Intro to Blood Flashcards
Plasma Protein Functions
Immune Functions Blood Buffers (Acid Base Balance) Enzymes Hemostasis Osmotic Pressure & Fluid balance Transport/Carry other molecules
Plasma Protein Types
Albumin
Globulins
Fibrinogen
Albumin Values
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
Globulin Values
All proteins except fibrinogen and albumin
- 5 gm/dL
- 2% total protein
Fibrinogen Values
300 mg/dL (0.3 g/dL)
4% of total protein
Colloid Osmotic Pressure (gm/dl, mmHg, %total osmotic P)
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%
Globulin Types
Alpha 1- 4% of total
Alpha 2- 8% of total
Beta- 12% of total
Gamma/Immunoglobulins- 16% of total; 1.5 gm/dL
Globulin Functional Grouping
Plasma Proteolytic Proteins
Plasma Protease Inhibitors
Carrier Proteins
Acute Phase Proteins
Plasma Proteolytic Systems
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)
Plasma Protease Inhibitors Function
Prevent the action of or slow down the action of various proteins
Plasma Protease Inhibitor Types
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
Carrier Protein Examples
Albumin
Haptoglobin
Hemopexin
Haptoglobin
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
Hemopexin
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
Acute Phase Proteins Form When….
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
Acute Phase Protein Examples
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
Hypoproteinemia Causes
Decreased protein intake (malnutrition) Decreased protein production (liver problems) Decrease protein absorption Excretion of protein Hemodilution (Perfusionist) Cut HCT 50% cuts protein 50%
Hypoproteinemia Affects
Acid-base balance Clotting mechanisms Enzyme-dependent Reactions Fluid balance Transport problems
How many liters in a kilogram?
1L = 1 kg
Hyperproteinemia Cause & Affect
Increased plasma proteins
Causes: Multiple myeloma- abnormal production of paraproteins
Affects: Hyperviscosity- increase chance of clot
Paraproteins
Abnormal immunoglobulin produced as a result of malignances of the spleen, liver, and bone marrow
Red Blood Cell Dimensions
Shape: Bioconcave Discoid Diameter: 8.1 microns Greatest thickness: 2.7 microns Least thickness: 1 micron Area: 138 microns^2 Volume: 95 microns^3
Life Cycle of Red Blood Cell
120 days; production affected by arterial pO2
Reticulocytes
Immature red blood cells
How are old damaged red blood cells removed?
Macrophages in liver and spleen
Ghosts/Red Cell Stroma
remnants of ruptured red blood cells
Red Blood Cell Contents (& Percentages)
Hemoglobin-25%
Water- 70%
Other constituents- 5%
(No nucleus/other organelles)
Ionic Concentrations of RBCs
Sodium: 18mEq/L Potassium: 81 mEq/L Chloride: 52 mEq/L Bicarbonate: 19mEq/L Protein: 5 mMol/L
How many molecules of hemoglobin in each RBC?
300 million
Hemoglobin Structure
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
Saturation
Percentage of heme molecules bound with oxygen
Oxyhemoglobin vs. deoxyhemoglobin
Affinity
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
Oxyhemoglobin Dissociation Curve
Causes of decreased affinity (shift to right)
Increase PCO2 (Bohr Affect)
Decrease pH
Increase temperature
Oxyhemoglobin Dissociation Curve
Causes of increased affinity
Decrease pCO2
Increase pH
Decrease Temperature
What percent of total O2 content of blood is dissolved in the plasma?
2%
What is the only form of O2 that produces a partial pressure?
Dissolved blood in the plasma
Henry’s Law
02dis=(PO2)(0.003 mlO2/dL/mmHg)
How much of O2 content of blood reversibly bound to Hb inside the RBC?
98%
Methemoglobin
Fe2+ oxidized to Fe3+ forms Methemoglobin
Does not bind with O2
Methemoglobin reductase
enzyme normally present in RBC that keeps iron in reduced state
Methemoglobin Causes….
Oxidation by nitrites or sulfonamides
congenital deficiency of methemoglobin reductase
Fetal Hemoglobin
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
Hemoglobin S
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)
What happens to sickle cells?
Structural change triggered by low O2 content
Change reversible or permanent
Sickle cells easily hemolyze; trapped in microvasculature
HbS Results
Retinal degeneration; ulcerations of low extremities; organ infarction
Causes of RBC Hemolysis
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
Types of WBCs
Granulocytes
Monocytes - will eventually become macrophages (3-8%)
Lymphocytes (20-25%)- T cells; B cells (new antibodies)
Types of Granulocytes
Neutrophils (60-70% of WBC count)
Eosinophils (2 to 4%)
Basophils (.5 to 1%)
What concentration do Neutrophils respond to?
Respond to 1 nM (1 billionth of a mole) concentration chemotactic molecules
Neutrophil Structure
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)
Major Basic Protein (MBP)
chemical released by eosinophils; binds to antigen and lyses the antigen’s membrane
Eosinophils Structure
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)
Basophil Structure
Least common WBC- 10 - 250 uL
5 to 7 microns in diameter
Found in tissue called mast cells
Monocytes Structure
20 to 1000/ uL
12 to 20 microns in diameter- very big
Mature into macrophages (histocytes)
Histocytes
Macrophages
Lymphocytes
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
Platelets
2 to 4 microns diameter
Arise from myeloid lineage progenitor cells
Produced in bone marrow by fragmentation of megakaryocytes
Hematopoiesis
blood cell formation
1 trillion new cells produced daily
Overview of Hematopoiesis in Bone Marrow
Sternum, ribs, vertebrae, proximal ends of long bones in adults; bone marrow of femur & tibia in children
Cytokines
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
Myeloid Progenitor
Can differentiate into red blood cells, platelets and certain white blood cells (granulocytes, monocytes/macrophage)
Lymphoid Progenitor
can differentiate into lymphocytes (specific white blood cell)
All blood components are tested for
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
Citrate anticoagulants
Commercially prepared
Used only to store blood and blood components
Contains: citrate, phosphate, dextrose, adenine