Blood Lecture 1 / Ch 4 Red Blood Cells

Question 1

Symptoms of Polycythemia Vera?

Answer 1

• Night Sweats
• Itching after hot bath
• Splenomegaly
• Plethora (Facial Redness)
• Hemorrhage or thrombosis
• Blurred Vision
• HTN

Question 2

Prognosis for pts with PV is ?

Answer 2

10 - 16 yrs

Question 3

Anemia

Answer 3

Hgb in males < 13

Hgb in females < 11

Question 4

Symptoms of Anemia ?

Answer 4

• Dyspnea
• Weakness
• Pale
• Palpitations
• Headaches
• Sluggishness

Older Population:

• Cardiac Failure
• Angina pectoris
• Confusion
• Claudication (Impaired blood
  flow) in the legs

Question 5

Treatment for Anemia ?

Answer 5

• Increase RBC in circulation
• Administration of recombiant
  Erythropoietin

Question 6

Site in which O2 binds to Hgb?

Answer 6

Heme molecule

Question 7

The exchange of O2 and CO2 occurs approximately how many times in the average life span of a RBC?

Answer 7

200,000

Question 8

Affinity definition

Answer 8

tendency to bind, hold, pick up or to release O2

Question 9

↑ CO2
↓ Ph ( Increased H+ content)

This occurs in metabolically active tissues, what can we expect of Hgb affinity?

Answer 9

Hgb would have less affinity for O2

Question 10

↓ CO2
↑ Ph (Decrease H+ content)

This occurs in the lungs, what can we expect of Hgb affinity?

Answer 10

Hgb would have an increase in affinity for O2

Question 11

Bohr effect definition

Answer 11

The influence of pH and CO2 on Hgb’s affinity to bind and to release O2

Question 12

Hgb concentrations for:

• Females
• Males
• Newborns

Answer 12

• Females : 12-16
• Males 13.5-18
• Newborns 15-24

Question 13

4 phases of fetal hemoglobin development.

Answer 13

1. Gower I
2. Gower II
3. Portland
4. Hgb F

Question 14

How do adult and fetal Hgb differ?

Answer 14

Hgb F is designed to extract O2 from maternal cells at the placenta. They have a greater affinity for O2 than Hgb A.

Question 15

Hgb Alpha polupeptide chains contain how many amino acids?

Answer 15

141

Question 16

Hgb Bravo polupeptide chains contain how many amino acids?

Answer 16

146

Question 17

HgbS = Sickle-cell anemia

Answer 17

– Predominantly among
African American
– Causes hemolysis

Question 18

HgbF Present from ?

Answer 18

G4 to 6mo old

Question 19

Heterozygous individuals for HgbS

Answer 19

Asymptomatic

Question 20

Homozygous individuals for HgbS

Answer 20

They have 2 defective genes that code for the Hgb molecule.

Question 21

HgbS results from what?

Answer 21

Substitution of the amino acid VALINE by GLUTAMIC ACID in position 6 in the beta chain.

Question 22

What causes the sickle shape of the cell?

Answer 22

HbS transports O2 normally but deoxyhemoglobin S crystallizes and takes on the classic sickle shape.

Question 23

Complications caused by HgbS?

Answer 23

• Discomfort
• Joint Pain
• Retinal degeneration
• Ulcerations of lower legs
• Infarctions of organs: Spleen and Liver.
• Priapism

Question 24

Thalassemias

Individuals whose Hgb molecues show production of only 1 type of polypeptide chain.

Answer 24

• Genetic disorders in the production of α or β Hgb polypeptide chains
• Prevalent in persons with
  Mediterranean or Asian
  ancestry.
• Low Hgb
• Fatigue

Question 25

Individuals that produce only Alpha chains is said to have what?

Answer 25

Beta Thalassemias | minor

Question 26

Individuals that produce only Beta chains is said to have what?

Answer 26

Alpha Thalassemias (major) - Blood transfusions required

Question 27

2,3 DPG AKA 2,3 (diphosphoglycerate)

Answer 27

``` - Produced by the breakdown of glucose. - Allows Hgb to release O2 to the tissues more easily. - Reversible storage Lesion - Bound 1:1 to Hgb ```

Question 28

Hct index of the RBC in adults.

Answer 28

Males: 38 - 54% Females: 38 - 46% Infants: 55-68% - This means that 38 - 54% of whole blood in a male is made up of red cells.

Question 29

A transfusion of 1 unit of packed red cells would change the Hct by how much?

Answer 29

0.03 - 0.04 | 3 - 4%

Question 30

When a Red cell ruptures, Hgb is released as what?

Answer 30

Plasma-Free-Hemoglobin | PFH

Question 31

Generally PFH is metabolized in the liver into primarily what?

Answer 31

Bilirubin by the Kupfer Cells (macrophages)

Question 32

In blood plasma, haptoglobin binds free hemoglobin (Hb) released from erythrocytes with high affinity and thereby inhibits its oxidative activity.Plasma Haptoglobin can bind the first 100 mg PFH / 100 ml of blood (safe solution) • Once Haptoglobin is over whelmed, PFH diffuses into tissues and renal tubules If 300-500 ml blood is hemolyzed, what can we expect?

Answer 32

- Jaundice - Renal failure - CV collapse - Decreased ABP - Renal tubules blockage by precipitation of Hgb.

Question 33

Adult Female Hgb / Hct

Answer 33

12 - 16 - 38 - 46

Question 34

Adult Male Hgb / Hct

Answer 34

13.5 - 18 - 38 - 54

Question 35

Infant Hgb / Hct

Answer 35

15 - 24 - 55 - 68