Chapter 18 - BLOOD Flashcards
Total blood volume in adult WOMAN
70 mL/kg
Total blood volume in adult MAN
80 mL/kg
________ is a suspension of cellular elements in plasma.
Whole blood
If you spin down a sample of blood containing an anticoagulant for __________, the bottom fraction contains FORMED ELEMENTS (RBCs, WBCs and platelets).
5 minutes at 10,000 g
The top fraction is ____________.
Blood plasma
The _____ having the highest density are at the bottom of the tube.
RBCs
WBCs and platelets form a WHITISH GRAY layer - the ________ - between the RBCs and plasma.
Buffy coat
The __________ is the fraction of the total column occupied by RBCs.
Hematocrit
The normal hematocrit for ADULT WOMEN.
40%
The normal hematocrit for ADULT MEN.
45%
The hematocrit in the NEWBORN is ____ and falls to ____ at 2 months of age, from which time it rises during development to reach adult values at puberty.
55%
35%
The __________ is a measure of concentration of RBCs, not of total body red cell mass
Hematocrit
Total RBC volume is ______ body weight in the ADULT WOMAN
28 mL/kg
Total RBC volume is ______ body weight in the ADULT MAN.
36 mL/kg
______ is a pale-white watery solution of electrolytes, plasma proteins, carbohydrates and lipids.
Plasma
Pink-colored plasma suggests the presence of hemoglobin caused by _______ and release of hemoglobin into the plasma.
Hemolysis (lysis of RBCs)
A brown-green color may reflect elevated ________ levels.
Bilirubin
Plasma can also be cloudy in __________.
Cryoglobulinemias
Plasma proteins at a normal concentration of 7.0 g/dL account for a colloid osmotic pressure or oncotic pressure of _________.
25 mmHg
Principal plasma proteins are:
Fibrinogen
Albumin
Globulins
Other coagulation factors
The molecular weights of plasma proteins range up to _______ kDa.
970 kDa
The plasma concentration of albumin ranges from _____________.
3.5 to 5.5 g/dL
Total plasma albumin pool of the body.
135 g
Albumin is synthesized by the liver at a rate of ________ body weight per day and due to CATABOLISM, has a half-life in the circulation of _________.
120 mg/kg
20 days
Urinary losses of albumin are normally negligible - __________.
<20 mg/day
Hepatic synthesis of albumin is strongly enhanced by a ____ plasma colloid osmotic pressure.
Low
The _______ molecule is a dimer of identical heterotrimers, each composed of Aa-, Bb and y chains.
Fibrinogen
Fibrinogen is synthesized only by the liver and circulates in plasma at concentrations of ___________.
150 to 300 mg/dL
The _________ greatly enhances fibrinogen synthesis.
Acute-phase response
Subsequent interaction of myosin and actin in the platelets of clot allows the clot to shrink to a plug that expels a slightly yellow-tinged fluid.
Serum
Absence of fibrinogen and other coagulation factor
Serum
True or False: Plasma can also form a clot.
True
Note: A plasma clot does not retract because it lacks platelets.
Subtraction of the albumin and fibrinogen moeity from total protein concentration yields the concentration of all the proteins grouped as __________.
Globulins
___________ can be used to fractionate plasma proteins.
Electrophoresis
The electrophoretic mobility of a protein depends on its ___________ as well as its __________.
molecular weight (size and shape) electrical charge
Almost any acute stress to the body (trauma, infection, disease) induces a reaction called the _________________.
Acute-phase response
Causes the RBCs to cluster and increases their effective density.
Fibrinogen
When anticoagulated blood from a patient with ____________ is placed in a glass tube, the RBCs fall more quickly under the influence of gravity that when the blood is from a healthy subject.
Hyperfibrinogenemia
________ thick for NORMAL BLOOD.
<15 mm
________ thick in certain inflammatory disorders.
> 40 mm
It is still widely used by clinicians to assess the presence and severity of inflammation.
ESR
Note: It is the rate of fall.
An _______ ESR would suggest that these complains are due to the reactivation of the disease and not just to a poor night’s sleep or depression.
Elevated
Plasma proteins comprise the following in decreasing order of electrophoretic mobility:
- Albumin
- a1 - globulins
- a2 - globulins
- b - globulins
- fibrinogen
- y - globulins
The three most abundant peaks:
Albumin, fibrinogen and y - globulins
Immunoglobulins are synthesized by ________ and _______.
B lymphocytes and plasma cells
True or False: Clinical laboratories most often perform electrophoresis of blood proteins on serum instead of plasma.
True
Proteins present in plasma at LOW CONCENTRATIONS are identified by immunological techniques such as __________ or _______________.
Radioimmunoassay
ELISA
The ________ synthesizes most of the globulins and coagualation factors.
Liver
_____________ is the source of most blood cells.
Bone marrow
The process of generation of all the cell types present in blood.
Hematopoiesis
Serves multiple roles ranging from the carriage of gases to immune responses and hemostasis.
Hematopoiesis
Pluripotent ___________ constitute a population of ADULT STEM CELLS found in bone marrow that are MULTIPOTENT and able to SELF-RENEW.
Long-term hematopoietic stem cells (LT-HSCs)
The __________ give rise to COMMITTED STEM CELLS or progenitors which after proliferation are able to differentiate into lineages that in turn give rise to ______________, each of which ultimately will produce one or a limited number of mature cell types.
Short-term hematopoietic stem cells (ST-HSCs)
Burst - forming units (BFUs) or colony - forming units (CFUs)
A gylcoprotein that stimulates proliferation of a common myeloid progenitor and promotes the production of neutrophils, eosinophils and monocytes-macrophages.
GM-CSF
is used clinically after bone marrow transplantation and in certain acute leukemias.
Recombinant GM-CSF (sargramostim [Leukine])
Are glycoproteins that guide the ultimate development of granulocytes and monocytes-macrophages/dendiritic cells
G-CSF
Are glycoproteins that guide the ultimate development of monocytes-macrophages/dendiritic cells
M-CSF
Is used therapeutically in neutropenia (e.g., after chemotherapy).
Recombinant G - CSF
Is also required for osteoclast development.
M - CSF
Has a broad effect on multiple lineages.
IL-3 (also known as MULTI-CSF)
Constitutively produce the IL-3
Liver and kidney
A homodimeric glycoprotein, sustains the terminal differentiation of eosinophilic precursors.
IL-5 (Colony-stimulating factor, eosinophil)
TPO binds to a TPO receptor called ________, which is the cellular homolog of the viral oncogene v-mpl (murine myeloproliferative leukemia virus).
c - Mpl
On stimulation by TPO, the __________ induces an increase in the number and size of megakaryocytes - the cells that produce platelets which thereby greatly augments the number of circulating platelets.
Mpl receptor
________ which is homologous to TPO, is produced by the KIDNEY and to a lesser extent by the liver.
EPO
This cytokine supports ERYTHROPOIESIS or red cell development.
EPO
HYPOXIA increases the abundance of the ______________, which enhances production of EPO messenger RNA.
a subunit of hypoxia-inducible factor 1 (HIF-1a)
Is not absolutely required for early commitment of progenitor cells to the erythroid lineage, it is essential for the differentiation of burst-forming unit-erythroid cells (BFU-Es) to colony-forming unit-erythroid cells (CFU-Es) or ___________ which still lack hemoglobin.
EPO
Proerythroblasts (also known as PRONORMOBLASTS)
The further maturation of cells downstream of proerythroblasts does not require _______.
EPO
Has proved effective in the treatment of anemia.
Recombinant EPO
Hemoglobin FIRST APPEARS at the stage of _________ and is CLEARLY EVIDENT in __________.
Polychromatic erythroblasts
Orthochromatic erythroblasts
The subsequent exocytosis of the nucleus produces __________, whereas the loss of ribosomes and mitochondria yields _________ which enter the circulation.
Reticuloyctes
Erythrocytes
_____________ may also appear in the ciirculation when erythropoiesis is HEAVILY ACTIVATED.
Immature reticulocytes
RBC are mainly composed of:
Hemoglobin
RBCs are non nucleated biconcave cells with a diameter of ________ and a volume of 90 fL.
7.5 um
Maintaining the shape pf the RBC is a CYTOSKELETON that is anchored to the plasma membrane by _____________ and the ______________.
Glycophorin
Band 3 Cl-HCO3 exchanger
The distinctive shape of the RBC provides a much larger ________________ than that of a spherical cell, thereby maximizing diffusion area and minimizing intracellular diffusion distances for gas exchange.
surface-to-volume ratio
The RBC performs three major tasks:
- carrying of O2 from the lungs to the systemic tissues
- carrying of CO2 from tissues to the lungs
- assisting in the buffering of acids and bases.
The most important constituent of the RBC is ______________.
hemoglobin
Globin synthesis begins in the ______________.
proerythroblast
By the end of the ______________ stage, the cell has synthesized all the hemoglobin it will carry.
orthochromatic-erythroblast
Normal blood hemoglobin content is _______ in the adult woman and ________ in the adult man.
- 0 g/dL
15. 5 g/dL
The hemoglobin concentration in red cell cytosol is extremely high, ________.
5.5 mM
The mean cell hemoglobin concentration is __________, or about five times the concentration of proteins in plasma.
35 g/dL
Enclosure of hemoglobin in red cells has the advantage of minimizing the loss of hemoglobin from the plasma through _________ across the blood capillary walls.
filtration
Because the mature RBCs contain no nucleus or other organelles, they can neither synthesize proteins nor engage in ______________.
oxidative metabolism
The RBC can engage in two metabolic pathways: ___________, which consumes 90% of glucose uptake and the ______________ which consumes the remaining 10% of glucose.
Glycolysis
Pentose shunt
The cell generates its ______ exclusively by glycolysis.
ATP
An important constituent of the RBC is _____________.
2,3-diphosphoglycerate (2,3-DPG)
RBCs use __________ to convert 1,3-diphosphoglycerate (1,3-DPG), part of the normal glycolytic pathway into 2,3-DPG.
DPG mutase
In RBCs, the cytosolic concentration of 2,3-DPG is normally _________, about the same as the concentration of hemoglobin.
4 to 5 mM
_________ acts on hemoglobin by reducing the O2 affinity of hemoglobin
2,3-DPG
Erythrocytes contain __________ at ∼2 mM, more than any other cell of the body outside the hepatocyte.
glutathione
*A high ratio of reduced glutathione (GSH) to oxidized glutathione (GSSG) protects the RBC against oxidant damage.
_____________ regenerates GSH from GSSG in a reaction that consumes NADPH.
Glutathione reductase
The RBC generates all its ________ from the glycolytic intermediate glucose 6-phosphate through the pentose phosphate pathway.
NADPH
RBCs carry two cytoplasmic isoforms of carbonic anhydrase, _______ and _______.
CA I and CA II
*These enzymes which rapidly interconvert CO2 and HCO3−, play a critical role in carrying metabolically produced CO2 from the systemic tissues to the pulmonary capillaries for elimination in the exhaled air.
______ has one of the fastest known enzymatic turnover rates.
CA II
CO2 carriage also depends critically on the _______________ in the RBC membrane.
Cl-HCO3 exchanger AE1
The transporter was originally known as ____________ because of its position on an SDS-polyacrylamide gel of RBC membrane proteins.
band 3 protein
_______ is the most abundant membrane protein in RBCs, with ∼1 million copies per cell.
AE1
One ______ molecule can transport as many as 50,000 ions per second—one of the fastest known transporters.
AE1
AE1 and most other members of the SLC4 family of HCO3− transporters are blocked by a disulfonic stilbene known as ______.
DIDS
The water channel _______ is the second most abundant membrane protein in RBCs, with 200,000 copies per cell.
AQP1
_______ appears to contribute more than half of the CO2 permeability of the RBC membrane.
AQP1
The name _______________ applies to all three types of granulocytes but often is used to refer specifically to neutrophils.
polymorphonuclear leukocytes
The average diameter of a neutrophil is _____, smaller than that of a monocyte (_____) or eosinophil (_____), somewhat larger than that of a basophil and much larger than that of a lymphocyte (______).
12 um
14 to 20 um
13 um
6 to 10 um
Granulocytes have a brief life span in the blood (_______) but on activation can migrate into the tissues.
<12 hours
The most abundant leukocytes, neutrophils are identified on the basis of the shape of the nucleus as ____________ (56% of leukocytes) and __________ (3% of leukocytes).
Mature segmented neutrophils
Immature band neutrophils
___________ have at least two lobes separated by a thin filament whereas ___________ have a nucleus of more uniform thickness.
Segmented neutrophils
Band neutrophils
Neutrophils have two types of granules (________ and _______) that contain lysosomal enzymes, peroxidase, collagenase, and other enzymes capable of digesting foreign material.
specific and azurophilic
In the presence of a ___________, neutrophils approach foreign substances such as bacteria to phagocytose them within a phagocytic vacuole.
chemotactic attractant
Bacteria are destroyed within the vacuole by the action of ___________ and ___________.
hydrogen peroxide (H2O2) and superoxide anion radical (O2−)
The granules of eosinophils contain ______________, which is toxic to parasites, as well as other enzymes. These cells are important in the response to parasites and viruses. Eosinophils also play a role in allergic reactions.
major basic protein (MBP)
