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Anatomy and Physiology > Haematology I > Flashcards

Haematology I Flashcards

1
Q

what percentage of plasma is water?

A

92% by weight

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2
Q

what are the 4 proteins found in plasma and what is the overall composition of proteins in plasma

A

albumins (58%)
globulins (37%)-protective, used to generate colloid oncotic pressure
fibrinogen (4%)
regulatory proteins (1%)
overall percentage= 7% by weight

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3
Q

what other solutes are found in plasma and what is their overall percentage in plasma

A

electrolytes
nutrients
respiratory gases
waste products
overall= 1% by weight

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4
Q

how many erythrocytes are there in blood per cubic mm

A

4.2-6.2 million

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5
Q

the average adult has a blood volume of how many litres

A

5L

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6
Q

blood accounts for approximately what percentage of your weight?

A

7%

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7
Q

what type of tissue is blood?

A

specialised form of fluid connective tissue

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8
Q

what are the components of blood

A

plasma, white blood cells and platelets, and red blood cells

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9
Q

what is the normal range of plasma in blood

A

approx 55% (normal range= 46-63%)

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10
Q

function of blood

A

transport – inorganic and organic molecules, formed elements and heat

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11
Q

what does blood transport?

A

Gases (O2 and CO2)
Nutrients
Excretory products (waste)
Temperature

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12
Q

what allows blood to be defensive

A

contains antibodies, white blood cells, and clotting factors

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13
Q

hematopoiesis

A

process of how all blood cells are produced

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14
Q

what is the initial cell responsible for producing all of the blood cells

A

multipotential hemopoietic stem cell (haemoblast)

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15
Q

what do haemoblasts divide into

A

common myeloid progenitor and common lymphoid progenitor

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16
Q

what does the common myeloid progenitor divide to produce

A

other blood cells except lymphocytes

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17
Q

what does the common lymphoid progenitor divide to produce

A

lymphocytes only

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18
Q

poiesis

A

production

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19
Q

process of developing an erythrocyte

A

haemocytoblast -> proerythroblast -> early erythroblast -> late erythroblast -> normoblast -> reticulocyte -> erythrocyte

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20
Q

where is the hameocytoblast found?

A

only in bone marrow and is able to reproduce due to nucleus

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21
Q

-blast

A

precursor cell

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22
Q

proerythroblast

A

-committed cell
pro: at the beginning
erythro- related to rbc
blast: precursor cell
not matured and only in bone marrow

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23
Q

which cells are in the developmental pathway of erythropoiesis

A

early erythroblast, late erythroblast, normoblast and reticulocyte

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24
Q

what are the 3 phases of the developmental pathway of erythropoiesis

A

ribosome synthesis
Hb accumulation
Ejection of nucleus

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25
Q

normoblast

A

rejection of the nucleus

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25
Q

which cell is the first cell to not have a nucleus in erythropoiesis

A

reticulocyte

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26
Q

what happens to the cells as they mature in erythropoiesis

A

the nucleus shrinks due to the increased Hb production as well as ribosome synthesis

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27
Q

what protein is needed to stimulate erythropoiesis

A

erythropoietin (EPO)

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28
Q

erythropoietin

A

protein that increases the amount of RBCs
-used in sports to increase oxygen production and enhance performance

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29
Q

what 4 other factors are needed for erythropoiesis

A

iron
vitamins b12 & folic acid (B9)
intrinsic factor -helps body absorb vitamin b12
AAs- needed to make the globin protein of Hb

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30
Q

where does erythropoiesis occur in the foetus

A

early in yolk sac, then liver & spleen later in bone marrow

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31
Q

where does erythropoiesis occur in an infant

A

all bone marrow

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32
Q

where does erythropoiesis occur in an adult

A

only red bone marrow (ribs, vertebrae, skull, upper ends of long bones)

33
Q

why does erythropoiesis occur in the red bone marrow

A

perfect environment for rbc production

34
Q

at what rate does erythropoiesis occur

A

2 -3 million red blood cells per second

35
Q

how does the biconcave shape of RBCs help it’s function

A

thicker outer membrane and thinner membrane allowing for flexibility and can fold in on itself

36
Q

why are rbcs at more risk of damage

A

no organelles and main component is Hb therefore can’t repair themselves

37
Q

what is the life span of rbcs

A

120 days but damage will leave this to be lower

38
Q

diameter of rbcs

A

7.2 um-8.8um

39
Q

what happens to damaged rbcs

A

broken down in macrophages in the spleen (mostly), liver, lungs or lymph nodes

40
Q

what is Hb broken down into

A

the haem portion (mainly ions) and the globin portion

41
Q

what happens to the broken down globin

A

the AAs are recycled to use for other processes

42
Q

what happens to the iron from broken down Hb

A

Fe is reused and re-enters circulation, combines with transferrin (transport protein) and stored in the liver as ferritin and goes back into the process of erythropoiesis

43
Q

what does haem get broken down into

A

bilirubin and binds withs albumin, transported to the liver and secreted into the bile which is excreted as urobilinogen in urine or stercobilinogen in faeces

44
Q

why is the erythrocyte breakdown efficient

A

more products are recycled from the breakdown than excreted

45
Q

4 steps of erythrocyte homeostasis (negative feedback)

A
  1. low oxygen blood level
  2. kidneys increase production of erythropoietin
  3. stem cells increase red blood cell production
    4.oxygen blood levels return to normal
46
Q

hypoxia

A

low levels of oxygen in your body tissues

47
Q

causes of hypoxia

A

Increase in exercise
High altitude
Smoking
Bleeding

48
Q

what is the approx number of Hb molecules per red cell

A

280 million

49
Q

where does synthesis of Hb begin

A

proerythroblast (committed cell)

50
Q

what percentage of Hb is produced in the erythroblast stage

A

65%

51
Q

where is the remaining Hb produced after the erythroblast stage

A

35% at the reticulocyte stage

52
Q

functions of Hb

A

Transports O2 from lungs to tissues
Transport CO2 from tissues to lungs

53
Q

what volume of Hb is blood

A

15g/dL of blood
Females 12 - 16g/dL and Males 13.5 - 17.5g/dL

54
Q

why do men have a higher Hb than females

A

levels of testosterone affect Hb production, greater muscle mass requires more RBCs due to an increased need for oxygen

55
Q

which type of Hb makes up most of Hb

A

HbA

56
Q

structure of HbA

A

4 subunits: 2 alpha (α) and 2 beta (β) subunits

57
Q

each subunit of HbA consists of…

A

(i) “haem” bound to (ii) long polypeptide chain “globin”

58
Q

what ion is found in the centre of the haem group of HbA

A

ferrous iron atom (Fe2+)

59
Q

iron atom (Fe2+)

A

reversibly binds with one molecule of oxygen (O2)

60
Q

Hb functions

A

Carriage of gases:
Oxygen
Carbon dioxide
Carbon monoxide
H+

61
Q

3 types of anaemia

A
  • Iron deficiency anaemia
  • Megaloblastic anaemia
  • Sickle cell anaemia
62
Q

Anaemia

A

Haemoglobin concentration in whole blood below the accepted normal range

63
Q

what is classified as a low level of Hb in blood

A

Less than13.5g/dL for men
Less than 12.0g/dL for women

64
Q

anaemia affects what fraction of the population

A

1/3

65
Q

causes of anaemia

A

Decreased RBC production - Lacking in a nutrient that is needed to produce RBCs

Increased RBC destruction – RBCs may be defective in some way and therefore at risk of premature breakdown leading to an increase in RBC destruction

Hidden blood loss or traumatic blood loss due to an injury for example

66
Q

what is the most common anaemia worldwide

A

Iron deficiency anaemia

67
Q

Features of iron deficiency anaemia

A

Lack of irons leads to cells that are:
Hypochromic (pale colour)
Microcytic (smaller than normal) red blood cells
-decreased mean cell volume

68
Q

causes of iron deficiency anaemia

A

pregnancy (increased demand on the mother)
bleeding from GI tract (ulcer, malignancy), malabsorption (reabsorbed iron in the GI tract)
menorrhagia (heavy menstrual flow) malnutrition (dietary)

69
Q

features of megaloblastic anaemia

A

Vitamin B12 deficiency or Folate deficiency
Abnormal RBC
Reduced haemoglobin concentration
Macrocytic (larger cells than normal)
Increased mean cell volume (MCV)

70
Q

signs of megaloblastic anaemia

A

Macrocytic red blood cells
Hyper segmented neutrophil

71
Q

Megaloblastic anaemia: Folate deficiency

A

Folic acid / Folate deficiency
Characteristics similar to Vitamin B12
Macrocytic anaemia
Causes: pregnancy, elderly, dietary deficiency

72
Q

what is folate and vitamin b12 needed for

A

healthy cell division, inadequate levels: cells are unable to divide

73
Q

Megaloblastic anaemia: vitamin B 12 deficiency

A

Need intrinsic factor (IF) – secreted by stomach for vitamin B12 absorption;
Causes:
Lack of IF – PERNICIOUS ANAEMIA
Crohn’s, coeliac disease (absorption)

Treatment
Vitamin B12 intramuscular injections

74
Q

why would taking vitamin b12 supplements be inadequate to treat megaloblastic anaemia

A

Without intrinsic can’t absorb vitamin b12

75
Q

signs of megaloblastic anaemia

A

Macrocytic red blood cells
Hyper segmented neutrophil (centre of picture)

76
Q

formation of sickle cell

A

Mutation in Hb gene producing Hb s which forms a strange structure within the RBC: when it takes up and gives away oxygen, alters the shape of the RBC
due to this shape, they aren’t as flexible and get stuck in blood vessels causing clots and pains

77
Q

sickle cell protects against what

A

malaria

78
Q

features of sickle cell anaemia

A

hereditary; African, West Indian
Abnormal haemoglobin structure
sickle shape cells, RBCs get stuck in blood vessels
no cure…..

79
Q

Thalassaemias

A

hereditary; Mediterranean, Middle/Far Eastern
Abnormal haemoglobin production - a and b thalassaemias

Anatomy and Physiology (10 decks)

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