Hema, Topnotch Flashcards
Plasma minus clotting factors
Serum
% plasma in whole blood
55%
% formed elements in whole blood
45%
Components of plasma in decreasing order
1) Water (90%)
2) Proteins
3) Inorganic ions
4) Lipids
5) Sugar
Alpha globulins (3)
1) Proteases
2) Antiproteases
3) Transport porteins
Beta globulins
Transport proteins
Gamma globulins
Immunoglobulins
Site of blood cell formation at 3 weeks AOG
Yolk sac
Site of blood cell formation: 3 mos AOG to birth
Liver
BM starts blood cell formation at what month
4 mos AOG
Age at which only bone marrow of flat bones and proximal epiphyseal region are actively participating in hematopoiesis
20 y/o
T/F Extramedullary hematopoiesis in full-term infant is always abnormal
T
Most abundant blood cell
RBC
Mechanism by which RBC acts as an acid-base buffer
Carbonic anhydrase: H2O + CO2 = H2CO3
RBC: Normal resting shape
Biconcave disc
RBC: Normal resting shape is maintained by
Spectrin
RBC: Normal space taken up by central pallor
1/3
RBC: Normal diameter
6-8 um
Hgb: Normal value in females
12-18 g/dL
Hgb: Normal value in males
14-18 g/dL
Hct: Normal value in females
37-47%
Hct: Normal value in males
40-54%
Hgb: Subunits
4 polypeptide subunits
% of oxygen from lungs transported by Hgb
97%
Blood is ___ times thicker than water
3
Steps in haemoglobin synthesis (5)
1) 2 succinyl CoA + 2 glycine = 1 pyrrole
2) 4 pyrroles = protoporphyrin IX
3) Protoporphyrin IX + ferrous iron = heme
4) Heme + polypeptide = Hemoglobin chain (alpha or beta)
5) 2 alpha chains + 2 beta chains = HgbA
How many O2 molecules can 1 Hgb molecule bind
4
Fetal Hgb chains
2 alpha, 2 gamma
Fetal vs adult Hgb: Higher affinity to O2
Fetal
Total iron in the body
4-5 g
Total iron in the body consists of
1) Hgb (65%)
2) Myoglobin
3) Heme compounds that promote intracellular oxidation
Hemoglobin with ferric iron attached
Methemoglobin
Iron loss in menses
0.7 mg/day
Iron excreted in the stool
0.6 mg/day
Last stage of RBC with nucleus
Orthochromatic erythroblast
Earliest stage of RBC normally found in circulation
Reticulocytes
of days reticulocytes mature in the circulation
1-2
T/F Reticulocytes does not contain remnant organelles
F, contains
Stages of erythrocyte maturation
1) Proerythroblast (Pronormoblast)
2) Basophilic erythroblast
3) Polychromatic erythroblast
4) Orthochromatic erythroblast (normoblast)
5) Reticulocyte (polychromatic erythrocyte)
6) Erythrocyte
Iron transporter
Transferrin
Primary storage form of iron
Ferritin
Supplemental storage of iron
Hemosiderin
Effect of EPO will manifest after how many days
5
Energy system used by RBCs
Anaerobic glycolysis
of ATPs generated from anaerobic glycolysis
2
3 major reaction pathways of aerobic respiration
1) Aerobic glycolysis
2) Krebs cycle
3) ETC
Net ATP from aerobic glycolysis
2
Net ATP from Krebs cycle
2
Net ATP from ETC
32
Net energy production from aerobic respiration
36 ATP
Net energy produced from anaerobic glycosis/respiration
2 ATP
Lifespan of adult RBC
120 days
Lifespan of fetal RBC
90 days
Cell responsible for extravascular destruction of RBC
Macrophage
Nutrients essential for DNA synthesis (2)
1) Vitamin B12
2) Folic acid
Nutrient deficiency: Megaloblastic anemia + neural deficits
Vitamin B12
Nutrient deficiency: Megaloblastic anemia + NTD
Folic acid
Substance needed for Vit B12 absoprtion
IF
Sources of Vit B12
Meat products
Sources of folic acid
Green leafy vegetables
Innate vs adaptive immunity: Complement system
Both
IgG vs IgM: Acute response
IgM
IgG vs IgM: Long-term response/protection
IgG
Lifespan of GRANULOCYTES in blood
4-8 hrs
Lifespan of GRANULOCYTES in tissues
4-5 days
Lifespan of Monocytes in blood
10-20 hrs
Lifespan of Lymphocytes
Weeks to months
2nd most abundant WBC
Lymphocyte
Weak phagocytes
Eosinophils
Released by mast cells and basophils for eosinophil chemotaxis
Eosinophil chemotactic factor
Basophils: Share functional similarities with what cell
Mast cell
Largest WBC
Monocyte
Smallest WBC
Lymphocyte
Prominent features of monocytes (2)
1) Eccentrically placed nucleus
2) Ground glass cytoplasm
Lifespan of platelets
7-10 days
Cell with pale, basophilic, non-granular cytoplasm
Lymphocyte
Least numerous WBC
Basophil
Neutrophils vs macrophages: Released as mature cells
Neutrophils
Neutrophils vs macrophages: Released as immature cells
Macrophages
Neutrophils vs macrophages: Can phagocytize 3-20 bacteria before dying
Neutrophils
Neutrophils vs macrophages: Can phagocytise up to 100 bacteria or larger particles before dying
Macrophages
Neutrophils vs macrophages: Lipases
Macrophages
Neutrophils vs macrophages: Proteases
Both
Neutrophils vs macrophages: Hypochlorite
Both
Neutrophils vs macrophages: Free radicals
Both
Conversion of monocytes to tissue macrophages takes how long
At least 8 hours
Monocyte and granulocyte production from BM in times of inflammation takes how long
3-4 days
Empyema vs abscess: Occur in normal spaces
Empyema
Empyema vs abscess: Occur in abnormal spaces
Abscess
Antibodies constitute ___% of plasma proteins
20%
IgA in mucosa
IgA2
IgA in serum
IgA1
Dimer vs monomer: IgA in serum
Monomer
Dimer vs monomer: IgA in secretions
Dimer
Divalent antibody
IgG
Most abundant antibody
IgG
Antibody: Smallest
IgG
Antibody: Primary immune response
IgM
Antibody: Largest
IgM
Antibody: Crosses placenta
IgG
Antibody: Secondary immune response
IgG
Antibody: Main Ab in secretions
IgA
Antibody: Allergies and hypersensitivity
IgE
Antibody: Surface of B lymphocytes
IgD
Antibody: Surface of mast cells
IgE
Antibody: Direct mechanisms (4)
1) Agglutination
2) Precipitation
3) Neutralization
4) Lysis
Antibody: Indirect mechanism
Complement activation
Antibody: Mechanism whereby ICs are formed
Precipitation
Complement: Mechanisms (3)
1) Opsonizarion
2) MAC
3) Stimulation of inflammation
Complement: Opsonin
C3b
Complement: Anaphylatoxin
C3a, C4a, C5a
Complement: Chemotaxin
C5a
Complement: MAC
C5b-C9
Complement: Stimulus of the classic pathway
Immune complex
T helper cells: CD and MHC
CD 4+, MHC II
T cytotoxic cells: CD and MHC
CD 8+, MHC I
T cells: Most numerous
T helper
T cytotoxic cells create holes via what substance
Perforin
T cytotoxic cells: Targets
1) Virally-infected cells
2) Tumor cells
3) Transplanted cells
T helper cell promotes B cell formation and proliferation via what cytokines
IL 4,5,6
T helper cells promotes proliferation and activation of cytotoxic, suppressor, and memory cells via what cytokine
Il-1
T cell: Makes sure normal cells are not killed
T suppressor
T cell: Assures better and quicker response for APC
T memory
Surface antigen: Type A
N-acetyl-galactosamine
Ig Type: Anti-A and Anti-B
MOSTLY IgM
Precursor to the ABO antigens
H antigen
Phenotype that does not present H antigen
Bombay
Phenotype that cannot receive Type O blood
Bombay
Bombay phenotyp cannot receive Type O blood because
Presence of anti-H
ABO locus is located on which chromosome
9
End of H antigen to which ABO antigens bind
D-galactose
Surface antigen: Type B
D-galactose
Surface antigen: AB
N-acetylgalactosamine and D-galactose
Surface antigen: O
H antigen
Surface antigen: Rh
CDEcde
Rh vs ABO antibody: Spontaneously acquired
ABO
Rh vs ABO antibody: Acquired from exposure to the specific RBC antigen
Rh
ABO antibodies: Start production at
2-8 months
ABO antibodies: Maximum tiger achieved at
8-10 y/o
Widely prevalent Rh antigen
D
Events in hemostasis (4)
1) Vasoconstriction
2) Platelet plug formation
3) Coagulation
4) Resolution
Type of thrombus formed in platelet plug formation
Primary
Type of thrombus formed in coagulation
Secondary
Substance secreted by endothelial cells for vasoconstriction
Endothelin-1
Platelet adhesion is mediated by: substance on platelet
Gp1b
Platelet adhesion is mediated by: substance on subendothelium
vWF
Platelet aggregation is mediated by: substance in the circulation
Fibrinogen
Platelet aggregation is mediated by: substance on platelet
GpIIbIIIa
Activates fibrinogen to fibrin
Thrombin
Cofactor in activation of fibrinogen to fibrin
Calcium
Activates prothrombin to thrombin
Prothrombin activator
Cofactor in activation of prothrombin to thrombin
Calcium
Initiating event of the EXTRINSIC pathway of the coagulation cascade
Vascular wall trauma
Initiating event of the INTRINSIC pathway of the coagulation cascade
Exposure of subendothelial collagen
Coagulation: Extrinsic coagulation cascade
III-VII-II-I
Coagulation: Intrinsic coagulation cascade
XII-XI-IX-VIII-X-V-II-I
Factor # absent/does not exist
Factor VI
Coagulation factors
I Fibrinogen IIProthrombin III Tissue factor IV Calcium V Proaccelerin (labile factor) VII Proconvertin (stable factor) VIII Antihemophilic factor (Factor A) IX Christmas factor (Factor B) X Stuart-Prower factor XI Factor C (plasma thromboplastin antecedent) XII Hageman factor XIII Fibrin-stabilizing factor
Prekallikrein is aka
Fletcher factor
HMWK is aka
Fitzgerald factor
Dissolution of clot is initiated by
tPA (tissue plasminogen activator)
4 phases of wound healing
1) Hemostasis
2) Inflammation
3) Proliferation (granulation tissue formation)
4) Maturation
Most crucial event in wound healing
Hemostasis
