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Physiology Unit 3 > Hematology and fetal circulation > Flashcards

Hematology and fetal circulation Flashcards

1
Q

What is hematocrit and what percentage of blood is this

A

Hematocrit are red blood cells (erythrocytes)
47% in males, 42% in females

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2
Q

Describe reasons that a patient might present with high or low hematocrit

A

High: High iron, blood doping
Low: Anemia, blood loss

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3
Q

What is 55% of the blood made of

A

Plasma- whole blood

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4
Q

What is 1% of whole blood made of

A

buffy coat- leukocytes, platelets

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5
Q

Which cells make all of the blood cells

A

HSC’s- hematopoietic stem cells

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6
Q

What are the 2 pools of progenitor cells

A

Myeloid- RBC’s, megakaryocytes (make platelets), eosinophils, basophils, neutrophils, monocytes
Lymphoid- make lymphocytes

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7
Q

What is the makeup (in percent) of RBC to WBC in the bone marrow

A

75% WBC (progenitor or maturing)
25% maturing RBCs (Progenitors or maturing)

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8
Q

What is the makeup of RBCs vs WBCs in circulation

A

500x as many RBCs in circulation vs WBCs

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9
Q

Where does extramedullary hematopoiesis occur

A

liver and spleen

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10
Q

Where do we find bone marrow in bones in kids vs adults

A

kids- all through cavities of bones
adults- only ends of long bones and in flat bones

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11
Q

What are platelets

A

fragments of megakaryocytes

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12
Q

What cell is the most abundant in the blood

A

RBC’s

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13
Q

What leukocyte is the most abundent in the blood

A

neutrophils

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14
Q

How much of plasma is made of plasma proteins

A

8%

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15
Q

Life span of RBCs/erythryocyes

A

120 days

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16
Q

How do RBCs make ATP

A

anaerobically

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17
Q

Function of erythryocytes bi-concave shape

A

Allow for swelling, flexibility to push through capilaries, increased surface area

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18
Q

structure of adult hemoglobin

A

2 alpha, 2 beta polypeptide chains (4 total)
an iron (heme) group on each chain (4 total)

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19
Q

What is the test that measures the terminal valine on each beta chain of hemoglobin to measure the 1-2 month average glucose level?

A

Hemoglobin A1c

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20
Q

What is the biggest factor to determine how much oxygen binds to hemoglobin

A

the amount of oxygen present that is creating the diffusion gradient

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21
Q

What are the 2 factors that make it harder for oxygen to bind to hemoglobin

A

high levels of 2,3, BPG or Hydrogen ions
- These both compete w oxygen

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22
Q

What is the significance of carbon monoxide and hemoglobin

A

Carbon monoxide competes with oxygen to bind on hemoglobin, and binds 200x stronger than oxygen(greater affinity)

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23
Q

Structure of fetal hemoglobin

A

Hemoglobin F: 2 alpha chains, 2 gamma hemoglobin chans
Stronger affinity for oxygen than hemoglobin A

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24
Q

Does hemoglobin A or hemoglobin F have a stronger affinity?

A

Hemoglobin F has a stronger affinity for oxygen

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25
Q

What are RBCs produced in response to

A

Blood loss, high altitude, aerobic exercise training, low o2 levels

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26
Q

List the pathway for RBC production

A

Chemoreceptors in kidneys sense low 02 levels–> release EPO–> stimulate production

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27
Q

Where is iron stored after RBC distruction

A

Liver

28
Q

What is the heme group used to make after RBC destruction

A

Bilirubin which is stored in the gallbladder for digestion use

29
Q

What is jaundice pathologically

A

buildup of biliruben in the blood

30
Q

What is the treatment for jaundice

A

phototherapy- convert biliruben to lumiruben to get rid of it from the blood

31
Q

If you have stem cell damage, what is the resulting anemia

A

aplastic anemia

32
Q

What anemia is common after chemotherapy

A

aplastic anemia

33
Q

If you have the distruction of RBCs or loss from bleeding, what type of anemia is this

A

hemolytic anemia (can be an autoimmune disorder

34
Q

What occurs when a glutamine is exchanged for a valine in terms of anemia?

A

sickle cell anemia- changes shape of hemoglobin

35
Q

What occurs in hemoglobin with sickle cell anemia

A

hemoglobin clumps more, higher prevalence in black and hispanic people

36
Q

If you have a lack of hemoglibin due to an inherited blood disorder, what is this

A

thalassemias

37
Q

What is on the tail of an A antigen

A

N-acetylgalactososomine

38
Q

What is on the tail of the B antigen

A

glactose

39
Q

What is on the tail of the antigen on O blood

A

It does not have anything in addition to the H antigen (every type has H antigen, but nothing extra)

40
Q

What antigen is Rh factor

A

Antigen D

41
Q

What is universal recipient

A

AB+ (no antibodies)

42
Q

What is universal donor

A

O- (no antigens)

43
Q

What do endothelial cells release when they are injured

A

5-HT

44
Q

What causes the vascular spasm?

A

Direct injury to smooth muscle, disrupted endothelial cells, local pain receptors stimulated

45
Q

What activates platelets

A

When platelets contact collagen they activate (swell and become sticky)

46
Q

What do platelets release when activated

A

ADP, Serotonin, Thromboxane A2

47
Q

End goal of phase 1 of coagulation

A

Prothrombin activator (Xa) (10a)

48
Q

End goal of phase 2 of coagulation

A

Thrombin

49
Q

End goal of phase 3 of coagulation

A

Fibrin

50
Q

End goal of stabilization of coagulation

A

13a

51
Q

What are the 2 pathways in phase 1, and what do both lead to the formation of?

A

intrinsic and extrinsic (both lead to the formation of factor X, which forms Xa)

52
Q

What occurs in phase 2 of coagulation

A

Factor Xa (prothrombin activator) converts prothrombin into thrombin

53
Q

What occurs in phase 3 of coagulation

A

thrombin converts fibrinogin ( soluble) into fibrin (insoluble)

54
Q

Which phase of coagulation requires Ca

A

stabilization

55
Q

What is the clot buster, and what activates it?

A

Plasmin is clot buster (remove clot), activated form of plasminogen, activated by Tissue Plasminogin Activator (TPA)

56
Q

Describe DIC

A

Uncontrolled clotting in all vessels, followed by bleeding due to the rest of the blood not being able to clot

57
Q

What causes DIC

A

sepsis, incompatable blood transfusions, pregnancy

58
Q

What does DIC lead to

A

multiple organ failure, death

59
Q

Describe thrombocytopenia

A

low platelet count leads to bleeding in small vessels all over the body (petechiae)
Platelet count under 50,000/ul blood

60
Q

Treatment of thrombocytopenia

A

platelet infusion

61
Q

Causes of imparied liver function related to blood disorders

A

Vitamin K deficiency (common in newborns)
Hepatitis or cirrhosis –> reduction of bile to absorb vitamin K, reduction in plasma proteins

62
Q

Hemophilias description and treatment

A

Hereditary bleeding disorder, missing one or more clotting factor
Treated with clotting factor transfusion ( most are x-linked recessive)

63
Q

Describe blood volume restoration when not in a hospital

A

Severe bleeding causes a low blood volume and in an emergency no time for blood typing or matching. Need to replace immediately, so use normal saline or electrolytes

64
Q

Describe the uterine blood flow in pregnancy

A

No pregnancy- arteries connect to capillaries and veins, no shuts
Preegnant- trophoblast invasion- bore holes in endometrium into maternal sinuses
post-partum- return to non-pregnant state

65
Q

Describe the fetal circulation of oxygenated blood

A

Placenta–>umbilical vein–>through the liver–>IVC–>R atrium–>Foramen ovale–>L atrium–>L ventrical–>Aorta–>Head

66
Q

Describe the fetal circulation of deoxygenated blood

A

Upper body/head–>SVC–>R atrium–>R ventricle–>Pulm artery–>Ductaus arteriosus–>Aorta–>feet and umbilical arteries

67
Q
A

Physiology Unit 3 (6 decks)

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