Exam 2: Oxygen Transport & Anemia

Question 1

What are the features of normal composition of blood?

Answer 1

55% plasma, 45% of formed elements (leukocytes, erythrocytes, platelets)

Question 2

What is the composition plasma?

Answer 2

91.5% water, 7% proteins (albumin, globulins)

Question 3

What is Hematopoiesis?

Answer 3

formation of blood components, blood cells

Question 4

What is Lymphopoiesis?

Answer 4

formation of lymphocytes

Question 5

What is the structure of Hemoglobin?

Answer 5

two alpha and two beta polypeptide chains (proteins), four heme groups

Question 6

How does hemoglobin differ between fetal and adult?

Answer 6

both have two identical alpha subunits, fetal hemoglobin has 2 gamma subunits, adults have 2 beta subunits

Question 7

What is the purpose of Iron?

Answer 7

Major component of hemoglobin that carries oxygen throughout body

Question 8

How much oxygen can bind to 1 hemoglobin?

Answer 8

4

Question 9

How does the regulation of erythropoiesis work?

Answer 9

kidneys secrete erythropoietin which stimulates RBC production the the bone marrow

Question 10

How does hemoglobin degradation work?

Answer 10

hemoglobin broken down into globin (goes to amino acids) and heme (with iron), heme breaks into iron (goes to red bone marrow) and biliverdin, biliverdin converted to bilirubin and excreted

Question 11

What is the main form of oxygen transportation?

Answer 11

Hemoglobin

Question 12

What is the main form of Carbon Dioxide transportation?

Answer 12

bicarbonate ion (or dissolved in blood or carbaminohemoglobin)

Question 13

What is Affinity?

Answer 13

Hemoglobin–oxygen affinity is the relationship between the oxygen tension of blood and its oxygen content, ability to hold onto oxygen, higher affinity = more binding

Question 14

What causes a left shift on the oxygen -hemoglobin disassociation curve?

Answer 14

increase pH (less H+), decrease PCO2 (partial pressure of CO2), decrease temperature

Question 15

What causes a right shift on the oxygen-hemoglobin disassociation curve?

Answer 15

decrease pH (more H+), increase PCO2, increase in temperature

Question 16

What does a right shift mean on the oxygen-hemoglobin disassociation curve?

Answer 16

decreased affinity for oxygen, oxygen actively unloads (at the tissues)

Question 17

What does a left shift mean on the oxygen-hemoglobin disassociation curve?

Answer 17

increased affinity for oxygen, less likely to let go of oxygen, more oxygen saturation (the lungs)

Question 18

What is the Erythropoietin feedback circuit?

Answer 18

decreased red cell mass and decreased arterial oxygen saturation leads to increase erythropoietin, increased red cell mass leads to decreased erythropoietin (from kidneys)

Question 19

What is anemia?

Answer 19

when the body lacks enough healthy RBC to carry adequate oxygen

Question 20

Relative (Dilutional) Anemia

Answer 20

Pregnancy

Question 21

Examples of decreased production of RBCs

Answer 21

Iron deficiency, B12/folate deficiency, thalassemia, aplastic, chronic renal failure

Question 22

Examples of increased destruction of RBCs

Answer 22

sickle cell/ Spherocytosis, antibody-mediated Drug Rxn

Question 23

Iron Deficiency Anemia

Answer 23

Hypochromic/Microcytic, presents as GI bleeding in men and menorrhagia in women, most common anemia

Question 24

What is Hypochromia?

Answer 24

not enough hemoglobin, less color when RBC is examined

Question 25

What does microcytic mean?

Answer 25

RBCs are smaller than usual

Question 26

Meaning of MCV/MCH/MCHC

Answer 26

MCV and MCH- size
MCH - shape, hemoglobin per RBC
MCHC - level of hemoglobin relative to size

Question 27

B12/ Folate Deficiency

Answer 27

Macrocytic (big cells), Pernicious anemia (decreased production RBC), increased size, normal MCHC

Question 28

What are red blood cell indices?

Answer 28

size, shape, quality

Question 29

Amenia of Chronic Kidney Disease

Answer 29

less production of RBC due to Kidneys failing to produce erythropoietin, burr cells: projections, serrated appearance

Question 30

Thalassemia

Answer 30

genetic mutation that leads to deficient synthesis of globin chains, hypochromic/ Microcytic, decreased RBC indices, common in people of Mediterranean descent

Question 31

Sickle Cell anemia

Answer 31

Valine (amino acid) -> glutamic acid error in the beta chain, blood low in oxygen

Question 32

Hereditary Spherocytosis

Answer 32

rather than a disk they are a sphere, more fragile RBCs, hemolytic anemia due to RBCs breaking down faster

Question 33

What will the Red Cell Indices look like for Acute Blood loss?

Answer 33

decreased in the number of RBCs…

Question 34

Is acute blood loss immediately detectable on CBC?

Answer 34

It is not immediately detectable

Question 35

What are the general clinical manifestations of anemia?

Answer 35

sometimes asymptomatic, pallor, fatigue, loss of stamina, weakness, tachycardia, exertional dyspnea, orthostatic hypotension, dizziness/syncope

Question 36

What is Polycythemia?

Answer 36

having a high concentration of RBCs (dehydration)

Question 37

How does Primary Polycythemia present? (Polycythemia vera)

Answer 37

idiopathic myeloproliferative disorder, RBC hyperplasia, increased blood viscosity, hypertension/ thrombosis/ hemorrhage, hepatomegaly/ night sweats/ post-bathing pruitus

Question 38

How does secondary Polycythemia present?

Answer 38

increased production of RBCs secondary to chronic hypoxia, maybe from altitude or lung disease, clinical manifestations are those of increased blood viscosity and underlying disease

Question 39

Clinical manifestations of Hyper-viscosity syndrome

Answer 39

visual disturbances, dizziness, claudication, stroke, myocardial infarction

Question 40

What terms describe decrease in RBC count/quality (anemia and risks)?

Answer 40

Microcytic/Hypochromic, normocytic, other shape, macrocytic