Lecture 1: Components of Blood Flashcards
What are the three components of blood?
(1) Plasma
- Water
- Proteins
- Non-protein solutes
(2) Leukocytes and Platelets
(3) Packed Red Blood Cells
What is plasma comprised of?
- Water
- Proteins (Albumin, Globulins, Coagulation factors)\
- Solutes (Na+, Cl-, Ca++, HCO3-, urea)
How much of extracellular fluid does plasma represent?
1/3
What does the plasma act as?
Transportation system both to and from the body tissues
T/F All blood (Red and White) cells come from pluripotent stem cells in bone marrow?
TRUE
What is another term for Red Blood Cell?
Erythrocyte
Where is the bone marrow located?
Axial skeleton in adults (long bones)
What are RBCs regulated by? How are they regulated?
Erythropoietin (hormone); it is released by renal tubules in response to hypoxia or decreased RBC
RBCs are dependent on what substances?
- Iron
- B12
- Folic acid
- B6
- Thyroid hormone
What is the earliest identifiable form of RBC? How many mature RBCs does it produce?
Proerythroblast; 8
T/F Nucleated RBCs are present in circulation.
FALSE; erythroblasts lose their nucleus right before entering circulation
What is a good indicator of bone marrow production?
Reticulocytes
How can you distinguish a reticulocyte from a mature RBC (as both are in circulation)?
Reticulocytes are larger and contain ribosomes
Around how many reticulocytes should be in circulation?
Number of reticulocytes circulating should be equal to the number of RBC being removed from circulation
Life span of RBC
120 days
What happens to degraded RBCs?
They are partially recycled and partially converted into bilirubin
What do erythrocytes do?
- Transport O2 from the lungs to the tissues of the body (HgB is the binding protein)
- Transport CO2 from the tissues to the lungs
Why are RBCs shape important?
Bi-concave shaped cells to be flexible and fit through capillary system
What are the 3 types of Granulocytes? What are their function?
(1) Neutrophils- phagocytic cells that respond to foreign bodies and bacteria
(2) Eosinophils- attack protozoa and helminths
(3) Basophils- become mast cells (hypersensitivity reactions)
What type of Granulocyte accounts for most of the WBC in circulation?
Neutrophils (60-70%)
What do monocytes play a role in?
- Become tissue macrophages
- Play a role in inflammation and initiating an immune response
What 2 types of lymphocytes are there? What are their differences?
- B: differentiation occurs in bone marrow; synthesize antibodies; provide humoral immunity
- T: differentiation occurs in thymus; destroy foreign cells or infected native cells; provide cell mediated immunity
Where are lymphocytes found?
In the lymphatic organs where they function as part of the immune system
What is another name for platelets?
Thrombocytes
What do platelets play a role in?
- Hemostasis
- Inflammation
- Wound healing
What is the life span of a platelet? Where are they derived?
8-10 days; megakaryocyte in bone marrow
What is the primary role of Hemoglobin? What is the iron containing portion of HgB?
Transports O2; Heme
T/F Iron is stored well within the body.
False; daily dietary iron is necessary
What are the 2 types of iron and where are they located?
- Active metabolic iron (80%; found within RBC)
- Iron reserve (ferritin- stored outside of the cell; stored in liver, spleen, bone marrow-hemosiderin)
Hgb (meaning and values)
- the amount of Hgb in 100mL of blood
- provides an indication of the O2 transport of the blood
- Females: 12.3-15.3 g/dL
- Males: 14-17.5 g/dL
Hct (meaning and values)
- packed cell volume, percentage volume of blood that is made up of erythrocytes
- usually 3 times the value of Hgb (decrease in anemia)
NORMAL - Females: 36-45%
- Males: 42-50%
MCV (meaning and values)
- Mean Corpuscle Volume
- Average size of a RBC
- calculated by dividing Hct by RBC count
- Normal: 80-100 fL
WBC (meaning and values)
- number of leukocytes in a cubic millimeter of blood
- increased in infections; decreased often but may represent malignancy
- Normal: 4.4-11.3 x 10^3 cells/mm3
Platelet count (meaning and values)
- Number of platelets in a cubic millimeter of blood
- Normal: 150,000-450,000
(will read “150” on CBC)
T/F ESR is not included in routine CBC.
TRUE (Erythrocyte Sedimentation Rate)
What is ESR and what do increased and decreased ESR indicate?
- The rate at which erythrocytes settle from the blood
- Increase: inflammation, infection, pregnancy
- Decrease: CHF, sickle cell anemia
What is a Wright stained blood smear?
- allows for manual evaluation of blood
- Looks at WBC and RBC morphology
WBC morphology (blood smear)
Determines the type of leukocytes in circulation
- Neutrophils (PMN: 45-73%, Band: 3-5%)
- Eosinophils 0-4%
- Basophils 0-1%
- Monocytes 2-8%
- Lymphocytes 20-40%
Left shift
shift to a bunch of young, banded neutrophils; INFECTION
RBC morphology (blood smear)
Determines size, shape, estimates of Hgb concentration (color of cell) and abnormalities
- Normal: 7-8 micrometer in diameter
- Important in determining pathology (target cells, sickle cells, spherocytes)
Anisocytosis
variation in RBC size
Poikilocytosis
variation in RBC shape
T/F Reticulocyte counts come on regular CBC.
FALSE
Reticulocyte count (measure and value)
Good indicator of RBC production
- Normal: 0.5-2.5% (count should be equal to number of RBC being removed from circulation)
- Elevated= anemia due to blood loss and/or hemolysis
- Reduced= anemia due to problems with RBC production (vitamin def, bone marrow supp)
What is the RPI
Raw Reticulocyte Count (%) x Patient’s Hematocrit / 45 x 0.5
Anemia + RPI .2
suggestshemolysis or acute hemorrhage
Anemia + RPI < 1
consistent with decreased RBC production
Indications for RBC transfusion
- Symptomatic deficit in oxygen carrying capacity
- Acute blood loss: whole blood
- Chronic anemia: packed RBC
T/F Patient should be crossmatched and typed for RBC transfusion.
TRUE
What is crossmatching?
Patient’s blood is mixed with donor blood to evaluate for lysis and clotting reactions (in lab)
- takes around 30 minutes
When would you use uncrossmatched blood?
- in massive blood loss
- with cardiovascular collapse
- Group O, Rh (-)
What is a Transfusion Reaction?
- antibody-mediated acute hemolytic reaction
- potentially life threatening
- most serious from mismatching of donor blood with recipient blood
What is Post Transfusion Fever without hemolysis?
- due to presence of foreign proteins in donor plasma
- can cause urticaria
What are platelet transfusions used for?
- usual dose: one unit per 10 kg body weight
- controlling bleeding in patients with thrombocytopenia due to bone marrow failure or chemo induced
T/F Platelet transfusion is useful for secondary thrombocytopenia.
FALSE
