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z PP1: Intro Physiology > Hematology Exam 3 > Flashcards

Hematology Exam 3 Flashcards

1
Q

What are the two components of the blood and what do they consist of

A

Blood Plasma: Watery liquid containing dissolved substances

Formed Elements:
-Cells (red and white blood cells)
-Cell Fragments (platelets)

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2
Q

What is a heatocrit

A

Percentage of total blood volume occupied by RBCs

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3
Q

Function of Blood Components: Transportation, Protection, Blood Clotting

A

Transportation:
-Plasma -> nutrients, proteins, waste products
-RBCs -> carry O2 to tissues & CO2 from tissues

Protection:
-WBCs -> infection & cancer

Blood Clotting:
Platelets: blood clotting during blood loss

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4
Q

Where are all blood cells descended from?

A

Hematopoietic Stem Cells

-Undifferentiated cells that give rise to progenitor (precursor) of any of the blood cells

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5
Q

Erythropoiesis (RBCs Production)

A

-Erythropoietin (EPO hormone) activated erythrocytes (RBCs) production

-Proerythroblast divides several times forming erythroblast and begins synthesizing hemoglobin

-Reticulocyte form at end of development -> Nucleus ejected & center indented & maintain some mitochondria, ribosomes, ER

-Reticulocytes pass from red blood marrow into bloodstream by capillaries & develop into mature RBCs 1-2 day entering bloodstream

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6
Q

Overview erythropoiesis basic steps

A

Bone Marrow
Hematopoietic stem cell -> proerythroblast -> erythroblast -> reticulocyte

Blood
reticulocyte -> erythrocyte

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7
Q

Red Blood Cells: Hemoglobin, Globin, Heme, Fe2+

A

Lack nucleus and organelles
Regulates blood flow and pressure

Hemoglobin: O2 transporter
Globin: protein w/ two alpha & two beta chains
Heme: nonprotein pigment bound to each chain of globin
Fe2+: Center of heme ring binds one O2 -> 4 O2 per hemoglobin

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8
Q

O2 transport in RBCs

A

O2 bind to Iron ion at center of each heme ring
4 oxygen per metabolism
Reversible (O2 release in tissues)

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9
Q

CO2 transport in RBCs

A

CO2 is a waste product of metabolism
CO2 is carried mainly as bicarbonate ions in blood
Some CO2 remained dissolved in plasma
CO2 is released in lungs (breathed out)

CO2 + H2O <–CA–> H2CO3 <—> H+ + HCO3-
CA = carbonic anhydrase

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10
Q

Carbon Monoxide Poisoning: CO looks, symptoms, exposure

A

CO odorless, tasteless, colorless gas “silent killer”
Leading cause of accidental poisoning deaths in America
Symptoms: headache, nausea, fatigue
Prolong exposure can lead to brain damage & death

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11
Q

Mechanism of Carbon Monoxide Poisoning

A

-CO binds to Hb to form carboxyhemoglobin (HbCO)
-Prevents binding O2 to HB -> hypoxia
-HbCO can revert to HB but takes time (HbCO complex stable)
-Cells die and organs stop working

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12
Q

Recycling of Hemoglobin Components 1-7

A

1: Phagocytosis of ruptured RBSc by liver, spleen, red bone marrow
2: Globin and heme portions of Hb are split apart
3: Globin is broken down into amino acids (reused)
4: Iron from heme binds transferrin (membrane proteins)
5: Fe3+ detaches from transferrin & binds ferritin (iron storage protein) in muscle fibers, liver cells, macrophages of spleen & liver
6: Fe3+ reattaches to transferrin upon release or absorption
7: Fe3+ transferrin complex is transported to red bone marrow for hemoglobin synthesis, taken up by RBS precursors

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13
Q

Recycling of Hemoglobin Components 8-14

A

8: Erthropoiesis in red bone marrow generate RBSc enter circulation
9: Non-iron portion of heme is converted to biliverdin (green) then into bilirubin (yellow-orange)
10: Bilirubin enters blood and transported to the liver
11: Bilirubin is released by hepatocytes into bile
12: Bacteria convert bilirubin into urobilinogen in large intestine
13: Urobilinogen is absorbed back into blood, converted to urobilin, excreted in urine
14: Most urobilogen is eliminated from feces as stercobilin

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14
Q

Regulation of Erythropoiesis

A

Volume of circulating RBC remains constant because of regulation of RBC production

Negative Feedback -> Controlled condition is amount of O2 delivered to tissues

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15
Q

Control mechanism of erythrocyte production

A

Decrease RBC count
Reduced O2 levels in blood
Kidney releases erythropoietin

Erythropoietin stimulates
Red bone marrow
enhanced erythropeisis
More RBC
Increased O2 in blood

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16
Q

Blood Groups and Blood Types: what surface contains, categorized based on, major groups

A

-Surface of RBCs contain genetically determined assortment of antigens or agglutinogens
-Blood groups are categorized based on presence or absence of various antigens
-Two major blood groups are ABO and Rh

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17
Q

ABO Blood Group System and types

A

A: antigen A, 40%, B antibodies,
B: antigen B, 10%, A antibodies
AB: antigen A & B, 5%, none, universal recipient
O: none, 45%, Both A and B antibodies, universal donor

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18
Q

Blood plasma contains antibodies called ________ that reacts with the A or B antigens

A

agglutinins

19
Q

Incompatible blood transfusion

A

Antibodies in recipient’s plasma binds to antigens on donated RBCs, causing agglutination and producing hemoolysis

20
Q

Rh blood group: discovery, Rh+, Rh-

A

First discovered in blood of Rhesus monkey

Rh positive: RBCs contain Rh antigen
Rh negative: RBCs do not contain Rh antigen

Normally plasma does not contain antibodies against Rh antigen

21
Q

What happens if Rh- gets Rh+ blood

A

Rh- gets Rh+ blood, immunosystem make Rh antibodies that remain in blood

If second transfusion w/ Rh+, formed Rh- antibodies will cause agglutination & hemolysis of donated RBCs

22
Q

Neutrophils: location and function

A

Granular leukocyte (visible granular)

Location:
Circulation; some in tissue

Function:
Phagocytosis of bacteria

23
Q

Basophils: location and function

A

Granular leukocyte (visible granular)

Location:
Circulation

Function:
Release histamine -> promotes inflammation in allergic reactions
Release heparin -> coagulation

24
Q

Eosinophils: location and function

A

Granular leukocyte (visible granular)

Location:
In blood and mucosal surfaces

Function:
Kill parasites
Inflammatory response

25
Q

Monocytes: location and function

A

Agranular leukocytes

Location:
Circulation (short time as phagocytes)

Function:
Phagocytes: migrate into tissues & organs, develop as macrophages
Macrophages: engulf cellular debris and microbes

26
Q

Lymphocytes: location and function

A

Agranular leukocytes (not visible leukocytes)

Location:
Lymphoid tissues (lymphoid nodes, thymus, spleen)

Function:
B lymphocytes (beta) - destroy bacteria, generate -> antibody production plasma cell

T lymphocytes (T) - Attack viruses, fungi, transplanted cells, cancer cells, some bacteria

Natural Killer (NK) - Attack infectious microbes, spontaneously arising tumor cells

27
Q

Mast Cells

A

In most tissues

Release, histamine, heparin, and proteases during inflammation

28
Q

Three aspects of stop bleeding in hemostasis

A

Quick, localized, controlled

29
Q

What are the three mechanisms to stop blood loss

A

-Blood vessel spasm
-Platelet Plug Formation
-Blood Coagulation or clotting (form fibrin threads)

30
Q

What stimulates platelets production

A

thrombopoietin
platelets are cell fragments

31
Q

Platelets functions

A

-store and release chemicals that promote blood clotting
-form platelet plug
-7-10 day life span
-removed by macrophages (in spleen or liver)

32
Q

Platelets have alpha and dense granule content released during platelet activation what are they

A

Alpha
-Fibrinogen
-van Willebrand factor
-Factor V and VIII
-Fibronectin
-Thrombin

Dense granule
-Ca+, ADP, ATP
-histamine
-serotonin
-epinephrine

33
Q

Hemostasis Vascular Spasm

A

-Damage to blood vessels activates contraction of smooth muscle
-Cause damage to smooth muscle, platelet factors, pain receptor
-Reduced blood loss for several minutes to hours

34
Q

Hemostasis Platelet Plug Formation

A

-Three stages
-Surface Receptors
-Stored components are released from platelet
-Activation of platelet aggregation

35
Q

Platelet Plug Formation stage 1

A

Platelet Adhesion
-Platelets contact and stick to damaged blood vessel
-Collagen fibers and van Willebrand factors exposed to blood

36
Q

Platelet Plug Formation stage 2

A

Platelet Activation
-Platelet release the content of granules
-Agents induce change in shape, proteins, metabolism (activation)
-Platelet extend projection and release vesicle content

37
Q

Platelet Plug Formation stage 3

A

Platelet Aggregation
-Gathering of platelets
-Recruited by ADP, TXA2, Thrombin
-Form platelet plug (fibrin threads tighten plug)

38
Q

Formation of fibrin plug

A

-Fibrous protein involved in formation of hemostatic plug
-Covers platelet plug forming a loose fibrin thread
-Molecules are crosslinked between lysine and glutamine by factor 13
(factor 13 -> make more stable, disulfide bonds)

39
Q

Blood Coagulation importance

A

*Form hemostatic plug
-activation of plasma coagulation proteins (clots)
-Are proteases
-Factors form thrombin and fibrin
-Enzymatic reactions

40
Q

Coagulation pathways: extrinsic

A

Quick
-Tissue Factor leaks into the blood from damaged cells
-TF with Ca2+ activates factor X
-Factor X with factor V & Ca2+ form prothrombinase

41
Q

Coagulation pathways: intrinsic

A

Slow
-Direct contact with blood
-Exposed collagen fibers and phospholipids activate clotting factor XII
–Factor XII with Ca2+ activates factor IX then others
–Factor X, V, and Ca2+ form prothrombinase

42
Q

Coagulation pathways: common pathway

A

Begins when prothrombinase formed
-prothrombinase and Ca2+ catalyze conversion of prothrombin into thrombin

43
Q

Fibrinolytic System (deletion of blood clots)

A

Elimination of fibrin plug
-system breaks down fibrin clot to fibrin degradation products
–Plasminogen dissolves clot at site of damage once damage is repaired
–Plasmin dissolves small inappropriate clots
–Restores obstructed circulation

44
Q

Three thrombin functions

A

-Bind to Ca2+ and converts fibrinogen to fibrin

-activates factor XIII crosslinks, stabilizes, strengthens fibrin threads (final plug)

-Activates factor V and platelets

z PP1: Intro Physiology (10 decks)

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