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PHGY 209 > Blood IV > Flashcards

Blood IV Flashcards

1
Q

Erythropoietin, released from […] in the presence of […], stimulates the […] to produce […], thereby maintaining […]

A

The kidney, hypoxia, bone marrow, more RBCs, homeostasis

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2
Q

Erythropoietin acts on […] only, not the […]

A

Committed stem cells, pluripotent stem cell

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3
Q

Explain the two functions of erythropoietin.

A

It both stimulates the proliferation of comitted stem cells into more red blood cell precursors (reticulocytes) and accelerates the maturation into reticulocytes .

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4
Q

Explain the effect of testosterone on erythropoietin.

A

It increases the release of erythropoietin and increases the sensitivity of RBC precursors to erythropoietin. This is why males have more RBCs than females.

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5
Q

Explain the effect of estrogen on red blood cells.

A

It decreases the release of erythropoietin and decreases the sensitivity of red blood cell precursors to erythropoietin. This is why females have fewer RBCs than males.

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6
Q

What is the typical life span of RBCs?

A

120 days

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7
Q

How can the lifespan of RBCs be prolonged?

A

It can’t.

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8
Q

Explain how old RBCs get disposed of.

A

They are recognized and removed from the circulation by macrophages. Some old RBCs are then hemolyzed (broken up) in the blood stem, but most are phagocytosed in the spleen (and some in the liver). Once the RBC membrane is digested, the contents are released.

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9
Q

Phagocytosis of old RBCs takes place in the […]

A

Spleen (sometimes in liver)

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10
Q

After an RBC is phagocytosed, what three components is it broken up into?

A

Heme, globin, and iron.

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11
Q

After an RBC is phagocytosed, explain the fate of heme.

A

It is first oxidized into biliverdin, a green pigment, by the macrophage. It is then released into the circulation and is converted into a bilirubin, a yellow-brown pigment. The bilirubin enters the liver and is secreted with the bile it releases into the small intestine, where it is then transported through the gut and eventually excreted through urine (small quantities) and feces (most of it).

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12
Q

The substance […] gives feces and urine their characteristic colour.

A

Bilirubin.

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13
Q

Bilirubin is present in a concentration of […] in the plasma.

A

1 mg/dL

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14
Q

After a RBC is phagocytosed, explain the fate of the iron.

A

It is released from the macrophage and is picked up by a plasma protein called transferrin, which renders it nontoxic. Iron can either be taken directly to the bone marrow to be reused for RBC erythropoiesis or stored in the gut, liver, or kidney in association with a protein called ferritin. The iron is reused by the bone marrow at a later time.

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15
Q

After a RBC is phagocytosed, explain the fate of the globin.

A

it is broken up into its amino acid constituents, which then enter the amino acid pool in the body to be reused for protein synthesis.

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16
Q

What is jaundice?

A

It is a yellow appearance to the skin due to an excess of bilirubin in the plasma.

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17
Q

What is the effect of jaundice on the health of adults and newborns?

A

In adults, it is harmless. In newborns, it is dangerous because the bilirubin can penetrate into the brain and lead to severe neurological problems.

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18
Q

Jaundice is also referred to as […]

A

Icterus

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19
Q

Name the 3 possible causes of icterus.

A
  1. Excessive hemolysis: RBCs too fragile and break up too easily, releasing excess heme.
  2. Hepatic damage: diseased liver, causing an accumulation of bilirubin in the blood
  3. Bile duct obstruction: the bile is unable to be carried to the intestinal tract, resulting in gallstones.
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20
Q

If an individual has a hematocrit of 35%, name two possible causes.

A

Fluid retention (causing higher proportion plasma) or anemia (fewer RBCs than normal)

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21
Q

If an individual has a hematocrit of 70%, name two possible causes.

A

Polycythemia or dehydration.

22
Q

Explain how polycythemia compares to normal conditions in terms of hemoglobin content and concentration of RBCs in the blood.

A

Normal: 16 g% Hb, 5-5.5 M RBC/uL
Polycythemia: >18g% Hb, >6 M RBC/uL

23
Q

What are the two types of polycythemia?

A

Relative (due to decreased plasma volume) or absolute, which can be physiological or pathological.

24
Q

Name four possible causes of physiological polycythemia. Explain them.

A
  1. Being at high altitudes: less O2 available so increased production of RBCs to be saturated with oxygen.
  2. Increased physical activity: need more oxygen, so higher RBC production
  3. Chronic lung disease (emphysema): the alveoli of the lungs become damaged and reduce the amount of oxygen that can enter into the circulation. Leads to increased RBCs.
  4. Heavy smoking: creates high carbon monoxide (CO) in the blood, which interferes with the transport of oxygen. Leads to increased RBCs.
25
Q

Name two three possible causes of pathological polycythemia.

A
  1. Tumours of cells producing erythropoietin
  2. Unregulated production by bone marrow
  3. Polycythemia vera: when the body produces a very large amount of RBCs (amount 7-8 million/uL), most likely due to a genetic abberation causing stem cell dysfunction.
26
Q

What problem(s) does polycythemia create in the body?

A

It increases blood viscosity and creates sluggish blood flow, which causes excess blood clots.

27
Q

What is anemia?

A

It is a decrease in the oxygen-carrying capacity of blood.

28
Q

Describe the characteristics of anemia in terms of RBC count and Hb content in men.

A

RBC count: <4 million cells/uL
Hb content: <11 g%

29
Q

Describe the characteristics of anemia in terms of RBC count and Hb content in women.

A

RBC count: < 3.2 million cells/uL
Hb content: <9 g%

30
Q

What is the typical Hb concentration in males and females?

A

Male: 16 g%
Female: 14 g%

31
Q

Name the 5 possible morphological conditions of RBCs in anemia.

A

Microcytic: small RBCs (<80 u^3)
Normocytic: normal-sized RBCs (80-94 u^3)
Macrocytic: large RBCs (>94 u^3)
Normochromic: regular amount of hemoglobin per RBC (33%)
Hypochromic: less hemoglobin per RBC than usual (<33%)

32
Q

How can you differentiate normochromic and hypochromic RBCs visually?

A

Hypochromic RBCs will be lighter in colour because of decreased hemoglobin.

33
Q

What are the three major etiologies of anemia?

A
  1. Diminished production of RBCs
  2. Ineffective maturation of RBCs
  3. Increased destruction of RBCs
34
Q

What are three possible causes of diminished production of RBCs? Name the type of anemia associated with each.

A
  1. Abnormal site (something wrong with the bone marrow). Yields aplastic/hypoplastic anemia
  2. Stimulation failure
  3. Inadequate raw materials. Yields iron deficiency anemia.
35
Q

Explain the possible causes of aplastic/hypoplastic anemia.

A

a. Unknown (most common)
b. Exposure to radiation
c. Chemicals or drugs

36
Q

Describe the types of RBCs found in the case of aplastic/hypoplastic anemia.

A

They are normocytic and normochromic.

37
Q

Explain the possible cause of stimulation failure anemia.

A

It is due to insufficient erythropoietin, which is caused by kidney (renal) disease.

38
Q

Describe the types of RBCs produced in the cause of stimulation failure anemia.

A

The RBCs are normocytic and normochromic.

39
Q

Explain the possible causes of iron deficiency anemia.

A

It can be caused by increased iron requirements due to infancy/adolescence/pregnancy or due to inadequate iron supplies. This can be due to loss of Fe in hemorrhage, dietary deficiency, or failure to absorb Fe.

40
Q

Describe the types of RBCs produced in the case of iron deficiency anemia.

A

The RBCs are microcytic and hypochromic.

41
Q

Describe the breakdown of iron in the body.

A

There are typically 4g of Fe in the body. 60% of it is stored in hemoglobin, 30% is stored in the liver, spleen, and gut, 5% is in the form of myoglobin, and 1% is for enzymes.

42
Q

Explain why women are more susceptible to iron deficiency anemia.

A

Women lose twice the amount of iron as men do (2 mg vs 1 mg per day or 50 mg vs 25 mg/month) because of the blood lost through menstruation.

43
Q

What are the possible causes of maturation failure anemia?

A

Deficiencies of vitamin B12 (failure to absorb) and folic acid (dietary absence). These shortages could also be caused by some forms of intestinal disease.

44
Q

Maturation failure anemia caused by vitamin B12 deficiency is called […], and is caused by […]

A

Pernicious anemia. Caused by a deficiency in the intrinsic factor in the stomach, which forms a complex with vitamin B12 and allows for its absorption.

45
Q

Hemolytic anemias may be accompanied by […]. Explain why.

A

Jaundice, because if the red blood cell is more fragile when release, they are more likely to break up as they squeeze through narrow capillaries and release their contents.

46
Q

What are the two types of hemolytic anemias?

A

They can be congenital or acquired.

47
Q

Explain the possible causes of congenital hemolytic anemias.

A

It can be caused by an abnormal membrane structure that makes it more fragile, an abnormal enzyme system, or an abnormal Hb structure.

48
Q

Hereditary spherocytosis is what kind of anemia?

A

It is a congenital hemolytic anemia caused by an abnormal membrane structure.

49
Q

Sickle cell anemia is what kind of anemia?

A

It is a congenital hemolytic anemia caused by abnormal hemoglobin structure.

50
Q

Explain the possible causes of acquired hemolytic anemia.

A

Toxins, drugs, or antibodies.

51
Q

What are the 3 major clinical indices used to assess blood health?

A

Number of RBCs, amount of hemoglobin in RBCs, and hematocrit

52
Q

Maturation failure anemia leads to RBCs that are […]

A

Macrocytic and normochromic

PHGY 209 (33 decks)

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