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Foundations of Medicine > Introduction to Blood > Flashcards

Introduction to Blood Flashcards

1
Q

What is average circulating volume of blood in a typical adult male ( 70 kg) and how is it distributed?

A

5 litres of blood
1L in lungs
3L in systemic venous circulation
1L in heart and arterial circulation

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2
Q

What are the functions of blood?

A

Carriage of physiologically active compounds (plasma)
Clotting (platelets)
Defence (white blood cells)
Carriage of gas (red blood cells)
Thermoregulation
Maintenance of ECF pH (7.4)

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3
Q

Platelets role in blood clotting?

A

-clotting factors need platelets to be present (platelets themselves do not participate in clotting cascade)

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4
Q

What is in blood?

A

Plasma, red blood cells, white blood cells and platelets.

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5
Q

What is percentage of body weight is plasma and percentage of blood?

A

4% of body weight is plasma and accounts for half of blood weight.

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6
Q

Composition of plasma?

A

95 % water
What isn’t water- made up of ions , hormones, enzymes , plasma proteins.

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7
Q

Role of plasma?

A

Circulates biologically active molecules & compounds
Composition normally kept within strict limits.

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8
Q

What are the three categories of plasma proteins?

A

Albumin
Globulin - Subdivided into alpha, ß, gamma globulins
Fibrinogen and other clotting factors

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9
Q

Where do plasma proteins perform their function?

A

Plasma proteins are not taken up by cells - perform their functions in the circulation. Compare with organic compounds e.g. hormones which use blood as a vehicle.

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10
Q

Describe Albumin’s role?

A

transports proteins that are not water soluble

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11
Q

Describe Globulin’s role?

A

Alpha and beta globulins transport proteins but gamma globulins function as antibodies.

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12
Q

Describe fibrinogen and other clotting factor roles?

A

Lipids get carried by fat soluble plasma proteins and can leave whenever.

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13
Q

Explain colloid oncotic pressure?

A

See A4 paper

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14
Q

What is hypoproteinaemia?

A

Abnormally low levels of circulating plasma protein

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15
Q

Why does hypoproteinaemia occur?

A

-prolonged starvation - can’t make proteins
-liver diseases -all plasma proteins are synthesized in liver
-intestinal diseases- problem with gut wall and can’t absorb protein to produce
-nephrosis (kidney problems) - losing proteins as kidney decides which components of fluid component of blood to keep
-

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16
Q

Common characteristic of hypoproteinaemia?

A

oedema- build up of fluid in interstitial fluid because of loss of plasma proteins and loss of oncotic pressure.

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17
Q

What are erythrocytes?

A

Mature red blood cells

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18
Q

What are the types of white blood cell?

A

Neutrophils
Monocytes
Basophils
Eosinophil
Lymphocytes

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19
Q

What are the parts of formed and non formed components of blood?

A

formed- RBC, WBC and platelets
Non formed- plasma

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20
Q

What are reticulocytes?

A

Are almost but not quite mature red blood cells.
released into circulation and mature in next 24 hours.

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21
Q

Where are all blood cells in circulation from?

A

A population of undifferentiated pluripotent stem cells in the bone marrow. ( Pluripotent hematopoietic stem cell)

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22
Q

What is hematopoiesis?

A

The maturation of blood cells. The process by which cells develop from undifferentiated stem cells to erythrocytes and white blood cells.

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23
Q

Fates of undifferentiated pluripotent cells?

A

Either commits to being a lymphocyte or not.
If lymphocyte- differentiates to lymphocyte stem cells.
If not - uncommitted stem cell

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24
Q

What are committed progenitor cells?

A

Cells that have committed to being one particular type of blood cell.

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25
Q

Pathway for red blood cell?

A

(in bone marrow) Goes through process where has mitochondria and ribosomes to produce energy aerobically and produce protein.
-When reaching erythroblast loses ability to synthesize proteins and aerobically respire.
-As erythrocyte has to generate energy anaerobically

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26
Q

How much hemoglobin does RBC have?

A

Hemoglobin is all the protein that RBC will ever have.

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27
Q

Reticulocyte stage?

A

Un fully matured RBC is released into circulation. Goes through another 24 hours of maturation.

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28
Q

Megakaryocytes?

A

-Always stay in blood marrow but bits of their cell membrane and cytoplasm get released and are platelets.

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29
Q

What are myeloid cells?

A

All cells in circulation except from lymphocytes (lymphoid cells)

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30
Q

Myeloid leukemia or lymphoid leukemia?

A

Cancers affecting lymphoid cells or myeloid specifically.

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31
Q

Composition of erythrocytes?

A

Densely packed with Haemoglobin – protein concerned with gas transport.

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32
Q

Characteristics of erythrocytes?

A

Most abundant blood cell (4 - 6 x1012/L)
120 day lifespan.
Highly flexible, biconcave, non-nucleated, diameter 7-8m.

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33
Q

What does spleen do?

A

Checks for deformed blood cells and recycles the component parts and releases hemoglobin. Protein broken down into AA and iron part of hemoglobin gets recycled.

34
Q

Function of red blood cell shape?

A

Increases ability to take in oxygen.

35
Q

How many molecules of oxygen bind to hemoglobin?

A

4 iron atoms at centre bind 4 mols of oxygen

36
Q

Colour change of blood?

A

– oxyhaemoglobin (arterial)
- deoxyhaemoglobin (venous)
When hemoglobin has oxygen is brighter and when without oxygen is bluey purple.

37
Q

What is Erythropoiesis?

A

Synthesis of red blood cells

38
Q

What controls and accelerates erythropoiesis?

A

Hormone erythropoetin stimulates the progression of pluripotent stem cells to erythroblasts. (Only in bone marrow)

39
Q

Where is erythropoetin secreted from?

A

The kidney (85%)
The liver (15%)

40
Q

When is erythropoetin release enhanced?

A

-When a lack of oxygen in blood
-When oxygen delivery to kidney is reduced- big increase

41
Q

What is hypoxia?

A

Reduction in oxygen delivery to tissue

42
Q

How long is delay from release of erythropoietin to release of RBC?

A

2-3 days

42
Q

Reasons for erythropoietin secretion?

A

-haemorrhage- loss of whole blood
-anaemia- loss of RBC production
-cardiac dysfunction-heart unable to pump blood
-lung disease-lungs cannot oxygenate blood

42
Q

Why is renal disease accompanied by anaemia?

A

Renal disease is kidney disease. Kidney is dominant source of erythropoietin and can’t produce adequate levels of RBC.

43
Q

What type of feedback is erythrpoietin secretion?

A

Negative feedback - trying to correct reduction in oxygen delivery. Trigger is lack of oxygen and response is release of erythropoietin.

44
Q

What are characteristics of leukocytes (white blood cells) ?

A

Larger than red blood cells and have a nucleus.
Less present than red blood cells.
Involved in defense against pathogens.

45
Q

What are the two broad categories of white blood cells?

A

Granulocytes and Agranulocytes

46
Q

Granulocytes name comes from?

A

Look like they have granules in cytoplasm.

47
Q

What white blood cells are in granulocytes?

A

-neutrophils
-basophils
-Eosinophils

48
Q

What white blood cells are in agranulocytes?

A

-Monocytes
-Lymphocytes

49
Q

What cells are in lymphocyte family?

A

-B Cells
-T cells (Helper T cells and Killer T cells)

50
Q

What are the most abundant white blood cells?

A

Neutrophils- account for 68%
half life of 10 hrs

51
Q

What are least abundant white blood cells?

A

Basophils -account for less than 1 %

52
Q

What percentage of white blood cells are eosinophils?

A

1%

53
Q

What percentage of lymphocytes make up white blood cells?

A

25%

54
Q

What percentage do monocytes make up?

A

5% circulating cells, after 72 hours migrate to connective tissue where they become macrophages (phagocytose pathogens )and live for 3 months

55
Q

What is leukopoiesis?

A

White blood cell formation/ maturation of leukocytes

56
Q

What controls leukopoiesis?

A

Controlled by a cocktail of cytokines (proteins/peptides released from one cell type which act on another). Depends on cocktail which white blood cell will be made to mature.

57
Q

What is the cocktail for maturation of white blood cells composed of?

A

Different types of Colony Stimulating Factors
e.g. Granulocyte CSF
Different types of Interleukins (between white blood cells )

58
Q

Where are cytokines released from?

A

-released from mature white blood cells

59
Q

What do cytokines do?

A

Stimulate both mitosis and maturation of leukocyte.

60
Q

What white blood cells target bacterial infections?

A

neutrophils (neutralize bacteria)

61
Q

What white blood cells target viral infections?

A

lymphocytes

62
Q

Why is cytokine cocktail dynamic?

A

The cytokine cocktail is therefore dynamic, changing it’s composition in response to infection to influence which white blood cell will be preferentially stimulated to form.

63
Q

What does differential white cell count show?

A

allows you to differentiate between infection types.

64
Q

What are characteristics of platelets?

A

membrane bound cell fragments (from megakaryocytes).
Rarely nucleated, 2-4m diameter.
Life span 10 days. (140-400x109/L)

65
Q

What are role of platelets?

A

Adhere to damaged vessel walls and exposed connective tissue to mediate blood clotting
DO NOT adhere to healthy intact endothelium.

66
Q

What is a haematocrit?

A

The haematocrit measures the % of red blood cells (RBC) as a fraction of whole blood.

67
Q

Where do the blood cells sit in centrifuge after centrifugation?

A

Red blood cells at the bottom, white cells and platelets in middle and plasma on top.

68
Q

What is normal range of red blood cells in whole blood?

A

Normal range 40-50%

69
Q

How will haematocrit change if dehydrated?

A

Loss of fluid component- haematocrit will increase.
Increase in erythropoietin- increase in haematocrit.

70
Q

Why is plasma yellow in colour?

A

Presence of Bilirubin.

71
Q

What is bilirubin?

A

Break down product of red blood cells.

72
Q

Jaundice cause? linking to bilirubin

A

Bilirubin is processed by liver and if liver is dysfunctional -cannot function and bilirubin backs up in blood. Bilirubin accumulates in blood and plasma takes on increased bilirubin . Causes skin and mucus membranes and whites of eye to turn yellow.

73
Q

What is viscosity?

A

How thick/sticky blood is compared to water.

74
Q

What is viscosity of plasma?

A

1.8 thicker than water

75
Q

What is viscosity of whole blood?

A

x 3-4 thicker than water (varies)

76
Q

Why does viscosity depend on haematocrit?

A

50% increase in haematocrit increases viscosity approx. 100%

77
Q

Why does viscosity depend on temperature?

A

increase in temp decreases viscosity and vice versa.
1oC changes viscosity by around 2%

78
Q

Why does viscosity depend on flow rate ?

A

decreased flow rate increases viscosity and vice versa

Foundations of Medicine (27 decks)

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