, B Lymphocytes do?

A

In response to antigens, differentiate into plasma cells that produce antibodies. Antibodies attach to the antigen and render them harmless. This antigen-antibody response combats infection and provides immunity.

94
Q

What do the agranular leukocyte, T Lymphocytes do?

A

T lymphocytes destroy foreign invaders (antigens) directly.

95
Q

What do the agranular leukocyte, Natural Killer (NK) cells do?

A

Natural killer cells attach infectious microbes and tumour cells.

96
Q

What shape are platelets?

A

Platelets are disk shaped.

97
Q

What is a bone marrow transplant?

A

A bone marrow transplants involve removal of the red bone marrow as a source of stem cells from the iliac crest.

98
Q

What is a cord blood transplant?

A

More certain advantages over a bone marrow transplant, a cord blood transplant involves removal of placenta stem cells from the umbilical cord.

99
Q

Normal coagulation requires vitamin K and is followed by clot retraction (tightening the clot) and ultimately fibrinolysis (dissolution of the clot).

A

Clotting in an unbroken blood vessel is called thrombosis.

100
Q

In the ABO blood type the presence or absence of A or B antigens on the RBCs determines blood type.

A

In the Rh system, those whose RBCs have Rh antigens are classified as Rh+ and those whose RBCs lack the Rh antigen are referred to as RH-.

101
Q

Negative feedback systems regulate the number of RBCs and platelets in circulation and their numbers remain steady. Hemopoiesis is the formation of formed elements.

A

The abundance of WBCs varies depending on invading pathogens or other foreign antigens.

102
Q

What is red bone marrow?

A

Red bone marrow is highly vascularised connective tissue located in the microscopic space between trabeculae of spongy bone tissue (chiefly in bone of the axil skeleton)

103
Q

What are pluripotent stem cells?

A

Pluripotent stem cells are derived from mesenchymme (tissue from which most connective tissue develops). Pluripotent stem cells are also known as hemocytoblasts and they have the capacity to differentiate into many different cell types.
Pluripotent stem cells produce myloid stem cells and lymphod stem cells.

104
Q

What are myloid stem cells?

A

Produced by pluripotent stem cells, myloid stem cells begin development in red bone marrow and give rise to RBCs, platelets, monocytes, neutrophils, eosinophils and basophils.

105
Q

Lymphoids give rise to…

A

Lymphoids give rise to lymphocytes. They start in the red bone marrow and then move to lymphatic tissue.

106
Q

What happens to red bone marrow as someone ages?

A

Blood cell formation decreases as someone ages.

107
Q

RED BONE MARROW -> PLURIPOTENT STEM CELLS -> MYLOID or LYMPHOID STEM CELLS -> PRECURSOR CELLS ->RBCS / WBCs/PLATELETS

A

Blood type A has A ANTIGEN and ANTI-B ANTIBODY so can receive blood from blood type A and blood type O. Incompatible with blood type B or AB (as has an anti-B antibody).

108
Q

What is erythropoietin (EPO)?

A

Erythropoietin (EPO) increases the number of red blood cell precursors. EPO is produced primarily in the kidneys and so in renal failure EPO decreases and RBC production is inadequate. Athletes use EPO to build muscles / strength.

109
Q

What is thrombopoietin?

A

Thrombopoietin (TPO) is produced by the liver and stimulates thrombocyte (platelet) formation.