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Phase 1 From KP notes > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What percentage of the blood is in the cellular phase? What percentage of this are erythrocytes?

A

45% and 99%

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2
Q

What percentage of the blood is in the fluid phase?

A

55%

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3
Q

How many litres of blood do we have?

A

5 litres

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4
Q

What is haemocrit?

A

The percentage of red blood cells in the blood by volume (45% or 0.45)

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5
Q

What is haematopoesis?

A

Process by which red blood cells are created. Continues throughout life

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6
Q

Where does haematopoesis occur in adults?

A

Bone marrow

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7
Q

Where does haematopoesis occur in the foetus?

A

Liver and spleen and other organs

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8
Q

How long do platelets live for?

A

7-10 days

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9
Q

How long do erythrocytes live for?

A

120 days

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10
Q

How long do white blood cells live for?

A

6 hours

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11
Q

Where are the precursor cells of red blood cells located in adults and children?

A

Bone marrow of axial skeleton (skull, neck, thorax and spine) for adults, bone marrow of all bones for children

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12
Q

Describe the locations in which red blood cells are progressively produced in utero

A

Yolk sac, liver, spleen, bone marrow

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13
Q

Are precursor cells found in the blood?

A

No

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14
Q

What is it called when precursor cells are found in the blood

A

Leukaemia

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15
Q

What stimulates precursor stem cells to proliferate and differentiate?

A

Hormonal growth factors

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16
Q

Which hormonal growth factor stimulates
a) red blood cells
b) white blood cells
c) platelets

A

a) EPO (erythropoietin)
b) G-CSF (granulocyte colony stimulating factor)
c) TPO

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17
Q

Which direction will the oxygen dissociation curve shift when
a) pH decreases
b) temperature decreases

A

a) right
b) left

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18
Q

What is a young red blood cell called?

A

Reticulocyte

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19
Q

What does a red blood cell contain?

A

Plasma membrane
Enzymes of glycolysis
Haemoglobin
Cytoplasm

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20
Q

What does haemoglobin do?

A

Carry oxygen from lungs to tissues, where it transfers oxygen to myoglobin in muscles

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21
Q

Describe the structure and function of haemoglobin

A

2 alpha chains
2 beta chains
4 haem groups
Quaternary structure

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22
Q

Describe blood typing

A

Some individuals have the gene that codes for the A antigen on the surface of their erythrocytes (Type A)
Some individuals have the gene for the B antigen (Type B)
Some have the gene for both and these antigens are codominant (Type AB)
Some have the gene for neither (Type O)

Type A = anti-B antibodies in the blood
Type B = anti-A antibodies in the blood
Type AB = neither of these
Type O = anti A and anti B antibodies on the surface of the erythrocytes

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23
Q

Which blood group is the
a) universal donor?
b) universal recipient?

A

a) O
b) AB

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24
Q

Is the O antigen dominant or recessive?

A

Recessive

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25
Q

What type of antibodies are being described when it comes to red blood cells?

A

Anti-erythrocytes antibodies
natural antibodies

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26
Q

Why do problems occur when an incompatible blood transfusion is given?

A

Antibodies (be specific about which ones) in the recipients blood attack the antigens (again, be specific) on the donor’s erythrocytes

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27
Q

What do Rhesus positive and negative mean?

A

D antigen is present/ absent

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28
Q

What is anaemia?

A

Reduction in haemoglobin in the blood

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29
Q

What is the range of normal haemoglobin values?

A

12.5-15.5 g/dL

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30
Q

What is polycthaemia?

A

Abnormally high haemoglobin levels

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31
Q

What causes polycthaemia?

A

Smoking, lung diseases, inefficient lungs - less oxygen is exchanged so more haemoglobin is required

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32
Q

What are the symptoms of anaemia?

A

Tiredness, lethargy, malaise, reduced exercise tolerance, shortness of breath on exertion, angina

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33
Q

What are the signs of anaemia?

A

Pallor, pale mucus membranes and palmar creases (pink hands), glossitis (sore tongue), angular stomatitis (cracking at the corners of the mouth), kylonychia (spoon shaped nails)

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34
Q

Different types/ classifications of anaemia?

A

Iron deficiency, B12/ folate deficiency, anaemia of chronic disorder, haemolysis, bone marrow failure/ infiltration

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35
Q

Describe why an iron deficiency causes anaemia

A

Iron is required for haemoglobin production
A lack of iron results in the reduced production of red blood cells

36
Q

What is MCV, and what are the normal values?

A

Mean corpuscular volume
Measure of the size of erythrocytes, and 89 +-7 fl (82-96fl)

37
Q

What happens to MCV in an iron deficient anaemic patient?

A

Decreases to below 80fl

38
Q

What causes iron deficiency anaemia?

A

Bleeding
- Occult gastrointestinal (most common type of bleeding)
- Menorrhagia (heavy periods)

Dietary
- Not enough iron in the diet
- Most common cause of iron deficiency anaemia

39
Q

What is macrocytic anaemia, and what causes it?

A

MCV of erythrocytes is above 100fl (large erythrocytes)
It is a symptoms of B12 and folate deficiency
- can occur without anaemia (raised MCV and normal haemoglobin levels) and this is caused by liver disease, alcohol and hypothyroidism
- vitamin B12 and folate are needed for DNA synthesis
- when deficient in them, fewer erythrocytes can be made in the bone marrow
- therefore, fewer, larger erythrocytes are released
- deficiency affects all dividing cells but bone marrow is active so is affected first

40
Q

What causes B12 deficiency?

A

Stomach damage
- intrinsic factor is required for the absorption of B12 in the terminal ileum
- produced by gastric parietal cells in the stomach
- damaged stomach means fewer gastric parietal cells
- less absorption of B12
- anaemia occurs

41
Q

What is pernicious anaemia?

A

Autoimmune disease
Antibodies made against gastric parietal cells which produce intrinsic factor
Less intrinsic factor is produced
Less B12 can be absorbed
Liver has 4 year store of B12 so slow onset

42
Q

Causes of folate deficiency?

A

Found in fruit and vegetables
- malabsorption due to coeliac disease
- not eating enough fruit and veg
- increased need due to haemolysis

43
Q

What is haemolysis?

A

Normal or increased cell production but decreased life span of erythrocytes

44
Q

What are the congenital causes of haemolysis?

A

Spherocytosis
- spherical blood cells
- get stuck in blood vessels easily
- dominant but variable penetrance

Pyruvate kinase deficiency
- converts phosphoenolpyruvate to pyruvate
- less ATP production
- build up of phosphoenolpyruvate

G6PD deficiency

Sickle Cell Anaemia
- sickle shaped erythrocytes become stuck in blood vessels easily

Thalassaemia
- mutation in haemoglobin chains

45
Q

Acquired caused of haemolysis

A

Autoimmune
- immune system attacks own blood cells
- can be triggered by a blood transfusion due to the presence of foreign antibodies

Mechanical
- fragmentation of erythrocytes by mechanical heart valve or intravascular thrombosis in DIC (disseminate intravascular coagulation)

Haemolytic disease of the foetus and newborn

46
Q

What is haemolytic disease of the foetus and newborn?/ Rhesus disease

A

Mother is rhesus negative but the first child is rhesus positive
- mother is exposed to the baby’s blood in pregnancy
- mother recognises and makes antibodies against the baby’s rhesus positive erythrocytes
- mother is sensitised to rhesus positive blood
- first baby is unaffected as it takes time to produce the antibodies
- second rhesus positive baby is affected
- antibodies are produced immediately, and destroys the baby’s erythrocytes
- results in haemolysis of the foetus/ newborn’s red blood cells
- anaemia and jaundice occur

47
Q

Features of neutrophils:
How numerous in comparison to other leucocytes?
Lifespan?
Which hormone controls rate of production?
Function?

A

Most numerous white blood cell
10 hours
Phagocytose and kill bacteria
Release
- chemotaxins (signal more white blood cells to come to the site)
- cytokines (inflammatory response)

48
Q

What is caused by a lack of neutrophils?

A

Recurrent bacterial infections

49
Q

Functions of B and T lymphocytes?

A

Immunity
Some generate antibodies against specific foreign antigens e.g bacteria and viruses
Others are immunological memory - generates immunity and allows vaccination

50
Q

Features of B lymphocytes:
Where are they formed?
Where are they stored?
What is their function?

A

Made in bone marrow
Stored in secondary lymphoid organs
Differentiate into plasma cells and produce immunoglobulins when stimulated by a foreign antigen

51
Q

Features of T lymphocytes

A

Made in bone marrow
Mature in thymus
Some are CD4 helper cells
- help B cells in antibody generation, responsible for cellular or cell mediated immunity
Some are cytotoxic cells (CD8) - T killer cells

52
Q

What is acute leukaemia, and what does it cause?

A

Proliferation of primitive precursor cells usually found in bone marrow

Causes…
- anaemia: pallor and lethargy
- neutropenia: infections
- thrombocytopenia: excessive bleeding

53
Q

What is acute myeloblastic leukaemia?

A

malignant proliferation of the precursor myeloblasts in the bone marrow
primarily affects adults

54
Q

what is high grade lymphoma?

A

lymphocytes in lymph nodes becoming malignant, very similar to leukaemia
Classified as Hodgkins’s disease and Non-Hodgkins lymphoma
Disease usually of the lymph nodes that spreads to the liver, spleen, bone marrow and blood

55
Q

How do you test platelet function function?

A

Prothombrin time
- time taken for a clot to form in a blood sample

56
Q

Describe the features of platelets

A

Cytoplasmic enucleate cells

57
Q

What precursor cells form platelets?

A

megakaryocytes

58
Q

Lifespan of platelets

A

5-10 days

59
Q

What is the range of normal numbers of platelets?

A

140-400x10^9/l

60
Q

What are the complication of reduced numbers of platelets?

A

Thrombocytopenia
Risk of cerebral bleeding

61
Q

What are the complications of high levels of platelets?

A

Thrombocytosis
Arterial and venous thrombosis
Increased risk of heart attack and stroke

62
Q

What proteins can be found in the blood?

A

Coagulation proteins

Plasma proteins

63
Q

What is vitamin K and why is it needed?

A

Essential for the correct synthesis of coagulation factors 2,7,9 and 10 (remember as 1972)

64
Q

Describe the circulation of coagulation proteins in the blood

A

Circulate in their inactive form

65
Q

Describe the function of coagulation proteins

A

Make blood clot
Convert soluble fibrinogen into insoluble fibrin

66
Q

Describe the functions of plasma proteins

A

Carrier proteins for nutrients and hormones

67
Q

What are coagulation proteins?

A

Enzymes made in the liver
Key enzyme is thrombin (makes platelet plug)

68
Q

How do plasma proteins circulate in the blood

A

In plasma component
Soluble

69
Q

Which is the most numerous plasma protein?

A

Albumin

70
Q

where is albumin produced

A

liver

71
Q

function of albumin

A

maintain oncotic pressure

72
Q

sign of a lack of albumin

A

oedema

73
Q

what does albumin carry?

A

fatty acids, steroids and thyroid hormones

74
Q

what are immunoglobulins

A

antibodies produced by plasma cells

75
Q

what are the classes of immunoglobulins?

A

IgG, IgM, IgA, IgE

76
Q

most important immunoglobulin class?

A

IgG

77
Q

What is haemostasis?

A

The arrest of bleeding

78
Q

what are the two components of haemostasis?

A

coagulation of blood
contraction of damaged blood vessels

79
Q

why is blood usually fluid inside blood vessels?

A

the proteins of the coagulation cascade circulate in their inactive state until they are activated by tissue factor

80
Q

what is tissue factor

A

a protein present on every cell apart from endothelial cells

81
Q

what stimulates blood clotting?

A

when endothelium is punctured, blood comes into contact with tissue factor and clotting occurs

82
Q

what is the term for when blood clots inside a vessel?

A

thrombosis

83
Q

what is the coagulation cascade?

A

series of proteolytic enzymes that circulate in an inactive state being activated in a cascade sequence to generate thrombin
thombrin cleaves fibrinogen to create fibrin polymerisation i.e a blood clot

84
Q

what is the significance of thee coagulation cascade having multiple steps?

A

allows for biological amplification
allows for regulation
not an all or nothing response
can be graduated in response to severity of challenge

85
Q

function of platelets

A

responsible for primary haemostasis
adhere to damaged endothelium and aggregate to form a platelet plug that blocks the hole in the vessel

Phase 1 From KP notes (6 decks)

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