Chapter 18: Blood Flashcards
What are the two main components of blood?
A. Plasma and formed elements
B. Plasma and lymphocytes
C. Platelets and proteins
D. Electrolytes and stem cells
A. Plasma and formed elements
Explanation: Blood is composed of plasma (the fluid portion) and formed elements, which include red blood cells (RBCs), white blood cells (WBCs), and platelets.
Which of the following is a function of blood?
A. Transporting oxygen and nutrients
B. Regulating pH and temperature
C. Protecting the body against infection
D. All of the above
D. All of the above
Explanation: Blood plays multiple roles: it transports oxygen, nutrients, and hormones; regulates body temperature and pH levels; and protects the body through immune responses.
Blood viscosity is primarily affected by ______ and ______.
RBCs and plasma proteins
Explanation: Viscosity refers to the thickness or stickiness of blood, which is influenced by the number of red blood cells and the concentration of plasma proteins.
Which plasma protein is responsible for maintaining osmotic pressure and transporting lipids and hormones?
A. Fibrinogen
B. Albumin
C. Gamma globulin
D. Prothrombin
B. Albumin
Explanation: Albumin is the most abundant plasma protein and is critical for maintaining osmotic pressure and transporting various substances in the blood.
The primary site for blood cell production in adults is the liver.
A. True
B. False
B. False
Explanation: In adults, blood cell production (hematopoiesis) primarily occurs in the red bone marrow.
What is the main function of fibrinogen?
A. Transport oxygen
B. Promote blood clotting
C. Regulate blood pH
D. Destroy pathogens
B. Promote blood clotting
Explanation: Fibrinogen is a soluble plasma protein that converts to fibrin during blood clotting, helping form a blood clot.
The condition resulting from a deficiency in plasma proteins, often caused by liver disease or malnutrition, is called ______.
Hypoproteinemia
Explanation: Hypoproteinemia leads to decreased osmotic pressure, causing fluid retention in tissues and conditions like ascites.
What is the osmolarity of blood primarily determined by?
A. Glucose and cholesterol
B. Plasma proteins and sodium ions
C. Hormones and nitrogenous wastes
D. Phosphate and sulfate ions
B. Plasma proteins and sodium ions
Explanation: Osmolarity depends on the concentration of solutes such as sodium ions and plasma proteins, which regulate water balance and blood volume.
Kwashiorkor is a condition caused by excessive protein intake.
A. True
B. False
B. False
Explanation: Kwashiorkor is caused by severe protein deficiency, leading to symptoms such as edema and muscle wasting.
Which of the following cells are involved in hematopoiesis?
A. Hepatocytes
B. Hematopoietic stem cells (HSCs)
C. Keratinocytes
D. Fibroblasts
B. Hematopoietic stem cells (HSCs)
Explanation: HSCs are the precursors to all blood cells and are responsible for hematopoiesis in the bone marrow.
The colloid osmotic pressure of blood is primarily due to the presence of ______ in plasma.
Albumin
Explanation: Albumin contributes the most to colloid osmotic pressure, helping maintain fluid balance between blood and tissues.
What is the primary function of hemoglobin?
A. Produce white blood cells
B. Transport oxygen and carbon dioxide
C. Remove waste products from blood
D. Regulate blood pressure
B. Transport oxygen and carbon dioxide
Explanation: Hemoglobin binds oxygen in the lungs and carries it to tissues, while also helping transport carbon dioxide back to the lungs for exhalation.
The enzyme carbonic anhydrase (CAH) in red blood cells helps regulate blood pH by catalyzing the reaction between ______ and ______.
CO₂ and H₂O (carbon dioxide and water)
Explanation: CAH converts carbon dioxide and water into carbonic acid, which helps maintain blood pH balance.
Erythropoietin (EPO) is produced by the bone marrow to regulate RBC production.
A. True
B. False
B. False
EPO is produced by the kidneys and stimulates red bone marrow to increase RBC production when oxygen levels are low.
What gives RBCs their unique biconcave shape?
A. The presence of a nucleus
B. The absence of mitochondria
C. Cytoskeletal proteins like spectrin and actin
D. High oxygen concentration in the blood
C. Cytoskeletal proteins like spectrin and actin
Explanation: These proteins provide resilience and allow RBCs to squeeze through small capillaries and return to their shape.
The stages of erythropoiesis include hematopoietic stem cells, erythroblasts, ______, and mature erythrocytes.
Reticulocytes
Explanation: Reticulocytes are immature RBCs that enter the bloodstream before maturing into erythrocytes.
Which condition is caused by a hereditary defect in hemoglobin that leads to sickle-shaped erythrocytes?
A. Thalassemia
B. Iron-deficiency anemia
C. Sickle-cell disease
D. Polycythemia
C. Sickle-cell disease
Explanation: Sickle-cell disease is a genetic condition that affects hemoglobin, causing RBCs to take on an abnormal shape and block blood flow.
Bilirubin is a byproduct of hemoglobin breakdown and is excreted in bile.
A. True
B. False
A. True
Explanation: Bilirubin is formed from the breakdown of heme and is processed by the liver for excretion in bile.
What are the three primary categories of anemia?
A. Iron-deficiency, polycythemia, hemolysis
B. Inadequate erythropoiesis, hemorrhagic anemia, hemolytic anemia
C. Hypoxia, jaundice, sickle-cell disease
D. Pernicious anemia, aplastic anemia, hypoplasia
B. Inadequate erythropoiesis, hemorrhagic anemia, hemolytic anemia
Explanation: These categories classify anemia by its underlying causes: insufficient RBC production, blood loss, or destruction of RBCs.
Polycythemia refers to an excessive number of ______ in the bloodstream.
Red blood cells (RBCs)
Explanation: Polycythemia increases blood viscosity and volume, leading to potential complications like stroke and heart failure.
Which pigment is responsible for the greenish color of bruises and bile?
A. Urochrome
B. Bilirubin
C. Biliverdin
D. Transferrin
C. Biliverdin
Explanation: Biliverdin is the initial breakdown product of heme and is later converted to bilirubin.
Hypoxemia is a state of elevated oxygen levels in the blood.
A. True
B. False
B. False
Explanation: Hypoxemia is a deficiency of oxygen in the blood, often leading to increased EPO production and RBC synthesis.
Sickle-cell disease provides a survival advantage in regions with high rates of ______.
Malaria
Explanation: People heterozygous for the sickle-cell gene are more resistant to malaria, giving them a survival advantage in endemic areas.
What determines a person’s ABO blood type?
A) The type of hemoglobin they produce
B) The presence or absence of antigens A and B on the surface of RBCs
C) The antibodies found in the plasma
D) The oxygen-carrying capacity of their blood
B) The presence or absence of antigens A and B on the surface of RBCs
Explanation: Blood types A, B, AB, and O are determined by the presence or absence of A and B antigens on the red blood cells.
People with type O blood have _____ antigens on their RBCs and produce both anti-____ and anti-____ antibodies.
no; A; B
Explanation: Type O blood lacks A and B antigens but produces both anti-A and anti-B antibodies, making it incompatible with types A, B, and AB.
Type AB blood is known as the universal recipient.
A) True
B) False
A) True
Explanation: Type AB blood lacks anti-A and anti-B antibodies, allowing it to receive blood from any ABO blood type.
What is the primary cause of hemolytic disease of the newborn (HDN)?
A) Incompatibility in ABO blood types
B) Rh incompatibility between an Rh− mother and Rh+ fetus
C) Vitamin B12 deficiency
D) High bilirubin levels in the mother
B) Rh incompatibility between an Rh− mother and Rh+ fetus
Explanation: HDN occurs when an Rh− mother develops anti-D antibodies that attack the RBCs of an Rh+ fetus, especially in subsequent pregnancies.
The treatment for HDN involves administering _____ to the mother to prevent her immune system from producing anti-D antibodies.
Rh immune globulin (RhoGAM)
Explanation: RhoGAM binds to Rh+ fetal antigens in the mother’s blood, preventing her immune system from recognizing and attacking them.
What is the frequency of type O blood in the U.S. population?
A) 45%
B) 30%
C) 11%
D) 4%
A) 45%
Explanation: Type O is the most common blood type in the U.S., with about 45% of the population being type O.
Which statement about the Rh group is true?
A) Anti-D antibodies are always present in Rh− individuals.
B) Rh+ individuals lack the D antigen.
C) Anti-D antibodies are produced only after Rh− individuals are exposed to Rh+ blood.
D) Rh− individuals can safely receive Rh+ blood once.
C) Anti-D antibodies are produced only after Rh− individuals are exposed to Rh+ blood.
Explanation: Unlike anti-A and anti-B antibodies, anti-D antibodies are not naturally present and form only after exposure to Rh+ blood.
The Kell and Duffy blood groups are primarily significant for transfusion reactions.
A) True
B) False
B) False
Explanation: The Kell and Duffy blood groups are primarily used in paternity testing and forensic cases but rarely cause transfusion reactions.
Which process occurs when antibodies bind to incompatible blood antigens?
A) Coagulation
B) Agglutination
C) Fibrinolysis
D) Erythropoiesis
B) Agglutination
Explanation: In transfusion reactions, antibodies bind to incompatible antigens on RBCs, causing them to clump (agglutinate), which can block blood flow and lead to hemolysis.
What plasma antibodies are present in type A blood?
A) Anti-A
B) Anti-B
C) Both anti-A and anti-B
D) None
B) Anti-B
Explanation: People with type A blood have A antigens on their RBCs and anti-B antibodies in their plasma.
HDN can be prevented by giving Rh− mothers _____ during pregnancy and after delivery of an Rh+ baby.
Rh immune globulin (RhoGAM)
Explanation: Rh immune globulin prevents the mother’s immune system from producing anti-D antibodies that could harm future Rh+ pregnancies.
Which of the following is a reason to determine non-ABO/Rh blood types?
A) Paternity testing
B) Measuring oxygen levels
C) Diagnosing HDN
D) Checking hydration levels
A) Paternity testing
Explanation: Non-ABO/Rh blood groups like Duffy and Kell are important for paternity testing and population genetics studies.
Which of the following is true about leukocytes?
A) They are the most abundant formed elements in blood
B) They have a lifespan of several months in circulation
C) They protect against infection and disease
D) They do not have nuclei or organelles
C) They protect against infection and disease
Explanation: Leukocytes (WBCs) are essential for immune defense. They are less abundant than red blood cells but crucial for protecting the body from infections and diseases.
The most abundant type of leukocyte is the __________, which plays a major role in bacterial infections.
Neutrophil
Explanation: Neutrophils constitute 60-70% of WBCs and are critical in fighting bacterial infections by phagocytizing bacteria and releasing antimicrobial chemicals.
Monocytes and lymphocytes are classified as granulocytes.
A) True
B) False
B) False
Explanation: Monocytes and lymphocytes are agranulocytes because they lack specific granules, unlike neutrophils, eosinophils, and basophils, which are granulocytes.
What condition is characterized by an abnormally low WBC count?
A) Leukocytosis
B) Leukopenia
C) Leukemia
D) Anemia
B) Leukopenia
Explanation: Leukopenia refers to a WBC count below 5,000 cells/μL and can be caused by radiation, infectious diseases, or certain drugs, leaving individuals at risk for infections.
The process of white blood cell formation is called __________.
Leukopoiesis
Explanation: Leukopoiesis is the production of WBCs from hematopoietic stem cells in the bone marrow.
Chronic leukemia progresses rapidly and is often fatal within months if untreated.
A) True
B) False
B) False
Explanation: Chronic leukemia progresses slowly and may go undetected for months or years, while acute leukemia progresses rapidly.
Monocytes differentiate into __________ once they leave the bloodstream and enter tissues.
A) Neutrophils
B) Macrophages
C) Basophils
D) Erythrocytes
B) Macrophages
Explanation: Monocytes transform into macrophages in the tissues, where they perform phagocytosis of pathogens and debris.
A high neutrophil count on a CBC indicates a __________ infection.
Bacterial
Explanation: Elevated neutrophil levels are a common response to bacterial infections.
What is the overall function of leukocytes?
Leukocytes protect the body from infections, remove dead cells and debris, and coordinate immune responses.
List the five kinds of leukocytes in order of abundance, identify whether each is a granulocyte or agranulocyte, and describe the functions of each one.
Neutrophils (Granulocyte): Fight bacterial infections through phagocytosis.
Lymphocytes (Agranulocyte): Coordinate immune responses, destroy infected cells, and produce antibodies.
Monocytes (Agranulocyte): Differentiate into macrophages and digest dead cells and pathogens.
Eosinophils (Granulocyte): Respond to parasitic infections and allergies.
Basophils (Granulocyte): Release histamine and heparin, promoting blood flow and preventing clotting.
What does leukopoiesis have in common with erythropoiesis? How does it differ?
Both processes begin with hematopoietic stem cells. Leukopoiesis produces WBCs, while erythropoiesis produces RBCs.
What can cause an abnormally high or low WBC count?
High (Leukocytosis): Infection, inflammation, leukemia.
Low (Leukopenia): Radiation, viral infections, toxic exposure (lead, arsenic).
Suppose myeloblasts began multiplying out of control, but their subsequent development remained normal. What types of mature WBCs would be produced in excess? What types would not?
Produced in excess: Neutrophils, eosinophils, basophils (granulocytes).
Not produced: Monocytes and lymphocytes (arising from monoblasts and lymphoblasts).
What are the three basic mechanisms of hemostasis?
A. Coagulation, vasoconstriction, platelet activation
B. Platelet plug formation, vascular spasm, coagulation
C. Hemolysis, fibrinolysis, platelet aggregation
D. Vasodilation, coagulation, fibrinolysis
B. Platelet plug formation, vascular spasm, coagulation
Explanation: The three mechanisms of hemostasis are vascular spasm (constriction of blood vessels), platelet plug formation (temporary seal), and coagulation (formation of a fibrin-based blood clot).
The enzyme _______ converts fibrinogen into fibrin, forming the structural framework of a blood clot.
Thrombin
Explanation: Thrombin is a key enzyme in the coagulation cascade that converts fibrinogen into fibrin, which forms a mesh to stabilize the clot.
The intrinsic mechanism of coagulation is triggered by factors outside the blood, such as tissue damage.
A. True
B. False
B. False
Explanation: The intrinsic mechanism is activated by factors found within the blood. It differs from the extrinsic mechanism, which is triggered by external tissue factors.
How do anticoagulants like heparin prevent inappropriate clotting?
A. By stimulating thrombin production
B. By blocking platelet aggregation
C. By inhibiting thrombin and prothrombin activator
D. By promoting fibrin formation
C. By inhibiting thrombin and prothrombin activator
Explanation: Heparin blocks thrombin and prothrombin activator, preventing the formation of fibrin and thereby stopping clot formation.
A(n) ______ is a traveling blood clot that can lodge in small arteries and cause infarction (tissue death).
Embolus
Explanation: An embolus is a dislodged clot that travels through the bloodstream and may cause blockage in critical vessels, leading to serious conditions like stroke or pulmonary embolism.
Disseminated intravascular coagulation (DIC) involves widespread clotting in intact blood vessels and can lead to organ failure.
A. True
B. False
A. True
Explanation: DIC is a severe condition where widespread clotting occurs, potentially blocking blood flow to organs and causing significant damage.
Which of the following disorders is characterized by a platelet count below 100,000/mL and may result in small hemorrhagic spots in the skin?
A. Thrombocytopenia
B. Thalassemia
C. Septicemia
D. Infectious mononucleosis
A. Thrombocytopenia
Explanation: Thrombocytopenia is a condition characterized by a low platelet count, leading to increased bleeding and formation of petechiae (small hemorrhagic spots).
