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SEM2 BIOSCIENCE > Case 7 > Flashcards

Case 7 Flashcards

1
Q

What parameter drives Hb gas exchange in both lung capillaries and peripheral tissues?

A

plasma [02]

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2
Q

What are the two factors that effect oxygen delivery to tissues?

A

[02]

cardiac output

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3
Q

What are the two states of Hb? How do they relate of oxygen binding?

A

Tense (low 02 affinity)

Relaxed (high O2 affinity)

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4
Q

What is myoglobin? How does its affinity for O2 differ to Hb?

A

Myoglobin is an 02 found in muscles

it has a higher affinity for O2 than Hb, meaning 02 is always given up at the muscles

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5
Q

How much blood does the average adult male have?

A

5-6L

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6
Q

What is the make up of bone marrow at birth?

A

Only red marrow

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7
Q

What is the function of red bone marrow?

A

Site of haematopoiesis

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8
Q

What is the function of yellow bone marrow?

A

Part of bone marrow stroma that makes up a microenvironment that provides physical support for haematopoiesis

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9
Q

Apart from yellow bone marrow, what other cells are contained within the stroma of bone marrow? (5)

A 
Fibroblasts
Macrophages
Adipocytes
osteoclasts
osteoblasts
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10
Q

Name the two ways in which EPO increases RBC production…

A

Increasing HSC rate of division and differentiation down erythroblast lineage

Increasing rate of Hb synthesis in RBC maturation process

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11
Q

From what lineage are natural killer cells derived?

A

Common lymphoid progenitor lineage

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12
Q

What is the average lifespan of a platelet?

A

7-9 days

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13
Q

What is the average lifespan of an RBC?

A

120 days

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14
Q

What is the average lifespan of a monocyte?

A

1-2 days

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15
Q

What is the average lifespan of a neutrophil?

A

5 days

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16
Q

What is the average lifespan of a basophil?

A

60-70 hours

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17
Q

What is the average lifespan of a eosinophil?

A

8-12 hours

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18
Q

Anti-A and anti-B antibodies are most commonly which class of immunoglobulin?

A

IgM

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19
Q

Why are ABO and Rhesus the most important blood group antigens?

A

Individuals who lack a blood group antigen have naturally occuring antibodies to that antigen

Can lead to transfusion reactions if exposed to the wrong blood type

20
Q

What is the function of the ABO gene product?

A

Enzyme that adds carbohydrate residues to H substance

H substance is a glycoprotein on the RBC cell surface

21
Q

What blood group is known as the universal donor group?

A

O

22
Q

What blood group is known as the universal recipient group?

A

AB

23
Q

What is the universal plasma donor group?

A

AB

only 4% of population

24
Q

What is the kleihauer test? How is it performed?

A

Blood test used to measure the amount of HbF transfer from foetus to mother during pregnancy, which in turn determines Rh+ exposure

Blood sample added to acid bath. HbF resistant to denaturation

25
Q

When should doses of anti-RhD+ antibodies be given to prevent haemolytic disease of the newborn?

A

28 weeks and 6 hours after birth

26
Q

How is anaemia classified?

A

By cause e.g haemolytic anaemia

By RBC size e.g microcytic, normocytic, macrocytic

27
Q

In addition to [Hb] measurement, what else may indicate iron deficiency anaemia?

A

Low serum ferritin

28
Q

What is anaemia of chronic disease?

How is it caused?

How is it treated?

A

Impaired RBC production that is not related to any form of deficiency

Caused by chronic diseases such as inflammation, renal disease, liver failure and cancer

Treatment of underlying disease will treat anaemia collaterally

29
Q

What is aplastic anaemia?

What examination sign forms a key part of the differential diagnosis?

A

Rare form of anaemia in which the HSC of the bone marrow become dysfunctional. Deficiencies seen in erythrocytes, leukocytes and thrombocytes

Increased rate of bruising suggests thrombocyte deficiency

30
Q

What is spherocytosis and elliptocytosis?

How does this relate to anaemia?

A

Abnormal shape of RBCs that make them more likely to burst open (lyse)

Often found in patients with hereditary haemolytic anaemia

31
Q

What is haemolytic anaemia? How is it classified?

A

Anaemia that results from an increase in rate of RBC destruction

Classified as either hereditary or acquired (autoimmune)

32
Q

What is hydroxyurea used to treat?

What is its mechanism of action?

A

Sickle cell anaemia

Increases the rate of HbF production. HbF doesn’t have the capacity to sickle in the way that the faulty B globulin sickle chains do

33
Q

What is the process of ‘group and save’?

A

Blood group investigations are performed (including antibody status). This is then kept on file

34
Q

What is crossmatching?

What happens to the process during an emergency?

A

Patients blood sample matched with blood products they are intended to receive prior to transfusion

Wavered in cases of emergency, universal donor blood type given. Risks of transfusion reactions thought to outweigh harm if non-treated

35
Q

What is compatability testing?

How does it differ to crossmatching?

A

Blood group and antibody investigations performed AND patients sample matched with tranfusion product they intend to receive

Cross matching is only the later

36
Q

What is the function of a leucodepletor?

A

Function to remove all white blood cells from the blood. This removes risk of transmission of WBC-born diseases such as variant CJD, BSE, cytomegalovirus

37
Q

What is the shelf life of RBCs?

A

35 days

38
Q

What viruses are blood products tested for?

A

HIV, hepatitis, syphilis

39
Q

what blood product has the highest risk of bacterial infection?

A

Platelets- they are stored at room temperature

40
Q

What is disseminated intravascular coagulation?

A

Aggregation of RBC throughout the body that block small arterioles and capillaries

Initiated by incompatible blood transfusions that activate complement, leading to aggregation and agglutination

41
Q

Each unit of erythrocytes raises HB levels by approximately…. g/L

A

10g/L

42
Q

What is fresh frozen plasma most commonly used to deliver?

A

Clotting factors

43
Q

What is cryoprecipitate most commonly used to deliver?

A

Fibrinogen

44
Q

Why is it important to consider haemodynamics before administration of blood products?

A

Blood products raised blood volume and increase cardiac output

This can exacerbate heart failure and pulmonary oedema

45
Q

Define altruism…

A

The selfless concern for the wellbeing of others

Driving force behind blood donation process

46
Q

What is the moral personhood argument (relating to ethics of blood donation)?

A

An argument against the commercialisation of blood donation suggesting that people and their components are not something that should be bought and sold

47
Q

A patient has to understand 3 things about their treatment before consent can be said to be ‘informed’. What are these three things?

A

Have to have an understanding of:

  1. What it is and why they need it
  2. Associated risks
  3. Any other alternatives

SEM2 BIOSCIENCE (13 decks)

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