Blood Physiology Flashcards

Question

What is the most abundant cation in ICF

Answer 1

Resting membrane potential, action potential, maintenance of ICF volume, regulation of pH (by exchanging for H+)

Answer 2

Proteins and phosphates (HPO4 2-)

Answer 3

Bicarbonate

Answer 4

Conc. Increases as blood passes through the capillaries, generating CO2 Chloride shift helps maintain balance of anions between ICF and ECF

Answer 5

45% ICF, 1% ECF

Answer 6

Cofactor for several enzymes and sodium potassium pump. Essential for synaptic transmission normal neurocardial function and myocardial function.

Answer 7

A clear colourless fluid made of 96% water and 4% solids.

Answer 8

a. proteins: 2-6% of solids, they are: albumin,globulin,fibrinogen, prothrombin,clotting factors,antibodies and enzymes b. Lipids: 5-15% of solids, they are Chylomicrons and Lipoproteins c. Carbs: glucose d. NPN: Urea and creatinine e. Electrolyte: sodium,calcium,potassium,chloride,bicarbonate

Answer 9

1.Return of proteins from tissues to blood 2.Redistribution of fluid from the blood 3.Removal of bacteria,toxins and other foreign bodies 4.Maintenance of structural integrity of tissue 5.Transport of lymphocytes 6.Routes for intestinal fat absorption

Answer 10

83 to 87% water and 13 to 17% solids

Answer 11

CARBS: Lactose LIPIDS: Triacylglycerols, palmitic acid, myrstic acid, stearic acid, butyric acid, oleic acid. PROTEINS: Caesin(80%), Enzymes(proteases,xanthine oxidase, lysozyme) Immunoglobulins MINERAL: calcium, magnesium, phosphorus, sodium, chloride VITAMINS: fat and water soluble vitamins except vitamin C

Answer 12

It makes galactose a structural unit for a growing Infant. Lactic acid in the intestine kills germs It is a source of proteins, minerals and vitamins

Answer 13

It is produced by membranes and the foetus. It's volume increases with gestational age. It is clear with some desquamated fetal cell and a small amount of lipids.

Answer 14

Protects fetus Medium of exchange of materials btwn mother and child

Answer 15

It fills the anterior chamber of the eye and is secreted by the ciliary body.

Answer 16

It causes glaucoma due to increased intraocular pressure

Answer 17

800- 1200mL

Answer 18

The sweat glands

Answer 19

By ANS (adrenal cortical steroid)

Answer 20

sweat can be 10-14L, which may cause Electrolyte imbalance.

Answer 21

Sodium= 12.6-127meq/L Potassium= 5-32 meq/L Chloride= 8.5-85 meq/L

Answer 22

They are isotonic fluids secreted by the lacrimal gland

Answer 23

They are isotonic normally and when they pass over the eye in large amounts. They are hypertonic when they pass over the eye in small amounts.

Answer 24

0.6 to 0.18g/dL, with and albumin/globulin ratio of 1:5 or 2:1. And a small amount of mucin

Answer 25

Breaking down the polysaccharides in their outer layer

Answer 26

Protect the eye from infection Lubticates the surface of the cornea Fill the irregularities of the cornea Protects the eye from injury

Answer 27

73-80% I.e low fat, body mass

Answer 28

2500mL/day

Answer 29

Urine(60%), insensible water loss from skin and lungs, perspiration and feaces

Answer 30

Osmolality is a measure of the concentration of dissolved particles such as salt or sugar in a solution. it is defined as the number of osmoles of solute per kilogram of solvent. An osmole is the number of particles that contribute to the osmotic pressure of a solution.

Answer 31

Simulates thirst ADH release

Answer 32

Thirst inhibition ADH inhibition

Answer 33

The force that causes water to move from areas of low solute concentration to areas of high solute concentration across a semi permeable membrane.

Answer 34

Low blood pressure Factors like diarrhoea, fever, burns, hemorrhage, that reduce blood volume

Answer 35

Dehydration, hypertonic hydration edema

Answer 36

Hypertonic saline

Answer 37

It must not cross the capillaries

Answer 38

Evans blue dye, Radioactive iodine, radioiodinate fibrinogen, radioiodinated albumin

Answer 39

it can cross capillaries but not cell membrane

Answer 40

It should distribute evenly between ECF and ICF

Answer 41

Isotonic solutions of sucrose, NaCl, Inulin, Mannitol.

Answer 42

Heavy water, titrated water, antipyrine and aminopyrine

Answer 43

Indirect method: indicators I.e dye dilution technique(the law of mass conservation)

Answer 44

A well mixed substance should only be present itself at the compartment of interest

Answer 45

Concentration= to amount injected /volume of distribution Amount of matter remained in a compartment is = amount of marker added - amount of marker lost from the compartment. Therefore, compartment volume = amount of marker added - amount of marker lost from the compartment / concentration of marker

Answer 46

It must be mixed evenly throughout the compartment It must have no physiological change It must be easy to measure It must be unchanged, or the amount changed should be known

Answer 47

ICF= Total body water- ECF volume

Answer 48

ISF = ECFV - PV

Answer 49

Proteins in plasma(colloids) cause pressure (osmotic pressure) that forces fluid from Interstitial spaces to blood.

Answer 50

A non crystalline chemical that is insoluble in water, and unable to pass through a semipermeable membrane, but it's diffusible

Answer 51

Osmolality Osmolarity Tonicity

Answer 52

It's the term for osmotic concentration, it is the number of osmoles per litre of a solution. The unit is osmoles/L. Even though osmotic pressure is dependent on osmolality, osmolarity in practice is used to calculate osmotic pressure.

Answer 53

A. the measurement of weight in water is a difficult process. B. The difference between osmolality and osmolarity is negligible and thus could be used interchangeably

Answer 54

A. OSMOLALITY is the concentration of a solution expressed as the total number of solute particles per kilogram. While... OSMOLARITY is the concentration of a solution expressed as osmoles of solute particles per litre of solution. B. OSMOLALITY is calculated considering mass of solution While... OSMOLARITY is calculated considering volume of solutio C. OSMOLALITY unit is osmol/L While... OSMOLARITY unit is mol/L D. OSMOLALITY does not depend on temp and pressure OSMOLARITY depend on temp and pressure

Answer 55

Water flows from ICF to ECF

Answer 56

Water flows from ECF to ICF

Answer 57

Tonicity is a measure of effective osmolality.

Answer 58

The movement of water across fluid compartments is not influenced by small molecules like Urea and alcohol, those pass rapidly. On the contrary, molecules like glucose and sodium take time, due to their sizes and thus... Influence the flow of water. The osmolality that causes the movement of water between components is EFFECTIVE OSMOLALITY.

Answer 59

Plasma contains more proteins than ISF

Answer 60

Homeostasis, Transport mechanism, Metabolic reactions, Aqeous humor, The characteristics and texture of a tissue is controlled by ICF, Temperature regulation, They are essential for diffusion and filteration, They are an ionising medium for regulating pH and Osmolality, They line cavities and lubricate surfaces of joints, CSF is a mechanical buffer that acts as a shock absorber for the brain and spinal cord.

Answer 61

Blood is a connective tissue, red in colour. It is Scarlet red when oxygenated in the arteries and Violet red when deoxygenated. The main function of the blood is transport. Transport of nutrients, waste products, hormones, and other substances from the places they were released to where they are needed. The properties of blood are: colour, volume, reaction and pH, specific gravity, viscosity, % body weight. The composition of blood: the blood cells and the liquid component- plasma

Answer 62

COLOR: blood is red in colour, Arterial blood is scarlet red because it contains more oxygen and venous blood is purple red because of more carbondioxide.

Answer 63

VOLUME: in a newborn baby it is 450mL In male it is 5-6mL In female it is 4-5mL It is typically 8% body weight in a normal human being i.e of 70kg. therefore in a person of 70kg, blood consists 4.9kg

Answer 64

blood is slightly alkaline with a pH of 7.4

Answer 65

Specific gravity of total blood : 1.052 to 1.061 Specific gravity blood cells : 1.092 to 1.101 Specific gravity of plasma : 1.022 to 1.026

Answer 66

blood is 5X more viscous than water. this is due to the RBC and plasma proteins

Answer 67

280 – 296mosm/l.

Answer 68

Transportation of substances Regulation of temperature and blood level of substances Protection or defence of the body against infections

Answer 69

1. Blood carries O2 from the lungs to the tissues and CO2 from tissues to the lungs in the body. This is also known as respiration function of the blood. 2. Blood transports nutritive substances like glucose, amino acids, lipids and vitamins derived from digested food from the gastrointestinal tract, to different tissues in the body. 3. Blood transport hormones secreted by endocrine glands to the their target organs or tissue. 4. Blood also transport enzymes. 5.Blood carried waste to liver, skin and kidneys for detoxification or removal.

Answer 70

1. Blood regulate body temperature by absorbing and distributing heat, thereby maintaining the thermoregulating mechanism in the body. 2. Blood regulate water content of the body. The content of the blood is freely interchangeable with interstitial fluid, this brings about the stability in water balance in the body. 3. Blood regulate acid base balance in the body through the plasma proteins and haemoglobin which acts as buffer, 4. Water and important substances like proteins, glucose, Na+, K+ are stored in the blood.

Answer 71

1.The blood play a role in inflammation, 2.The WBC destroy microorganisms and cancer cells, preventing infections, 3.Antibodies and compliments neutralize or destroy pathogens. 4.Platelets and clotting factors initiate clotting and minimize blood loss.

Answer 72

Plasma is a straw-colored clear liquid part of blood. It contains 91% to 92% of water and 8% to 9% of solids. The solids are the organic and the inorganic substances

Answer 73

glucose, amino acids, lipid, cholesterol, vitamins, enzymes hormones, plasma proteins.

Answer 74

trace elements, O2, CO2, Na+, K+, Cl–

Answer 75

Liver, spleen, bone marrow and B-lymphocytes.

Answer 76

albumin-60% Globulin- 36% Fibrinogen- 4%

Answer 77

check drawing 11 in booklet.

Answer 78

1.022-1.026

Answer 79

Albumin : 69,000 Globulin : 156,000 Fibrinogen : 400,000

Answer 80

Total proteins : 7.3 g/dL (6.4 to 8.3 g/dL) Serum albumin : 4.7 g/dL Serum globulin : 2.3 g/dL Fibrinogen : 0.3 g/dL

Answer 81

Albumin: Helps to maintain osmotic pressure Globulin: Transport of lipids and fat soluble substances Fibrinogen: participates in blood clotting

Answer 82

The ratio between plasma level of albumin and globulin is called albumin/globulin (A/G) ratio. It is important indicator of some diseases involving liver or kidney. The normal value is 2:1

Answer 83

1. transportation 2.Osmoregulation 3. The role in defense mechanism of the body 4. Role in coagulation: 5. Regulation of acid base balance 6. Viscosity of the blood 7.Suspension stability of the red blood cells

Answer 84

TRANSPORTATION: Plasma proteins are essential for the transport of various substances in the blood: -Transferrin transports iron -Ceruloplasmin transport copper -Albumin transports fatty acids, bilirubin, calcium many drugs etc. -Transcortin transports cortisol and corticosterome -Lipoproteins transports lipids -Haemoglobin transports free haemoglobin -Alpha and beta globulins transport substances such as iron, copper, and lipids

Answer 85

plasma proteins are colloidal and non-diffusible and exert a colloidal osmotic pressure which helps to maintain a normal blood volume and water content in the interstitial fluid and tissues. Albumin content regulates colloidal osmotic or oncotic pressure/osmotic pressure. Osmotic pressure exerted by plasma proteins play an important role in the exchange of various substances between blood and the cells through capillary membrane. as seen from starlings hypothesis

Answer 86

The net filtration through capillary membrane is proportional to the hydrostatic pressure difference across the membrane minus the oncotic pressure difference

Answer 87

The plasma proteins particularly the gamma globulins plays a important role in the defense mechanisms of the body by acting as antibodies (Imminoglobulins). The reaction of the antibodies to antigens of various microorganisms prevents the body against infections. The Igs and compliments protects the body against foreign bodies and remove damaged tissues.

Answer 88

fibrinogen and other clotting factors found in plasma is essential for the coagulation of blood.

Answer 89

plasma proteins particularly the albumin are important in regulating the acid base balance in the blood because of their buffering action.

Answer 90

the plasma proteins provide viscosity to the blood which is important for maintaining the blood pressure.

Answer 91

the globulin and fibrinogen helps in suspension stability of the red blood cells during circulation. Globulin and fibrinogen also accelerate rouleaux formation by the red blood cells.

Answer 92

The RBC also known as erythrocytes are biconcave disc, anucleate, essentially has no organelles. Red color of the RBC is due to the presence of the coloring pigment called hemoglobin. RBCs play a vital role in transport of respiratory gases. RBCs are larger in number compared to the other two blood cells, namely white blood cells and platelets.

Answer 93

RBC count ranges between 4 and 5.5 million/cu mm of blood. In adult males, it is 5 million/cu mm and in adult females, it is 4.5 million/cu mm.

Answer 94

5 million/cu mm- 5.5 million/cu mm

Answer 95

4.5 million/cu mm- 5 million/cu mm

Answer 96

RBCs are disk shaped and biconcave (dumbbell shaped). Central portion is thinner and periphery is thicker. The biconcave contour of RBCs has some mechanical and functional advantages: -Helps in equal and rapid diffusion of oxygen and other substances into the nterior of the cell. -Large surface area is provided for absorption or removal of different substances. -Minimal tension is offered on the membrane when the volume of cell alters. -Because of biconcave shape, while passing through minute capillaries, RBCs squeeze through the capillaries very easily without getting damaged.

Answer 97

Diameter : 7.2 µ (6.9 to 7.4 µ). Thickness : At the periphery it is thicker with 2.2 µ and at the center it is thinner with 1 µ because of the biconcave shape. Surface area : 120 sq µ. Volume : 85 to 90 cu µ.

Answer 98

Check drawing 12, booklet

Answer 99

Due to the absence of nucleus in human RBC, the DNA is also absent. Other organelles such as mitochondria and Golgi apparatus also are absent in RBC. Because of absence of mitochondria, the energy is produced from glycolytic process. Red cell does not have insulin receptor and so the glucose uptake by this cell is not controlled by insulin. The cell also has a network of actin and spectrin which act as a cytoskeleton to anchor the inner parts of the surface glycoproteins and maintain the shape of the cell.

Answer 100

As a result of osmotic changes, and the consequent passage of water into the RBC through the cell membrane, the diameter increases with a shift in the acid-base balance of the blood toward the acid side. The RBC are therefore more slightly larger in venous than in arterial blood.

Answer 101

The stroma of RBC contains lipids, insoluble proteins and cholesterol, the antigenic nature of the erythrocyte appears to be a property associated with the stroma. Hb makes up about 30 to 34% of wet weight of Red Blood Cell and 95 to 98% of dry weight of Red Blood Cell. RBC also contains the enzymes of the glycolytic system- catalase and carbonic anlydrase, all of the glutathione of the blood as well as other enzymes and organic and inorganic salts. Potassium is present in high concentration in RBC, relative to sodium.

Answer 102

-Rouleaux formation: when anti coagulated blood sample is allow to stand for a period of time, the RBC pule up one above the other and settles at the botton of the tube. This property of the RBC is called rouleaux formation. -Packed Cell Volume (PCV): When anticoagulated blood centrifuged for a period of time. The RBC settle down leaving a clear plasma at the top. The RBC for 45% of the total blood and the volume of plasma 55%. This is called the packed cell volume or haematocrit. -Specific gravity: 1.092 to 1.101 -Agglutination: RBC, carry blood group antigens (Anti A, B, AB, Rh factors). The reaction between antigen and antibody result in agglutination.

Answer 103

Average lifespan of RBC is about 120 days. After the lifetime the senile (old) RBCs are destroyed in reticuloendothelial system.

Answer 104

Increase in the RBC count is known as polycythemia, when it occurs due to physiological conditions, it is physiological polycythemia: -Age: At birth, the RBC count is 8 to 10 million/cu mm of blood. The count decreases within 10 days after birth due to destruction of RBCs causing physiological jaundice in some newborn babies. In adults it ranges between 4 and 5.5 million/cu mm -Sex: Before puberty and after menopause in females the RBC count is similar to that in males. During reproductive period of females, the count is less than that of males (4.5 million/cu mm). -High altitude: Inhabitants of mountains (above 10,000 feet from mean sea level) have an increased RBC count of more than 7 million/cu mm. It is due to hypoxia (decreased oxygen supply to tissues) in high altitude. Hypoxia stimulates kidney to secrete a hormone called erythropoietin that causes increased production of RBC. -Muscular exercise: There is a temporary increase in RBC count after exercise. It is because of mild hypoxia and contraction of spleen. Spleen stores RBCs. Hypoxia increases the sympathetic activity resulting in secretionof adrenaline from adrenal medulla. Adrenaline contracts spleen and RBCs are released into blood ---Emotional conditions: RBC count increases during the emotional conditions such as anxiety. It is because of increase in the sympathetic activity. -Increased environmental temperature: Increase in atmospheric temperature increases RBC count. Generally increased temperature increases all the activities in the body including production of RBCs. -After meals: There is a slight increase in the RBC count after taking meals. It is because of need for more oxygen for metabolic activities.

Answer 105

1. High barometric pressures: At high barometric pressures as in deep sea, when the oxygen tension of blood is higher, the RBC count decreases. 2. During sleep: RBC count decreases slightly during sleep and immediately after getting up from sleep. 3. Pregnancy: It is because of increase in ECF volume. Increase in ECF volume, increases the plasma volume also resulting in hemodilution. So, there is a relative reduction in the RBC count.

Answer 106

Specific gravity: 1.092 to 1.101

Answer 107

Polycythemia vera – this is a pathological condition in which the red blood cell count and PCI is high. Polycythemia vera is caused by genetic aberration in the haemocytoblastic cells. The viscosity of the blood in polycythemia vera is increase 10 times that of water. Anemia.

Answer 108

Haemopoiesis or haemotopoiesis is the process of formation of new blood cellular components. It has been estimated that in an adult human, approximately 10^11 – 10^12 new blood cell are produced daily in order to maintain steady state level in the peripheral circulation.

Answer 109

In human embryo, the first detectable precursors of blood cells are found in the yolk sac. By the third month of fetal life, however, the processes of blood cell formation (haemotopoiesis) predominantly occur in the liver. By the fourth and fifth month, haemotopoiesis commences in the bone marrow where it is fully active by the seventh to eight month, and At birth practically the whole bony skeleton contains active marrow. During the childhood and adolescence there is a market recession of marrow activity in the long bone so that in the adult activity is limited to truncal skeleton and skull, only a little remaining in the proximal ends of humeral and formural shafts. In adult, the marrow normally consists of islands of cellular active marrow separated and support by fat. After the age of 50 years the proportion of active marrow declines somewhat, that of the fat increasing.

Answer 110

Hemopoietic stem cells are the primitive cells in the bone marrow, which give rise to the blood cells. Hemopoietic stem cells in the bone marrow are called uncommitted pluripotent hemopoietic stem cells (PHSC). PHSC is defined as a cell that can give rise to all types of blood cells. In early stages, the PHSC are not designed to form a particular type of blood cell. And it is also not possible to determine the blood cell to be developed from these cells: hence, the name uncommitted PHSC In adults, only a few number of these cells are present. But the best source of these cells is the umbilical cord blood. When the cells are designed to form a particular type of blood cell, the uncommitted PHSCs are called committed PHSCs. Committed PHSC is defined as a cell, which is restricted to give rise to one group of blood cells

Answer 111

-Lymphoid stem cells which give rise to lymphocytes and natural killer (NK) cells. -Colony forming blastocytes which give rise to myeloid cells

Answer 112

-Colony forming unit – erythrocytes (CFU – E) this give rise to erythrocytes -Colony forming unit – Granulocytes/monocytes (CFU – GM) this give rise to neutrophils, eosinophils, monocytes and basophils. -Colony forming unit – Megakaryocytes (CFU – M) this give rise to platelets.

Answer 113

Haemopoietic growth factors are glycoprotein hormones that regulate the proliferation and differentiation of haemopoietic progenitor cells and function of mature blood cells.

Answer 114

Erythropoietin, Thrombopoietin colony-forming stimulating factor granulocyte (GCSF), Macrophage colony-stimulating factor (M – CSF) Cytokines (IL3, 5, 6 & 11)

Answer 115

The production of RBC occurs in the bone marrow and is a complex, regulated process for maintaining adequate numbers of erythrocytes in the peripheral blood. Erythropoiesis is the process which involves the origin development and maturation of erythrocytes.

Answer 116

Proerythroblast, Early normoblast, Intermediate normoblast, late normoblast, Reticulocyte

Answer 117

It's a very large cell 20µM in diameter. The nucleus occupies the cell completely(large nucleus) with multiple nucleoli and a reticular network. This cell does not contain haemoglobin. The cytoplasm is basophilic. The proerythroblast multiplies several times to form the early normoblast.

Answer 118

has a diameter of 15µm. The nucleoli of the nucleus disappears. Condensation of chromatin network occurs cytoplasm is basophilic in nature. There is little or no haemoglobin in this cell.

Answer 119

this cell is 10 to 12µ in diameter. The chromatin network condense further. Though the nucleus is still present, the haemoglobin starts appearing. The cytoplasm is basophilic. It stains both acidic and basic stains and is referred to as polychromophilic.

Answer 120

this cell is 8 to 10µ in diameter. There is a small nucleus and a very much condense chromatin network present. The quantity of haemoglobin increases and the cytoplasm becomes almost acidophilic (arthochromic erythroblast). The nucleus later disintegrates and disappears (phyknosis).

Answer 121

This is an immature RBC. It is larger than a mature RBC. The cytoplasm contains the remain of the reticular network. The normal value in the blood is 2 to 6%. The number increases value when production and release of RBC increases. Recticulocyte is basophilic due to the remaining of golgi apparatus, mitochondria and other organelles in the cytoplasm.

Answer 122

The rate of RBC production equals its destruction, this is because of a hormone called erythropoietin.

Answer 123

Erythropoietin is is a polycoprotein hormone (M, 33000), which is normally present in plasma at low concentration (about 10mmol/L) and with a half-life of about 5 hours with 165 amino acids. Erythropoietin is secreted mostly by the kidney (90%) and the liver (10%) and the brain in response to local hypoxia. The hormone acts on the red marrow to cause the increased output of erythrocytes until the rise of haemoglobin concentration of the blood restores normal delivery of O2 to the tissues.

Answer 124

they are grouped into - general factors -maturation factors -factors necessary for Hb formation

Answer 125

-Erythropoietin -thyroxine -hemapoietic growth factors -vitamins

Answer 126

Being a general metabolic hormone, thyroxine accelerates the process of erythropoiesis at many levels. So, hyperthyroidism and polycythemia are common.

Answer 127

Vitamins B,C,D,E in absence may cause anemia or related disorders

Answer 128

These factors induce the proliferation of PHSCs. Interleukins (IL) are glycoproteins, which belong to the cytokines family. Interleukins involved in erythropoiesis: a. Interleukin-3 (IL-3) secreted by T-cells b. Interleukin-6 (IL-6) secreted by T-cells,endothelial cells and macrophages c. Interleukin-11 (IL-11) secreted by osteoblast

Answer 129

Vitamin B12 Intrinsic factor of castle Folic acid

Answer 130

Vitamin B12 is an extrinsic factor since its obtained from diet. It's absorbtion in the intestine requires intrinsic factor of castle. It is store in the Liver, and in muscle (in small amounts) It is responsible for DNA synthesis in the RBC, it's deficiency causes large RBC with weak cell membranes, i.e macrocytic anemia. Deficiency of B12 causes pernicious anemia.

Answer 131

It is produced in the gastric mucosa by the parietal cells of the gastric glands. It is responsible for the absorption of B12 through the intestinal walls. Therefore, a deficiency of intrinsic factor of castle would cause pernicious anemia. Deficiency of intrinsic factor occurs in: i. Severe gastritis ii. Ulcer iii. Gastrectomy.

Answer 132

Folic acid is also essential for maturation. It is required for the synthesis of DNA. In the absence of folic acid, the synthesis of DNA decreases causing failure of maturation. This leads to anemia in which the cells are larger and appear in megaloblastic (proerythroblastic) stage. And, anemia due to folic acid deficiency is called megaloblastic anemia.

Answer 133

-First class proteins and AMINO acids -Iron -Copper -Cobalt and Nickel -Vitamins

Answer 134

Proteins of high biological value are essential for the formation of hmoglobin. Amino acids derived from these proteins are required for the synthesis of protein part of hemoglobin, i.e. the globin.

Answer 135

Necessary for the formation of heme part of the hemoglobin.

Answer 136

Necessary for the absorption of iron from the gastrointestinal tract

Answer 137

These metals are essential for the utilization of iron during hemoglobin formation.

Answer 138

Vitamin C, riboflavin, nicotinic acid and pyridoxine are also essential for the formation of hemoglobin.

Answer 139

2α- and 2β-

Answer 140

14 to 16 g/dL.

Answer 141

14 to 16 g/dL

Answer 142

Hemoglobin (Hb) is the iron containing coloring matter of (RBC). It is a chromoprotein forming 95% of dry weight of RBC and 30% to 34% of wet weight. Function of hemoglobin is to carry the respiratory gases, oxygen and carbon dioxide. It also acts as a buffer. Molecular weight of hemoglobin is 68,000.

Answer 143

-Erythroblasts in the bone marrow undergo mitosis and begin making Hb, first by synthesizing haem and the polypeptide chains of globin separately and then by combining them to form Hb -Synthesis of haem begins in the mitochondria with the condensation of succinyl coenzyme-A and glycine to form δ-amino lavulinic acid. This step is controlled by the enzyme ALA-synthase which requires pyridoxine (Vit B6)`s co-factor and is inhibited by haem. -Protoporphyrin IX is formed after several reactions and the enzyme ferrochelatase catalyses the insertion of ferrous iron into the protoporphyrin ring to form heam. -Each haem molecule combines with a polypeptide chain, a globin synthesized by ribosomes, forming a subunit of Hb called a Hb chain (MW – 16,000) -4 of these bind together loosely to form the whole haemoglobin molecule.

Answer 144

-Transport of Oxygen -Transport of carbon dioxide - Buffering agent

Answer 145

When oxygen binds with Hb, a physical process called oxygenation occurs, resulting in the formation of oxyhemoglobin. The iron remains in ferrous state in this compound. Oxyhemoglobin is an unstable compound and the combination is reversible, i.e. when more oxygen is available, it combines with Hb and whenever oxygen is required, Hb can release oxygen readily . When oxygen is released from oxyhemoglobin, it is called reduced Hb or ferrohemoglobin.

Answer 146

When carbon dioxide binds with Hb, carbhemoglobin is formed. It is also an unstable compound and the combination is reversible, i.e. the carbon dioxide can be released from this compound. The affinity of Hb for carbon dioxide is 20 times more than that for oxygen.

Answer 147

Hemoglobin acts as a buffer and plays an important role in acidbase balance

Answer 148

>Adult haemoglobin – HbA, (2α and 2β) and >Fetal haemoglobin – HbF (2α and 2γ- chains).

Answer 149

Abnormal types of hemoglobin or hemoglobin variants are the pathologic mutant forms of hemoglobin. These variants are produced because of structural changes in the polypeptide chains caused by mutation in the genes of the globin chains

Answer 150

-Hemoglobinopathies -Hemoglobin in thalassemia and related disorders.

Answer 151

Hemoglobinopathy is a genetic disorder caused by abnormal polypeptide chains of hemoglobin. Some of the hemoglobinopathies are: -HbS -HbE -HbM -HbC

Answer 152

The β-chains are abnormal. It is found in people with hemoglobin C disease, which is characterized by mild hemolytic anemia and splenomegaly

Answer 153

The β-chains are abnormal. It is found in people with hemoglobin C disease, which is characterized by mild hemolytic anemia and splenomegaly

Answer 154

It is the abnormal Hb present in the form of methemoglobin. It occurs due to mutation of genes of both in α and β chains, resulting in abnormal replacement of amino acids. It is present in babies affected by HbM disease or blue baby syndrome. It is an inherited disease, characterized by methemoglobinemia.

Answer 155

Here also the β-chains are abnormal. It is present in people with HbE disease which is also characterized by mild hemolytic anemia and splenomegaly.

Answer 156

the most common hemoglobinopathy being sickle cell anaemia. Hb molecule has an abnormal β chain, in which valine replaces glutamine in the 6th position of the β-chain of globin.

Answer 157

This group of disorders is characterized by failure to synthesize normal quantities of Hb. The disorder is termed α or β – thalassaemia, depending upon which chain is synthesized in reduced quantities. Some of the abnormal hemoglobins found in thalassemia are hemoglobin G, H, I, Bart’s, Kenya, Lepore and constant spring.

Answer 158

-RBCs are destroyed in the reticuloendothelial system (spleen) and the Hb will be released in plasma. -Hb is degraded by the reticuloendothelial cells and split into globin and iron and porphyrin. -Globin is utilized for the resynthesis of Hb. -Heme is degraded into iron and porphyrin. -Iron is stored in the body as ferritin and hemosiderin, which are reutilized for the synthesis of new Hb. -Porphyrin is converted into a green pigment called biliverdin -Most of the biliverdin is converted into yellow pigments called bilirubin which are removed by the liver as bile. -A yellow tint of the skin and eyes caused by the excess of bilirubin is called jaundice an inflamed liver can also jaundice.

Answer 159

Anaemia is deficiency of Hb in the blood which is caused by too few RBC or decrease Hb concentration in the RBC, or PCV. Anaemia will occur if there is reduction in RBC count, Hb content and packet cell volume.

Answer 160

1. Decreased production of RBC 2. Increased destruction of RBC 3. Excess loss of blood from the body

Answer 161

(1) Morphological classification base of the size shape of the RBC. (2) Etiological classification (causes of the anaemia)

Answer 162

(1) Morphological classification base of the size shape of the RBC. (2) Etiological classification (causes of the anaemia)

Answer 163

-Normocytic normochromic -Microcytic hypochromic -Macrocytic hypochromic -Macrocytic normochromic

Answer 164

mean corpuscular volume (MCV).

Answer 165

Color is determined by mean corpuscular hemoglobin concentration (MCHC)

Answer 166

Size (MCV) and color (MCHC) of RBCs are normal. But the number of RBC is less

Answer 167

RBCs are smaller in size with less Hb/ color (MCHC)

Answer 168

RBCs are larger in size with normal Hb levels/color. RBC count is less.

Answer 169

RBCs are larger in size. MCHC is less, so the cells are pale (less colored).

Answer 170

1. Hemorrhagic anemia 2. Hemolytic anemia 3. Nutrition deficiency anemia 4. Aplastic anemia 5. Anemia of chronic diseases.

Answer 171

Hemorrhage refers to excessive loss of blood. Hemorrhage can occur in condition like accident, ulcer, excessive uterine bleeding, purpura and haemophilia. It has 2 types: -chronic -acute

Answer 172

It refers to loss of blood by internal or external bleeding, over a long period of time. It occurs in conditions like peptic ulcer, purpura, hemophilia and menorrhagia. Due to continuous loss of blood, lot of iron is lost from the body causing iron deficiency. This affects the synthesis of hemoglobin resulting in less hemoglobin content in the cells. The cells also become small. Hence, the RBCs are microcytic and hypochromic

Answer 173

Acute hemorrhage refers to sudden loss of a large quantity of blood as in the case of accident. Within about 24 hours after the hemorrhage, the plasma portion of blood is replaced. However, the replacement of RBCs does not occur quickly and it takes at least 4 to 6 weeks. So with less number of RBCs, hemodilution occurs. However, morphologically the RBCs are normocytic and normochromic

Answer 174

Hemolysis means destruction of RBCs. Anemia due to excessive hemolysis which is not compensated by increased RBC production is called hemolytic anemia. It is classified into two types: A. Extrinsic hemolytic anemia. B. Intrinsic hemolytic anemia.

Answer 175

It is the type of anemia caused by destruction of RBCs by external factors. Healthy RBCs are hemolized by factors outside the blood cells such as antibodies, chemicals and drugs. Extrinsic hemolytic anemia is also called autoimmune hemolytic anemia. Common causes of external hemolytic anemia: i. Liver failure ii. Renal disorder iii. Hypersplenism iv. Burns v. Infections like hepatitis, malaria and septicemia vi. Drugs such as penicillin, antimalarial drugs and sulfur drugs vii. Poisoning by chemical substances like lead, coal and tar viii. Presence of isoagglutinin's like antiRh ix. Autoimmune diseases such as rheumatoid arthritis and ulcerative colitis.

Answer 176

It is the type of anemia caused by destruction of RBCs by external factors. Healthy RBCs are hemolized by factors outside the blood cells such as antibodies, chemicals and drugs. Extrinsic hemolytic anemia is also called autoimmune hemolytic anemia. Common causes of external hemolytic anemia: i. Liver failure ii. Renal disorder iii. Hypersplenism iv. Burns v. Infections like hepatitis, malaria and septicemia vi. Drugs such as penicillin, antimalarial drugs and sulfur drugs vii. Poisoning by chemical substances like lead, coal and tar viii. Presence of isoagglutinin's like antiRh ix. Autoimmune diseases such as rheumatoid arthritis and ulcerative colitis.

Answer 177

i. Liver failure ii. Renal disorder iii. Hypersplenism iv. Burns v. Infections like hepatitis, malaria and septicemia vi. Drugs such as penicillin, antimalarial drugs and sulfur drugs vii. Poisoning by chemical substances like lead, coal and tar viii. Presence of isoagglutinin's like antiRh ix. Autoimmune diseases such as rheumatoid arthritis and ulcerative colitis.

Answer 178

It is the type of anemia caused by destruction of RBCs because of the defective RBCs. There is production of unhealthy RBCs, which are short lived and are destroyed soon. Intrinsic hemolytic anemia is often inherited.Because of the abnormal shape in sickle cell anemia and thalassemia, the RBCs become more fragile and susceptible for hemolysis. it includes: sickle cell anemia and thalassemia (alpha and beta)

Answer 179

Sickle cell anemia is due to the abnormal hemoglobin called hemoglobin S (sickle cell hemoglobin). In this, αchains are normal and βchains are abnormal. The molecules of hemoglobin S polymerize into long chains and precipitate inside the cells. Because of this, the RBCs attain sickle (crescent) shape and become more fragile leading to hemolysis. Sickle cell anemia occurs when a person inherits two abnormal genes (one from each parent). In children, hemolyzed sickle cells aggregate and block the blood vessels, leading to infarction (stoppage of blood supply). The infarction is common in small bones. The infarcted small bones in hand and foot results in varying length in the digits. This condition is known as hand and foot syndrome. Jaundice also occurs in these children.

Answer 180

In normal Hb, number of α and β polypeptide chains is equal. In thalassemia, the production of these chains become imbalanced because of defective synthesis of globin genes. This causes the precipitation of the polypeptide chains in the immature RBCs, leading to disturbance in erythropoiesis. The precipitation also occurs in mature red cells, resulting in hemolysis. Thalassemia is of 2 types: i. α-thalassemia. ii. β-thalassemia.

Answer 181

In normal Hb, number of α and β polypeptide chains is equal. In thalassemia, the production of these chains become imbalanced because of defective synthesis of globin genes. This causes the precipitation of the polypeptide chains in the immature RBCs, leading to disturbance in erythropoiesis. The precipitation also occurs in mature red cells, resulting in hemolysis. Thalassemia is of 2 types: i. α-thalassemia. ii. β-thalassemia.

Answer 182

α-thalassemia occurs in fetal life or infancy. In this αchains are less, absent or abnormal. In adults, βchains are in excess and in children, γchains are in excess. This leads to defective erythropoiesis and hemolysis. The infants may be stillborn or may die immediately after birth.

Answer 183

In βthalassemia, βchains are less in number, absent or abnormal with an excess of αchains. The αchains precipitate causing defective erythropoiesis and hemolysis

Answer 184

Anemia that occurs due to deficiency of a nutritive substance necessary for erythropoiesis is called nutrition deficiency anemia. The substances which are necessary for erythropoiesis are iron, proteins and vitamins like C, B12 and folic acid. The types of nutrition deficiency anemia are: -Iron deficiency anemia -Pernicious anemia -protein deficiency anemia -Megaloblastic anemia

Answer 185

Iron deficiency anemia is the most common type of anemia. It develops due to inadequate availability of iron for Hb synthesis. RBCs are microcytic and hypochromic. Causes of iron deficiency anemia: i. Loss of blood ii. Decreased intake of iron iii. Poor absorption of iron from intestine iv. Increased demand for iron in conditions like growth and pregnancy. Symptoms: brittle nails, spoonshaped nails (koilonychias), brittle hair, atrophy of papilla in tongue and dysphagia (difficulty in swallowing).

Answer 186

Due to deficiency of proteins, the synthesis of hemoglobin is reduced. The RBCs are macrocytic and hypochromic.

Answer 187

Pernicious anemia is the anemia due to deficiency of vitamin B12. It is also called ADDISON'S ANEMIA. It is due to atrophy of the gastric mucosa because of autoimmune destruction of parietal cells. The gastric atrophy results in decreased production of intrinsic factor and poor absorption of vitamin B12, which is the maturation factor for RBC. RBCs are larger and immature with almost normal or slightly low hemoglobin level. Synthesis of hemoglobin is almost normal in this type of anemia. So, cells are macrocytic and normochromic or hypochromic. Symptoms: lemon yellow color of skin (due to anemic paleness and mild jaundice) and red sore tongue. Neurological disorders such as paresthesia (abnormal sensations like numbness, tingling, burning, etc.), progressive weakness and ataxia (muscular incoordination)

Answer 188

Megaloblastic anemia is due to the deficiency of another maturation factor called folic acid. Here, the RBCs are not matured. The DNA synthesis is also defective, so the nucleus remains immature. The RBCs are megaloblastic and hypochromic. Symptoms pernicious anemia appear in megaloblastic anemia also. However, neurological disorders may not develop

Answer 189

Aplastic anemia is due to the disorder of red bone marrow. Red bone marrow is reduced and replaced by fatty tissues. Bone marrow disorder occurs in the following conditions: i. Repeated exposure to Xray or gamma ray radiation. ii. Presence of bacterial toxins, quinine, gold salts, benzene, radium, etc. iii. Tuberculosis. iv. Viral infections like hepatitis and HIV infections. In aplastic anemia, the RBCs are normocytic and normochromic.

Answer 190

i. Repeated exposure to Xray or gamma ray radiation. ii. Presence of bacterial toxins, quinine, gold salts, benzene, radium, etc. iii. Tuberculosis. iv. Viral infections like hepatitis and HIV infections.

Answer 191

It is characterized by short lifespan of RBCs, caused by disturbance in iron metabolism or resistance to erythropoietin action. Anemia develops after few months of sustained disease. RBCs are normocytic and normochromic. \ Common causes anemia of chronic diseases: i. Noninfectious inflammatory diseases such as rheumatoid arthritis (chronic inflammatory autoimmune disorder affecting joints). ii. Chronic infections like tuberculosis (infection caused by Mycobacterium tuberculosis) and abscess (collection of pus in the infected tissue) in lungs. iii. Chronic renal failure, in which the erythropoietin secretion decreases (since erythropoietin is necessary for the stimulation of bone marrow to produce RBCs, its deficiency causes anemia). iv. Neoplastic disorders (abnormal and disorganized growth in tissue or organ) such as Hodgkin’s disease (malignancy involving lymphocytes) and cancer of lung and breast. RBCs are generally normocytic and normochromic in this type of anemia. However, in progressive disease associated with iron deficiency the cells become microcytic and hypochromic

Answer 192

i. Noninfectious inflammatory diseases such as rheumatoid arthritis (chronic inflammatory autoimmune disorder affecting joints). ii. Chronic infections like tuberculosis (infection caused by Mycobacterium tuberculosis) and abscess (collection of pus in the infected tissue) in lungs. iii. Chronic renal failure, in which the erythropoietin secretion decreases (since erythropoietin is necessary for the stimulation of bone marrow to produce RBCs, its deficiency causes anemia). iv. Neoplastic disorders (abnormal and disorganized growth in tissue or organ) such as Hodgkin’s disease (malignancy involving lymphocytes) and cancer of lung and breast.

Answer 193

-Skin: Brittle nails, color of the skin and mucous membrane becomes pale, paleness is more constant and prominent in buccal, pharyngeal mucous membrane, conjunctivae, lips, ear lobes, palm and nail bed. -CVS: tachycardia, blood vessel is dilated and cardiac murmurs are produced, velocity of blood flow is increased. -Respiration: There is an increase in rate and force of respiration, it leads to breathlessness and dyspnea (difficulty in breathing), Oxygenhemoglobin dissociation curve is shifted to right. -Digestive system: Anorexia, nausea, vomiting, abdominal discomfort and constipation are common. In pernicious anemia, there is atrophy of papillae in tongue. In aplastic anemia, necrotic lesions appear in mouth and pharynx. -Metabolism: Basal metabolic rate increases in severe anemia -Kidney: Renal function is disturbed. Albuminuria is common. -Reproduction: In females, the menstrual cycle is disturbed. There may be menorrhagia, oligomenorrhea or amenorrhea -Neuromuscular junction: increased sensitivity to cold, headache, lack of concentration, restlessness, irritability, drowsiness, dizziness or vertigo (especially while standing) and fainting. Muscles become weak and the patient feels a lack of energy and fatigued quite often and quite easily

Answer 194

1. Larger in size. 2. Irregular in shape. 3. Nucleated. 4. Many types. 5. Granules are present in some type of WBCs. 6. Lifespan is shorter.

Answer 195

4,000 to 11,000/cu mm

Answer 196

½ to 15 days

Answer 197

1. Granulocytes which have granules. 2. Agranulocytes which do not have granules

Answer 198

i. Neutrophils with granules taking both acidic and basic stains. ii. Eosinophils with granules taking acidic stain. iii. Basophils with granules taking basic stain

Answer 199

i. Monocytes. ii. Lymphocytes

Answer 200

Along with monocytes, the neutrophils provide the first line of defense against the invading microorganisms. They are: -10 to 12µ in diameter. -They have 2 – 5 lobes and fine granules in the cytoplasm. -They have a lifespan of 2-5days. -They have a % composition of 40 to 60 -They have a volume of 3,000 to 6,000 cu.mm The granules contain NADPH oxidase catalase, myeloperoxidase plus antimicrobial proteins called defensins (α and β). When stained with Leishman stain, the granules appear violet in colour.

Answer 201

Eosinophils have coarse (larger) granules in the cytoplasm, which stain pink or red with eosin. Nucleus is bilobed and spectacle-shaped. Eosinophils play an important role in the defense mechanism of the body against the parasites. During parasitic infections, there is a production of a large number of eosinophils which move towards the tissues affected by parasites. Eosinophils are responsible for detoxification, disintegration and removal of foreign proteins. -Diameter of the cell varies between 10 and 14 µ. -lifespan is 7 to 12 days -% composition is 2 to 4 -volume is 150 to 450 Cu.mm

Answer 202

Basophils also have coarse granules in the cytoplasm. The granules stain purple blue with methylene blue. Nucleus is bilobed. -Diameter of the cell is 8 to 10 µ. -lifespan is 12 to 15 days -% composition is 0 to 1% -Volume is 0 to 100cu.mm Basophils play an important role in healing processes. So their number increases during healing process. Basophils also play an important role in allergy or acute hypersensitivity reactions (allergy). This is because of the presence of receptors for IgE in basophil membrane.

Answer 203

Monocytes are the largest leukocytes with diameter of 14 to 18 µ. The cytoplasm is clear without granules. Nucleus is round, oval and horseshoe shaped, bean shaped or kidney shaped. Nucleus is placed either in the center of the cell or pushed to one side and a large amount of cytoplasm is seen. -diameter is 14 to 18 -lifespan is 2 to 5days -% composition is 2 to 6 - volume is 200 to 600cu.mm Monocytes are the largest cells among the leukocytes. Like neutrophils, monocytes also are motile and phagocytic in nature. These cells wander freely through all tissues of the body. Along with neutrophils, these leukocytes provide the first line of defense. Monocytes secrete: 1. Interleukin-1 (IL-1). 2. Colony stimulating factor (M-CSF). 3. Platelet-activating factor (PAF).

Answer 204

1. Interleukin-1 (IL-1). 2. Colony stimulating factor (M-CSF). 3. Platelet-activating factor (PAF).

Answer 205

Like monocytes, the lymphocytes also do not have granules in the cytoplasm. Nucleus is oval, bean-shaped or kidney-shaped. Nucleus occupies the whole of the cytoplasm. A rim of cytoplasm may or may not be seen -Diameter: 7 to 12 -Lifespan: ½ to 1 -% comp. 20 to 30 - Volume 1,500 to 2,700 Cu.mm Lymphocytes play an important role in immunity. Functionally, the lymphocytes are classified into two categories, namely T lymphocytes and B lymphocytes. T lymphocytes are responsible for the development of cellular immunity and B lymphocytes are responsible for the development of humoral immunity

Answer 206

-Surface of particle is rough. -Lacks protective protein coat. -Binding of antibodies to antigen (opsonization).

Answer 207

Leucopoiesis is the process by which white blood cells (leukocytes) are produced in the body. It involves the differentiation of hematopoietic stem cells into various types of white blood cells, including granulocytes, monocytes, and lymphocytes. This process is regulated by various cytokines and growth factors, which stimulate the proliferation and differentiation of precursor cells into mature white blood cells

Answer 208

check your fucking book

Answer 209

just check the book

Answer 210

lymph glands, spleen, thymus, tonsils and various packed lymphoid tissues elsewhere in the body such as -the bone marrow and -in payer’s patches underneath the epithelium in the gut walls

Answer 211

Many growth factors are involved in the maturation process of leucocytes. These are interleukin – 1 (IL – 1), IL – 3, 5, 6, 11 granulocyte-macrophage colony–stimulating factor (GM – CSF) granulocyte CSF (G – CSF) and monocyte CSF (M – CSF).

Answer 212

Leukocytosis is the increase in total leukocyte (WBC) count. It occurs in conditions such as: 1. Infections 2. Allergy 3. Common cold 4. Tuberculosis 5. Glandular fever.

Answer 213

Leukemia is the condition which is characterized by abnormal and uncontrolled increase in leukocyte count more than 1,000,000/cu mm. It is also called blood cancer.

Answer 214

Leukopenia is the decrease in the total WBC count. It occurs in the following pathological conditions: 1. Anaphylactic shock 2. Cirrhosis of liver 3. Disorders of spleen 4. Pernicious anemia 5. Typhoid and paratyphoid 6. Viral infections.

Answer 215

1. Age: WBC count is about 20,000 per cu.mm in INFANTS and about 10,000 to 15,000 per cu.mm of blood in CHILDREN. In ADULTS, it ranges between 4,000-11,000 per cu.mm of blood. 2. Sex: Slightly more in males than in females. 3. Diurnal variation: Minimum in early morning and maximum in the afternoon.

Answer 216

Immunity is defined as the capacity of the body to resist pathogenic agents. It is the ability of body to resist the entry of different types of foreign bodies like bacteria, virus, toxic substances

Answer 217

I. Innate immunity. II. Acquired immunity.

Answer 218

Innate immunity is the inborn capacity of the body to resist pathogens. By chance, if the organisms enter the body, innate immunity eliminates them before the development of any disease. It is otherwise called the natural or non-specific immunity

Answer 219

GIT:Enzymes in digestive juices and the acid in stomach destroy the toxic substances or organisms entering digestive tract through food. Lysozyme present in saliva destroys bacteria Respo: Defensins and cathelicidins in epithelial cells of air passage are antimicrobial peptides. Neutrophils, lymphocytes, macrophages and natural killer cells present in lungs act against bacteria and virus Urogenital: Acidity in urine and vaginal fluid destroy the bacteria Skin: The keratinized stratum corneum of epidermis protects the skin against toxic chemicals. The β-defensins in skin are antimicrobial peptides. Lysozyme secreted in skin destroys bacteria Phagocytic cells: Neutrophils, monocytes and macrophages ingest and destroy the microorganisms and foreign bodies by phagocytosis Interferons : Inhibit multiplication of viruses, parasites and cancer cells Complement proteins: Accelerate the destruction of microorganisms

Answer 220

Acquired immunity is the resistance developed in the body against any specific foreign body like bacteria, viruses, toxins, vaccines or transplanted tissues

Answer 221

Cellular immunity Humoral immunity

Answer 222

T lymphocytes or T cells, which are responsible for the development of cellular immunity B lymphocytes or B cells, which are responsible for humoral immunity

Answer 223

1. Helper T cells or inducer T cells. These cells are also called CD4 cells because of the presence of molecules called CD4 on their surface. 2. Cytotoxic T cells or killer T cells. These cells are also called CD8 cells because of the presence of molecules called CD8 on their surface. 3. Suppressor T cells. 4. Memory T cells.

Answer 224

T lymphocytes are processed in thymus. The processing occurs mostly during the period between just before birth and few months after birth. Thymus secretes a hormone called thymosin, which plays an important role in immunity. It accelerates the proliferation and activation of lymphocytes in thymus. It also increases the activity of lymphocytes in lymphoid tissues

Answer 225

After the transformation, all the types of T lymphocytes leave the thymus and are stored in lymphoid tissues of lymph nodes, spleen, bone marrow and GI tract.

Answer 226

1. Plasma cells. 2. Memory cells.

Answer 227

After transformation, the B lymphocytes are stored in the lymphoid tissues of lymph nodes, spleen, bone marrow and the GI tract.

Answer 228

Humoral immunity is defined as the immunity mediated by antibodies, which are secreted by B lymphocytes. B lymphocytes secrete the antibodies into the blood and lymph. The blood and lymph are the body fluids (humours or humors in Latin). Since the B lymphocytes provide immunity through humors, this type of immunity is called humoral immunity or B cell immunity. Antibodies are the gamma globulins produced by B lymphocytes. These antibodies fight against the invading organisms. The humoral immunity is the major defense mechanism against the bacterial infection

Answer 229

Cell-mediated immunity is defined as the immunity developed by cell-mediated response. It is also called cellular immunity or T cell immunity. It involves several types of cells such as T lymphocytes, macrophages and natural killer cells and hence the name cell mediated immunity. Cell-mediated immunity does not involve antibodies. Cellular immunity is the major defense mechanism against infections by viruses, fungi and few bacteria like tubercle bacillus. It is also responsible for delayed allergic reactions and the rejection of transplanted tissues. Cell-mediated immunity is offered by T lymphocytes and it starts developing when T cells come in contact with the antigens. Usually, the invading microbial or non-microbial organisms carry the antigenic materials. These antigenic materials are released from invading organisms and are presented to the helper T cells by antigen-presenting cells.

Answer 230

Check your book

Answer 231

The NK cell is a large granular cell with indented nucleus. It is considered as the third type of lymphocyte and it is often called the non – T, non – B cell. NK cell kills the invading organisms or the cells of the body without prior sensitization. It is not a phagocytic cell but it has granules that contains hydrolytic enzymes which play an important role in the lysis of cells.

Answer 232

Complement is a collective term that describes a system of about 20 proteins many of which are precursors. The main actors in the system are 11 proteins designated C1 through C9. These are present in the plasma protein in the blood. The enzymes precursors are normally inactive, but they can be activated mainly by antigen – antibody reaction.

Answer 233

a. Classical pathway b. Lectin pathway c. Alternate pathway.

Answer 234

In this the C1 binds with the antibodies and triggers a series of events in which other enzymes are activated in sequence. These enzymes or the byproducts formed during these events produce the following activities: i. Opsonization: Activation of neutrophils and macrophages to engulf the bacteria, which are bound with a protein in the plasma called opsonin. ii. Lysis: Destruction of bacteria by rupturing the cell membrane. iii. Chemotaxis: Attraction of leukocytes to the site of antigen-antibody reaction. iv. Agglutination: Clumping of foreign bodies like RBCs or bacteria. v. Neutralization: Covering the toxic sites of antigenic products. vi. Activation of mast cells and basophils, which liberate histamine: Histamine dilates the blood vessels and increases capillary permeability. So, plasma proteins from blood enter the tissues and inactivate the antigenic products

Answer 235

i. Opsonization: Activation of neutrophils and macrophages to engulf the bacteria, which are bound with a protein in the plasma called opsonin. ii. Lysis: Destruction of bacteria by rupturing the cell membrane. iii. Chemotaxis: Attraction of leukocytes to the site of antigen-antibody reaction. iv. Agglutination: Clumping of foreign bodies like RBCs or bacteria. v. Neutralization: Covering the toxic sites of antigenic products. vi. Activation of mast cells and basophils, which liberate histamine: Histamine dilates the blood vessels and increases capillary permeability. So, plasma proteins from blood enter the tissues and inactivate the antigenic products

Answer 236

Lectin pathway occurs when mannose-binding lectin (MBL), which is a serum protein binds with mannose or fructose group on wall of bacteria, fungi or virus

Answer 237

It is due to a protein in circulation called factor I. It binds with polysaccharides present in the cell membrane of the invading organisms. This binding activates C3 and C5, which ultimately attack the antigenic products of invading organism.

Answer 238

Each B lymphocyte is designed to be activated only by one type of antigen. It is also capable of producing antibodies against that antigen only. This property of B lymphocyte is called specificity. In lymphoid tissues, the lymphocytes, which produce a specific antibody, are together called the clone of lymphocytes.

Answer 239

Platelets or thrombocytes are the formed elements of blood. Platelets are small colorless, non-nucleated and moderately refractive bodies. Diameter : 2.5 µ (2 to 4 µ) Volume : 7.5 cu µ (7 to 8 cu µ). Lifespan: 8-11 days Count: 200,000 and 400,000/cu mm

Answer 240

Glycoproteins prevent the adherence of platelets to normal endothelium, but accelerate the adherence of platelets to collagen and damaged endothelium in ruptured blood vessels. Glycoproteins also form the receptors for: 👉adenosine diphosphate (ADP) and 👉thrombin.

Answer 241

Phospholipids accelerate the clotting reactions. The phospholipids form the precursors of: 👉thromboxane A2 👉and other prostaglandin-related substances.

Answer 242

👉Contractile proteins: Actin, myosin,thrombosthenin 👉von willebrand factor 👉Platelet derived growth factor (PDGF) 👉Platelet activating factor (PAF) 👉fibrin stabilizing factor 👉Vitronectin 👉Thrombospondin

Answer 243

i. Actin and myosin: Contractile proteins, which are responsible for contraction of platelets. ii. Thrombosthenin: Third contractile protein, which is responsible for clot retraction

Answer 244

Responsible for adherence of platelets and regulation of plasma level of factor 8.

Answer 245

Clotting factor 13

Answer 246

Responsible for repair of damaged blood vessels and wound healing. It is a potent mytogen (chemical agent that promotes mitosis) for smooth muscle fibers of blood vessels.

Answer 247

Causes aggregation of platelets during the injury of blood vessels, resulting in prevention of excess loss of blood.

Answer 248

Promotes adhesion of platelets and spreading of tissue cells in culture

Answer 249

Inhibits angiogenesis (formation of new blood vessels from pre-existing vessels).

Answer 250

1. Adensosine triphosphatase (ATPase) 2. Enzymes necessary for synthesis of prostaglandins.

Answer 251

1. Adrenaline 2. 5-hydroxytryptamine (5-HT; serotonin) 3. Histamine.

Answer 252

1. Alpha granules 2. Dense granules.

Answer 253

1. Clotting factors – fibrinogen, V and XIII 2. Platelet-derived growth factor 3. Vascular endothelial growth factor (VEGF) 4. Basic fibroblast growth factor (FGF) 5. Endostatin 6. Thrombospondin.

Answer 254

1. Nucleotides 2. Serotonin 3. Phospholipid 4. Calcium 5. Lysosomes.

Answer 255

1. Age: Platelets are less in infants (1,50,000 to 2,00,000/cu mm) and reaches normal level at 3rd month after birth. 2. Sex: There is no difference in the platelet count between males and females. In females, it is reduced during menstruation. 3. High altitude: Platelet count increases. 4. After meals: After taking food, the platelet count increases.

Answer 256

Adhesiveness Aggregation Agglutination

Answer 257

Adhesiveness is the property of sticking to a rough surface. During injury of blood vessel, endothelium is damaged and the subendothelial collagen is exposed. While coming in contact with collagen, platelets are activated and adhere to collagen. Adhesion of platelets involves interaction between von Willebrand factor secreted by damaged endothelium and a receptor protein called glycoprotein Ib situated on the surface of platelet membrane. Other factors which accelerate adhesiveness are collagen, thrombin, ADP, Thromboxane A2, calcium ions, P-selectin and vitronectin

Answer 258

Aggregation is the grouping of platelets. Adhesion is followed by activation of more number of platelets by substances released from dense granules of platelets. During activation, the platelets change their shape with elongation of long filamentous pseudopodia which are called processes or filopodia. Filopodia help the platelets aggregate together. Activation and aggregation of platelets is accelerated by ADP, thromboxane A2 and platelet-activating factor

Answer 259

Agglutination is the clumping together of platelets. Aggregated platelets are agglutinated by the actions of some platelet agglutinins and platelet-activating factor.

Answer 260

👉 Haemostatic role – platelet play a role in blood clotting by activating intrinsic prothrombin activator, secreting PF3 Ca+ and clotting factors (FXiii, thrombin and fibrinogen). Formation of platelet plug and vasoconstrictors. The actin, myosin and thrombosthenin in platelet causes clott retraction. 👉 Role in repair of ruptured blood vessel platelets produces PDGF which repairs the damaged endothelieum of the ruptured blood vessels 👉 Defense mechanism – by forming agglutination, the platelet can encircle the invading organism or foreign bodies and destroy them by phagocytosis.

Answer 261

1. Collagen, which is exposed during damage of blood vessels 2. von Willebrand factor 3. Thromboxane A2 4. Platelet-activating factor 5. Thrombin 6. ADP 7. Calcium ions 8. P-selectin: Cell adhesion molecule secreted from endothelial cells 9. Convulxin: Purified protein from snake venom.

Answer 262

1. Nitric oxide 2. Clotting factors: 2, 9, 10, 11 and 12 3. Prostacyclin 4. Nucleotidases which breakdown the ADP.

Answer 263

Platelets are formed from bone marrow. Pluripotent stem cell gives rise to the colony forming unit-megakaryocyte (CFU-M). This develops into megakaryocyte. Cytoplasm of megakaryocyte form pseu do podium. A portion of pseudopodium is detached to form platelet, which enters the circulation. Production of platelets is influenced by colony-stimulating factors and thrombopoietin. Colony-stimulating factors are secreted by monocytes and T lymphocytes. Thrombopoietin is a glycoprotein like erythropoietin. It is secreted by liver and kidneys.

Answer 264

1. Thrombocytopenia 2. Thrombocytosis 3. Thrombocythemia 4. Glanzmann’s thrombasthenia

Answer 265

Decrease in platelet count is called thrombocytopenia. It leads to thrombocytopenic purpura Thrombocytopenia occurs in the following conditions: i. Acute infections ii. Acute leukemia iii. Aplastic and pernicious anemia iv. Chickenpox v. Smallpox vi. Splenomegaly vii. Scarlet fever viii. Typhoid ix. Tuberculosis x. Purpura xi. Gaucher’s disease.

Answer 266

i. Acute infections ii. Acute leukemia iii. Aplastic and pernicious anemia iv. Chickenpox v. Smallpox vi. Splenomegaly vii. Scarlet fever viii. Typhoid ix. Tuberculosis x. Purpura xi. Gaucher’s disease.

Answer 267

ncrease in platelet count is called thrombocytosis. Thrombocytosis occurs in the following conditions: i. Allergic conditions ii. Asphyxia iii. Hemorrhage iv. Bone fractures v. Surgical operations vi. Splenectomy vii. Rheumatic fever viii. Trauma (wound or injury or damage caused by external force).

Answer 268

i. Allergic conditions ii. Asphyxia iii. Hemorrhage iv. Bone fractures v. Surgical operations vi. Splenectomy vii. Rheumatic fever viii. Trauma (wound or injury or damage caused by external force).

Answer 269

Thrombocythemia is the condition with persistent and abnormal increase in platelet count. Thrombocythemia occurs in the following conditions: i. Carcinoma ii. Chronic leukemia iii. Hodgkin’s disease.

Answer 270

i. Carcinoma ii. Chronic leukemia iii. Hodgkin’s disease.

Answer 271

Glanzmann’s thrombasthenia is an inherited hemorrhagic disorder, caused by structural or functional abnormality of platelets. It leads to thrombasthenic purpura. However, the platelet count is normal. It is characterized by normal clotting time, normal or prolonged bleeding time but defective clot retraction.

Answer 272

Check the book guy

Answer 273

Haemostasis is a complex processes that lead to the arrest of bleeding of stoppage of bleeding.

Answer 274

1. Vasoconstriction 2. Platelet plug formation 3. Coagulation of blood.

Answer 275

Immediately after the blood vessel is cut or severed, the blood vessel constricts to decrease the loss of blood. This vasoconstriction is as a result of reflex autonomic action, the real vasoconstriction occur after activated platelets secrete serotonin and thromboxane A2 which are vasoconstrictors.

Answer 276

When a blood vessel is cut, the result is adhesion of platelets to the exposed endothelial collagen, basement membrane and elastic fibres. Adhesion causes platelets to activate releasing substances like ADP, thromboxane A2 which attract more platelets to aggregate together and form platelet plug.

Answer 277

Contact of blood with exposed collagen and elastic fibres initiates a complex series of reactions which result in the formation of fibrin. Blood clotting factors in the plasma are present in an inert proenzymes form. When a activated, are converted to an active form and inturn actives the other factors. This triggered enzyme system term a ‘cascade’ sequence of reaction.

Answer 278

fibrinogen

Answer 279

prothrombin

Answer 280

thromboplastin (Tissue factor)

Answer 281

Labile factor (Proaccelerin or accelerator globulin)

Answer 282

Dem never sabi

Answer 283

Stable factor

Answer 284

Antihemophilic factor (Antihemophilic globulin)

Answer 285

Christmas factor

Answer 286

stuart-power factor

Answer 287

plasma thromboplastin artecedent

Answer 288

Hegman factor (contact factor)

Answer 289

Fibrin stabilizing factor

Answer 290

Check the book

Answer 291

Check the book too

Answer 292

fibrinolysis is the process of removing fibrin from circulation by degrading it enzymatically to fibrin degradation products (FDP). The purpose is to maintain potency in the vascular system controlling excess fibrin deposition on blood vessel wall. To do this plasminingen in the plasma in converted to plasmin.

Answer 293

Coagulation or clotting is defined as the process in which blood loses its fluidity and becomes a jelly-like mass few minutes after it is shed out or collected in a container.

Answer 294

Most of the clotting factors are proteins in the form of enzymes. Normally, all the factors are present in the form of inactive proenzyme. These proenzymes must be activated into enzymes to enforce clot formation. It is carried out by a series of proenzyme-enzyme conversion reactions. First one of the series is converted into an active enzyme that activates the second one, which activates the third one; this continues till the final active enzyme thrombin is formed. Enzyme cascade theory explains how various reactions, involved in the conversion of proenzymes to active enzymes take place in the form of a cascade. Cascade refers to a process that occurs through a series of steps, each step initiating the next, until the final step is reached.

Answer 295

1. Formation of prothrombin activator 2. Conversion of prothrombin into thrombin 3. Conversion of fibrinogen into fibrin.

Answer 296

i. During the injury, the blood vessel is ruptured. Endothelium is damaged and collagen beneath the endothelium is exposed. ii. When factor XII (Hageman factor) comes in contact with collagen, it is converted into activated factor XII in the presence of kallikrein and high molecular weight (HMW) kinogen. iii. The activated factor XII converts factor XI into activated factor XI in the presence of HMW kinogen. iv. The activated factor XI activates factor IX in the presence of factor IV (calcium). v. Activated factor IX activates factor X in the presence of factor VIII and calcium. vi. When platelet comes in contact with collagen of damaged blood vessel, it gets activated and releases phospholipids. vii. Now the activated factor X reacts with platelet phos pholipid and factor V to form prothrombin activa tor. This needs the presence of calcium ions. viii. Factor V is also activated by positive feedback effect of thrombin (see below).

Answer 297

the formation of prothrombin activator is initiated by platelets, which are within the blood itself

Answer 298

the formation of prothrombin activator is initiated by the tissue thromboplastin, which is formed from the injured tissues.

Answer 299

i. Prothrombin activator that is formed in intrinsic and extrinsic pathways converts prothrombin into thrombin in the presence of calcium (factor IV). ii. Once formed thrombin initiates the formation of more thrombin molecules. The initially formed thrombin activates Factor V. Factor V in turn accelerates formation of both extrinsic and intrinsic prothrombin activator, which converts prothrombin into thrombin. This effect of thrombin is called positive feedback effect

Answer 300

i. Thrombin converts inactive fibrinogen into activated fibrinogen due to loss of 2 pairs of polypeptides from each fibrinogen molecule. The activated fibrinogen is called fibrin monomer. ii. Fibrin monomer polymerizes with other monomer molecules and form loosely arranged strands of fibrin. iii. Later these loose strands are modified into dense and tight fibrin threads by fibrin-stabilizing factor (factor 13) in the presence of calcium ions. All the tight fibrin threads are aggregated to form a meshwork of stable clot.

Answer 301

Platelet count Bleeding time Clotting time

Answer 302

Bleeding time (BT) is the time interval from oozing of blood after a cut or injury till arrest of bleeding. Usually, it is determined by Duke method using blotting paper or filter paper method. Its normal duration is 3 to 6 minutes. It is prolonged in purpura.

Answer 303

Clotting time (CT) is the time interval from oozing of blood after a cut or injury till the formation of clot. It is usually determined by capillary tube method. Its normal duration is 3 to 8 minutes. It is prolonged in hemophilia.

Answer 304

Prothrombin time (PT) is the time taken by blood to clot after adding tissue thromboplastin to it

Answer 305

1. Hemophilia. 2. Purpura. 3. von Willebrand disease.

Answer 306

Hemophilia is a group of sex-linked inherited blood disorders, characterized by prolonged clotting time. However, the bleeding time is normal. Usually, it affects the males, with the females being the carriers. Hemophilia occurs due to lack of formation of prothrombin activator. That is why the coagulation time is prolonged. The formation of prothrombin activator is affected due to the deficiency of factor 8, 9 or 11. Types of hemophilia are A,B,C Symptoms of hemophilia: i. Spontaneous bleeding. ii. Prolonged bleeding due to cuts, tooth extraction and surgery. iii. Hemorrhage in gastrointestinal and urinary tracts. iv. Bleeding in joints followed by swelling and pain v. Appearance of blood in urine. Treatment: replacement of missing clotting factors

Answer 307

Also called classical hemophilia, it is due to the deficiency of factor 8. 85% of people with hemophilia are affected by hemophilia A.

Answer 308

Also called Christmas disease, it is due to the deficiency of factor 9. 15% of people with hemophilia are affected by hemophilia B.

Answer 309

Also called factor 11 deficiency, it is due to the deficiency of factor 11. It is a very rare bleeding disorder.

Answer 310

i. Spontaneous bleeding. ii. Prolonged bleeding due to cuts, tooth extraction and surgery. iii. Hemorrhage in gastrointestinal and urinary tracts. iv. Bleeding in joints followed by swelling and pain v. Appearance of blood in urine.

Answer 311

Purpura is a disorder characterized by prolonged bleeding time. However, the clotting time is normal. Characteristic feature of this disease is spontaneous bleeding under the skin from ruptured capillaries. It causes small tiny hemorrhagic spots in many areas of the body. The hemorrhagic spots under the skin are called purpuric spots (purple colored patch like appearance). That is why this disease is called purpura. Blood also sometimes collects in large areas beneath the skin which are called ecchymoses.

Answer 312

von Willebrand disease is a bleeding disorder, characterized by excess bleeding even with a mild injury. It is due to deficiency of von Willebrand factor, which is a protein secreted by endothelium of damaged blood vessels and platelets. This protein is responsible for adherence of platelets to the endothelium of blood vessels during hemostasis after an injury. It is also responsible for the survival and maintenance of factor VIII in plasma. Deficiency of von Willebrand factor suppresses platelet adhesion. It also causes deficiency of factor 8. This results in excess bleeding, which resembles the bleeding that occurs during platelet dysfunction or hemophilia.

Answer 313

Thrombosis or intravascular blood clotting refers to coagulation of blood inside the blood vessels Causes Injury to the blood vessels Roughened endothelium Slow blood flow Agglutination of RBC Toxic thrombosis Congenital absence of protein C

Answer 314

Protein C is a circulating anticoagulant, which inactivates factors 5 and 8. Thrombosis occurs in the absence of this protein. Congenital absence of protein C causes thrombosis and death in infancy.

Answer 315

👉Medically blood grouping is important to avoid blood transfusion reaction by transfusing compatible blood. 👉Both ABO and Rhesus incompatibility can cause erythroblastosis fetalis. Blood grouping is necessary before marriage. 👉Blood grouping is helpful in medicolegal cases like maternal and paternal disputes. 👉Blood grouping is necessary for blood donation. The donor and the recipient blood group must be known. 👉Blood grouping is necessary for organ transplant since many tissues and organs also have these antigens.

Answer 316

During thrombosis, lumen of blood vessels is occluded. The solid mass of platelets, red cells and/or clot, which obstructs the blood vessel, is called thrombus. The thrombus formed due to agglutination of RBC is called agglutinative thrombus

Answer 317

Embolism is the process in which the thrombus or a part of it is detached and carried in bloodstream and occludes the small blood vessels, resulting in arrests of blood flow to any organ or region of the body. Embolus is the thrombus or part of it, which arrests the blood flow. The obstruction of blood flow by embolism is common in lungs (pulmonary embolism), brain (cerebral embolism) or heart (coronary embolism).

Answer 318

Insufficient blood supply to an organ or area of the body by the obstruction of blood vessels is called ischemia. Ischemia results in tissue damage because of hypoxia (lack of oxygen). Ischemia also causes discomfort, pain and tissue death. Death of body tissue is called necrosis

Answer 319

Infarction means the tissue death due to loss of blood supply. Loss of blood supply is usually caused by occlusion of an artery by thrombus or embolus and sometimes by atherosclerosis

Answer 320

Necrosis is a general term that refers to tissue death caused by loss of blood supply, injury, infection, inflammation, physical agents or chemical substances.