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PBL SEM 2 > PBL 7 > Flashcards

PBL 7 Flashcards

1
Q

what is the composition of blood?

A

55% plasma

 - proteins 7% —> albumins, globulins, fibrinogen, prothrombin
 - water 91%
 - other solutes 2% —> ions, nutrients, waste products, gases, regulatory substances

45% formed elements

 - platelets < 1%
 - leukocytes < 1% —> neutrophils, lymphocytes, monocytes, eosinophils, basophils
 - erythrocytes > 99% —> biconcave discs, approx 6-7um
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2
Q

plasma vs. serum

A

plasma = liquid portion of blood. transports proteins, nutrients, antibodies, hormones etc around the body

serum = plasma - clotting factors (esp. fibrinogen) and blood cells. it is the liquid part of the blood after coagulation

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3
Q

if you want to obtain just plasma, what must be added?

A

anti-coagulants

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4
Q

why does the spleen rupture easily?

A

filled will blood therefore like a balloon so ruptures easily

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5
Q

what is yellow bone marrow mainly composed of?

A
  • adipose tissue

- stem cells for cartilage and bone

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6
Q

what is used to diagnose leukaemia?

A

bone marrow biopsy

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7
Q

where is bone marrow taken from in bone marrow biopsy?

A

sternum, pelvis

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8
Q

what is TIBC?

A
  • total iron binding capacity

- amount of iron bound to carrier proteins

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9
Q

ferrous vs. ferric iron

A

ferrous - Fe++

ferric - Fe+++ — cannot be absorbed

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10
Q

serum levels of what can be measured to determine iron?

A
  • ferritin
  • transferrin
  • iron
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11
Q

what blood group is the universal donor?

A

O-

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12
Q

what blood group is the universal recipient?

A

AB+

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13
Q

what is the Rh antigen?

A
  • the +ve or -ve part of the blood type refers to the presence or absence of the Rh antigens on the surface of the red cells
  • most people are Rh positive
  • the full Rh blood group system includes around 50 different red blood cell antigens, but the most important is RhD protein — if you have RhD, you are Rh positive, if you don’t, you are Rh negative
  • a person with Rh-negative blood can donate to a person with or without Rh
  • a person with Rh positive blood can only donate to someone with Rh positive blood
  • the Rh antigens are transmembrane proteins that appear to be used for the transport of CO2 and/or ammonia across the plasma membrane
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14
Q

how can problems occur in pregnancy to do with Rh antigen?

A
  • problems can occur if the mother has Rh-negative blood and the child has Rh-positive blood
  • some RBCs can cross the placenta into the mother’s bloodstream — anti-RhD antibody develops
  • these antibodies then go back into a future foetus and attack the foetus’ RBCs
  • mother can receive an anti-RhD injection to prevent this immune response
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15
Q

how is blood tpye inherited?

A

codominance

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16
Q

what blood antigens are dominant?

A

A and B

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17
Q

what happens to Hb in sickle cell anaemia?

A

polymerises to form a large Hb chain

  • dehydrates
  • changes shape
  • O2 can’t bind
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18
Q

what is a common cause of microcytic anaemia?

A

thalassaemia

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19
Q

how is thalassaemia inherited?

A

autosomal recessive

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20
Q

what are some causes of low Hb levels?

A
  • cancer
  • Hodgkin’s lymphoma
  • cirrhosis
  • chronic kidney disease
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21
Q

is folic acid deficiency anaemia macro/normo/micro cytic?

A

macrocytic

22
Q

in what form is iron stored in cells?

A

Fe+++

23
Q

what could cause too much iron in the body?

A
  • excessive intake, liver disease, alcohol abuse

- could lead to cirrhosis, heart disease and diabetes

24
Q

how do you treat iron deficiency anaemia?

A
  • iron supplements — ferrous sulphate tablets

- eat an iron-rich diet — red meat, green veg, fruit

25
Q

what is glandular fever and how is it diagnosed?

A
  • common in teenagers, young adults and students
  • usually stems from an infection with the Epstein-Barr virus (EBV) = a highly contagious herpes virus
  • can cause mild inflammation of the liver known as hepatitis
  • symptoms: flu-like symptoms, sore throat, swelling of lymph nodes, fatigue, weakness, temperature, nausea
  • no cure — rest and sleep, drink lots of fluids, take painkillers, do not drink alcohol
26
Q

what are some weird symptoms of Fe deficient anaemia?

A
  • strange food cravings eg. ice, hair, paper, chalk
  • restless legs
  • flat tongue
27
Q

how long does foetal Hb stay in baby for?

A

around 6 months

28
Q

what is rhesus disease?

A

= a condition where antibodies in a pregnant woman’s blood destroy her baby’s blood cells

  • doesn’t harm the mother but can cause the baby to become anaemic and develop jaundice
  • occurs when baby is Rh positive and mother is Rh negative
  • the antibodies to Rh cannot cross to the placenta in the first pregnancy but can in subsequent pregnancies
29
Q

what is the anti-D immunoglobulin injection and why is it given?

A
  • given to a mother to prevent causing rhesus disease in the baby
  • given at 28 weeks gestation and after childbirth
  • injection works by destroying any RhD positives blood cells that may have crossed over from the placenta into the mother’s bloodstream
30
Q

what is the Kleihauer test?

A

= a blood test to screen for foetal haemoglobin that may have transferred from a foetus to a mother’s bloodstream

  • mainly used to assess the severity of a fetomaternal haemorrhage (FMH) — a condition in which a disruption in the placental barrier allows foetal blood to enter the maternal circulation
  • shows if mother needs the anti-D immunoglobulin injection
  • the test is based in the fact that foetal Hb is more resistant to acid elation than adult Hb
  • 5ml threshold
31
Q

what is haemolysis?

A

= the destruction of red blood cells prior to the end of their normal 120 day lifespan

  • 2 types: extravascular (more common) and intravascular haemolysis
  • extravascular haemolysis occurs primarily in the spleen whereas intravascular is the breakdown of RBCs within the circulation, leading to the release of free Hb into the blood
  • the fall in RBC count leads to a reduced oxygen-carrying capacity of the blood and relative hypoxia, which stimulates EPO secretion, up regulating erythropoiesis
32
Q

what is iron overload and what can it cause?

A

= too much iron in body

  • can be a problem for people who get lots of RBC transfusions
  • as red cells break down over time, the iron in the Hb is released
  • the body has no natural way to rid itself of excess iron, so extra iron is stored in body tissues
  • transferrin carries iron through the blood to organs where it is stored (usually liver, spleen, bone marrow) — excess iron can lead to injury of the organs in which it is deposited
33
Q

what is Hb electrophoresis?

A

used to measure different types of Hb in the blood

34
Q

what is a sign of haemolytic anaemia?

A

yellow skin

increased destruction of RBC

35
Q

what are causes of megaloblastic anaemia?

A
  • B12/folate def
  • drugs
  • impairment of DNA synthesis — grow but can’t divide
36
Q

is megaloblastic anaemia macro/normo/micro cytic?

A

macrocytic

37
Q

what is pernicious anaemia?

A

autoimmune condition where there is atrophy of the gastric mucosa, with failure of intrinsic factor — decreased Vit B12 absorption

38
Q

is pernicious anaemia macro/normo/micro cytic?

A

macrocytic

39
Q

name a chronic disorder that can cause anaemia

A

rheumatoid arthritis

40
Q

how to remember macrocytic anaemias. which are megaloblastic

A 
F - folate def
A - alcohol
T - thryoid
R - reticulocytosis
B - B12 def
C - cytotoxic drugs

F, B and C are megaloblastic

41
Q

what is the universal plasma donor?

A

AB+

42
Q

what is not included in the mandatory microbiological testing of donated blood?

A

gonorrhea

  • HIV
  • HEP B
  • HEP C
  • SYPHILLIS
43
Q

what is the primary production site of erythropoietin?

A

kidneys

44
Q

why are RBCs broken down in the spleen?

A

because they are much wider than the trabeculae of the spleen’s red pulp

45
Q

how wide are normal RBCs?

A

8um

46
Q

what conditions are Howell-Jolly bodies seen in? what are they not seen in?

A 
seen in:
- following splenectomy 
- coeliac disease
- severe haemolytic anaemia
- megaloblastic anaemia 
(these all affect the spleen_

not seen in:
- Hodgkin lymphoma

47
Q

what type of anaemia can be caused by excess alcohol?

A

non-megaloblastic anaemia (macrocytic)

48
Q

how many mls of blood does an average blood donor donate?

A

470mls

49
Q

what are haemolytic anaemias classed as?

A

anaemia caused by excessive erythrocyte destruction

50
Q

at 6 months pregnancy, where does the majority of haematopoiesis occur?

A

bone marrow

PBL SEM 2 (44 decks)

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