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
Monocytes: location and function
Agranular leukocytes Location: Circulation (short time as phagocytes) Function: Phagocytes: migrate into tissues & organs, develop as macrophages Macrophages: engulf cellular debris and microbes
26
Lymphocytes: location and function
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
Mast Cells
In most tissues Release, histamine, heparin, and proteases during inflammation
28
Three aspects of stop bleeding in hemostasis
Quick, localized, controlled
29
What are the three mechanisms to stop blood loss
-Blood vessel spasm -Platelet Plug Formation -Blood Coagulation or clotting (form fibrin threads)
30
What stimulates platelets production
thrombopoietin platelets are cell fragments
31
Platelets functions
-store and release chemicals that promote blood clotting -form platelet plug -7-10 day life span -removed by macrophages (in spleen or liver)
32
Platelets have alpha and dense granule content released during platelet activation what are they
Alpha -Fibrinogen -van Willebrand factor -Factor V and VIII -Fibronectin -Thrombin Dense granule -Ca+, ADP, ATP -histamine -serotonin -epinephrine
33
Hemostasis Vascular Spasm
-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
Hemostasis Platelet Plug Formation
-Three stages -Surface Receptors -Stored components are released from platelet -Activation of platelet aggregation
35
Platelet Plug Formation stage 1
Platelet Adhesion -Platelets contact and stick to damaged blood vessel -Collagen fibers and van Willebrand factors exposed to blood
36
Platelet Plug Formation stage 2
Platelet Activation -Platelet release the content of granules -Agents induce change in shape, proteins, metabolism (activation) -Platelet extend projection and release vesicle content
37
Platelet Plug Formation stage 3
Platelet Aggregation -Gathering of platelets -Recruited by ADP, TXA2, Thrombin -Form platelet plug (fibrin threads tighten plug)
38
Formation of fibrin plug
-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
Blood Coagulation importance
*Form hemostatic plug -activation of plasma coagulation proteins (clots) -Are proteases -Factors form thrombin and fibrin -Enzymatic reactions
40
Coagulation pathways: extrinsic
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
Coagulation pathways: intrinsic
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
Coagulation pathways: common pathway
Begins when prothrombinase formed -prothrombinase and Ca2+ catalyze conversion of prothrombin into *thrombin*
43
Fibrinolytic System (deletion of blood clots)
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
Three thrombin functions
-Bind to Ca2+ and converts fibrinogen to *fibrin* -activates factor XIII crosslinks, stabilizes, strengthens fibrin threads (final plug) -Activates factor V and platelets