- biconcave discs - anucleate - no organelles (anaerobic ATP production) - contains spectrin

- blood has abnormally low O2 carrying capacity - sign, not disease - fatigue, pallor, SOB, chills

Hematology Physio Flashcards by Elizabeth Sager

What are the components of blood

plasma (55%)
formed elements (erythrocytes (45%), leukocytes, platelets (1%))

How well did you know this?

Not at all

Perfectly

What is the normal pH range of our blood

7.35-7.45

How well did you know this?

Not at all

Perfectly

What is the average blood volume of adult males and females

Male: 5-6L
Female: 4-5L

How well did you know this?

Not at all

Perfectly

Describe the functions of blood

Distribution (O2, nutrients, waste, hormones)
Regulation (temp, pH, fluid)
Protection (blood loss, infection)

How well did you know this?

Not at all

Perfectly

What are the components of plasma

- 90% water
- proteins mostly produced by the liver (albumin, globulin, fibrinogen)
- clotting factors
- hormones
- respiratory gases & electrolytes
- nutrients

How well did you know this?

Not at all

Perfectly

What is the normal albumin-globulin ration

4:2

How well did you know this?

Not at all

Perfectly

Does serum contain clotting factors?

No, clotting factors are found only in plasma

How well did you know this?

Not at all

Perfectly

What cell gives rise to all formed elements of our blood?

Multipotential hematopoietic stem cell (hemocytoblast)

How well did you know this?

Not at all

Perfectly

What are the two types of cells that differentiate from hemocytoblasts

common myeloid progenitor

common lymphoid progenitor

(these branch farther into many cells, leukemias will affect one line or the other)

How well did you know this?

Not at all

Perfectly

Define erythrocytes

biconcave discs
anucleate
no organelles (anaerobic ATP production)
contains spectrin

How well did you know this?

Not at all

Perfectly

What is the purpose of spectrin in erythrocyte plasma membranes

provides flexibility to change shape as needed

(deficiency leads to a type of anemia)

How well did you know this?

Not at all

Perfectly

Describe the structure of hemoglobin

protein globin: 2 alpha & 2 beta chains (adults, 2 gamma in fetal)
heme pigment bonded to globin
iron atom in each heme (can bind 4 O2)

How well did you know this?

Not at all

Perfectly

What is a reticulocyte

a mature form of a red blood cell that is not yet an erythrocyte

(formed during erythropoiesis after nucleus is ejected)

How well did you know this?

Not at all

Perfectly

Where does erythropoiesis occur

red bone marrow

How well did you know this?

Not at all

Perfectly

What is a scenario in which reticulocyte count would be low

aplastic anemia

How well did you know this?

Not at all

Perfectly

What regulates erythropoiesis

Hormones
- erythropoietin
- testosterone

Nutrients
- amino acids, lipids, carbs
- iron
- vit B12

How well did you know this?

Not at all

Perfectly

What is iron stored in the cells as and what is it transferred by

Storage: ferritin & hemosiderin

Transport: transferrin

How well did you know this?

Not at all

Perfectly

What is the lifespan of a RBC

100-120 days

(then destroyed by macrophages in the spleen)

(Hgb A1C measures this)

How well did you know this?

Not at all

Perfectly

What happens after a RBC is broken down

iron salvaged for reuse
heme degraded to yellow pigment unconjugated bilirubin, which gets conjugated in the liver, excreted as stercobilin & urobilinogen
globin metabolized into amino acids

How well did you know this?

Not at all

Perfectly

Define anemia

blood has abnormally low O2 carrying capacity
sign, not disease
fatigue, pallor, SOB, chills

How well did you know this?

Not at all

Perfectly

What kinds of anemia are caused by insufficient erythrocytes

hemorrhagic
hemolytic (RBCs destroyed)
aplastic (Bone marrow destroyed)

How well did you know this?

Not at all

Perfectly

What kinds of anemia are caused by low Hgb

iron deficiency (secondary to hemorrhage, impaired iron absorption
pernicious (Vit B12 deficiency, lack of intrinsic factor for absorption)

How well did you know this?

Not at all

Perfectly

What kinds of anemia are caused by abnormal Hgb

thalassemia (absent/faulty globin, think delicate RBC)
sickle cell (gene code, low in oxygen)

How well did you know this?

Not at all

Perfectly

When does sickling happen in sickle cell anemia

When oxygen dissociates from the heme (especially during high O2 demand like exercise)

How well did you know this?

Not at all

Perfectly

Define polycythemia

excess of RBCs that increase blood viscosity - bone marrow cancer, O2 loss, blood doping

What process allows WBC to leave capillaries

diapedesis

What makes up granulocytes & agranulocytes

**Granulocytes** - neutrophils (50-70%) - eosinophils (2-4% - basophils (1%) **Agranulocytes** - lymphocytes (25-45%) - monocytes (3-8%)

Which WBCs will stain with Wright's stain

granulocytes (neutrophils, eosinophils, basophils) - larger, shorter lived - lobed nuclei - phagocytic

Which WBC has granules that contain hydrolytic enzymes or defensins

Neutrophils (bacteria slayers)

Which WBC digests parasitic worms & modulates immune response

eosinophils

Which WBC contains histamine & functions similarly to mast cells

basophils

Describe the 2 types of lymphocytes

- T cells: act against virus-infected cells & tumor cells - B cells: give rise to plasma cells that produce antibodies

What is the largest WBC and what does it do

monocytes - differentiates into macrophages - activates lymphocytes for immune response

What chemical messengers from bone marrow & mature WBCs stimulate leukopoiesis

interleukins & colony-stimulating factors

Describe platelets

- anucleate cell fragments - formation regulated by thrombopoietin (hormone from liver & kidneys)

What are in the granules of platelets & why are these important

- Ca, enzymes, ADP, phospholipids, platelet derived growth factor, serotonin - important in hemostasis

What does the platelet membrane consist of

- lipid bilayer - glycoprotein receptors (important in hemostasis)

What are the functions of platelets

- form temporary plugs that seal breaks in blood vessels - circulating when inactive and made mobile by nitric **oxide & prostacyclin from endothelial vessel lining**

Describe the phases of hemostasis

- primary (vascular spasm & platelet plug) - secondary (coagulation) - stoppage of hemostasis (proteins) - fibrinolysis (clot dissolves)

Describe the steps of platelet plug formation (step 2 of hemostasis)

- adhesion via vWB factor - aggregation via ADP - secretion of granular contents

Describe coagulation (step 3 of hemostasis)

- reactions in which blood is transformed from liquid to gel - reinforces platelet plug with fibrin threads - requires coag/clotting factors, Ca, phospholipids

Describe the 3 phases of coagulation

- prothrombin activator formed - prothrombin converted to thrombin - thrombin catalyzes fibrinogen to form fibrin mesh

Which clotting factors require vitamin K

Factors II, VII, IX, and X

What is the major difference between the intrinsic pathway and extrinsic pathway of clotting

Intrinsic: direct to blood vessel injury Extrinsic: tissue cell trauma prior to blood vessel response

What forms all clotting factors

the liver (all circulate in blood in an inactive form)

What is the main end product of phase 1 of coagulation

formation of prothrombin activator (activates prothrombin to thrombin in phase 2)

What is the main end product of phase 3 of coagulation

fibrin mesh

Describe clot retraction

- actin & myosin in platelets contract within 30-60 mins which squeezes serum from the clot

Describe clot repair

- **PDGF** stimulates division of smooth muscle cells & fibroblasts to rebuild vessel - **VEGF** stimulates endothelial cells to restore lining

Which proteins inactivate activated clotting factors

- antithrombin III - protein C - heparin

What things prevent platelet adhesion

- nitric oxide, prostacyclin (from endothelial lining) - vit E, quinine (anticoags)

Describe fibrinolysis

- begins within 2 days - plasminogen converted to plasmin by tPA, factor XII, thrombin

Describe disseminated intravascular coagulation (DIC)

- widespread clotting blocking intact blood vessels - can cause severe bleeding - common in pregnancy, septicemia, incompatible transfusion - prevention: ASA, heparin, warfarin

Describe thrombocytopenia

- deficiency of platelets - petechiae d/t spontaneous widespread hemorrhage - tx with transfusion of concentrated platelets

Describe the types of hemophilia

- A: most common, deficiency of factor VIII - B: deficiency of factor IX - mild, deficiency of factor XI - prolonged bleeding (into joints)

Which blood groups can cause vigorous transfusion reactions

ABO & Rh

Which blood group is a universal recipient

Which blood group is a universal donor

Which blood group can receive blood from B or O

B (has anti-A antibody)

Which blood group can receive blood from A or O

A (has anti-B antibody)

Which blood group can receive blood from only group O

O (has anti-A and anti-B antibodies)

Which blood group can receive blood from A, B, AB, or O

AB (no antibodies)

When do Rh antibodies form

- if an Rh negative person receives Rh+ blood - NOT spontaneous

Describe hemolytic disease of the newborn (erythroblastosis fetalis)

anti-Rh antibodies cross placenta and destroy RBCs of an Rh+ baby after Rh- mom becomes sensitized to Rh+ exposure & produces anti-Rh antibodies

What happens in a transfusion reaction

- occurs in mismatched infusions - donors cells are attacked by recipients agglutinins, clog small vessels, rupture & release Hgb - diminished O2 capacity, renal failure