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NUT1005 > Blood > Flashcards

Blood Flashcards

1
Q

What are the functions of blood

A

Maintain homeostasis (body temp, pH, fluids etc.), transport, immune system, regulate blood clotting, remove toxins

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2
Q

What are the 4 main components of blood

A

Plasma, Erythrocytes (RBC), Leukocytes (WBC), thrombocytes (platelets)

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3
Q

Where is the vast majority of blood at rest

A

Venous system

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4
Q

What % of the blood is plasma

A

Around 55%

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5
Q

What % of the blood is leukocytes and platelets

A

1%

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6
Q

What percentage of the blood is erythrocytes

A

44%

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7
Q

What is the haematocrit

A

The percentage of total blood volume that is RBC

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8
Q

What makes up the buffy coat in a test tube of separated blood

A

WBC and platelets

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9
Q

What is the lightest and heaviest components on the blood

A

Lightest= plasma, heaviest = RBC

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10
Q

What is the function of plasma

A

90% water so used for transport and thermoregulation as (water has a high capacity so used to hold, distribute and release heat generated within tissues)

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11
Q

What does plasma consist of

A

Water, plasma proteins, nutrients, waste products and dissolved gases

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12
Q

How are plasma proteins identified in a lab

A

Electrophoresis- different plasma proteins have different electrical charge

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13
Q

Why is it useful to identify changes in plasma proteins

A

Used to identify abnormal patterns related to clinical conditions

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14
Q

What are the two benefits of the indented disc shape of RBC

A

1) provides a larger surface area for O2 diffusion
2) thin so rapid diffusion of O2

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15
Q

Why is mean cell volume an important clinical index

A

Used in diagnosis e.g. type of anaemia

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16
Q

What are microcytic RBC and what type of anaemia are the associated with

A

Small RBC associated with iron deficiency anaemia

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17
Q

What are macrocytic RBC and what type of anaemia are they associated with

A

Large RBC associated with folate deficiency anaemia

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18
Q

What are the two parts of haemoglobin

A

4 chain protein (globin part) and four iron containing haem groups

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19
Q

What are the 4 forms of the globin proteins in haemoglobin

A

Alpha, beta, gamma and delta

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20
Q

Which globin proteins combination are most common

A

2 alphas, 2 betas (97% of adults)

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21
Q

What does each haem group consist of

A

A porphyrin ring that contains one iron atom

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22
Q

How many molecules of O2 can haemoglobin carry

A

4 as each iron atom in haem can combine reversibly with one molecule of oxygen

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23
Q

Why is the majority of oxygen in the blood bound to haemoglobin

A

As oxygen is poorly soluble in plasma

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24
Q

What is haem and why does it appear red when oxygenated and blue when deoxygenated

A

Haem is a pigment and the different colours are due to it’s iron content

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25
Q

What 2 factors determine Hb’s ability to bind to O2

A

Partial pressure of O2 and number of available binding sites

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26
Q

Why does Hb unload more oxygen to tissues during oxygen

A

Lower PO2 in tissues due to increased metabolic demand

27
Q

Other than O2 what else can bind to haemoglobin

A

Carbon dioxide, H+ component of carbonic acid, carbon monoxide

28
Q

What are haemoglobinopathies

A

Diseases that promote abnormal haemoglobin production e.g. sickle cell anaemia

29
Q

What causes sickle cell anaemia

A

Mutated gene coding for beta globin chain in Hb results in amino acid change (glutamic acid to valine), therefore Hb polymerises at low pO2 sp long crystals of HbS form (sickle shaped RBC are produced)

30
Q

What are the problems associated with sickle cell anaemia

A

RBC become trapped in small vessels due to shape and block them which deprives downstream tissues and results in ischemia (reduced O2 levels) and infarction (tissue death)

31
Q

What are the 4 blood groups

A

A, B, O, AB

32
Q

What is an antigen

A

A molecule that can induce an immune response

33
Q

What can antigens consist of

A

Proteins, glycoproteins and glycolipids

34
Q

What is a blood group

A

A classification based on the presence of inherited antigenic substance on the surface of a RBC

35
Q

What antibodies and antigens do type A have

A

Anti-B bodies and A antigens

36
Q

What antibodies and antigens do type B have

A

anti-A bodies and B antigen

37
Q

What antibodies and antigens do type AB have

A

No antibodies and A and B antigens

38
Q

What antibodies and antigens do type O have

A

Anti- A and anti-B bodies and no antigens

39
Q

Which group are universal recipients and why

A

AB as can receive blood from any ABO group without developing a haemolytic transfusion reaction

40
Q

Which group are universal donors

A

O and blood can be given to any ABO group without triggering a haemolytic transfusion reaction as no antigens to triggers response

41
Q

What is a haemolytic transfusion reaction

A

Where the recipients RBC will agglutinate an lyse if they have antibodies against them in their blood

42
Q

What is used to determine blood type

A

ABO blood group system and the presence/ absence of the Rhesus D antigen

43
Q

Are blood groups permanent

A

Mostly yes as they are inherited however infection, malignancy, autoimmune disease or after bone marrow transplant may cause it to change

44
Q

What is haemostasis

A

The arrest/ stop of bleeding from a broken blood vessel controlled by haemostatic mechanisms

45
Q

Where are haemostatic mechanisms most effective and why

A

Arterioles, venules and capillaries as slower flow velocity

46
Q

What are platelets

A

Small cell fragments (anuclear) that have budded off the outer edges of large bone marrow cells (megakaryocytes)

47
Q

What are the three steps of haemostasis

A

Vascular spasm, formation of a platelet plug and blood coagulation

48
Q

What occurs during vascular spasm

A

A temporary measure where the smooth muscle layer surrounding a damaged blood vessel constricts immediately to slow blood flow and minimise loss, damaged cells and platelets release vasoconstrictors (ADP and serotonin etc.) and the ends of the endothelial surfaces are pushed together and adhere to each other

49
Q

How is a platelet plug formed

A

1) platelets stick to the exposed collagen made visible by the damaged endothelium
2) platelets stick to eachother using von willebrand,s factor (a plasma protein)
3) bound platelets realesse ADP, 5HT and Thromboxane A2 which causes the platelets to be become sticky and adhere to eachother causing a rapid build up of platelets at the site, sealing the platelet plug for further compaction, vasoconstriction and the release of clotting factors

50
Q

What is the role of prostacyclin in blood clotting

A

Inhibits platelet aggregation so the platelet plug is limited to the defect and does not spread to normal tissue

51
Q

What occurs during blood coagulation

A

The blood clot forms on top of the platelet plug and reinforces it, (a large soluble plasma protein) into fibrin (an insoluble thread like molecule) which RBC become enmeshed in the fibrin plug

52
Q

Describe the clotting pathway and the plasma proteins (factors) involved

A

Fibrinogen is converted to fibrin monomers by thrombin (protease), fibrin monomers are converted to a fibrin polymer by factor XIIIa and Ca++, which forms the clot

53
Q

What are the two anticlotting systems

A

Anti-thrombin and thrombomodulin (proteins C and S)

54
Q

What does anti-thrombin do

A

Inhibits many of the clotting factors (esp thrombin), it’s activity is enhanced by heparin which is normally present on endothelial cells

55
Q

What is the role of thrombomodulin

A

Expressed by endothelial cells and binds to thrombin to eliminate its coagulant effects and activate protein C

56
Q

What is fibrinolysis

A

The breakdown of a fibrin clot (usually after healing)

57
Q

What is a thrombus

A

A blood clot within a vessel/heart

58
Q

What is an embolus

A

Detached mass able to travel in a blood vessel

59
Q

What is an embolism

A

The lodging of an embolus

60
Q

What is thrombo-embolism

A

Blockage by a thrombus that has travelled

61
Q

What is Virchow’s triad

A

3 things that could lead to abnormal thrombus formation in the body (blood stasis/inefficient circulation, changes to vessel wall and thrombogenic changes in blood e.g hypercoagulation)
Inflammatory factors are a modern day addition

62
Q

What is von willebrand,s disease

A

Lack of von willebrand factor leading to poor platelet aggregation

63
Q

What factor is deficient in Haemophilia A and B

A

A- VIII, B- IX

NUT1005 (18 decks)

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