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Physiology > Blood > Flashcards

Blood Flashcards

1
Q

Why is it important that blood has a high heat capacitance?

A

Thermoregulation

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2
Q

How many liters of blood are in men (on average)? Women?

A

5 liters for women

5.5 liters for men

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3
Q

What are the three separate layers of a blood sample that are seen when spun out? What percent of the blood are each?

A

Blood layer -42%
Buffy white coat -min
Plasma -58%

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4
Q

The blood is what percent of the body weight?

A

7-8%

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5
Q

What are the three major categories of the components of plasma?

A

Water
Proteins
Other solutes

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6
Q

What the four categoeries of proteins in plasma? Which is found in highest concerntration?

A

Albumin**
Globuin
Fibrininogen
Regulatory protein

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7
Q

What are the three types of cells in the blood in order of their abundance?

A
  1. RBCs
  2. Platelets
  3. WBCs (basophil lowest)
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8
Q

What is serum? How does this compare to plasma?

A

Plasma without fibrinogens and other coagulation factors

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9
Q

What is a mEq?

A

mM of ion multiplied by its charge

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10
Q

What is the anion gap calculation?

A

[Na] - ([Cl[ +[HCO3])

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11
Q

What are the primary cations in the plasma? Interstitial fluids? Intracellular fluid?

A

Plasma = Na
Interstitial fluid = Na
Intracellular fluid = K

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12
Q

What are the primary anions in the plasma? Interstitial fluids? Intracellular fluid?

A

Plasma = Cl and HCO3
Interstitial fluid = Cl and HCO3
Intracellular fluid = HPO4/proteins

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13
Q

What is the normal range of the anion gap?

A

8-16 mEg/L

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14
Q

What does the anion gap measure?

A

The anions that are not measured

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15
Q

What is the reason for looking at the anion gap?

A

Looks for metabolic acidosis

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16
Q

What can cause an increased anion gap?

A

Acidosis (DKA, lactic/salicylic acidosis)

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17
Q

What causes an increased anion gap?

A

[HCO3] goes down d/t increase in acids

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18
Q

Can you have a normal anion gap with acidosis?

A

Yes, if Cl balances out the loss of HCO3 (or vice versa)

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19
Q

How does hypoalbuminemia affect the anion gap?

A

Decreases anion gap d/t retention of CL and HCO3

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20
Q

What is osmolality?

A

osmoles of solute / Kg of solvent

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21
Q

What is an osmole?

A

Moles of solute times the number of ions or particles upon its dissociation in solution

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22
Q

What are the five major determinants of osmolality?

A

Na, Cl, HCO3, BUN, and glucose

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23
Q

The molality of plasma is higher or lower than interstitial fluid? Why?

A

Slightly higher because the plasma contains proteins (albumin) that cannot cross the capillary membrane

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24
Q

What is the osmotic pressure?

A

Pressure produced by the plasma proteins

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25
Q

What is albumin?

A

Transporter for FFAs, Ca, Cu, steroids, bili etc

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26
Q

Loss of albumin leads to what?

A

Edema

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27
Q

What is the primary cause of colloid osmotic pressure? What percent does this contribute?

A

Albumin–70-80% of colloid osmotic pressure

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28
Q

What percent of plasma protein is made up of albumin?

A

58%

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29
Q

What can cause hypoalbuminemia?

A

Malnutrition
Liver disease
Malabsorption

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30
Q

What can cause hypoalbuminemia?

A

Overhydration
Sepsis
hypoxia
Nephrotic syndrome

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31
Q

What is the function of gamma-globulins?

A

Immunoglobulins

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32
Q

What is the purpose of transferrin?

A

Binds free Fe (since free Fe is toxic)

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33
Q

Is free Fe toxic?

A

Yes

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34
Q

What is the function of haptoglobin?

A

Binds free Hb that can enter the plasma after the lysis of RBCs to transport it to the liver

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35
Q

Can Hb be excreted in the urine? Can Hb + haptoglobin?

A

Yes for Hb, it is small enough

No for Hb + haptoglobin

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36
Q

What happens to the HB/HP complex?

A

Macrophages in liver and spleen endocytose it to conserve Fe

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37
Q

What is the half-life of free haptoglobin?

A

5 days

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38
Q

What is half-life of haptoglobin when bound to HB?

A

90 minutes

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39
Q

What would happen to plasma Hb and haptoglobin levels during an episodes of increased intravascular hemolysis?

A

Decreased haptoglobin levels

Increased Hb levels

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40
Q

What happens to platelets when it binds collagen/ligands in the vessels?

A

Increases surface area through projections

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41
Q

What is the purpose of a blood smear?

A

Estimate the relative abundance of different cells (RBCs, WBCs, platelets etc), size,or color of RBCs

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42
Q

What is the stain used to a blood smear?

A

Giemsa stain

43
Q

What is the term describing the normal color of Hb? Less colored?

A

Normochromic

Hypochromic

44
Q

What is hematopoiesis?

A

The process by which RBCs are formed

45
Q

What is the life span of RBCs?

46
Q

What is the source of hematopoiesis? (where is it)

A

Stem cell in bone marrow

47
Q

Are the progenitor cells from the hematopoietic stem cells differentiated?

A

Not really, and one stays a stem cell

48
Q

What are the two lineages of the hematopoietic stem cell?

A

Lymphoid lineage

Myeloid lineage

49
Q

How is the hematopoietic system regulated?

A

Whole bunch of growth factors working in a combinational fashion

50
Q

Why is it important that the RBCs have a biconcave shape?

A

Increase surface area/volume ratio

Easily and reversibly deformable

51
Q

Why is it important that RBCs are easily and reversibly deformable? What happens if they are not (like when they are older)?

A

Needs to pass through tiny passages in the spleen

If old, cannot, and thus endocytosed

52
Q

What is the function of carbonic anhydrase in RBCs?

A

Enzyme facilitates that conversion of CO2 into HCO3

53
Q

In what form do RBCs carry CO2?

54
Q

What is the primary HB type in adults?

55
Q

What are the four chains that comprise Hb?

A

two alpha

two beta

56
Q

What is the amino acid in the Hb that accepts H+ in the blood?

57
Q

What is erythropoietin?

A

Growth factor that stimulates the production of RBCs

58
Q

In what stage of development do immature RBCs lose their nucleus?

A

Erythroblast stage

59
Q

What are the four stages of RBC development?

A

Erythroid progenitors
Erythroblasts
Reticulocytes
Erythrocytes

60
Q

How long do reticulocytes circulate for? An increase in this is indicative of what?

A

24-48 hours

Increase = increase in erythropoiesis

61
Q

Where is erythropoietin produced?

A

The kidneys

62
Q

What is the stimulus for erythropoetin synthesis?

A

O2 levels in the kidneys

63
Q

What are the 5 factors that decrease O2 delivery to the kidney?

A
  1. Low blood volume
  2. Low Erythrocyte numbers
  3. Low functional HB
  4. poor blood flow
  5. Pulmonary disease
64
Q

Why can chronic renal failure cause anemia?

A

Lack of erythropoietin

65
Q

What are the two fates of old RBCs?

A

Lyse in circulation

Phagocytosed by macrophages in the liver and spleen

66
Q

What happens to the protoporphyrin ring of the broken RBCs?

A

Converted to Bilirubin by liver

67
Q

What happens to the Fe in Hb?

68
Q

What is hematocrit?

A

% of total volume of RBCs per total blood volume

69
Q

What causes high hematocrit levels?

Low?

A

High = Polycythemia or dehydration

Low = Anemia, overhydration, or malnutrition

70
Q

What is the mean corpuscular (cell) volume?

A

Hematocrit %/RBC count

71
Q

What is the normal ranges for MCV?

72
Q

What is the mean corpuscular Hb [c] (MCHC)?

A

Hb x100 / Hematocrit %

73
Q

What is the reference range for MHCH?

A

33-37 g/dL

74
Q

How can anemias be classified?

A

Cell size

Hb levels

75
Q

What are platelets?

A

Small nucleus-free fragment of megakaryocytes

76
Q

How long do platelets last? What organ destroys them?

A

10 days

liver

77
Q

What activates platelet? What happens with activation?

A

When glycoproteins on the surface bind collagen and other factors at sites of injury

Activation = shape changes and secretions of clotting factors

78
Q

Which WBC is found in the highest amount? Lowest?

A 
Highest = PMNs
Lowest = Basophils
79
Q

Why is are there more cations in the plasma, compared to the interstitial fluid?

A

[Albumin] higher

80
Q

What to plasma [K] if there is a significant amount of cell lysis? Why is this not problematic in the body? Where is it a problem?

A

Increases, but kidneys handle it

It IS a problem if there is blood cell lysis during the sampling process

81
Q

Within any one compartment in the body (e.g interstitial fluid, intracellular fluid etc) is there a slight charge, or do the cations balance the anions?

82
Q

What can diarrhea cause the anion gap to do? How?

A

Increase d/t loss of HCO3

83
Q

How can you have an acidosis without an anion gap?

A

If Cl goes up as much as HCO3 goes down

84
Q

What is the formula for calculating plasma osmolality?

A

2 [Na] + ([BUN] /2.8) + [glucose]/18)

85
Q

What is the range of osmolality of blood?

A

285-295 mOsm/kg H2O

86
Q

Why is there a 2 coefficient in from of [Na] in the equation for determining plasma osmolality?

A

Account for Cl that dissolves with it

87
Q

Why do you divide the [BUN] and glucose?

A

convert to milliosmoles per kg

88
Q

What does the lymphoid lineage of cells give rise to?

A

T cells
B cells
NK cells

(all the lymphocytes)

89
Q

What does the myeloid lineage of cells give rise to?

A

PMNs
eosinophils
monocytes
Erythrocytes

90
Q

What are “colony forming units”?

A

Groups of lymphoid or myeloid progenitor cells

91
Q

What are “blasts”?

A

Precursor cells of many types

92
Q

What is the disorder where there are too many RBCs made?

A

Polycythemia

93
Q

What is the half-life of reticulocytes? Why is this important?

A

24-48 hours.

Useful for seeing how much new RBC synthesis is occurring

94
Q

What do kidneys produce when they sense that O2 levels are low?

A

Erythropoietin

95
Q

What is HIF-alpha?

A

A transcription factor that is constantly synthesized

96
Q

What happens to HIF-alpha in the presence of oxygen? What does this cause?

A

An enzyme adds a hydroxyl group to a Pro residue, causing VHL to target it for degradation for the proteasome

97
Q

A decrease in oxygen levels leads to a (increase/decrease) in HIF-alpha? How?

A

Increase d/t decreased degradation by proteasomes

98
Q

What happens to platelets at the end of their life?

A

Destroyed by liver

99
Q

What is the process of platelet formation?

A

Thrombopoiesis

100
Q

What is the chemical that is secreted constitutively by the liver and bone marrow, and stimulate megakaryocyte-progenitor cells?

A

TPO (thrombopoietin)

101
Q

What are the progenitor cells that give rise to platelets?

A

Megakaryocyte-progenitor cells

102
Q

What is the feedback mechanism for thrombopoiesis?

A

Increases in platelet numbers causes a negative feedback by binding to and degrading TPO

103
Q

What happens to the megakaryocytes when they mature?

A

Spill out platelets

Physiology (75 decks)

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