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BASIG q1 > exam 9 > Flashcards

exam 9 Flashcards

1
Q

Mb vs Hemoglobin

fx:
structure :
o2 dissociation curve:

which one has a higher percent saturation in tissues? In lungs?

A

Mb
fx: bind and transport o2
structure: Monomer tertiary stucture folded alpha helices
1 heme group per 1 02
O2: hyper bolic

Hemoglobin
fx: transport and store CO2 and O2
structure : tetramer (between 2 alpha globulin and 2 beta glob)
quaternary structure
4 heme groups per (1 per glob chain ) so binds 4 02.
o2 dissociation curve: sigmoidal

Mb has a higher percent saturation in tissue?
percent saturation is about the same in lungs

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2
Q

what is allosterism and does it work with Hb or Mb and why

what kind of curve does an allosteric protein have

A

it is regulation of proteins by binding effector molecules

it works with quaternary structures only so Hb

sigmoidal

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3
Q

Homotropic effector:

Heterotropic effector:

A

Homotropic effector: effector is identical to true ligand o2 and positive effector of Hb

Heterotropic effector:
effector chemical different

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4
Q

Name POSITIVE effectors that are important for Hb

what happens to the to the dis. curve

what does it do to O2 (hold release)

A

CO
O2

shifts to the left

Decrease O2 release ,
holds O2 INCREASES AFFINITY

R>T state

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5
Q

Name NEGATIVE effectors that are important for Hb

what happens to the to the dis. curve

what does it do to O2 (hold release)

A

-H+ (low pH) stable doexy form
this is because histadine side chains like Protons
-Co2
-2,3 bisphosphatglycerate (2,3 GPG)
-increase in temperature

increases realease of O2 decreases affintiy

shifts curve to right

T> R state

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6
Q

List 3 fates of CO2

A
  1. bicarb HcO3 (increases H+ which can protanate Hb and stabilize the T state. 60%
  2. carbinohemoglobin ….HbCO2…. co2 binds to alpha of hemoglobin. 30%
  3. disolve 10 %
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7
Q

what is bohr effects

talkabout how it relates to Lungs and tissue

A

change in Hb Oxygen due to pH

Lungs
have increase pH so CO2 is released and oxyhb is favored

Tissues
have a decrease in pH so [CO2] increases and deoxyHb is favored

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8
Q

2,3BPG affects what affinity and how

A

increases affinity of FHb so that the maternal Hb can give o2 to the baby

2,3BPG binds less tightly to HbF than to HbA

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9
Q

what two cells does erthopoiesis start with

what cell is the cell right before rbc

what is reticulocytosis

A

BFU-E
CFU- E

reticulocyte

reticulocytosis is when the body releases reticulocytes early (48 hrs in Bm and 48 in circulation) instead of the normal time it takes for rbc to mature which is 48 in bm and 24 in circulation

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10
Q

EPO is released by what organ

where does it bind

what are its effects

A

kidneys

it binds to epo receptor in BM to increase RBC

effects
-increases BFUE (increase proliferation)
-increase CFUE (decreasing cell death)
-increase hb syntheeis
-increas FE absorption
-increase erythroid differentiation
- release and production of reticulocytes

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11
Q

memorize

A
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12
Q

what is red cell distribution width (RDW)

what does low and high RDW indicate

A

measure of distribution of individual values for rbc volumes

shows cells of uneven size

low =
roughly the same size but doesnt mean healthy
can all be micro or macrocytic

high=
uneven sizes anisocytosis may be due to anemia

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13
Q

compare severe acute malnutrition (SAM)

Marasmus
-deficiency
-body looks like
-albumin levels
-viceral organ involved?

Kwashiorkor

A

Marasmus
-deficiency: calories all nutrition
-body looks like : broom stick loss of fat
-albumin levels: normal to slight
-viceral organ involved? no

Kwashiorkor
-deficiency: protein malnutrition
-body looks like: distension of stomach, spare sub cut fat and muscle
-albumin levels: large decrease
-viceral organ involved? yes

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14
Q

which on is associated with these sx (Bulimia or anorexia nervosa)
- <30 yo
-amenorrhea
- electrolyte imbal
-risk of cardiac arrythmias

A
  • <30 yo - B
    -amenorrhea - A
  • electrolyte imbal-B
    -risk of cardiac arrythmias - B
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15
Q

vit A
purpose:
deficiency causes:

hyper vitaminosis

A

vit A (FAT SOLUBLE)
purpose:
- lipid matabolism
-vision (rhodospin in rod need)
-immune
deficiency causes:
-squamous metaplasia
*bitot spots, keratomalacia,
cornea ulcers
-nighblindness
-infection

Hyper:
(acute)
-yellow skin (not sclera)
-papilledema
-cerebral hypertension
(chonic)
-liver injury with fibrosis and death bone and joint pain
-

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16
Q

Vit D
fx:
deficiency dx:

hypervitaminosis D:

A

Vit D
fx: reabsorption of calcium , raise calcium from bone , absorption of phosphorous and calcium in stomach

deficiency dx:
causes decreased serum calcium and phosphate.
- rickets
-osteomalcia
hypocalcemic tetany

hypervitaminosis D:
calcification of kidneys due to hypercalcemia

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17
Q

premature babys may have what vit deficiency

A

vit e due to underdeveloped gut , causes neurogical dz and hemolysis

vit K due to lack of intestinal bacteria
causes bleading ,
caused by deficiency of coagulation factors
Ptprolonged initially and PTT also prolonged

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18
Q

what happens with thiamine deficiency vit B1

A

think neuro heart and nystagmus

-dry beriberi (peripheral neuropathy(
-wet beriberi (heart failure makes edema)
-wenicke-korsakoff syndrome (sever chronic deficiency) nystagmus ataxia defective memaory

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19
Q

who get riboflavin deficiency or B2

A

anorexia nervosa patient

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20
Q

niacin deficiency vit B3

dz and signs

A

pellegra

3 d’s

dementia
diarrhea
dermatitis (tips of fingers spared)

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21
Q

pyridoxine b6 deficiency

A

convulsions
seborrheic dermatitis (scaling) glossitits peripheral neuropathy

22
Q

Vit C ascorbic acid deficiency

Vit C overdose

A

scurvy
lack of tensile strength hollagen joint pain, loss of teath bad wound healing

overdoes
increased kidney stones
increased absorption of iron

23
Q

copper deficiency

A

myelonueropathy numbness difficulty using legs anemia

24
Q

Zinc Deficiency

A

acrodermatitis enteropathica oozing rash around eye nose and mouth peranal perioal

poor night vision

diarrhea

25
Q

selenium deficiency

A

myopathy including cardiomyopathy

26
Q

what does ferritin do

what does transferrin do

A

ferritin: it stores iron in enterocyte

transferrin: transfers 2 ferric iron Fe 3+

27
Q

1 ml of blood has how much iron

A

0.5 mg

28
Q

what is ferrous is it toxic

A

unbound iron Fe2+ toxic that catalyzes ffenton reation to make free radicals

29
Q

name the three places iron is

A
  1. in use with globin 75 % (3g)
  2. storage in ferritine hemosiderine 25% 1g
  3. in circulation 0.1% 4000mg
30
Q

list least to most bio available heme iron from food

now list non heme free iron that comes from plants , list from least to most

A

heme iron» ferrous iron Fe2+» ferric Fe3+> Elemental iron Fe0

Ferric Fe3+
Ferrous (Fe2+) supplements
Elemental iron Fe0

31
Q

what is transferrin

what causes its synthesis

A

it transportes Fe3+ Ferric iron
prevents fenton reaction

low iron levels cause synthesis

32
Q

describe absorption of iron

A
33
Q

cell uptake of iron

A
34
Q

wh

A
35
Q

at is the usual cause of deficiency anemia

A

period blood loss

36
Q

when iron levels are low what happens to the amount of transferin and ferritin

A

low feratin
high transferrin (measured by TIBC)

37
Q

describe signs of deficient anemia

A

spoon shapped nails (koilochia)
anisocytosis ( different sized cells)
target cells

38
Q

cause of macrocytic anemia

A

decrease in folic acid (either by absoprtion or diet)

decrease in B12 (by absorption or diet) * causes nueroapthy if not tx)***

39
Q

look at other side of this card

A
40
Q

what is pernicious anemia PA

caused by

A

malabsorption of B 12

caused by autoimmune destroying perietal cells (resposible for making IF or intrinsic factor) this creates Ab that bind to I and prevents b12 binding

MALABSORPTION AND MEGOBLASTIC ANEMIA

tx with b12 shot or folate allows for synthesis of dTMP by passing need to recycle folate

41
Q

what is gold standard to detect if b12 or folate deficiency

A

methylmalonic acid

42
Q
A
43
Q
A
44
Q

how do we test for jaundice
give equation

A
45
Q

what is kernicterus

A

when unconjigated biliruben get stuck in the brain due to untreated neonatal jaundice
tx with blue lit to make plana structure (DOESNT CHANGE TO CB)

46
Q

what is B-flucaronidase

A

gut bacteria to help conjugate biliruben . babys lack this and are unalt to comfort UCB to CB so they get jaundice

47
Q

a decrease in UCB uptake causes what

A

increase in UCB and jaundice

48
Q

why is DBIL normal in pre hepatic jaundice

A

cause CB is not released into circulation due to healthy live

49
Q

hepatic and post hepatic…

increase of decrease fecal urobillinogen

A

both are decrease

50
Q
A

BASIG q1 (11 decks)

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