lymph node organs, iron cycle, hemostasis, evaluation of blood - Sheet1 Flashcards

1
Q

What is the spleen, and what are its primary functions?

A

The spleen is the largest secondary lymphoid organ and functions as a site of fetal hematopoiesis, filters and cleanses the blood, mounts immune responses to bloodborne microorganisms, phagocytoses old, damaged, and dead blood cells, and serves as a blood reservoir (up to 300 mL).

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2
Q

What role does the spleen play in hematopoiesis?

A

The spleen serves as a site for fetal hematopoiesis, producing blood cells before birth.

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3
Q

How does the spleen filter and cleanse the blood?

A

The spleen filters the blood by removing old or damaged blood cells and pathogens through phagocytosis, ensuring the blood is clean and healthy.

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4
Q

What is the immune response function of the spleen?

A

The spleen mounts immune responses to bloodborne microorganisms, producing lymphocytes and antibodies to fight infections.

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5
Q

What is the lymphatic system, and how do lymph nodes function within it?

A

The lymphatic system is a network of tissues and organs that help rid the body of toxins, waste, and other unwanted materials. Lymph nodes are part of this system and serve as sites for the development and activity of lymphocytes, monocytes, and macrophages, filtering interstitial fluid (lymph) and transporting it back into circulation.

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6
Q

What structural features do lymph nodes possess?

A

Lymph nodes have fibrous capsules that provide structural support and protect the tissues within.

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7
Q

What role do lymph nodes play in the immune system?

A

Lymph nodes are the first encounter between antigens and lymphocytes, housing macrophages that filter lymph of debris, foreign substances, and microorganisms while providing antigen-processing functions.

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8
Q

How do macrophages function in lymph nodes?

A

Macrophages in lymph nodes filter lymph, removing debris and pathogens, and facilitate the activation of lymphocytes during immune responses.

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9
Q

What are Kupffer cells, and what is their function?

A

Kupffer cells are specialized macrophages located in the liver that play a critical role in filtering and phagocytosing pathogens and dead cells from the blood, contributing to immune response and maintaining liver health.

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10
Q

What are the implications of dysfunction or injury to the spleen?

A

Dysfunction or injury to the spleen can lead to an increased risk of infections, as the organ is crucial for filtering blood and mounting immune responses. Additionally, it can result in anemia due to the inability to effectively remove old or damaged RBCs.

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11
Q

What are the consequences of lymph node removal (e.g., during cancer treatment)?

A

Removal of lymph nodes can lead to lymphedema (swelling due to lymph accumulation), impaired immune responses, and increased susceptibility to infections due to the reduced ability to filter lymph and mount effective immune responses.

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12
Q

How does dysfunction of Kupffer cells affect the body?

A

Dysfunction of Kupffer cells can lead to impaired filtration of pathogens and dead cells, resulting in increased infections, liver disease progression, and a compromised immune response.

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13
Q

What is the iron cycle?

A

The iron cycle describes the processes of iron absorption, storage, and utilization in the body. Approximately 67% of iron is bound to erythrocytes and myoglobin, 30% is stored in phagocytes, and 3% is lost daily through urine, sweat, bile, sloughing cells, and bleeding.

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14
Q

How much iron is needed daily for erythropoiesis?

A

About 25 mg of iron is needed daily for erythropoiesis, with 23-24 mg coming from the recycling of erythrocytes and 1-2 mg from dietary sources.

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15
Q

What happens to iron during the breakdown of senescent cells?

A

During the breakdown of senescent cells, iron is released into the bloodstream. This free iron can either bind to transferrin for transport in circulation or be stored in macrophages’ cytoplasm as ferritin or hemosiderin.

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16
Q

What is the role of ferritin in the iron cycle?

A

Ferritin is the major intracellular iron storage protein, which sequesters excess iron to prevent toxicity and releases it when needed for erythropoiesis or other physiological processes.

17
Q

What is the role of transferrin in the iron cycle?

A

Transferrin is a protein that binds free iron in the bloodstream and transports it to tissues, including the bone marrow for hemoglobin synthesis and erythropoiesis.

18
Q

How is iron homeostasis regulated?

A

Iron homeostasis is primarily controlled by the hormone hepcidin, which is synthesized in the liver. Hepcidin production is regulated by dietary iron absorption, the rate of erythropoiesis, and oxygen saturation levels.

19
Q

What is hemostasis?

A

Hemostasis is the process of arresting bleeding, which involves a series of coordinated events to prevent excessive blood loss following vascular injury.

20
Q

What are the key components necessary for hemostasis?

A

The key components necessary for hemostasis include: 1) Platelets - small cell fragments that play a crucial role in forming the initial plug; 2) Vasculature - endothelial cells lining the blood vessels and the subendothelial matrix, which provide structural support and facilitate interactions; 3) Blood proteins (clotting factors) - proteins involved in the coagulation cascade that lead to clot formation.

21
Q

What occurs during vascular injury?

A

Vascular injury leads to vasoconstriction, which is the narrowing of blood vessels to reduce blood flow to the affected area and minimize blood loss.

22
Q

What is the role of platelets in hemostasis?

A

Platelets adhere to the site of injury and aggregate to form a hemostatic plug, providing an initial barrier against blood loss. They also release signaling molecules that further recruit more platelets and activate the coagulation cascade.

23
Q

How does tissue factor activate the coagulation cascade?

A

When endothelial cells are damaged, tissue factor (TF) is exposed and interacts with circulating factor VII, initiating the coagulation cascade. This cascade involves a series of enzymatic reactions that activate various clotting factors, ultimately leading to the formation of fibrin.

24
Q

What happens during secondary hemostasis?

A

In secondary hemostasis, platelets interact with clotting factors to form a stable fibrin clot. Fibrin strands weave through the platelet plug, strengthening it and preventing further bleeding.

25
Q

What occurs during clot retraction and dissolution?

A

After a stable clot forms, clot retraction occurs, which helps to close the wound by pulling the edges of the blood vessel together. Eventually, fibrinolysis takes place, where the clot is dissolved by plasmin, allowing for normal blood flow to resume as the tissue heals.

26
Q

How is the hematological system evaluated?

A

The evaluation of the hematological system involves assessing bone marrow function and performing various blood tests to gather information about blood cell counts and characteristics.

27
Q

What are the primary tests of bone marrow function?

A
  1. Bone Marrow Aspiration - This procedure involves withdrawing a small amount of bone marrow fluid, usually from the sternum or pelvis, to analyze the cells within the marrow.
  2. Bone Marrow Biopsy - A more comprehensive test that removes a core sample of bone marrow, providing reliable and detailed information about hematopoiesis and the presence of any abnormalities.
28
Q

What information can bone marrow tests provide?

A

Bone marrow tests can assess:
- Bone marrow iron stores
- Differential cell counts (the proportion of different types of blood cells)
- Presence of abnormal cells or diseases affecting blood production, such as leukemias or aplastic anemia.

29
Q

What role do blood tests play in hematological evaluation?

A

Blood tests provide critical information about the absolute and relative numbers of various blood cells and their structural and functional characteristics. They often serve as the initial justification for further testing, such as bone marrow aspiration.

30
Q

What are some examples of blood tests used in clinical practice?

A

Common blood tests include:
- Complete Blood Count (CBC) with differential: Measures overall blood cell counts and types.
- WBC (White Blood Cell) Count: Indicates the number of white blood cells.
- Hemoglobin (HgB) Count: Measures the amount of hemoglobin in the blood.
- Hematocrit (Hct): Indicates the percentage of red blood cells (RBCs) in the blood.
- Platelet (PLT) Count: Measures the number of platelets in the blood.
- Differential Count: Determines the number of different types of white blood cells.

31
Q

What labs are checked when a patient is anemic?

A

In cases of anemia, specific labs are checked to assess underlying causes:
- Iron Levels: Measures the amount of iron in the blood.
- Ferritin: Low levels indicate poor ability to store iron, suggesting iron deficiency anemia.
- Transferrin: Low levels indicate poor ability to transport iron in the blood, also suggesting iron deficiency anemia.
- Folate (Vitamin B9): Low levels indicate poor ability to synthesize RBCs, pointing to folate deficiency anemia.