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PHYSIOLOGY > ME01 - Hematology 1,2,3 > Flashcards

ME01 - Hematology 1,2,3 Flashcards

1
Q

What is the composition of Blood

A

PLASMA (5% of TBW) - fluid medium of blood; where cells are suspended; yellow colored contains proteins, nutrients and wastes
SERUM - Plasma minus clotting factors
- closest to distilled water

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2
Q

Essential Component of Clotting System

A

Blood Coagulation Proteins

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3
Q

Major contributors to Osmotic Pressure of Plasma

A

Albumin

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4
Q

Types of Globulins present in Plasma

A

Alpha - Proteases, antiproteases, transport proteins
Beta - Transferrin, other transport proteins
Gamma - Immunoglobulins

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5
Q

Other products involved in the plasma

A

Electrolytes - Major ECF Cation: Na+
Organic Nutrients - Lipids, CHO, Amino Acids
Organic Wastes - Carried to the sites of breakdown or excretion (urea, uric acid, bilirubin, ammonium ions)

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6
Q

Plasma collectively exert __________ within the circulatory system

A

Colloidal osmotic Pressure

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7
Q

Plasma proteins are derived from

*Primary source of plasma proteins

A

Liver

except Immunoglobulins which are derived from plasma cells

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8
Q

How can liver disorders and clotting factors relate

A

Liver disorders can alter the composition and functional properties of blood
Liver disease can lead to uncontrolled bleeding due to inadequate synthesis of proteins involved in clotting

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9
Q

Formed elements are made in the ________ via the process called ___________

A

Bone Marrow

Hematopoiesis

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10
Q

1st site of blood cell production during 3rd week of fetal embryologic development

A

Yolk Sac/Aorta Gonad Mesonephros (AGM) Region

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11
Q

Chief site of blood cell formation shortly after birth

A

Liver

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12
Q

Site of Hematopoiesis that begins during the 3rd month of embryogenesis

A

Liver

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13
Q

Organs that gives minor contribution in Hematopoiesis during Liver Stage

A

Spleen and Lymph nodes

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14
Q

Only source of hematopoiesis “post-natally”

A

Bone Marrow

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15
Q

During when does hematopoiesis in the bone marrow begin

A

4th month of development

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16
Q

Hematopoiesis in relation to age

A

Birth to Puberty - marrow throughout the skeleton remains red and hematopoietically active

Age 20 and above - only vertebrae, ribs, sternum, skull, pelvis & proximal epiphyseal region of humerus retain red marrow. Remaining marrow becomes yellow, fatty and inactive

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17
Q

Hematopoiesis Organs in Order

A

Yolk Sac&raquo_space; Liver, Spleen&raquo_space; Bone Marrow

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18
Q

Chief site of blood formation PRE-NATALLY

A

Liver

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19
Q

Chief site of blood formation POST NATALLY

A

Bone Marrow

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20
Q

Post embryonic extramedullary hematopoiesis is ________ in a full term infant

A

Abnormal

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21
Q

What causes extramedullary hematopoiesis in adults

A

In conditions such as Hemolytic Anemia, it maxes out bone marrow compensatory mechanism thus “asking help” from spleen, liver and lymph node

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22
Q

Difference of Progenitors (Committed Cell Types) from Hsc (Parent Cell)

A

Loss of Pluripotency
Lack of Capacity for Self-renewal
Higher fraction of cells traversing the cell cycle
Reduced ability to efflux foreign substances
Change in their surface protein profile

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23
Q

Genetic Basis for Transition of Hsc to Committed Progenitors

A

Marked downregulaion of large number of hsc-associated genes

Progressive upregulation of limited number of lineage-specific genes

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24
Q

Cytokine that induces production of other cytokines from many cells
Works in synergy with other cytokines on primitive hematopoietic cells

A

IL-1

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25
Q

Cytokine for T-cell growth factor

A

IL-2

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26
Q

Cytokine that stimulates the growth of multiple myeloid cell types, involved in delayed type hypersensitivity

A

IL-3

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27
Q

Cytokine for Eosinophil growth factor and affects mature cell function

A

IL-5

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28
Q

Cytokine that stimulates B lymphocyte growth:

Works in synergy with other cytokines on megakaryocytic progenitors

A

IL-6

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29
Q

Principal regulator of early lymphocyte growth

A

IL-9

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30
Q

Cytokine that stimulates growth of multiple lymphoid and myeloid cells

A

IL-11

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31
Q

Cytokine that modulates T-lymphocyte activity and stimulates natural killer cell proliferation

A

IL-15

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32
Q

Cytokine that affects growth and maturation of B, T and natural killer cells

A

IL-21

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33
Q

Cytokine that induces production of other cytokines from many cells

A

SCF

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34
Q

Stimulates proliferation of erythroid progenitors

A

EPO

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35
Q

Promotes proliferation of monocytic progenitors

A

M-CSF

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36
Q

Stimulates proliferation of neutrophilic progenitors

Acts in synergy with IL-3 on primitive myeloid cells and activates mature neutrophils

A

G-CSF

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37
Q

Cytokine that affects granulocyte and macrophage progenitors and activates macrophage

A

GM-CSF

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38
Q

Cytokine that affects hematopoietic stem cells and megakaryocytic progenitors

A

TPO

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39
Q

Gives the whole blood its characteristics

A

RBC

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40
Q

Function of RBC

A

Transports hemoglobin (carries oxygen) from lungs to tissues
Transports CO2 from tissues to lungs for expulsion
Acts as acid-base buffer for whole blood

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41
Q

What enzyme is involved in catalyzing reaction between CO2 and H2O to form carbonic acid or H2CO3

A

Carbonic Anhydrase

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42
Q

Normal resting shape of RBC

A

Biconcave disc

Central 1/3 appears pale compared to its periphery

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43
Q

Implications of RBC Structure

A

Large ratio of SA to volume
Enable RBCs to for stacks for smoother blood flo
Allows large reversible elastic deformation as it passes through microcirculation

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44
Q

Hgb vs Hct

A

HGB - protein inside RBC that binds with oxygen

HCT - % of whole blood occupied by cellular elements

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45
Q

Normal values for Hgb and Hct

A

Hgb Male - 14-18g/dL Female 12-18g/dL

Hct Mlale - 46(40-54) Female 42 (37-47)

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46
Q

Structure of adult hemoglobin (HbA)

A

2 alpha units and 2 beta units

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47
Q

Formation of Hgb

A 
2succinyl CoA + 2 glyine
4 pyrrole >> protoporphyrin IX
Protoporphyrin IX + Fe++ >> Heme
Heme + Polypeptide >> Hemoglobin chain (a or B)
2 a chains + 2 B chains >> HbA
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48
Q

How many oxygen molecules can 1 hemoglobin molecule bind

A

4 oxygen molecules

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49
Q

How many oxygen molecules can 1 myoglobin molecule bind

A

1 oxygen molecule

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50
Q

Structure of HbF

A

2 a and 2 gamma chains

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51
Q

Has higher affinity to oxgen

A

HbF because it binds less to 2-3 BPG

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52
Q

Enzyme that causes shift to the right of the O2-Hgb Dissociation curve or increase unloading of O2

A

2,3 BPG

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53
Q

Essential metallic component of Heme

A

Iron

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54
Q

Total iron in the body

A

4-5 g

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55
Q

Primary storage protein for iron found in the liver

A

Ferritin

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56
Q

Storage of iron outside the liver

A

Hemosiderin

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57
Q

Transport of iron in the blood

A

Transferrin

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58
Q

Hormone responsible for RBC Production

A

Erythropoietin

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59
Q

Stimulus for EPO production

A

Hypoxia

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60
Q

Formation of Erthrocytes/RBC

A 
Proerythroblast
Basophil erythroblast
Polychromatophilic erythroblast
Orthochromic erythroblast
Reticulocyte
Erythrocyte
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61
Q

(+) Nucleus, ER absorbed

A

Orthochromatic Erythroblast

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62
Q

No nucleus

(+) remnants of Golgi Apparatus, mitochondria and other organelles

A

Reticulocytes

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63
Q

Average life span of RBC

A

Adult - 120 days

Fetal - 90 days

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64
Q

RBC Destruction (Intravascular)

A

RBC membrane breeched&raquo_space; becomes fragile» self destruct in RED PULP OF SPLEEN

RBC is destroyed» Hgb that escapes is bound to “Haptoglobin”&raquo_space; Hgb-Haptoglobin complex goes to the liver

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65
Q

RBC Destruction (extravascular)

A

Ingestion by a macrophage (Kuppfer cells of liver/macrophages in spleen and blood)&raquo_space; degraded within lysosomes&raquo_space; lipid, protein and heme

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66
Q

2 signals that differentiate young from OLD RBC

A
  1. Decreased deformability

2. Altered surface properties

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67
Q

Heme (in hemoglobin) is converted to iron and BILIVERDIN by “heme oxygenase”&raquo_space; Biliverdin is converted to _____ (final product of Hgb Metabolism)&raquo_space; Excreted into bile in GIT

A

Bilirubin

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68
Q

Conjugated Bilirubin excreted in the urine

69
Q

Conjugated Bilirubin excreted in feces

A

Stercobilin

70
Q

Role of Vitamin B12 and Folic Acid in RBC Formation

A

essential for synthesis of DNA

Formation of thymidine triphosphate, building block of DNA

71
Q

Vitamin B12/Folic Acid Deficiency can cause what time of Anemia

A

Megaloblastic Anemia (macrocytes with flimsy membranes that are oval in shape and irregular)

72
Q

Neural Deficits are caused by what deficiency

A

Vitamin B12 Deficiency

73
Q

Neural Tube Defects are caused by what deficiency

A

Folic Acid Deficiency

74
Q

Capability of the body to resist almost all types of organisms or toxins that tend to damage tissues and organs

75
Q

2 types of Immunity

A

Innate Immunity

Acquired Immunity

76
Q

Innate Immunity vs Acquired Immunity

A

INNATE ACQUIRED
Pre-existing Antibody-mediated
(skin, mucous membranes, lymphoid cells
complement system)

Not acquired through contact Occurs after exposure to antigen
with non self (antigen)

Non specific                                     Specific

     Quick                                    Delayed Response
77
Q

Granulocytes/PML/Myeloid Cells

A

Basophils, Eosinophils, Neutrophils

78
Q

Agranulocytes

A

Monocytes, Lymphocytes

79
Q

Site of production of lymphocytes, Plasma cells

A

LN, Spleen, Thymus, Peyer’s patches

80
Q

Site of production of granulocytes, monocytes

A

Bone Marrow

81
Q

Lifespan of Monocytes

A

10-20 hours in the blood, for several months in the tissues

82
Q

Lifespan of Granulocytes

A

4-8 hours in the blood, 4-5 days in the tissues

shortened during infection

83
Q

Lifespan of Lymphocytes

A

Weeks to months

84
Q

Arrange WBC according to number

A 
Neutrophil
Lymphocytes
Monocytes
Eosinophils
Basophils
85
Q

Appearance of Macrophage indicates

A

Inflammation

86
Q

Functions of WBC

A

Neutrophils - acute inflammatory response to tissue injury
Eosinophils - allergic reactions and parasitic infection
Basophil - allergic reaction
Monocytes -
Platelets - Hemostasis

87
Q

Prominent feature is the highly lobulated nucleus

A

Neutrophills

88
Q

Prominent feature is bilobed nucleus, stain bright red with eosin dye

A

Eosinophil

89
Q

Weak phagocyte

A

Eosinophil

90
Q

Share functional similarities with Mast Cells

91
Q

Basophils produces _______

A

Histamine, Heparin, Bradykinin, Serotonin

92
Q

Prominent feature is bilobed/trilobed, largely densely basophilic (blue) granules

93
Q

Resident phagocyte

94
Q

Prominent feature is eccentrically placed nucleus

95
Q

Small, non-nucleated cells from Megakaryocytes

96
Q

Life span of platelets

97
Q

Prominent feature is round, densely stained nucleus with a pale basophilic, non-granular cytoplasm

A

Lymphocytes

98
Q

Cells of the adaptive immunity

A

Lymphocytes

99
Q

What is the largest WBC

100
Q

What is most numerous, least numerous WBC

A

Most numerous: Neutrophils

Least Numerous: Basophils

101
Q

Cells involved in adaptive immunity and parasitic infection

A

Adaptive immunity : Lymphocytes

Parasitic Infection: Eosinophils

102
Q

Differences of Neutrophils and Macrophages

A

NEUTROPHILS MACROPHAGES
Released as mature cells Released as immature cells
Phagocytize 3-20 bacteria Phagocytize 100 bacteria

103
Q

Similarities of Neutrophils and Macrophages

A

Chemotaxis - method by which they are attracted to the site of injury
Diapedesis - Entering the tissue
Ameboid Movement - movement through the tissue
Lysosomes present: Proteases, hypochlorite, Lipases
Peroxisomes: Free radicals like superoxide, hydrogen peroxide

104
Q

Movement out of the circulatory system and into the site of injury

A

Diapedesis

105
Q

Movement of neutrophils and macrophages towards a chemical signal

A

Chemotaxis

106
Q

Mast cells release _______ to cause vasodilation and increased vascular permeability

107
Q

1st line of defense
Present within minutes
Identifies pathogen&raquo_space; phagocytosis

A

Tissue macrophage

108
Q 
2nd line of defense
Blood monocytes (inactive) are converted to tissues: macrophage (active)
Response takes time (up to 8 hours)
109
Q

4th line of defense

takes 3-4 days

A

Inc Monocytes & Granulocyte production by BM

110
Q

Monocytes and Granulocytes are mediated by

A

TNF, IL-1, GM-CSF, M-CSF

111
Q

The battlefield of dead cells and pathogens

112
Q

caused by special immune system that forms antibodies and/or activated lymphocytes that attack and destroy the specific invading organism or toxin

A

Adaptive Immunity

113
Q

antibodies are gamma globulins called

A

immunoglobulins

114
Q

Portions of Antibodies

A

Variable Portion: determines specificity to antigen

Constant Portion: determines other properties of antibodies

115
Q 
Different functions of Immunoglobulins
IgG
IgM
IgA
IgE
IgD
A

IgG - most abundant, secondary response, smallest, to cross placenta
IgM - primary immune response, largest
IgA - main in secretions (milk, saliva, tears)
IgE - allergies and hypersensitivity
IgD - antigen receptor present on surface of B lymphocytes

116
Q

DIRECT ACTION of Antibodies

A

Agglutination - clumping
Precipitation - insoluble Ag-Ab complex
Neutralization - AB covers the toxic sites of the antigenic agent
Lysis - rupture of the agent

117
Q

INDIRECT ACTION of Antibodies

A

via the Complement System

118
Q

Part of innate and adaptive immunity

Complement proteins are soluble proteins in the blood stream

A

Complement System

119
Q

3 important processes involved in Complement System

A

Opsonization - marker that makes easier to phagocytize foreign bodies
Membrane Attack Complex (MAC) - perforate foreign organisms
Stimulate Inflammation

120
Q

Complement responsible for Opsonization

121
Q

Complement is an anaphylatoxin (induces inflammation)

A

C3a, C4a, C5a

122
Q

Which complement is chemotactic to WBCs

123
Q

Which complement is part of the Membrane Attack Complex (MAC)

124
Q

Types of T cells

A

T-helper cells (CD4, MHCII)
Cytotoxic T cells (CD8, MHCI)
Suppressor T cells

125
Q

Cancer cells
Virally infected cells
Transplanted/Grafted cells

126
Q

Most numerous of T cell

Various “helper” function

A

Helper T cell

127
Q

“Helper function” of T cells

A

Regulatory function of lymphokines
Stimulation of growth and proliferation of Cytotoxic T cells & Suppressor T cells
Stimulation of growth and differentiation of B-cell and antibody formation
Activation of macrophage system

128
Q

Direct attack cell capable of killing microorganisms
Creates “holes” (perforins)
Targets virally infected cells, cancer cells and transplanted cells

A

Cytotoxic T cell

129
Q

Suppressing action of Helper T cell and Cytotoxic T cells

Important role in limiting the ability of the immune system to attack a person’s own body tissue

A

Suppressor T cell

130
Q

Could either be passive or active immunity

A

Artificial Immunity

131
Q

Disadvantage of artificial immunity

A

Short life span of antibodies, hypersensitivity reaction

132
Q

Type of immunity that is has developed antigen in the body

A

Active immunity

133
Q

Type of immunity that you administer the antibody

A

Passive immunity

134
Q

Induced after contact with foreign antigen (usually killed or live attenuated infectious agents)

A

ACTIVE IMMUNITY
Advantage: long term protection
Disadvantage: slow onset of action

135
Q

Administration of antibody (in antisera) in a vaccine

A

PASSIVE IMMUNITY
Advantage: prompt availability of large amount of antibodies
Disadvantage: short life span of antibodies, hypersensitivity reaction

136
Q

Blood groups is based on _________

A

Carbohydrate antigens (A and B) present on RBC membrane either as glycoprotein/glycospingolipids

137
Q

What determines the O-A-B Blood type

A

Two genes, one one each of two paired chromosomes

138
Q

Universal Donor

139
Q

Universal Recipient

140
Q

Why are agglutinins produced in people who do not have the respecive agglutinogens in their red blood cells?

A

Small amounts of type A and B antigens enter the body in food, in bacteria and in other ways, substances initiate dev’t of anti A and anti B agglutinins

141
Q 
ABO System Blood Group
Genotypes       Blood Types    Agglutinogen      Agglutinins
OO
OA or AA
OB or BB
AB
A

Genotypes Blood Types Agglutinogen Agglutinins
OO O - Anti A and Anti B
OA or AA A A Anti B
OB or BB B B Anti A
AB AB A and B No antibodies

142
Q

Rh Blood Group

A

Blood group with 6 Antigens – C, D, E, c, d, e

143
Q

Blood group that is supposed to be exposed to blood products to develop antibodies

A

Rh Blood Group

Agglutinins are produced after massive exposure to the Rh agglutinogens

144
Q

Most widely prevalent antigen

A

D
If you have D antigen - Rh+
If you do not have D antigen - Rh- (No exposure to blood group does not develop antibodies for D antigen)

145
Q

Complication that manifest in second Rh+ baby

A

Hemolytic Disease of the Newborn

146
Q

Implications and Treatment of HDN

A

Erythroblastosis Fetalis , where the antibodies developed by the mom attacks the fetus RBC resulting to (+) hemolysis

Treatment - Rhogam
Rhogam destroys anti D antibodies to prevent hemolysis of the 2nd baby

147
Q

IDENTIFYING BLOOD TYPE
Forward
Reverse

A

Pretesting of blood
Forward - identify antigen by antisera
Reverse - identify isoagglutinin in serum

148
Q

Matches donor blood unit to recipient’s blood

A

Cross Matching

149
Q

Serum used for Rh typing

A

Anti-D serum

150
Q

Transfusion Agglutination Reactions in ABO Blood Group

A

Delayed hemolysis - AgAb complex cause agglnt

Immediate hemolysis - Ab meet Ag donor RBCs

151
Q 
BLOOD TRANSFUSION PRODUCTS
Whole Blood
Packed RBCs
Platelet concentrates
Fresh Frozen Plasma
Cryoprecipitate
Cryosupernate
A

Whole Blood - Cases of Acute Hemorrhage
Packed RBCs - Anemia and symptoms of Dizziness, Inc HR
Platelet concentrates - Mucosal bleeding, Px with fever or infection
Fresh Frozen Plasma - Thrombocytic Thrombocytopenic purpura
Cryoprecipitate - More spec. clotting factor fibrinogen, F8, vWF
Cryosupernate - Contains factor IX (hemophilia B)

152
Q

Prevention of blood loss

A

Hemostasis

153
Q

Stages of Hemostasis

A

Vasoconstriction - Use of Endothelin 1
Primary Hemostasis - Formation of initial platelet plug
Secondary Hemostasis - Coagulation cascade
Clot Retraction - Dissolved blood clot

154
Q

Mechanism in Vasoconstriction

A

Local myogenic spasm - strongest contributor
Autocoid factors such as thromboxane A2, Endothelin
Nervous reflexes

155
Q

Thrombocytes
Originate from megakaryocyte
Eventually cleared by macrophages in the blood and in the spleen

156
Q

Stages in Formation of Platelet Plug

A

Platelet adhesion - Plt secrete glycoprotein Ib bind to vWF
Platelet activation - thromboxane A2 activates other platelets
Platelet aggregation - fibrinogen in blood bind to GpIIbIIIa

157
Q

Formation of thombin
Stabilizes thrombin _______
Dissolves Fibrin __________

A

Fibrin

Plasmin

158
Q

Platelet count

159
Q

Formation of fibrin through the coagulation cascade

A

Secondary Hemostasis

  • Extrinsic Pathway
  • Intrinsic Pathway
160
Q

Important clotting factors

A

Tissue Factor - Factor III - triggers Extrinsic Pathway

Hageman factor - Factor XII - trigger Intrinsic Pathway

161
Q

Extrinsic vs Intrinsic Pathway

A

Extrinsic Pathway – BLOOD

  • initiates coagulation cascade
  • can be explosive
  • limited quantities of traumatized tissue, Factor X, VII and V
  • clotting occur in 15 sec

Intrinsic Pathway – TISSUES

  • Amplifies the cascade
  • slower, clotting in 1 to 6 minutes
162
Q

Which part of Coagulation Cascade does extrinsic and intrinsic pathways converge

A

Factor Xa - mediated generation of thrombin to form prothrombin

163
Q

What other factors are involved in the coagulation cascade

A

Calcium, - involved in all steps except the first 2 steps
Vitamin K - required to produce prothrombin and other clotting factors
Anticoagulant mechanism

164
Q

Smooth endothelium

Glycocalyx layer repels platelets ad clooting factors

A

Endothelium

165
Q

Secreted by endotheliu, that binds thrombin thereby reducing free thrombin
Activates Protein C which inactivates Factor V and VIII

A

Thrombomodulin

166
Q

What are intravascular anticoagulants

A

Antithrombin III - inactivates thrombin

HEPARIN - increases activity of antithrombin III

167
Q

Lysis of blood clot

A

Injured vascular endothelial cells&raquo_space; plasminogen activators&raquo_space; plasminogen&raquo_space; plasmin&raquo_space; helps degradation of fibrin to fibrin degradation products

168
Q 
ABNORMALITIES IN COAGULATION
Severe Bleeding
Liver Diseases
Vit K Deficiency
Hemophilia A
Hemophilia B

Excess Coagulation

A

Severe Bleeding
Liver Diseases - Liver produce clotting factors (neonates supplemental)
Vit K Deficiency - Vit K dependent factors
Hemophilia A - Factor 8 deficiency
Hemophilia B - Factor 9 deficiency

Excess Coagulation
Protein C and Protein S (cofactor of Protein C)
DIC

169
Q

General Functions of Blood

A

Vehicle of Transport
Regulation of pH and ion composition
Defense against toxins and pathogens via WBC lymphocytes
Stabilization of body temperature

PHYSIOLOGY (13 decks)

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