Blood Flashcards
1
Q
Is blood a type of connective tissue?
A
YES, it’s a specialized type of connective tissue
2
Q
What is the average volume of blood in a 70kg male?
A
5.5 L
3
Q
What is the pH of arterial blood?
A
7.4
4
Q
What is the pH of venous blood?
A
7.35
5
Q
What are the functions of blood (5)?
A
1) transport oxygen and carbon dioxide
2) transport of nutrients, hormones, waste products, etc
3) regulation of body temp., pH, osmolality
4) hemostasis
5) immunity
6
Q
What are the three layers formed once blood has been centrifuged?
A
1) plasma (top)
2) buffy coat - 1%
3) RBCs - 42-47% (bottom)
7
Q
What is found in the buffy coat layer?
A
WBCs such as leukocytes and platelets
8
Q
What is hematocrit?
A
percentage of blood that is RBCs
9
Q
What is the hematocrit number for males and females?
A
males: 45
females: 40
10
Q
What is newborns’ hematocrit?
A
newborn: 55
decreases to 35 at 2 months then adult value at puberty
11
Q
What color is plasma during fasting?
A
straw-colored (due to bilirubin)
12
Q
What color is plasma following a fatty meal?
A
white
13
Q
What happens when you allow blood to sit in a test tube? What are the components of the layers?
A
blood will coagulate, forming a clot and sink to the bottom, containing fibrinogen. the other layer is a protein-rich fluid called serum
14
Q
Where is albumin found, serum or blood clot?
A
serum
15
Q
Where are immunoglobulins found, serum or blood clot?
A
serum
16
Q
Where are RBCs found, serum or blood clot?
A
blood clot
17
Q
What is the major difference between plasma and serum?
A
plasma contains fibrinogen and serum does not
18
Q
What is Ezetimibe?
A
cholesterol-lowering drug
19
Q
What protein is involved with colloid osmotic pressure and what is its function in regulating this pressure? What happens when its level in blood drops?
A
albumin, helps pull fluid back into the blood from tissues, edema occurs when albumin levels drop
20
Q
Transferrin, angiostatin, and plasminogen are all examples of what?
A
beta-globulins
21
Q
ceruloplasmin, AAT (alpha anti-trypsin), and protein C are all examples of what?
A
alpha-globulins
22
Q
Gamma-globulins are synthesized by what type of cells?
A
plasma cells
23
Q
Prothrombin, fibrinogen, and accelerator globulin are examples of what?
A
clotting factors
24
Q
What are some functions of complement proteins found in blood?
A
immunity and inflammation
25
What are some functions of lipoproteins found in blood?
transport cholesterol and triglycerides
26
What are the formed elements of blood (3)?
erythrocytes, leukocytes and thrombocytes
27
What are 2 major type of leukocytes found in blood?
1) granulocytes (contains specific granules)
| 2) agranulocytes
28
Are lymphocytes granular or agranular?
agranular
29
Are neutrophils granular or agranular?
granular
30
Are basophils and eosinophils granular or agranular?
granular
31
Are monocytes granular or agranular?
agranular
32
How many erythrocytes are found in one cubic millimeter?
4.2 to 6.1 million
33
What is the diameter of an erythrocyte?
about 7.5 micrometers
34
What is the shape of an erythrocyte?
biconcave disk
35
What is significant about the shape of an erythrocyte?
increases surface area to volume ratio. helps facilitate gaseous exchange
36
Do RBCs have organelles?
no, this provides space for Hb, which is an endogenous pigment
37
What does the term polycythemia refer to?
elevated RBCs
38
What does the term anemia refer to?
low levels of RBCs
39
What's another way one can be anemic without having a low level of RBCs?
normal level of RBCs with decreased number of Hb
40
What are the two major transmembrane proteins found in erythrocytes?
1) glycophorins (unique to RBCs)
| 2) Band 3
41
What is the function of band 3?
antiporter of chloride and bicarbonate
42
Briefly describe the interaction between band 3, band 4.2, ankyrin and spectrin
Band 3 is the transmembrane protein and 4.2 binds to it on the intracellular side, which in turn interacts with ankyrin. This complex then binds to spectrin (cytoskeleton)
43
Briefly describe the interactions between glycophorin, band 4.1, actin, and spectrin
Glycophorin is the transmembrane protein and 4.1 binds to it on the intracellular side. This complex then interacts with both actin and spectrin
44
What is adducin and what is its importance?
calmodulin-binding protein that promotes actin-spectrin association
45
What is hereditary spherocytosis?
any mutations in band 3, band 4.2, ankyrin or spectrin causes RBC to lose its biconcave appearance and become more spherical in shape. The leads to phagocytosis by splenic macrophages
46
What is hereditary elliptocytosis?
any mutation in glycophorin, band 4.1 or spectrin causes the RBC to become more eliptical in shape
47
What are the different blood group systems, known as antigens (5)?
1) ABO
2) Rh (designates +/-)
3) Kell
4) Duffy
5) Lewis
48
What is the clinical significance of the Duffy system?
when present on RBC, it allows Plasmodium vivax (malaria parasite) to enter. African-Americans are missing this antigen, thus they are resistant to malaria parasites
49
When considering blood transfusion, which of the blood group system do we not have to worry about?
Lewis
| Kell kills, Duffy dies and Lewis lives
50
What occurs in erythroblastosis fetalis?
mother is Rh neg. and fetus is Rh pos.
1) Nothing happens during the first pregnancy but mother does develop antibodies against Rh
2) subsequent pregnancy of another Rh pos fetus will cause the mother's anitbodies to attack
3) RhoGAM is administered at about 20 weeks gestation that prevents any adverse effects
* **clinical side note: the first pregnancy can be a miscarriage and patients can forget about those or didn't know they had one
51
Are inclusions normally found in RBCs?
no
52
Small basophilic nuclear fragments in the cytoplasm of erythrocytes are found in a blood smear, what are these inclusion bodies?
Howell-Jolly Bodies
53
What happens when Howell-Jolly bodies pass through the spleen?
the macrophages removes the nuclear fragments (pitted out) and the RBCs are returned to circulation
54
Howell-Jolly Bodies are found in patients with...
severe hemolytic anemia, dysfunctional spleens, or after splenectomy (basically if spleen can't chew out the inclusion bodies)
55
How does G6PD deficiency lead to precipitation of Heinz bodies?
During times of oxidative stress, glutathione is unable to remove ROS, Hb denatures and Heinz bodies are precipitated out
56
How do RBCs get a bite appearance?
when Hb denatures in RBCs due to oxidative stress from G6PD deficiency, these RBCs will pass through the spleen where the marophages will attempt to remove the denatured Hb by taking a "bite" leading to the distinct feature of a bite cell
57
What is the immediate precursor to a mature erythrocyte?
reticulocyte
58
What are reticulocytes' distinctive feature in a micrograph?
cytoplasm displays specks of basophilia due to clusters of free polysomes (synthesizes Hb)
59
What percent of the circulating blood volume is reticulocytes?
1%
60
What does an increase in number of reticulocytes indicate?
demand for oxygen that is not fully met (hemorrhage, recent ascent to a higher altitude)
61
Is it okay to have more RBCs? The more the better right?
NO, long term increase of RBCs will lead to more viscous blood, impairing oxygen delivery
62
How many leukocytes are found in a cubic millimeter?
5,000 - 10,000
63
Which leukocyte is the most abundant? second most? least?
neutrophils are most abundant, lymphocytes are second most and basophils are the least
64
Which type of granules are found in every type of WBCs? And what do they represent?
azurophilic (primary) granules, they represent lysosomes
65
What do neutrophils look like under a microscope?
lobulated, about twice as big as RBCs, and granulated
66
How many types of granules do neutrophils have?
Three:
1) azurophilic (primary)
2) specific (secondary)- light pink
3) tertiary
67
What are found in specific granules of neutrophils?
enzymes that are antimicrobial in function
68
What are found in tertiary granules of neutrophils?
enzymes to degrade extracellular matrix and basal lamina that will aid them in their migration to site of inflammation
69
What is the immediate precursor to neutrophils?
band cell, the nucleus forms a band that once lobulated will become neutrophils
70
What does "shift to the left" mean in a WBC differential?
increase in band cells which will increase number of neutrophils as well. this occurs during bacterial infection
71
What are Dohle bodies?
inclusion bodies found in neutrophils due to bacterial sepsis. they are remnants of rER
72
What does a typical nucleus look like in an esosinophil?
bi-lobed
73
What types of granules are found in eosinophils?
1) azurophilic granules
| 2) specific granules - dark pink to red
74
When will the levels of neutrophils increase?
during bacterial infection
75
What is the distinctive feature of eosinophils in an EM?
a white stripe will run down the middle of the granules with dark on each side
76
What do the specific granules of eosinophils contain?
enzymes that in fighting off parasitic infections
77
When will the levels of eosinophils increase?
during allergic reactions, inflammatory bowel disease, parasitic infestation
78
What shape do the nucleus of basophils have?
S-shaped, but hard to distinguish due to the basophilic nature
79
What granules are found in basophils?
1) azurophilic (primary) granules
| 2) specific (secondary) granules - dark blue
80
What do the specific granules of basophils contain?
histamine, heparin, chemotaxic factors that attract eosinophils and neutrophils to site of injury
81
How do basophils look in EM?
secondary granules have light center with dark halo
82
In acute allergic reactions, what happens to the level of basophils?
decrease
83
How are mast cells and basophils similar?
their chemical component: ie. histamine and heparin
84
How big are lymphocytes? What do they look like under microscope?
they vary in size, but most of the time they are about the size of an erythrocyte. the nucleus occupies almost the entire cell
85
What are the 3 types of lymphocytes?
1) B lymphocytes
2) T lymphocytes
3) Natural killer cells
86
Will you be able to distinguish the different types of lymphocytes in a blood smear?
no, all lymphocytes will look the same in a blood smear
87
When will the levels of lymphocytes rise?
during viral infections
88
Monocytes are one of the largest leukocytes, briefly describe their appearance
prominent nucleus, horseshoe or kidney-shaped, cytoplasm is dark (blue/gray and intense)
89
What are thrombocytes?
platelets that are fractured megakaryocytes
90
What are the four zones of platelets?
1) peripheral
2) structural
3) membrane
4) organelle
91
What is found in the peripheral zone of platelets?
plasmalemma and glycocalyx
92
What is found in the structural zone of platelets?
microtubules and actin/myosin
93
What is found in the membrane zone of platelets?
open canalicular and dense tubular systems
94
What is found in the organelle zone of platelets?
mitochondria, glycogen, peroxisomes, and three types of granules
95
What's the function of platelets?
blood clotting and tissue repair
96
What are the three types of granules found in platelets?
1) lambda
2) alpha
3) delta
97
Which type of granules are found in platelets contain lysosomes?
lambda
98
Which type of granules are found in platelets contain pro-coagulation factor and platelet-derived growth factor for tissue repair?
alpha
99
Which type of granules are found in platelets contain calcium, ATP, ADP, serotonin, histamine, and other mediators?
delta
100
The following conditions can lead to which alteration of formed elements?
* *1) decreased oxygenation (body is not meeting the demand), lung disease, heart disease
* *2) renal cell caricinoma
3) hepatocellular carcinoma
4) decreased plasma volume
elevated levels of erythrocytes
101
The following conditions can lead to which alteration of formed elements?
1) aplastic anemia
* *2) hemolytic anemia
* *3) pernicious anemia
* *4) disruption of myeloid tissue, such as cancer or radiation
decreased levels of erythrocytes
102
The following conditions can lead to which alteration of formed elements?
* *1) acute bacterial infection
* *2) inflammatory processes
3) physical stress
4) tissue necrosis
5) granulocyte leukemia
elevated levels of neutrophils
103
The following conditions can lead to which alteration of formed elements?
1) Typhoid fever
2) Brucelosis
* *3) many viral infections
* *4) massive infection
5) drugs
decreased levels of neutrophils
104
The following conditions can lead to which alteration of formed elements?
* *1) allergic reactions
* *2) inflammatory bowel disease
* *3) parasitic infestation
elevated eosinophils
105
The following conditions can lead to which alteration of formed elements?
corticosteroid use
decreased eosinophils
106
The following conditions can lead to which alteration of formed elements?
1) Hodgkin's lymphoma
2) inflammatory bowel disease
3) hypothyroidism
elevated basophils
107
The following conditions can lead to which alteration of formed elements?
1) corticosteroid use
* *2) acute allergic reaction
3) hyperthryoidism
decreased basophils
108
The following conditions can lead to which alteration of formed elements?
* *1) viral infections
2) tuberculosis
* *3) lymphocytic leukemia (common cause of significant elevation)
increased lymphocytes
109
The following conditions can lead to which alteration of formed elements?
1) HIV
2) corticosteroids and other immunosuppresive drugs
decreased lymphocytes
110
The following conditions can lead to which alteration of formed elements?
* *1) inflammation
2) tuberculosis
3) malaria
4) Rocky Mountain spotted fever
5) monocytic leukemia
6) chronic ulcerative colitis
7) regional enteritis
increased monocytes
111
What clinical significance do decreased levels of monocytes have?
rare
112
The following conditions can lead to which alteration of formed elements?
* *1) splenectomy
2) cancer
3) stress
4) exercise
5) iron deficiency
6) chronic inflammation
increased platelets
113
The following conditions can lead to which alteration of formed elements?
* *1) splenic sequestration (hypersplenism)
2) aplastic anemia
3) leukemia
4) metastasis to bone marrow
5) viral infections
6) antineoplastic agents and chemotherapy
decreased platelets
