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Medicine; Phase 1 > Cardio - Blood > Flashcards

Cardio - Blood Flashcards

1
Q

Define thrombosis

A

formation of a clot (thrombus) inside a blood vessel

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2
Q

what happens to platelets when they are activated

A

they change shape from smooth discoid to spiculated (spikey) and pseudopodia (protusions)

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3
Q

benefits of platelets being activated

A

increases surface area and increases possibility of cell-cell interactions

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4
Q

what happens to glycoprotein IIb/IIIa receptor when the platelet is activated

A

increases number of receptors
increases affinity of receptor for fibrinogen
fibrinogen links receptors, binding platelets together (platelet aggregation)

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5
Q

what cells are part of the cellular component of blood?

A

red blood cells (erythrocytes)
leukocytes
platelets

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6
Q

what makes up plasma components of blood

A

proteins and water

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7
Q

what are the features of erythrocytes (RBCs)

A

anucleate
discoid
biconcave

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8
Q

Where are erythrocytes (RBCs) formed in adults, children and foetus

A

adults- bone marrow of axial skeleton
children- all bones
foetus- liver, spleen &yolk sac

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9
Q

what is the life span of erythrocytes (RBCs)

A

120 days

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10
Q

what is the regulatory protein of erythrocytes (RBCs)

A

erythropoietin (produced by kidney and liver)

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11
Q

why does haemoglobin have to be enclosed in a membrane

A

otherwise will clog up kidneys

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12
Q

reticulocyte

A

an immature RBC

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13
Q

features of platelets

A

anucleate & discoid

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14
Q

function of platelets

A

involved in the clotting process & formation of platelet plug

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15
Q

life span of platelets

A

7 to 10 days

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16
Q

regulatory hormone for platelets

A

thrombopoietin (TPO) (produced by kidney and liver)

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17
Q

nucelus, function and life span of neutrophils

A

multi-lobed nucelus phagocytosis of bacteria and foreign material
10 hours

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18
Q

nucelus, function, appearance and life span of eosinophils

A

bi-lobed
very eosinophillic (pink)
combat parasites & neutralises histamine
8-12 hours

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19
Q

nucelus, function, appearance and life span of basophils

A

bi lobed nucleus
very prominent dark blue granules of histamine
allergic reaction & histamine
8-10 hours

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20
Q

nucelus, function and life span of monocytes and macrophages

A

reniform (kidney bean shaped) nucelus
phagocytotic role/ antigen presenting cells
8-12 hours

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21
Q

what do monocytes differentiate into

A

macrophages and dendritic cells

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22
Q

function, appearance and life span of lyphocytes

A

B= plasma cells/ memory cells & produce antibodies
T= Thelper, T cytoxic Tsupressor
8-12 hours
“ fried egg”

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23
Q

what is the structure of haemoglobin

A

2 alpha chains
2 beta chains
Haem group containg fe 2+ in the centre

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24
Q

how does foetal haemoglobin differ from adult

A

foetal has 2 alpha and 2 gamma chains (instead of 2 beta)

means has a higher affinity for oxygen which compensates for the relatively lower O2 saturation it receives

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25
Q

what causes the different shaped red blood cells in sickle cell disease

A

beta chains replaced by S chains

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26
Q

define haemostasis

A

the process to prevent and stop bleeding

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27
Q

coagulation

A

process by which blood changed from a liquid to a gel/solid

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28
Q

what happens to a vessel when it is damaged

A

constricts to limit blood flow to affected area

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29
Q

what mediates vascular constriction

A

endothelin-1

neural control

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30
Q

what happens to platelets after the exocytosis of alpha granules

A

platelets become activated so there is more platelet cross linking and aggregation (spiculated and more glycoprotein IIaIIIb receptors)

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31
Q

what does asprin do to platelet amplification

A

inhibits pathway

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32
Q

what cross links platelets

A

fibrinogen

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33
Q

how does the platelet plug stay where its wanted

A

1) prostaglandins produced by undamaged endothelium inhibit platelet aggregation
2) NO released by undamaged endothelium cause vasodilation and inhibits platelet aggregation and activation

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34
Q

what are the vitamin K dependent clotting factors

A

10, 9, 7 and 2

1972

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35
Q

how are blood clots broken down

A

fibrinolytic pathway

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36
Q

explain the fibrinolytic pathway

A

plasminogen -> plasmin which breaks down fibrin

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37
Q

what % is cellular and fluid compartment of blood

A

cellular 45%

fluid 55%

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38
Q

what is haemopoiesis

A

formation of the blood cells

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39
Q

what is the process of differentiation of red blood cells, white B cells and platelets called

A

RBC- erythropoiesis
white blood cells- myelopoiesis
platelets- thrombopoiesis

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40
Q

what is the hormonal growth factors that control haemopoiesis of red blood cells and platelets

A

red cells- erythropoitein

platelts- thrombropoitein

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41
Q

what organs remove red blood cells

A

spleen, liver, bone marrow

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42
Q

function of dendritic cells

A

present antigens to the immune system

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43
Q

where to B and T lymphocytes mature

A

B- bone marrow

T- thymus

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44
Q

function of B and T lymphocytes

A

B- generate antibodies when stimulated by antigens

T- cell- mediated immunity and help B cells (Ab production)

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45
Q

what are the 2 types of T lymphocytes

A

T helper cells- suppress and regulate immune response

Cytotoxic T cells- target damaged/ infected cells for death

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46
Q

define haemostasis

A

blood inside the vessels remains fluid

blood outside the vessels should clot

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47
Q

how is blood kept fluid inside of vessels

A

1) platelets and proteins of the coagulation cascade circulate in an inactive state
2) endothelial cells, anticogulant pathway & fibrinolytic pathway keep it fluid

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48
Q

define anucleate cells

A

lacking a nucleus

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49
Q

what do platelets bind to when their is damage to the blood vessel

A

bind to collagen via glycoprotein Ia

and GPIIIa/IIb bind to VWF in the subendothelium

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50
Q

after the platelets bind (adhere) to the endothelium what happens

A

they change shape/ activate and release contents (degranulate)

51
Q

what granules do platelets release

A

electron dense granules and alpha granules (fibrinogen and VWF)

52
Q

what happens after platelets release granules

A

aggregate to form a platelet thrombus

53
Q

what is the role of GPIb

A

platelet adhesion

54
Q

what is the role of GPIIb/IIIa

A

platelet cross-linking and aggregation

55
Q

what is role of the dense storage granules

A

platelet activation and aggregation (when released)

56
Q

what are the proteins in plasma

A

albumin
carrier proteins
coagulation proteins
immunoglobulins

57
Q

what is the role of albumin

A

determines oncotic pressure of the blood (keeps intravascular fluid in that space)

58
Q

how does the coagulation cascade affect fibrinogen

A

converts soluble fibrinogen into insoluble fibrin polymer

59
Q

what is haemophilia

A

severe bleeding into muscles and joints

60
Q

where are coagulation factors synthesised

A

liver

61
Q

what are red cell antigens

A

red cell membrane proteins

62
Q

what can cause a transfusion reaction

A

red blood cells (which are used in the transfusion) have antigens on cell membrane which the body recognises as foreign and the body produces antibodies against them

63
Q

what surface antigens and antibodies are there in plasma for A, B, AB and O blood groups

A

A- A antigen, B antibodies
B- B antigen, A antibodies
AB- A and B antigens, no antibodies
O- no antigen, A and B antibodies

64
Q

what is the universal blood donator group

A

O-

65
Q

what is the universal blood recipient group

A

AB +

66
Q

what is Rh D antigen

A

antigen on RBC surface which can cause an immune response

67
Q

what does Rh D + and - mean

A

+ have D antigen

- don’t have D antigen

68
Q

can - Rh D receive + or - blood

A

+ no

- yes

69
Q

can + Rh D receive + and - blood

A

yes can receive both

70
Q

where is the glycoprotein IIb/IIIa located

A

on surface of platelet

71
Q

why do platelets change shape when they are activated

A

increase surface area to inc the possibility of cell-cell interactions

72
Q

what are the features of arteries

A

low resistance conduits

elastic

73
Q

conduits

A

channels for liquid (blood) flow

74
Q

where is the principle site of resistance to vascular flow

A

arterioles

75
Q

what is total peripheral resistance equal to

A

total arteriolar resistance

76
Q

what do arterioles have a major role in determining?

A

arterial pressure and distributing flow to tissue/organs

77
Q

role of arteries

A

cushion systole

maintain blood flow to organs during diastole

78
Q

difference between blood flow/ cardiac output to blood volume in circulation

A

blood flow- to organs

blood volume- in circulation, arteries, arterioles, capillaries, veins, lymphatics, endothelium

79
Q

describe vasoconstriction

A

vascular smooth muscle contracts
smaller radius of vessel
greater resistance and reduced flow

80
Q

describe vasodilation

A

vascular smooth muscle relaxes
bigger radius
smaller resistance and greater flow

81
Q

what is it called when the vascular smooth muscle never relaxes completely

A

myogenic tone

82
Q

describe features of capillaries

A

large area and slow flow

which allows time for nutrient and waste exchange

83
Q

what determines flow in the capillaries

A

arteriolar resistance

number of open pre-capillary spincters

84
Q

are veins high or low resistance conduits

A

low resistance and compliant

85
Q

how is blood returned to heart through veins against gravity (what aids it)

A

valves (also prevent backflow)

skeletal muscle (during contraction- squeezes the veins and forces more blood back to heart)

respiratory pump- inspiration, inc intra-abdominal pressure, transmitted to abdominal veins.

86
Q

what is transported in the lymphatics and where is it returned to the heart

A

fluid/ protein excess filtered from capillaries

thoracic duct in left subclavian vein

87
Q

what aids the unidirectional flow in lymphatics

A

smooth muscle in lymphatic vessels
skeletal muscle pump
respiratory pump

88
Q

cardiac output CO equation

A

heart rate x stroke volume

89
Q

blood pressure equation

A

Cardiac output x total peripheral resistance

90
Q

how much longer is diastole than systole

A

x2

91
Q

equation for pulse pressure

A

systolic - diastolic pressure

92
Q

mean arterial pressure

A

diastolic pressure + 1/3 pulse pressure

93
Q

ohm’s law flow

A

flow= pressure gradient / resistance

94
Q

poiseuilles equation

A

flow= radius ^4

95
Q

define cardiac output

A

the amount of blood ejected by each ventricle per minute

heart rate x stroke volume

96
Q

define stroke volume

A

the volume of blood ejected by each ventricle with each beat

97
Q

heart rate

A

the number of times the heart beats per minute

98
Q

end diastolic volume

A

volume of blood in each ventricle at the end of diastole

(just before heart contraction) 130ml

99
Q

ejection fraction

A

percentage of end-diastolic volume ejected with each beat

100
Q

end- systolic volume

A

volume of blood remaining in each ventricle at the end of systole
(contraction)
50ml

101
Q

what can affect cardiac output

A

any factor that affects stoke volume and heart rate

exercise, emotions, pregnancy, posture, sweating, age, gender

102
Q

what 3 factors affect stoke volume

A

preload
myocardial contractility
afterload

103
Q

what is preload and what happens if it is increased

A

end diastolic volume

increase in EDV means increase in stroke volume

104
Q

what is frank- starling law

A

within physiological limits, the force of contraction is directly proportional to initial length of muscle fibre

105
Q

if increased end diastolic volume, what does frank-starling predict

A

increased EDV= increased fiber length= increases force of muscle contraction= increases stroke volume= increases cardiac output

106
Q

what does preload depend on

A

venous return
atrial pump activity
ventricular compliance

107
Q

what does venous return depend on

A

skeletal pump activity, ECF volume, sympathetic activity- venoconstriction

108
Q

how does atrial pump activity affect preload

A

atrial contraction increases due to sympathetic activity

109
Q

what is ventricular compliance

A

compliant ventricles= more filling

less compliance= pathology- can’t expand as much

110
Q

what is myocardial contractility (inotropy)

A

increased contractility= increased stroke volume

111
Q

what increases contractility

A

more ventricular muscle mass
sympathetic stimulation
hormones- acetylcholine
drugs and chemicals- caffeine

112
Q

what is afterload

A

force against which ventricles contract/ eject

113
Q

what is cardiac output inversely proportional to

A

peripheral resistance

114
Q

what does peripheral resistance depend on

A

vessel diameter and viscosity of blood

115
Q

how does vasoconstriction and increased viscosity affect stroke volume

A

they increase peripheral resistance which decreases stroke volume

116
Q

what affects heart rate

A

autonomic activity

117
Q

what causes increase in HR (tachycardia >100) and decrease in heart rate (bradycardia <60)

A

tachycardia- sympathetic stimulation

bradycardia- vagal stimulation

118
Q

how is Cardiac output maintained when heart rate increases or decreases

A

heart rate increase- the duration of diastole shortens so EDV decreases

heart rate decrease- diastole prolongs, ECV does not decrease as much as expected

119
Q

how is frank-starling possible? how is force of contraction directly proportional to initial length of muscle fiber?

A

1) increased EDV= increased stretch of muscle fibers= increased interaction between thick and thin filaments= inc force of contraction
2) inc stretch opens stretch sensitive Ca2+ channels= inc cytosol calcium= inc force of contraction
3) stretch enhances affinity of troponin C for calcium= increased binding of calcium to troponin C= increased force of contraction

120
Q

define systolic and diastolic BP

A 
systolic= highest, when ventricles contract 
diastolic= lowest, when ventricles relax
121
Q

calculate mean arterial pressure

A

D + 1/3(S-D)

122
Q

what is used to measure BP

A

sphygmomanometer

123
Q

how does nitric oxide (NO) affect blood vessles

A

vasodilator

124
Q

how does endothelin affect blood vessles

A

vasoconstrictor

Medicine; Phase 1 (10 decks)

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