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Physiology/Pathophysiology I > Intro to Blood > Flashcards

Intro to Blood Flashcards

1
Q

Plasma Protein Functions

A 
Immune Functions
Blood Buffers (Acid Base Balance)
Enzymes
Hemostasis
Osmotic Pressure & Fluid balance
Transport/Carry other molecules
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2
Q

Plasma Protein Types

A

Albumin
Globulins
Fibrinogen

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3
Q

Albumin Values

A 
4.5 gm/dL
62% Total plasma protein
MW 66,000
14-17 grams produced daily by liver (9% total)
Principle protein responsible for COP
Transports free fatty acids & bilirubin
Binds with variety of drugs
Secondary carrier: heme, thyroxin, cortisol
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4
Q

Globulin Values

A

All proteins except fibrinogen and albumin

  1. 5 gm/dL
  2. 2% total protein
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5
Q

Fibrinogen Values

A

300 mg/dL (0.3 g/dL)

4% of total protein

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6
Q

Colloid Osmotic Pressure (gm/dl, mmHg, %total osmotic P)

A

Albumin: 4.5g/dL, 21.8 mmHg, 77.9%
Globulins: 2.5g/dL, 6.0 mmHg, 21.4%
Fibrinogen: .3 gm/dL, 0.2 mmHg, 0.7%

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7
Q

Globulin Types

A

Alpha 1- 4% of total
Alpha 2- 8% of total
Beta- 12% of total
Gamma/Immunoglobulins- 16% of total; 1.5 gm/dL

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8
Q

Globulin Functional Grouping

A

Plasma Proteolytic Proteins
Plasma Protease Inhibitors
Carrier Proteins
Acute Phase Proteins

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9
Q

Plasma Proteolytic Systems

A

Complement System

Kinin System (forms bradykinin by kallikreins)

Blood Coagulation System (thrombin converts fibrinogen to fibrin)

Fibrinolytic System (produce plasmin from plasminogen which breaks down fibrin)

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10
Q

Plasma Protease Inhibitors Function

A

Prevent the action of or slow down the action of various proteins

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11
Q

Plasma Protease Inhibitor Types

A

Alpha 2 Macroglobulin- 250mg/dL, 3.5umol; inhibits plasma, thrombin, kallikrein

Antithrombin III- 15 mg/dL, 2.5umol; inhibits thrombin, factor Xa, IXa; prevents coagulation, heparin induces effect

C1 inhbitor- 18 mg/dL, 1.5 umol, inhibits activated C1r, C1s, kallikrein; rises in tissue inflammation or injury

Alpha 2 Plasmin Inhibitor- 7mg/dL, 1.0umol, inhibits plasmin, also called alpha 2 antiplasmin

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12
Q

Carrier Protein Examples

A

Albumin
Haptoglobin
Hemopexin

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13
Q

Haptoglobin

A

Transports plasma hemoglobin from lysed erythrocytes
Plasma concentration: 130 mg/dL
Produced by liver
Binds up to 3 gm of Hb- 5x normal released on daily basis
Combo binds to receptor sites in liver where iron is reprocessed

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14
Q

Hemopexin

A

Transports heme from plasma hemoglobin
Plasma concentration: 50-100 mg/dL
Complex removed from circulation and iron reprocessed
If binding capacity exceeded- metheme binds with albumin to form methemalbumin
Complex not filtered by normal glomerulus

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15
Q

Acute Phase Proteins Form When….

A

Tissue injury or infections produce inflammation
Interleukin 1 (IL-1) formed (induce systemic response)
Systemic acute response- fever, increased release certain hormones, increased production acute phase proteins

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16
Q

Acute Phase Protein Examples

A

Hemostatic Factors- fibrinogen, van Willebrand factor
C3 and factor B components of complement
Haptoglobin
Protease inhibitors- alpha1-antichymotrypsin; alpha2-antiplasmin
C-reactive protein- binds to altered cell membranes; activate complement pathway

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17
Q

Hypoproteinemia Causes

A 
Decreased protein intake (malnutrition)
Decreased protein production (liver problems)
Decrease protein absorption
Excretion of protein
Hemodilution (Perfusionist)
Cut HCT 50% cuts protein 50%
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18
Q

Hypoproteinemia Affects

A 
Acid-base balance
Clotting mechanisms
Enzyme-dependent Reactions
Fluid balance
Transport problems
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19
Q

How many liters in a kilogram?

A

1L = 1 kg

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20
Q

Hyperproteinemia Cause & Affect

A

Increased plasma proteins
Causes: Multiple myeloma- abnormal production of paraproteins
Affects: Hyperviscosity- increase chance of clot

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21
Q

Paraproteins

A

Abnormal immunoglobulin produced as a result of malignances of the spleen, liver, and bone marrow

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22
Q

Red Blood Cell Dimensions

A 
Shape: Bioconcave Discoid
Diameter: 8.1 microns
Greatest thickness: 2.7 microns
Least thickness: 1 micron
Area: 138 microns^2
Volume: 95 microns^3
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23
Q

Life Cycle of Red Blood Cell

A

120 days; production affected by arterial pO2

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24
Q

Reticulocytes

A

Immature red blood cells

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25
Q

How are old damaged red blood cells removed?

A

Macrophages in liver and spleen

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26
Q

Ghosts/Red Cell Stroma

A

remnants of ruptured red blood cells

27
Q

Red Blood Cell Contents (& Percentages)

A

Hemoglobin-25%
Water- 70%
Other constituents- 5%

(No nucleus/other organelles)

28
Q

Ionic Concentrations of RBCs

A 
Sodium: 18mEq/L
Potassium: 81 mEq/L
Chloride: 52 mEq/L
Bicarbonate: 19mEq/L
Protein: 5 mMol/L
29
Q

How many molecules of hemoglobin in each RBC?

A

300 million

30
Q

Hemoglobin Structure

A

4 individual polypeptide chains of amino acids
(2 alpha chain (141 AA’s) and 2 beta chains (146 AAs)
heme molecule attached to each chain
each heme molecule can bind with one molecule of oxygen

31
Q

Saturation

A

Percentage of heme molecules bound with oxygen

Oxyhemoglobin vs. deoxyhemoglobin

32
Q

Affinity

A

how easy it is for the heme molecules to bind (or release) oxygen

high affinity- easy to bind, hard to release
low affinity- hard to bind, easy to release
relationship shown by oxyhemoglobin dissociation

33
Q

Oxyhemoglobin Dissociation Curve

Causes of decreased affinity (shift to right)

A

Increase PCO2 (Bohr Affect)
Decrease pH
Increase temperature

34
Q

Oxyhemoglobin Dissociation Curve

Causes of increased affinity

A

Decrease pCO2
Increase pH
Decrease Temperature

35
Q

What percent of total O2 content of blood is dissolved in the plasma?

A

2%

36
Q

What is the only form of O2 that produces a partial pressure?

A

Dissolved blood in the plasma

37
Q

Henry’s Law

A

02dis=(PO2)(0.003 mlO2/dL/mmHg)

38
Q

How much of O2 content of blood reversibly bound to Hb inside the RBC?

A

98%

39
Q

Methemoglobin

A

Fe2+ oxidized to Fe3+ forms Methemoglobin

Does not bind with O2

40
Q

Methemoglobin reductase

A

enzyme normally present in RBC that keeps iron in reduced state

41
Q

Methemoglobin Causes….

A

Oxidation by nitrites or sulfonamides

congenital deficiency of methemoglobin reductase

42
Q

Fetal Hemoglobin

A

Gower I, Gower II, Portland, HbF
Production starts in fourth month in utero
Hb A replaces all fetal Hb between 3rd-6th months after birth

43
Q

Hemoglobin S

A

Sickle Cell Anemia
Beta chain substitution of valine for glutamic acid in position six
African Americans
Homozygous vs. heterozygous (100% HbS vs. 40% HbS, 60% HbA)

44
Q

What happens to sickle cells?

A

Structural change triggered by low O2 content
Change reversible or permanent
Sickle cells easily hemolyze; trapped in microvasculature

45
Q

HbS Results

A

Retinal degeneration; ulcerations of low extremities; organ infarction

46
Q

Causes of RBC Hemolysis

A

Immune Response from transfusion
Sepsis, bacterial or viral infection
RBC membrane stress from mechanical causes
Medications/toxins (alcohol)
Aging cells
Activation of complement system by antigen-antibody complexes
Enzyme deficiencies

47
Q

Types of WBCs

A

Granulocytes
Monocytes - will eventually become macrophages (3-8%)
Lymphocytes (20-25%)- T cells; B cells (new antibodies)

48
Q

Types of Granulocytes

A

Neutrophils (60-70% of WBC count)
Eosinophils (2 to 4%)
Basophils (.5 to 1%)

49
Q

What concentration do Neutrophils respond to?

A

Respond to 1 nM (1 billionth of a mole) concentration chemotactic molecules

50
Q

Neutrophil Structure

A

5,500/uL
10-15 microns in diameter
Polymorphonuclear- 2 to 5 lobes on the nuclear
Lives 10-12 hours in blood before moving into tissue
5-6 days in tissue
Immature neutrophils released into circulation called Bands
After release: 50% vascular system, 50% attach to endothelial lining of capillaries (margination)

51
Q

Major Basic Protein (MBP)

A

chemical released by eosinophils; binds to antigen and lyses the antigen’s membrane

52
Q

Eosinophils Structure

A

Approximately 10 to 760/ uL
12 to 17 microns in diameter
Life span of 12 to 24 hours
Mature in bone marrow-circulate for day then enter tissue spaces (skin, bronchi, bronchioles)

53
Q

Basophil Structure

A

Least common WBC- 10 - 250 uL
5 to 7 microns in diameter
Found in tissue called mast cells

54
Q

Monocytes Structure

A

20 to 1000/ uL
12 to 20 microns in diameter- very big
Mature into macrophages (histocytes)

55
Q

Histocytes

A

Macrophages

56
Q

Lymphocytes

A 
Lymphoid lineage progenitor cells
Most complex of WBC
650 to 4500/ uL- T cells 75% of total
5 to 12 microns in diameter
Specific test distinguish between T and B cells
57
Q

Platelets

A

2 to 4 microns diameter
Arise from myeloid lineage progenitor cells
Produced in bone marrow by fragmentation of megakaryocytes

58
Q

Hematopoiesis

A

blood cell formation

1 trillion new cells produced daily

59
Q

Overview of Hematopoiesis in Bone Marrow

A

Sternum, ribs, vertebrae, proximal ends of long bones in adults; bone marrow of femur & tibia in children

60
Q

Cytokines

A

hematopoietic growth factors which are glycoprotein molecules
Released by many cells
Controls growth/differentiation of stem &progenitor cells
Regulates immune response
Involved with inflammation
Aids in function of mature blood cells

61
Q

Myeloid Progenitor

A

Can differentiate into red blood cells, platelets and certain white blood cells (granulocytes, monocytes/macrophage)

62
Q

Lymphoid Progenitor

A

can differentiate into lymphocytes (specific white blood cell)

63
Q

All blood components are tested for

A 
Hep B surface antigen
Antibody to hep b core antigen
Antibody to hep c virus
Antibody to human T cell lymphotrophix virus type 1 and 2
Antibody to HIV types 1 and 2
HIV antigen 
Alanine aminotransferase- liver fcn
64
Q

Citrate anticoagulants

A

Commercially prepared
Used only to store blood and blood components
Contains: citrate, phosphate, dextrose, adenine

Physiology/Pathophysiology I (5 decks)

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