Chapter 17: Blood Flashcards
What is hematology?
Study of blood
What are the functions of blood?
Transport, protection and regulation
What does blood transport?
Oxygen, carbon dioxide, nutrients, waste, hormones
What part of the blood is part of protection?
Leukocytes (white blood cells)
What does the circulatory consist of?
The heart, blood and blood vessels
What does the cardiovascular system consist of?
Heart and blood vessels
How much blood does an adult usually have?
4 - 6 L
What is blood?
Liquid connective tissue consisting of cells and extracellular matrix
_______ is aa clear, light yellow fluid
Plasma
What are the 3 formed elements?
RBCs, WBCs, and platelets
What are erythrocytes also known as?
Red blood cells
What are thrombocytes known as?
Platelets
What are leukocytes known as?
White blood cells
What are the 2 categories of leukocytes?
Granulocytes and agranulocytes
What are the granulocytes (name them)?
Neutrophils, eosinophils, basophils
What are the granulocytes (name them)?
Neutrophils, eosinophils, basophils
What are the agranulocytes?
Lymphocytes and monocytes
_____ is the % of blood cells compared to the total blood volume
Hematocrit
What’s the heaviest formed element/settles first?
Erythrocytes
What percentage of blood is the erythrocytes?
37 - 52%
What percentage of blood is the erythrocytes?
37 - 52%
What % of the blood is white blood cells and platelets?
1
What percentage of blood is the plasma?
47 - 63%
What is plasma a mixture of?
Water, proteins, electrolytes, nutrients, nitrogenous wastes, hormones and gases
What’s is the the only difference between plasma and serum?
Plasma has fibrinogen while serum does not
What is the remaining fluid when blood clots and solids are removed called?
Serum
What’s the liquid portion of blood?
Plasma
What are the 3 major categories of plasma proteins?
Albumin, globulins and fibrinogen
________ is the most abundant category of blood, as it contributes to viscosity and osmolarity, influences blood pressure, flow and fluid balance
Albumin
What is the category of the plasma proteins that serves as an antibody and a carrier protein?
Globulin
What in the blood helps with clotting?
Fibrinogen
Other than _____ , plasma proteins are formed in the _____.
Gamma globulins and liver
What are gamma globulins produced by?
Plasma cells
_____ is the resistance of a fluid to flow (thickness or stickiness of a fluid).
Viscosity
Whole blood is _____ times as viscous as water.
5
________ is the total molarity of dissolved particles
Osmolarity
High osmolarity causes _______, while low osmolarity causes ________.
Fluid absorption into blood raising BP
Fluid to remian in the tissues, edema
Hypoproteinemia is the deficiency of ______
Plasma proteins
What are some signs of hypoproteinemia?
Extreme starvation, liver or kidney diseases and severe burns
Children with _______ have severe protein deficiency, withy thin arms and legs and a swollen abdomen.
Kwashiorkor
Adults produce ____ platelets, _____ RBCs and _____ WBCs daily.
400 billion , 100-200 billion and 10 billion
Homeopoiesis is the ________
Production of blood, especially its formed elements
______ produces all seven formed elements
Red blood bone marrow
How many classes of formed elements does the colony-forming unit make?
1
________ hemopoiesis is the blood formation in the bone marrow while _____ hemopoiesis is blood formation in the lymphatic organs
Myeloid and lymphoid
What does lymphoid hemopoiesis only involve beyond infancy?
Lymphocytes
What are the 2 main functions of red blood cells?
Carry oxygen from lungs to cell tissues
Pick up CO2 from tissues and bring to lungs
Insufficient RBCS can cause death in minutes due to ______
Lack of oxygen to tissues
What is blood type determined by?
Surface glycoproteins and glycolipids
What do RBCs lack?
Mitochondria, mitosis, protein synthesis, DNA and nucleus
What percent of cytoplasm is hemoglobin?
33%
What gases are involved with the RBCs?
Oxygen delivery to tissues
Carbon dioxide transport to lungs
What does carbonic anhydrase do?
Produces carbonic acid from m carbon dioxide and water
How many protein chains do globins have and what is this divided into?
4, 2 alpha and 2 beta chains
______ are non protein moieties that bind to ferrous ion (Fe) at its center
Heme groups
What does RBC count and hemoglobin concentration indicate?
The amount of oxygen blood can carry
Why are hematocrit %, hemoglobin concentration and RBC count lower in women than men.?
Androgens stimulate RBC production
Women have periodic menstrual losses
Male blood clots faster, and fewer vessels in male skin
What are the steps to red blood cell production?
- Hemopoietic stem cell
- Colony forming - unit (Erythrocyte CFU)
- Erythroblast (Hemoglobin made, nucleus disappears)
- Reticulocyte (Leave marrow to blood)
- Erythrocyte (Polyribosomes disappear(
_____ RBCs are produced per second, has a development of _____ and has an average lifespan of _____
~ 1 million, 3 - 5 days and 120 days
What element is one of the key nutritional requirements for erythropoiesis?
Iron
Iron is lost daily through _______ and women lose ___ a day while men lose ____ a day.
Urine, feces and bleeding
0.9 mg/day and 1.7 mg/day
How much iron should be consumed daily?
5 -20 mg/day
_______ converts Fe3+ to absorbable Fe2+
Stomach acid
Gastroferritin binds _____ and transports it to _____
Fe2+ and intestine
Fe2+ is absorbed into the blood and binds to ______ for transport
Transferritin
_____ for hemoglobin and ______ for myoglobin
Bone marrow and muscle
____ binds to Fe2+ create ferritin for storage
Liver apoferritin
What are the steps of iron metabolism?
- Mixture of Fe2+ and Fe3+ is injested
- Stomach converts Fe3+ to Fe2+
- Fe2+ binds to gastroferritin
- Gastroferritin transports Fe2+ to small intestine and releases it for absorption
- In blood plasma Fe2+ binds to transferritin
- In liver, some transferritin releases Fe2+ for storage
- Fe2+ bind to apoferritin to be stored as ferritin
- Remaining transferrin is distributed to other organs where Fe2+ is used to make hemoglobin, myoglobin etc
What kind of feedback system occurs in erythropoiesis?
Negative feedback
Production of ______ stimulates bone marrow.
Erythropoietin
How long does it take from RBC count to go back up after it decreases?
3 - 4 days
What’s re some stimuli for erythropoiesis that causes the negative feedback loop?
Low levels of oxygen (hypoxemia) - Moving to higher altitudes
Increase in exercise (Muscles consume oxygen faster)
Loss of lung tissue in emphysema
Where do RBCs rupture/lyse?
In narrow channels of spleen and liver
What do macrophages in the spleen do?
Digest membrane bits and separate heme from globin
What is its called when the heme pigment is converted to green?
Billiverdin
What is billiverdin converted to that is yellow?
Billirubin
What gives brown feces its color and yellow urine its color?
Feces - Urobillnogen
Urine - Urochrome
Billirubin _______ and gut bacteria turns _____ into brown urobilliogen.
Binds albumin and bile
What is an excess of RBCs called?
Polycythemia
What are the kinds of polycythemia and explain.
Primary - cancer of erthrythropoietic cell line in red bone marrow (RBC count as high as 11 million)
Secondary - Can be from dehydration, high altitude or physical conditioning (RBC count as high as 8 million)
Embolism, stroke and heart failure are all dangers of _______.
Polycythemia
_____ is the low-carrying capacity of RBCs
Anemia
Some causes of anemia include _____ anemia, _____- anemia and ________.
Hemorrhagic (blood loss), hemolytic (RBC destruction) and inadequate erythropoiesis or hemoglobin synthesis
_______ anemia involves the autoimmune destruction of the stomach that makes the intrinsic factor.
Pernicious
What are some things that can lead to inadequate erythropoiesis or hemoglobin synthesis?
Inadequate vitamin B12/lack of intrinsic factor
Iron - deficiency
Kidney failure
Aplastic anemia
Aplastic anemia is _________.
Cessation of myeloid function
What are 3 effects of anemia?
Tissue hypoxia and necrosis
Low blood osmolarity producing tissue edema
Low blood viscosity
What causes sickle-cell?
A recessive allele that modifies the structure of the hemoglobin molecule
The only thing that differs a person with sickle cell from a normal person is the _______ amino acid of the beta chain.
Sixth
______ are used to distinguish self blood type form foreign, _____ are secreted by plasma cells as a part of an immune response to foreign matter and _____ causes clumping of RBCs.
Antigens, antibodies, agglutination
RBC antigens are called ____, are divided into __ and _____ and are determined by ____
Agglutinogens
A and B
Glycolipids on RBC surface
Antibodies are also known as ____ and divided to ___ and ___ and are found in the _____.
Agglutinins
Anti-A and anti-B
Plasma
Blood Type A person has ___ antigens, Blood Type B person has ___ antigens, Blood Type AB person has ___ antigens and Blood Type O person has ___ antigens
A
B
A and B
Neither
The most common blood type is ____ while the rarest is _____.
O and AB
You can not form antibodies against your _______.
Antigens
What is responsible for mismatched transfusion reaction?
Agglutination
Charles Brew was the first African American to pursue an adavanced degree in medicine in _____, which led him to use ____ rather than whole blood which gave way to less transfusion reactions.
Blood banking and transfusion
Plasma
What does O blood type lack?
RBC antigens
Why is type AB the universal recipient?
It lacks plasma antibodies, so no anti-A or anti-B
Where and when was the Rh Agglutinogens discovered?
Rhesus monkey and 1940
What type of agglutinogens are not usually present?
Anti-D
What kind of mother may have issues during her pregnancy/transfusion?
A Rh- woman with an Rh+ fetus/blood transfusion would have no issues the first time but would the second time
What is given to pregnant Rh- women and why?
RhoGAM and because it binds fetal Agglutinogens so she will not form Anti-D antibodies
What can the Rh antibodies that attack fetal blood cause?
Severe anemia and toxic brain syndrome
What id the least abundant formed element?
Leukocytes (WBCs)
______ protects against infectious microorganisms and pathogens.
White blood cells
How long do leukocytes stay the bloodstream before migrating to connective tissue?
A few hours
_____- have a three to five-lobed nucleus
Neutrophils
________ have large rosy-orange granules, with a bilobed nucleus.
Eosinophils
____ have large, abundant, violet granules thaat cover the nucleus.
Basophils
_____ is usually the largest WBC
Monocyte
A large number of neutrophils can lead to ____ infections, a large number of eosinophils can lead to ____ and a large number of basophils can lead to ________.
Bacterial infections
Parasitic infections, allergies, collagen infections
Chickenpox, sinusitis, diabetes
What do basophils secrete and what do they do?
Histamine (vasodilator) - Speeds up flow of blood to an injured area
Heparin (anticoagulant) - Promotes mobility of other WBCs in the area
What are neutrophils nicknamed?
Band-, stab- and PMN cells
A large number of lymphocytes leads to ____ and a large number of monocytes leads to _______.
Diverse infections and immune responses
Numbers of viral infections and inflammation
______ destroys cancer, foreign and virally infected cells, presents antigens to activate other immune cells and secretes antibodies, providing immune memory.
Lymphocytes
_______ leaves the bloodstream, transforming into macrophages.
Monocytes
What is the production of leukopoeisis?
Production of white blood cells
Hemopoietic stem cells are also called ______.
Hemocytoblasts
What do hemocytoblasts differentriate to?
Myeloblasts, monoblasts and lymphoblasts
Myeloblasts form_______, monobalsts form ____ and lymphoblasts form ____.
Neutrophils, eosinophils, basophils
Monocytes
Lymphocytes
Where are granulocytes stored and released?
In the red bone marrow
Dead ____ causes the creamy color of pus.
Neutrophils
Granulocytes leave the blood stream in ____ hours and leave ____ days later, while monocytes leave in _____, transform into macrophages and live for ______.
8 hours
5 days
20 hours
Several years
What is a normal WBC count range?
4 - 10 thousand
______ is a low WBC count below ___ and ___ is a high WBC count, higher than ____.
Leukopenia, 5,000, Leukocytosis, 10,000
Radiation, HIV and poisons are all causes of _______.
Leukopenia
What are some causes of leukocytosis?
Infection, allergy, disease
_____ is the cancer of hemopoietic tissue, usually producing a very high number of circulating leukocytes.
Leukemia
Myeloid leukemia is uncontrolled ______ production while _____ leukemia is uncontrolled lymphocytes or monocytes production.
Granulocytes
Lymphoid
Acute leukemia appears _____, with death within _______, while _______ goes undetected for months, with the survival time being 3 yeas
Suddenly, months and chronic leukemia
Hemostasis is ______ while hemorrhage is ________
The cessation of bleeding
Excessive bleeding
What are the 3 steps of stopping bleeding?
Vascular spasm, Platelet plug formation, blood clotting (coagulation)
_____ are small fragments of megakaryocyte cells, with a normal count of ___________
Platelets
130,000 to 400,000
What are some platelet functions?
Phagocytizes bacteria
Initiates formation of clot-dissolving enzyme
Secretes clotting factors and growth factors for vessel repair
What is platelet formation called?
Thrombopoiesis
What happens in the vascular spasm stage of hemostasis?
Blood vessels constrict
In _____ platelets adhere to blood vessels pulling it together.
Platelet plug formation
What is the main goal of blood clotting?
To convert fibrinogen to fibrin
______ is the sticky protein that sticks to the walls of blood vessels
Fibrin
In the ____ pathway, factors released by damaged tissue begin in cascade while in the ______ pathway, factors in blood begin cascade.
Extrinsic and intrinsic
What is the most effective defense against bleeding?
Clotting
What are clotting factors called?
Procoagulants
Extrinsic pathway is initiated by _______ cascade to factors ___, __ and ___
Tissue thromboplastin
Factor 7, 5 and 10
Instrinsic pathway is initiated by factor ___ cascade to factor ____ to ____ to ____ to _____.
7, 11, 9, 8, 10
What is required for both the extrinsic and intrinsic pathway?
Calcium
What is hemophilia?
Deficiency of any clotting factor that can shut down the coagulation cascade
What kind of disease is hemophilia?
Sex-linked recessive (X)
What are the kinds of hemophilia, what does this entail and what are the percentages?
Hemophilia A missing factor VIII (83%)
Hemophilia B missing factor IX (15%)
Hemophilia C missing factor XI (autosomal)
What is embolism?
Blood clotting in a vessel
_______ is abnormal clotting in an unbroken vessel and is most likely to occur _____.
Thrombosis
In the leg veins of inactive people
What is infarction called?
Tissue death
How many Americans die annually of thromboembolism (traveling blood clot)?
650,000
____ are masses of clotted blood in tissues.
Hematomas
What is required for the formation of clotting factors?
Vitamin K
______ suppresses thromboxane.
Aspirin
What animals have been used as anticoagulants?
Medicinal leeches (hirudin)
Snake venom (Arvin)
