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Pathophysiology 4 > Heme structure & function > Flashcards

Heme structure & function Flashcards

1
Q

functions of blood

A
  • transport of:
  • ->metabolic components, nutrients, hormones
  • gas exchange
  • immune defense
  • coagulation
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2
Q

WHOLE BLOOD b/d:

-whats in it

A

plasma 55%

  • ->proteins–albumins, globulins, fibrinogen, prothrombin
  • ->water (91%)
  • ->other solutes–ions, nutrients, waste products, gases, regulatory processes

formed elements 45%

  • ->platlets
  • ->leukocytes–neutrophils, lymphocytes, monocytes, eosinophils, basophils
  • ->erythrocytes= >99% of formed elements
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3
Q

in a centrifuged sample of blood, what is the layer order

A

plasma on top
buffy coat
formed elements on bottom

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4
Q

what is plasma mainly consisted of

A

water

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5
Q

serum vs plasma

A

serum=plasma thats been allowed to clot in the lab in order to remove fibrinogen and other clotting factors that can interact with diagnostic testing

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6
Q

what contains clotting factors

A

plasma

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7
Q

most plasma proteins are produced by ?

-except for?

A

liver

EXCEPT for immunoglobulins aka antibodies-

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8
Q

what produces antibodies

A

plasma cells in lymph nodes

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9
Q

total blood volume in adult

A

5.5 L

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10
Q

plasma contains two major groups of plasma proteins

A
  1. albumins

2. globulins

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11
Q

list the cellular elements of blood

A

RBCS (erythryocytes)
WBCS (leukocytes)
Platelets (thrombocytes)

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12
Q

role of erythrocytes

A

tissue oxygenation

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13
Q

what is the most abundant cells in blood

A

erythrocytes

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14
Q

erythrocyte structure, life span, what removes old rbcs?

A

inside=hemoglobin

  • mature rbc lacks nucleus and cytoplasmic organelles
  • limited life span=100-120 days
  • spleen removes RBCs from circulation
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15
Q

role of hemoglobin

A

carries the gases, electrolytes that regulate diffusion thru cell plasma membrane

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16
Q

role of leukocytes

-categories?

A
  • defend the body against infection
  • remove dead or injured host cells
  • granulocytes–neutrophils, basophils and eosinophils—all PHAGOCYTES
  • agranulocytes
  • ->monocytes, macrophages–PHAGOCYTES
  • ->lymphocytes—IMMUNOCYTES
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17
Q

role of thrombocytes

A

blood coagulation
control bleeding
**technically not true cells—they are irregularly shaped cytoplasmic fragements

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18
Q

basic roles of the lymphoid organs

A

provide sites of:

-residence, proliferation, differentiation or function of lymphocytes and mononuclear phagocytes

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19
Q

largest lymphoid organ

A

spleen

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20
Q

role of spleen (3)

A
  • functions as site of fetal hematopoiesis
  • filters and cleanses the blood
  • acts as a resevoir for lymphoctes and other blood cells
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21
Q

list the primary lymphoid organs

A

thymus

bone marrow

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22
Q

secondary lymphoid organs

A

spleen
lymph nodes
tonsils
Peyer patches in ileum of small intest

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23
Q

lymph nodes role

A

-site of development or activity of large number of lymphoctes, monocytes and macrophages

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24
Q

red marrow consists of?

-also called

A

red aka active or hematopoietic marrow

-also called myeloid tissue

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25
Q

yellow marrow consits of

A

inactive marrow

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26
Q

where are stem cells found

A

bone marrow

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27
Q

two most common stem cell populations

A
  1. hematopoietic stem cells

2. mesenchmal stem cells

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28
Q

Hematopoietic stem cells

  • what are they
  • what do they develop into?
A

progenitors of all hematologic cells

-develop into: blood cells (RBC + WBC + Plats) and osteoclasts

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29
Q

mesenchymal stem cells are?

  • role?
  • what can they differentiate into?
A

stromal cells and have a role in maintaining hematopoietic stem cells
-can differentiate into: osteoblasts, adipocytes, chondrocytes

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30
Q

what do osteoblasts and osteoclasts produce?

A

cytokines

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31
Q

what do cytokines do

A

proliferate and maintain hematopoietic cells

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32
Q

Myelopoiesis

-define

A

is the development of GRANULOCYTES (BEN) and monocytes from the differentiate of myeloid progenitor cells in bone marrow

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33
Q

what are the granuloctes and monocytes generated from

A

Myeloid progenitor cells

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34
Q

lymphocytes are generated from

-what is this process called

A

lymphoid progenitor cells–>lymphopoiesis

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35
Q

what are platelets derived from and what is the process called

A

megakaryocytes

process is called thrombopoiesis

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36
Q

what controls thrombopoiesis

A

thrombopoietin

37
Q

what do megakaryocytes under during thrombopoiesis

A

mitosis— but NOT cell division

-cytoplasm and plasm membrane fragment into the platelets

38
Q

lymphoid progenitor cells differentiate into?

A
  1. B cells
  2. T cells
  3. NK cells
39
Q

megakaryocytes differentiate into?

A

thrombocytes

40
Q

reticulocytes differentiate into?

A

erythryocytes

41
Q

myeloblasts differentiate into?

A

basophils eosinophils neutrophils (granuloytes)

monocytes—-which then differenatie into dendritic cells and macrophages

42
Q

colony stimulating factors

A
  • specific hematopoietic growth factors

- needed for prod of myeloid, erythroid, lymphoid and megakaryocytic lineages

43
Q

where does hematopoiesis occur

  • fetus
  • after birth
A

liver
spleen
of the fetus

bone marrow after birth

44
Q

regulation of erythropoiesis mediated by

A

erythropoietin

45
Q

where is erythropoietin secreted and in resp to what

A

kidneys and in response to tissue hypoxia

46
Q

erythropoietin (EPO) causes?

A

compensatory increase in erythryocyte production if oxygen content of blood decreases (anemia, high altitude, pulm dz, etc)

47
Q

erythropoesis define

A

development of RBC

48
Q

erythropoiesis depends on?

A

vitamin B12 ***
folate ****

B6
riboflavin
niacin

49
Q

iron binds to ____ in the blood

A

transferrin

50
Q

iron is transported to ____ after binding to transferring

A

macrophages

51
Q

where is iron stored and as what

A

stored in cytoplasm as ferritin

52
Q

describe the steps of iron cycle

A
  • reutilizes iron released from old or damaged erythrocytes
    1. iron binds to transferrin in blod
    2. transported to macrophages
    3. stored in cytoplasm as ferritin
53
Q

iron homeostasis is controlled by

A

hepcidin

54
Q

what is hepcidin and its role

-where is it produced

A

small hormone—regulates ferroportin–principal transport for iron from stores in hepatocytes + macrophages (in spleen + intestines)
its prod by hepatocytes

55
Q

ferroportin role

A

transmembrane protein— transports the stored iron from hepatocytes, macrophages in spleen/intestines

56
Q

hemostasis define

A

arrest of bleeding

57
Q

two pathways involved w/ hemostasis

A

PRIMARY HEMOSTASIS

  1. vasoconstriction
  2. formation of platelet plug

SECONDARY HEMOSTASIS

  1. activation of the clotting/coag cascade
  2. formation of a fibrin bloood clot
58
Q

basic steps/process for hemostasis

A
  1. injury/rupture of BV
  2. BV around wound constricts—-this reduces blood flow to the damaged area
  3. activated platelets stick to injury site
  4. plats become sticky and clump together to form platelet plug
  5. plats and damaged tissue release clotting factors
  6. blood clotting mechanism to form Fibrin—–acts like a mesh to stop bleeding
59
Q

what factors involved with intrinsic pathway

-blood test?

A 
XII 
XI 
X
IX
VIII
TEST=aPTT---activated partial thromboplastin time
60
Q

factors involved for extrinsic pathway

-blood test?

A

VII
X
TEST=prothrombin time PT

61
Q

common pathway steps

A

Prothrombin II + thrombin–>fibrinogen I–>fibrin clot

62
Q

Fibrinolysis define

ex

A

enzymatic b/d of the fibrin in blood clots
-process tht prevents blood clots from growing and become problematic

**clot retraction + clot dissolution

EX: TPA

63
Q

what enzyme is responsible for fibrinolysis

A

plasmin—splits fibrin and fibrinogen into fibring degradation products that dissolve the clots

64
Q

life span of RBC

A

120 days

65
Q

structure of RBC

-what can affect their strucutre

A
  • disc shape, uniform in size and shape
  • inside=hemoglobin
  • **B12 deficiency, folate deficiency and iron deficiency can affect their appereance
66
Q

what is hemoglobin

A

protein that transport oxygen

67
Q

infections stimulate _____ to produce a higher number of _____

A

bone marrow to produce neutrophils

68
Q

what WBC is incr with allergies

A

eosinohpils

69
Q

thrombocytopenia

A

low platelets

70
Q

excessive bleeding and bruising

A

thrombocytopenia

71
Q

thrombocytosis

A

too many platelets

72
Q

what is evaluated in CBC lab test

A

all the cells that circulate in the blood:

  • RBCs
  • WBCs
  • Plats
73
Q

anemia

A

low RBC count

74
Q

RBC count?

A

actual number of RBCs in blood sample

75
Q

hemoglobin lab test

A

total amount of oxygen-carrying protein in the blood—generally reflects number of RBCs in blood

76
Q

Hematocrit

A

measure percentage of total blood volume that consists of RBCs

77
Q

RBC indicies?

A

provide information on the physical features of the RBCs

78
Q

Mean Corpuscular Volume (MCV)

A

measurement of the avg size of RBCs

79
Q

Mean corpuscular hemoglobin (MCH)

A

calculated measurement of the avg AMOUNT of hemoglobin inside your RBCs

80
Q

mean corpuscular hemoglobin concentration (MCHC)

A

calculated measurement of the avg CONCENTRATION of hgb inside RBCs

81
Q

Red Cell distribution width (RDW)

A

measurement of the variation in size of RBCs

82
Q

Reticulocyte count

A

measurement of the absolute count or pervent of newly released young RBCs

83
Q

WBC differential

A

can be added if WBC count is too low or high

-differential IDs and counts number of the five types of WBCs present

84
Q

Mean platelet volume

A

can be indicated in a CBC or not

-measurement of avg size of plats

85
Q

platelet distribution width (PDW)

A

can be included in a CBC or not

-reflects how uniform plats are in size

86
Q

immature granulocytes

  • what is it
  • what does it indicate
A

WBCs that havent fully developed b4 being releasd from bone marrow into cirulation

  • only present in bone marrow (NOT in circulating blood)
  • can indicate an infection or blood CA
87
Q

Reticulocyte Hemoglobin

A

measures hgb present inside of reticulocytes

-often reported as a Mean reticulocyte hemoglobin content or a reticulocyte hemoglobin equivalnt

88
Q

blood smear

  • done when
  • wht does it do
A

as a follow up to abnormal results on an automated CBC

compares WBC size, shape and general apperance to normal WBCs
RBC morphology=evals size, shape and color—-indicator of hgb content

Pathophysiology 4 (8 decks)

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