Blood - Mace Flashcards
What is the life time in blood for B and T lymphocytes?
Some stay alive for months to decades
Type A blood can safely donate RBCs to ___ and can receive RBCs of type ___
A. O, AB
B. AB, O
C. A, B
D. B, A
E. O, O
B. AB, O
Type A blood can donate to AB b/c blood has both A and B antigens - so no antibodies in plasma against A
Can receive O b/c O doesn’t have any antigens
What is the life time in blood for a basophil?
unknown
What are the 3 major categories of plasma proteins?
- Albumins
- Globulins
- Fibrinogen
LMWH is what type of anticoagulant? What is its MOA?
- Injectable anticoagulant
- Inhibits Factor Xa by antithrombin and IIa
- Prevents conversion of prothrombin into thrombin
- Acts in the Common Pathway
- (Lovenox, Fragmin)
The intrinsic pathway is activated by the activation of what factor?
Factor XII
What is cooperative binding in Hgb?
- The Hgb molecule has 4 hemes, surrounded by 4 globulins.
- Changes conformation to expose heme to outside - binds O2, pulls the heme with the O2 inside, exposing another heme group (only 1 heme group is exposed at a time)
What cells produce the white blood cells?
Myeloblasts, monoblasts, and lymphoblasts
T/F anticoagulants dissolve clots
False - they inhibit clot formation
What factors are involved in the intrinsic pathway?
Factors XII, XI, IX, VIII
Regulation of pH and ions involves?
Ca2+, K+, Na+ (electrolytes)
pH remains at 7.4
The coagulation phase can start in 2 pathways and both enter the common pathway by activating what factor? How do these 2 pathways differ?
- Factor X
- Differ in speed of activation and what stimulates the pathway itself (intrinsic vs extrinsic)
What component of blood becomes dramatically larger when a patient is immunocompromised?
The Buffy Coat (oversupply of WBCs + platelets)
What is the life time for a monocyte?
3 days in circulation - Die 24 hrs after activation
What is heme?
A ring molecule with iron ion (Fe2+) attached in the center
Warfarin (Coumadin) is what type of anticoagulant? What is its MOA?
- Oral anticoagulant
- Inhibits hepatic production of Vit K-dependent clotting factors and cofactors
- Prevents activation of clotting factors (II, VII, IX, X)
- Works in all 3 pathways
What is involved in blood helping to defend against toxins and microorganisms?
- Leukocytes
- Complement system –> immune system
What happens when the sympathetic response is initiated?
- Inc BP
- Inc HR –> preserve blood function (perfusion)
Fibrinolysis is a small cascade that begins within 2 days of the formation of a clot. What is involved in the cascade?
- Kallikrein (activated via thrombin), leads to activation of
- Plasminogen (activated form) –> into plasma
- Protease that destroys fibrin polymer
- Stimulated by Tissue Plasminogen Activator (t-PA)
Summary of Extrinsic Pathway
- Damage outside
- Thromboplastin (Factor III) + Factor VII + Ca2+
- Activated Factor X
What inhibits erythropoiesis?
High O2 content
Dabigatran is what type of anticoagulant? What is its MOA?
- Oral anticoagulant
- Direct thrombin inhibitor (competitive/reversible)
What is the function of t-PA?
- Produced by endothelial cells
- Tissue Plasminogen activator - thrombolytic
- Transforms plasminogen to plasmin –> cuts up fibrin fibers –> increases speed of clot breakdown
- This is outside of the 3 pathways (It is about Fibrinoysis)
Heparin is what type of anticoagulant? What is its function?
- Injectable anticoagulant
- Increases rate of thrombin-antithrombin reaction (1000x’s)
- Inhibits coagulation factors Xa and IIa
- Prevents conversion of prothrombin into thrombin
- Acts in the Common Pathway
What stimulates erythropoiesis?
Hypoxemia (low O2 content in the BLOOD)
What is the function of neutrophils?
- Phagocytes (everything bad)
- Oxidative burst (kills bacteria)
- 1st at site of injury
Properties of leukocytes
- Short time in blood
- Migration, diapedesis, chemotaxis
How many platelets circulate and for how long?
350-500k circulate for about 10 days (then phagocytized)
Where is thrombopoietin produced?
kidneys
When is the sympathetic response initiated?
If there is a >10% blood loss - it induces systemic vasoconstriction
What are the functions of all 3 types of lymphocytes?
- B cells differentiate into plasma cells –> antibody producer
- T cells can be divided into T-killer (directly kill) and T-helper cells (bring the army)
- NK cells are non specific immune cells (kill via apoptosis)
What are the 3 types of Globulins?
- Alpha (smallest)
- Beta (involved in transport & complement system)
- Gamma (largest) antibodies (Ig)
Agglutinins are produced without prior exposure by what age?
8 months
Which lymphocyte goes into the blood, then the thymus to become naive immunocompetent?
T lymphocytes
What hormone is involved in erythropoeisis?
EPO (erythropoietin)
Type O can receive from what donors?
Only O
The conversion of fibrinogen to firbin is catalyzed by the enzyme?
Thrombin
Rivaroxaban is what type of anticoagulant? What is its MOA?
- Oral anticoagulant
- Binds directly to activated Factor X (Xa) inactivating it (once activated then inhibits)
- Blocks amplification of the Common Pathway
What temperature is blood at compared to the body?
- Blood temp is 1 degree C above body temp
- The body will shunt blood towards the core when cold and the opposite when warm
What factors are involved in the extrinsic pathway?
Factors III and VII
What is the function of eosinophils?
- Phagocytes of allergen related Ag-Ab complexes
- Release cytotoxic compounds (kill parasitic worms)
Please feel free to add whatever you want to this deck!
What occurs during the platelet plug formation?
Platelets arrive at site of injury and stick to exposed collagen fibers
What is the function of the constant region of an antibody?
The heavy chain - identified by the immune system - defines how a specific antibody will contribute to an immune response
What is the positive feedback loop in the common pathway?
Prothrombin activator converts Prothrombin (Factor II) into Thrombin –> Thrombin then binds with Factor V again –> More prothrombin activator is made
What surface antigen does blood Type O have? What antibodies is it against?
- Neither surface antigen A or B
- Both anti-A and anti-B antibodies
What is anemia?
Low O2 carrying capability in blood itself
How does an agglutination test work?
Unknown blood type + Anti-body Antiserum (contains isolated antibodies) = Agglutination reaction
Ex: Blood to be tested has surface antigen A + AntiA antiserum (contains anti A antibodies) = Agglutination will occur
Why can erythrocytes (RBCs) transport oxygen?
A. Because cells of the body need oxygen for metabolism
B. Because RBCs contain hemoglobin which have heme units that bind to oxygen
C. Because the heart creates a pressure gradient that forces blood and RBCs through the cardiovascular system
D. B & C
E. All of the above
B. Because RBCs contain hemoglobin which have heme units that bind to oxygen
(Think about the RBC itself vs the entire body)
What is an antibody?
A protein that binds antigens (ANTI-body, GEN-erator)
_____ is not found in the plasma
A. Glycogen
B. Fibrinogen
C. Glucose
D. Urea
E. Albumin
A. Glycogen
Adaptive immunity has memory and involves what cells?
B cells (humoral) and T cells (cellular)
What is the pathway for hypoxemia?
- Sensed by liver and kidneys (inadequate O2 transport)
- Secretion of erythropoietin
- Stimulation of red bone marrow
- Accelerated erythropoeisis
- Increased RBC count
- Increased O2 transport
Myeloid stem cells produce what blast cells?
Erythroblasts, Megakaryoblasts, Myeloblasts, Monoblasts
What do platelets look like under the microscope?
Like trash, grains of sand, artifact
What are nitrogenous compounds (waste)?
- Urea
- Uric acid
- Cr (high N containing compounds) - related to protein metabolism
What are the 3 Phases of Hemostasis?
- Vascular spasm
- Platelet plug formation
- Coagulation phase
Granulocyte distribution
Neutrophils 50-70%
Eosinophils 1-4%
Basophils 0.5-1%
What occurs during the coagulation phase?
Cascade that converts inactive proteins to active forms & forms a blood clot
The enzyme that can digest fibrin and dissolve a clot is?
Plasmin
Describe hypoxemia
Low O2 in the blood - all of the blood is low in O2
Ex: Sickle cell anemia, or not enough O2 in the environment
What occurs during vascular spasm?
Blood vessel constricts to limit blood escape
What are the agranular leukocytes?
Monocytes, B lymphocytes, T lymphocytes
What are the parts of the erythrocyte structure?
- Biconcave disc
- Lack of organelles
- Spectrin (cytoskeleton protein)
Lymphatic stem cell production pathway
Lymphatic stem cell –> Lymphoblasts –> B lymphocytes and T lymphocytes (Agranular leukocytes)
What surface antigen does blood Type A have? What antibodies is it against?
- Surface antigen A
- Anti-B antibodies
What surface antigen does blood Type B have? What antibodies is it against?
- Surface antigen B
- Anti-A antibodies
What are the compounds of plasma?
- Plasma proteins (albumins, globulins, fibrinogen)
- Nitrogenous compounds (waste)
- Nutrients and gases
- Electrolytes (ions)
Hematocrit = ?
Hematocrit = RBC / Total Volume (% or volume fraction)
Summary of the Intrinsic Pathway
- Damage inside –> Platelets
- Factor XII activates
- Factor XI which then activates
- Factor IX + Ca2+, platelet factor 3 (PF3) which activates
- Factor VIII
- Factor X activated
What are the 5 main functions of the blood?
- Transport of gases, nutrients, etc.
- Regulation of pH ions
- Stabilizes body temp
- Prevent fluid loss at sites of injury
- Defend against toxins and microorganisms
What is the structure and function of leukocytes?
Nucleus: initially spherical, changes in some during development (multi-lobar)
Granules –> “Vesicles” contain important components that allow for function
What cells are considered APCs (antigen presenting cells)?
Monocytes
What is involved in blood helping to prevent fluid loss at sites of injury?
Involves fluid balance:
Plasma proteins/formed elements (osmotic pressure) as well as hemostasis
If the plasma layer is less than 55% what could this be a sign of?
Dehydration
Monoblasts produce?
Monocytes (Agranular Leukocyte)
In the red bone marrow, stems cells divide to produce what 2 specific stem cells?
- Myeloid stem cells
- Lymphatic stem cells (Lymphoid)
The extrinsic pathway is initiated by what factor?
Factor III
Innate immunity involves what cells?
NK cells
Most plasma proteins are formed by what organ?
liver (except gamma - produced by plasma cells)
Which lymphocyte stays in the bone marrow to mature into their active form?
B lymphocytes
Prior to fibrinolysis of a clot what occurs?
Clot retraction (think “string purse”: platelets with pseudopods pull together)
Where are multipotent stem cells produced?
In red bone marrow
What is the function of basophils?
- Involved in the inflammatory response & releases:
- Histamine - vasodilator, inc capillary permeability
- Heparin - anticoagulant
What are the types of Hemoglobin?
- Oxyhemoglobin (O2 bound to Fe)
- Deoxyhemoglobin (No O2 bound to Fe)
- Carbaminohemoglobin (CO2 attached to globin part)
What are the white blood cells?
- Granular leukocytes (basophils, eosinophils, neutrophils) and
- Agranular leukocytes (monocytes, B, and T)
What is the life time in blood for a neutrophil?
10-12 hrs
Type AB blood can receive from what donors?
A,B, & O (universal recipient)
What happens when an erythrocyte has roughening on its surface?
When the erythrocyte arrives in the spleen - leukocytes in the spleen recognize the “roughness” and break them down
Platelets do NOT secrete
A. Procoagulants
B. Thrombopoeitin
C. Growth factors
D. Vasoconstriction
E. Chemicals that sttract neutrophils
D. Vasoconstriction (cannot secrete this)
What do myeloblasts produce?
Granular leukocytes = Basophils, Eosinophils, and Neutrophils
What is an agglutination test?
A test based on the presence of agglutinating antibodies in a blood sample that can react with specific antigens and form visible clumps
Where are erythrocytes produced and where do they go to be destroyed?
Production = red bone marrow
Destroyed = spleen
Platelet Structure
- Cell fragments
- Contain granules
- Early: serotonin, thromboxane, ADP
- Later: Procoagulants, Platelet derived growth factor (PDGF)
What does it mean to have Rh positive blood?
Born with RBCs that contain surface antigen D and in the plasma no anti-D antibodies are produced (will never make Abs against D Ag)
What are albumins?
- Most abundant and smallest plasma proteins
- Responsible for reacting osmolarity in the blood
What are the benefits of the biconcave structure of the erythrocyte?
- Allows more RBCs to be in a small capillary at one time
- More gas exchange per unit volume
- Narrowing in the middle - allows RBCs to fold over on themselves and go to wherever they need to
- Allow for certain amount of stacking = Rouleau
Describe hypoxia
Low O2 in the tissue - the rest of the blood has O2
Ex: tourniquet or blood clot
What surface antigen does blood Type AB have? What antibodies is it against?
- Surface antigens A and B
- Neither anti-A or anti-B antibodies
What is the function of the variable region on an antibody?
Gives the antibody its specificity for binding antigen (includes the ends of the light and heavy chains)
What does it mean to have Rh negative blood?
Born with and never produce surface antigen D on the surface of RBCs and do not have any anti-D antibodies, even after 8 months (unless exposed to Rh positive blood)
What is the process of the destruction of RBCs?
- Worn out RBC sensed by WBC on surface of the spleen and phagocytosis occurs
- Hgb broken down into Globin and Heme
- Globin hydrolyzed to free amino acids
- Heme broken into Iron and Biliverdin
- Iron –> stored in liver, reused to make more RBCs, or lost by sweat, feces, urine
- Biliverdin –> Bilirubin used in production of Bile –> digestive tract –> lost through urine –> Urobilinogen –> urine (urobilin) or feces (stercobilin)
What gives blood its red color?
Hemoglobin (red - transports blood gases)
What is the liquid portion of blood (~92% water)
plasma
What is the life time in blood for an eosinophil?
10 hrs
What is the life time in blood for NK cells?
Short (10 days)
Most platelet inhibitors block what on platelets?
Receptors on platelets (Plavix)
What are examples of gases and nutrients the blood transports?
O2, CO2, glucose, urea, waste, aa
What is the function of macrophages?
- Phagocytes (clean up team)
- Late arrivals
Where are monocytes housed?
Housed long term in other organs, spleen, and lymph nodes
If all the 280 million molecules of hemoglobin inside RBCs were free in the plasma,
A. It would cause a considerable inc in blood oxygen carrying capacity
B. If would facilitate delivery of oxygen into tissues irrigated by small capillaries
C. It would facilitate the oxygen diffusion into cells distant from blood capillaries
D. It would significantly increase blood osmolarity
D. It would significantly increase blood osmolarity
Explanations:
A. This would not change Hgb concentration B. Possible except RBCs are able to get into capillaries so there would be no change C. Doesn’t matter if Hgb is inside the blood cell or the plasma - it will still be releasing O2 at the same energy rate to get to distant cells
Where are lymphocytes housed?
- B and T cells - majority in lymph system
- NK cells - in blood
What is the composition of plasma?
- 95% water (universal solvent)
- Determines viscosity/osmolarity of blood
- Serum is plasma without fibrinogen
Type B blood type can receive from what donors?
Type B and O
Type A blood can receive from what donors?
A and O
What is the blood comprised of?
- Plasma (55% of whole blood)
- Buffy coat (WBC + platelets)
- Erythrocytes (45% of whole blood)
- Note: Buffy coat (WBC + platelets) + Erythrocytes = Formed Elements
Inadequate O2 transport or low O2 in the blood itself is sensed by what organs?
Liver and kidneys
What is fibrinogen?
Soluble fiber used to create clots
What is the function of the antigen binding site on an antibody?
Bind and identifies a specific antigen (there are 2 of these sites)
When agglutination occurs in a test what 2 things happen?
- The antiserum binding to the surface antigen will clump the blood together
- This stops RBCs from transporting O2 - so you see a purple color
What is the MOA of Plavix?
- Platelet inhibitor - blocks receptors on platelets
- Acts by inhibiting platelet plug formation
