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Hematology and Immunology > Hematology Physiology > Flashcards

Hematology Physiology Flashcards

1
Q

Where is Iron stored?

A

1) Hemoglobin/myoglobin

2) Ferritin and Hemosiderin

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2
Q

What transports Iron?

A

Transferrin

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3
Q

Where is iron absorbed in the GI system?

A

Proximal duodenum

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4
Q

What transports iron across the apical membrane of a cell in the intestinal wall?

A

Divalent metal transporter (DMT1)

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5
Q

What transports iron into the blood?

A

Ferroportin 1

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6
Q

What regulated Ferroportin 1? How does it do this?

A

1) Hepicidin

2) Causes the degradation of Ferroportin 1 in enterocytes and macrophages

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7
Q

Where is hepicidin synthesized and released?

A

Liver

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8
Q

Where does heme synthesis take place?

A

1) Bone marrow and liver

2) Specifically in the mitochondria and cytoplasm

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9
Q

Where do the first three steps of heme synthesis take place

A

Mitochondria

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10
Q

What is the first step of heme synthesis?

A

1) Succinyl CoA + Glycine –> Aminolevulinic acid (ALA)
2) Enzyme: ALA synthase
3) Inhibited by glucose
4) Enhanced by Hypoxia, alcohol and barbituates

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11
Q

What is the second step of heme synthesis?

A

1) ALA –> Porphoblinogen
2) Enzyme: ALA dehydratase
3) Inhibited by Lead

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12
Q

What is the last step of heme synthesis?

A

1) Protoporphyrin IX –> Heme
2) Enzyme: Ferrochelatase
3) Inhibited by Lead

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13
Q

What steps in heme catabolism take place in the spleen?

A

1) Heme –> biliverdin (heme oxygenase)

2) Biliverdin –> bilirubin (biliverdin reductase)

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14
Q

What converts conjugated bilirubin to conjugated?

A

UDP-Gluconyrl transferase

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15
Q

What carries unconjugated bilirubin?

A

Albumin. It must be carried because it is lipophilic.

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16
Q

What are the different types of hemoglobin?

A

1) Hemoglobin A (beta chains)
2) Hemoglobin F (gamma chains)
3) Hemoglobin A2 (delta chains)

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17
Q

What chromosome are the alpha like chains on? Beta like?

A

1) Alpha = 16

2) Beta = 11

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18
Q

What are the steps in the glutathione defense?

A

1) Reduction of NADP via Glucose 6 phosphate —> 6-Phosphogluconate (G6PD)
2) Reduction of Glutathione via NADPH and Glutathione reductase
3) Conversion of Hydrogen peroxide to water via reduced glutathione and glutathione peroxidase

19
Q

What are influences on the dissociation of oxygen curve?

A

CADET face Right

1) CO2
2) Acidic blood (increased H)
3) 2,3 DPG (Bisphosphoglycerate)
4) Exercise
5) Temperature

20
Q

What are the states of hemoglobin?

A

1) Tense state (deoxyhemoglobin)

2) Relaxed state (Oxyhemoglobin)

21
Q

Increased oxygen affinity when one heme gropu binds is known as?

A

Positive cooperativity

22
Q

What does 2,3- bisphosphoglycerate bind to?

A

Deoxygenated hemoglobin (tense state)

23
Q

What is the components of hemostasis?

A

1) Primary hemostasis (Hemostatic plug formation)
2) Secondary hemostasis (Fibrin clot formation)
3) Thrombolysis

24
Q

Describe the steps in hemostaitc plug formation (primary hemostasis)

A

1) Platelet adhesion (mediated by vWF)
2) Platelet secretion of granules
3) Platelet aggregation

25
Q

What does von Willebrand Factor mediate?

A

1) Platelet adhesion in an area of endothelial injury

26
Q

What are the diferent type of platelet granules and what do they contain?

A

1) Alpha granules - contain vWF, growth factors V and VIII, and fibrinogen
2) Dense bodes- contain serotonin, ADP, and Calcium (ADP and Ca are important in aggregation)

27
Q

What does the fibrin clot formation consist of?

A

1) Extrinsic pathway

2) Intrinsic pathway

28
Q

Describe the secondary hematostasis extrinsic pathway

A

1) Activated by tissue factor from endothelial cells
2) Coagulation factor VII is most important
3) Measured by Prothrombin time (PT)

29
Q

Describe the secondary hematostasis intrinsic pathway

A

1) Activated by vessel rupture
2) Involves coagulation factors XII, XI, IX, VIII
3) Measured by Partial thromboplastin time

30
Q

What is measured by PT? PTT?

A

1) PT (Prothrombin time) = Extrinsic

2) PTT Partial Thromboplastin time)= Intrinsic

31
Q

What coagulation factors are vitamin K dependent? What drug uses this dependency to treat?

A

1) Factors II, IX, X, and proteins S and C

2) Warfarin- inhibits vitamin K epoxide reductase

32
Q

What is the goal of both the intrinsic and extrinsic pathway of fibrin clot formation?

A

1) To activate factor X which will convert prothrombin to thrombin

33
Q

What does thrombin do?

A

1) Thrombin converts fibrinogen to fibrin

2) Fibrin acts as the cement for the platelet plug

34
Q

What is important about coagulation factor VIII?

A

It helps stabilize and activate coagulation X

35
Q

What is dependent upon thrombin levels to be activated?

A

Thrombin activated fibrinolysis inhibitor (TAFI)

36
Q

What is the major effector of fibrinolysis? What activates it?

A

1) Plasmin

2) tissue plasminogen activator

37
Q

What does plasmin do?

A

1) Degrades fibrin

2) Degrades coagulation factors V and VIII

38
Q

What is the function of tPA?

A

1) tPA activates plasminogen to plasmin

2) Plasmin is involved with the cleavage of fibrin

39
Q

What can cause a decreased Sedimentation rate?

A

1) Polycythemia
2) Sickle cell anemia
3) Congestive heart failure
4) Microcytosis

40
Q

What is the site links platelets together? What increases the amount present?

A

1) GpIIb/IIIa

2) Adenosine

41
Q

How do platelets bind to vWF?

A

1) Gp1b receptor

42
Q

How is bilirubin taken up in the liver? Excreted?

A

1) Passive

2) Active transport (MRP2)

43
Q

What is the normal P50 for hemoglobin? Myoglobin?

A

1) pO2 of 26 mmHg

2) pO2 of 1 mmHg

44
Q

Describe the size of the following:

1) Petechiae
2) Purpuraee
3) Ecchymoses

A

1) Less than 5 mm in diameter
2) 5cm to 1 cm
3) >1cm

Hematology and Immunology (6 decks)

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