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Physiology of Disease > Exam 2 Blood Lab > Flashcards

Exam 2 Blood Lab Flashcards

1
Q

a buffy coat layer

A

consists of WBC’
is a thin white (or grey) layer
lies between the heavier RBC layer and the lighter yellow plasma

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2
Q

Why would the hemoglobin levels of an anemic patient be lower than the hemoglobin levels of a normal healthy individual

A

because hemoglobin resides in RBC’s you would anticipate a low hematocrit level to coincide with a low hemoglobin level

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3
Q

________ refers to the percentage of red blood cells or erythrocytes in a sample of whole blood

A

hematocrit

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4
Q

1 The organ that immediately responds to low oxygen levels by stimulating production of RBC’s by producing erythropoietin is the

A

kidney

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5
Q

iron deficient anemia

A

lower than normal hematocrit due to lack of iron either through loss or inadequate intake

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6
Q

polycythemia

A

higher than normal hematocrit

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7
Q

sickle cell anemia

A

lower than normal hematocrit due to abnormal hemoglobin resulting in early destruction of RBC’s

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8
Q 
List the results of experiment 11-1 from highest hematocrit (highest such as 60) first to lowest (such as 10) last
male in denver
female in denver
female with iron deficiency anemia
female in boston
male with aplastic anemia
male in boston
A 
m in denver
f in denver
m in boston
f in boston
female with iron deficiency anemia
male with aplastic anemia
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9
Q

We see differences in average hematocrit between males and females. Please tell me which gender usually has the higher hematocrit and give the reason described in the overview

A

Males typically have a higher hematocrit level than females. This is due to the higher level of testosterone, which causes the kidneys to release erythropoetin. Erythropoetin is the hormone that stimulated the building of RBC’s leading to increased hematocrit levels

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10
Q

You were asked to predict how the hematocrits of people living in Denver, at high altitude, would compare to those living in Boston, at sea level

A

the hematocrit of people living at altitude is usually higher than those at sea level

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11
Q

explain how the kidneys respond to chronic hypoxemia (low oxygen in arterial blood) and what effect this has on hematocrit levels

A

The kidneys are stimulated to release more EPO due to the lack of O2 in the blood. This EPO stimulates formation of more RBC’s in turn, increasing the hematocrit levels.

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12
Q

possible causes of anemia include

A

iron deficiency

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13
Q

possible causes of polycythemia vera include

A

chronic lung disease such as emphysema leading to hypoxemia

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14
Q

reticulocytes are the immature version of red blood cells

You are reviewing the Complete blood cell count of your patient, a member of the cross country team. You notice that s/he has a hematocrit of 50(normal…about 35) and a reticulocyte count of 5% (n/l is 1-2%) Does this seem appropriate? Why or why not? What could cause this?

A

The runner does not have a normal hematocrit levels for an athlete, typically they have lower hematocrit levels. One cause of this could be due to erythropoietin injections.

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15
Q

place the samples from activity 11-3 in order from highest hemoglobin to lowest (anemic)

male with polycythemia
healthy female
healthy male
female with iron deficiency anemia
female olympic athlete
A 
olympic
polycythemia
male
female
iron deficiency anemia
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16
Q

purpose of stirring blood

A

Stirring will cause lysis of the RBC’s to determine the amount of hemoglobin present

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17
Q

which dietary deficiency would cause the ratio of PCV to hemoglobin to be less than 3

A

iron is needed to form hemoglobin. If you can’t form hemoglobin you can’t fill the cell. Iron is needed to form hemoglobin so iron deficient anemia leads to microchromic (less color due to less hemoglobin) anemia and a PCV to hemoglobin greater than 3(lower denominator raises the ratio)

(sample 3, the women with fe def anemia had a ratio of 5)

On the other hand B12 and folate deficiency does not allow the cell to divide. The cell becomes “full of hemoglobin” and is macrochromic, macrocytic with a low ratio……lots of hemoglobin in the cell

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18
Q

discuss the change in Hematocrit (PCV) ratio to hemoglobin between the female with iron deficiency and the healthy female

A

A female with iron deficiency will have a higher ratio of PCV to hemoglobin than a healthy individual. The iron deficient female will have decreased hemoglobin causing an increase in the ratio.

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19
Q

the [a][b][c] measures the settling of RBC’s in a vertical stationary tube of blood during one hour

A

erythrocyte sedimentation rate

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20
Q

select the correct statement concerning the ESR

A

increased production of fibrinogen and immunoglobulins cause RBC’s to clump together, stack up and form a column that are heavier and settle faster thus an increase in sedimentation rate

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21
Q

When ESR is used to follow inflammatory diseases

A

ESR increases as inflammation increases

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22
Q

the sedimentation rate for sample 6, a patient with angina pectoris compared to the sample from the healthy individual. the sedimentation rate was for the person with angina pectoris was

A

The same as the normal ESR

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23
Q

During a myocardial infarction (MI) blood flow is so reduced that myocardial cells become ischemic and die (necrosis) During angina pectoris blood flow is reduced below the needs of the cells but returns prior to cell death.

A

MI increases ESR more than angina pectoris because there is greater damage during MI and thus greater inflammation compared with angina pectoris

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24
Q 
place the samples in order from slowest (smallest) sedimentation rate to fastest sedimentation rate
healthy person with angina pectoris
menstruating female
MI
sickle cell anemia
iron deficiency anemia
A 
sickle cell anemia
angina pectoris
menstruating female
iron deficiency anemia
MI
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25
Q

An increase in ESR is

A

associated wit worsening anemia

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26
Q

Select the correct answer(s)

Type A blood

A

A person with type A blood can have 1 allele for type A antigen and one allele for the absence or A or B antigen (type O)

A person with type A blood can have 2 alleles for type A antigen

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27
Q

Select the correct answer(s)

type AB blood

A

A person with Type AB Blood can have 1 allele for type A antigen and one allele for type B antigen

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28
Q

all the cells in the human body, including red blood cells, are surrounded by a plasma membrane that contains genetically determined glycoproteins, called_______

A

antigens

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29
Q

Select the best answer
people are born with antibodies that react against the AB antigens that they do not possess (people with blood type A are born with anti B etc)

rH negative People are born with anti rH antibody

people are NOT born with antibodies that react against the AB antigens that they do not possess (people with blood type A are NOT born with anti B etc)

rH negative People are born with anti rH antibody

Correct
people are born with antibodies that react against the AB antigens that they do not possess (people with blood type A are born with anti B etc)

rH negative People are NOT born with anti rH antibody

people are NOT born with antibodies that react against the AB antigens that they do not possess (people with blood type A are NOT born with anti B etc)

rH negative People are NOT born with anti rH antibody

A

people are born with antibodies that react against the AB antigens that they do not possess (people with blood type A are born with anti B etc)

rH negative People are NOT born with anti rH antibody

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30
Q

To determine an individual’s blood type, drops of the blood sample are mixed

A

separately with antiserum containing antibodies that recognize either type A antigens, type B antigens or Rh antiges

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31
Q

the universal DONOR is blood type

A

O-

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32
Q

Agglutination

A

results in red blood cell lysis

indicates the presence of an agglutinogen

results in a potentially life-threatening blood transfusion reaction

33
Q

the reason individuals that are AB+ are known as universal recipients is that

A

they have both A and B antigens on the surface of their red blood cells and the blood serum lacks antibodies against A, B or Rh antigens

34
Q

If giving type O blood to someone with type A it is important to separate the packed cells from the plasma and give only the packed cells. Why is this?

A

Must separte the packed cells in the plasma. Plasma contains antibodies against type A blood that need to be removed so they do not destory the persons blood cells.

35
Q

which blood sample did not agglutinate with any of the antibodies tested and why

A

Blood Type O- because the blood cells do not have antigens present on the surface to interact with the anitbodies when added. Therefore, no agglutination occurred

36
Q

to donate to someone with blood type B- the person’s blood type would have to be

A

B, O, Rh-

37
Q

to donate to someone with blood type O+ the person’s blood type would have to be

A

O-, O+

38
Q

to donate to someone with blood type B+ the person’s blood type would have to be

A

B, O, + and -

39
Q

the term “in vitro” refers to

A

outside the body

40
Q

molecules that are foreign to the body are referred to as

A

nonself

41
Q

the fluid portion of blood without clotting factors is ______

A

serum

42
Q

a negative test result when the object that is being tested is actually present is a

A

false negative

43
Q

which has an epitope?

A

an antigen

44
Q

chlamydia FA” FA stands for [a] [b

A

fluorescent antibody

45
Q

place the steps in DFA in the correct order

  1. Place sample on the slide and fix with 95% ethyl alcohol, rinse with FA buffer
  2. apply FA mounting media, count elementary bodies and interpret results
  3. apply chlamydia flourescent antibody then place in petri dishes loaded with FA buffer
  4. incubate for 20” and rinse with PBS to remove excess antibody
A

1, 3, 4, 2

46
Q

fluorescence is found on the

A

antibody

47
Q

IF you forgot to fix the samples to the slide

A

All would test negative because the washing steps would remove the samples

48
Q

Your patient tests positive for chlamydia and is prescribed standard treatment-1 gram of azithromycin which s/he takes immediately. S/he takes a vow of celibacy and returns 2 days after finishing her treatment for a test of cure.

A

This is bad idea because DFA test for antigens. Though treatment may be effective chlamydia antigen may remain and s/he may still test positive

49
Q

what example is given in the introduction of 12 activity 3 of a use for Direct Elisa

A

A home pregnancy test which measures hCG in the urine of women who are pregnant.

50
Q

direct ELISA

A

labels the antigen or protein

51
Q

indirect ELISA

A

labels the antibody against the antigen or protein

52
Q

Which is true of the direct ELISA

A

the positive patient sample contains the specific antigen

53
Q

In Activity 3 indirect ELISA

A

it is better practice to replace paper towels and not risk contamination

54
Q

In Activity 3 indirect ELISA

A

It is a better practice to dispose of biohazardous materials such as HIV antigens in Biohazard containers

55
Q

What must occur in order for an HIV infected individual to test positive with the indirect ELISA test?

A

seroconversion

56
Q

Seroconversion refers to

A

converting to postive for a specific antibody which implies any exposure to the antigen

57
Q

Why might a patient have an indeterminate result for a particular antigen/antibody?

A

The patient may be in the process of seroconverting

58
Q

developing buffer in exercise 12 activity 3 indirect ELISA contains

A

secondary antibody

59
Q

The key substance found in developing buffer is

A

the enzyme linked to the secondary antibody

60
Q

a positive result for HIV in the indirect ELISA performed contains

A

Antibodies against HIV

61
Q

In indirect elisa the binding site of the secondary antibody is to the

A

constant region of the primary antibody

62
Q

describe direct ELISA

A

It is looking for the direct foreign object in the body by looking for the antigen that binds to the antibody. A secondary antibody is added to the serum to allow for potential reaction with the antigen, if the antigen is present, clumping will occur. A substrate is added to to change the color and the amount of color present is directly proportional to the amount of antigen present, showing that the patient is positive for the antigen.

63
Q

describe indirect ELISA

A

The serum is tested for the presence of the antibody. The secondary antibody added will bind to the constant region of the primary antibody if it the antibody is present in the sample. The secondary antibody being added is used to show the presence of the antibody in the serum.

64
Q

why is ELISA considered enzyme linked

A

ELIZA is considered enzyme linked because in both direct and indirect ELIZA the enzyme that allows identification of the antigen or antibody presence is chemically linked to the antibody in the sample.

65
Q

describe the significance of the variable region on the primary antibody v the constant region on the secondary region in an indirect elisa assay

A

the VARIABLE region on an antibody is specific to that antigen. An antibody with the variable region, if present, attaches to the antigen on the plastic.

To identify the presence of that specific antibody a second antibody is then added. If any antibodies are present (i.e. have attached to the antigen)then the second antibody identifies it by sticking to the constant region. The second antibody is identifying ANY antibody. Because the second antibody has an enzyme when substrate, a molecule that changes color when exposed to the enzyme is added, the sample will “light up”

so the variable region is needed on the primary antibody to “match to the antigen”

the constant region is needed on the primary antibody to attach to the secondary labeled antigen

66
Q

Why does the ability of the secondary antibody to bind in this assay suggest the presence of antibodies to HIV?

A

The binding of the secondary antibody provides evidence that the person has built antibodies against the antigen. The second antibody has an enzyme attached to it, the enzyme reacts with the substrate and causes a color change. The secondary antibody should only be present after rinse if there is a primary antibody present, which will only be present if the antibody was made to react with the HIV epitope.

67
Q

please describe in your own words the main difference between indirect ELISA and Western blot

A

The indirect ELISA uses cell wells that relate to antigen mixtures to recognize the presence of antibody whereas the Western blot has a protein representing the antigen the antibody is recognizing.

68
Q

western blotting
southern blotting
northern blotting

A

protein
DNA
RNA

69
Q

gel electrophoresis is used to separate proteins on the basis of

A

charge

size

70
Q

western blotting is used to test for the presence of

A

antibodies like indirect elisa

71
Q

nitrocellulose strips contain

A

HIV antigens separated by electrophoresis

72
Q

The purpose of the washing buffer was to

A

remove any nonspecific binding of antibodies thus decrease the risk of a false positive

73
Q

The substrates are

A

chemicals that are changed by the enzyme linked to the antibody

74
Q

how would you describe the binding site of the secondary antibody?

A

it is the constant region of the primary antibody

75
Q

The primary antibodies in the Western blot

A

come from the patient sample

76
Q

A difference between ELISA and Western blot is

A

Western blot looks at separated antigens

77
Q

Antibodies from a positive patient sample in Western and indirect ELISA bind to the

A

a constant region of the enzyme linked antibody

antigen bound to the nitrocellulose strip or to plastic

78
Q

Explain why Western blot is more sensitive and more specific than ELISA for HIV testing.
Explain why Western blot is more sensitive and more specific than ELISA for HIV testing.

A

Western blot looks for antibody present against the HIV antigen it is divided for more specificity, where ELISA looks for antibodies that look like HIV antigen (but is not specific to the epitopes for HIV)

Physiology of Disease (8 decks)

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