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3MB Haematology > Physiology > Flashcards

Physiology Flashcards

1
Q

What is blood?

A

Specialised fluid composed of cells suspended in a liquid called plasma

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2
Q

What is the average adult blood volume in litres?

A

4.5-6 litres

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3
Q

What are the 3 types of blood cell?

A

Red blood cell
White blood cell
Platelets

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4
Q

What are the main components of plasma?

A

Water (90%)
Proteins (mostly albumin, Ig, clotting factors)
Nutrients
Salts

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5
Q

What are the 2 types of white cells?

A

Granulocytes

Agranulocytes

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6
Q

List the main granulocytes

A

Neutrophils
Eosinophils
Basophils

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7
Q

List the main agranulocytes

A

Lymphocytes

Monocytes

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8
Q

What do red blood cells do?

A

Carry oxygen

Buffer CO2

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9
Q

What do platelets do?

A

Stop bleeding

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10
Q

What do white blood cells do?

A

Fight infection and pathology

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11
Q

What is the process by which blood cells are produced?

A

Haemopoiesis from pleuripotent stem cells

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12
Q

Where are the sites of haematopoiesis in the embryo?

A

Yolk sac
Liver
Spleen

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13
Q

Where are the sites of haematopoiesis from birth to maturity?

A

Bone marrow
Liver
Spleen

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14
Q

Where are the sites of haematopoiesis in the adult?

A

Bone marrow of skull, ribs, sternum, pelvis and proximal femur

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15
Q

Outline the cell stages of erythropoiesis

A

Pronormoblast - early normoblast - intermediate normoblast - late normoblast - reticulocyte - erythrocyte

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16
Q

Describe the structure of a neutrophil

A 
Segmented nucleus (polymorph)
Neutral-staining
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17
Q

What are the functions of a neutrophil?

A

Phagocytose invaders

Attract other immune cells

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18
Q

Describe the structure of a eosinophil

A

Bi-lobed

Bright orange-red granules

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19
Q

What are the functions of an eosinophil?

A

Fight parasitic infections

Involved in hypersensitivity

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20
Q

Describe the structure of a basophil

A

Infrequent in circulation

Large deep purple granules with obscured nucleus

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21
Q

What are the functions of a basophil?

A

Circulating version of a mast cell

Mediates hypersensitivity

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22
Q

Describe the structure of a monocyte

A

Large single nucleus

Faintly staining granules, often vacuolated

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23
Q

What are the functions of a monocyte?

A

Enter tissues and become macrophages
Phagocytose invaders
Attract other immune cells
Live longer than neutrophils

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24
Q

What methods can be used to identify primitive precursors?

A

Immunophenotype (antigen on cell surface)

Bio-assay (culture in vitro)

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25
What is a common site for bone marrow biopsy?
Posterior iliac crest
26
Do red blood cells have a nucleus and/or mitochondria?
No nucleus or mitochondria, thus no DNA either
27
What is the average life-span of a red blood cell?
120 days
28
Red blood cells are produced from pleuripotent stem cells. True/False?
True
29
What happens to old red blood cells?
Phagocytic cells of the liver and spleen engulf old red blood cells
30
What happens to the haem group of broken down red blood cells?
Converted into bilirubin that is conjugated by the liver
31
Which hormone regulates erythrocyte production?
Erythropoietin
32
What stimulates erythropoietin release by the kidney?
Reduced oxygen carrying capacity of erythrocytes
33
At which stage of erythropoiesis does no further cell division take place? (i.e. not pleuripotent cells)
When polychromatic erythroblast forms (Hb in cytoplasm)
34
How do red blood cells synthesise ATP/energy? N.B. remember no mitochondria
Anaerobic glycolysis
35
Which compound is produced when there is reduced phosphate in the blood? What effect does this compound exert?
2,3-BPG | This releases O2 from Hb
36
Glutathione is a tripeptide consisting of which amino acids?
Glutamate Cysteine Glycine
37
What does glutathione protect against?
Toxic effects of oxygen free radicals
38
In what 3 forms is CO2 transferred to the lungs?
``` Physically dissolved (10%) Bound to Hb (30%) As bicarbonate (60%) ```
39
Which enzyme is vital for CO2 transport?
Carbonic anhydrase
40
How does the composition of adult and foetal Hb differ?
Foetal: alpha2-gamma2 Adult: alpha2-beta2
41
Foetal Hb has a higher affinity for O2 than adult Hb. True/False?
True
42
Foetal Hb has a higher affinity for 2,3-BPG than adult Hb. True/False?
False | Foetal Hb has less affinity for 2,3-BPG than adult Hb, favouring O2 transfer from mother to foetus during pregnancy
43
What is haemopoiesis?
Formation of blood cells
44
What are mature red blood cells called?
Erythrocytes
45
List the main groups of mature white blood cells
Granulocytes (neutrophils, basophils, eosinophils) Monocytes (macrophages) Lymphocytes (B cells, T cells, NK cells)
46
State the lifespan for a red blood cell, neutrophil and platelet
Red cell: 120 days Neutrophil: 7-8 hours Platelet: 7-10 days
47
Why is a reticulocyte blue on blood film?
Doesn't have the full amount of Hb yet
48
Outline the progression from precursor to mature neutrophil
Myeloblast - promyelocyte - myelocyte - metamyelocyte - neutrophil
49
Where do precursor cells of blood cells come from? (what is the precursor of the precursors?!)
Haemopoietic progenitor cell, derived from stem cells
50
Self-renewal is a property of all haemopoietic cells. True/False?
False | Only occurs in stem cells; lost in descendants
51
Which germ cell layer are haemopoietic stem cells derived from?
Mesoderm
52
Circulating haemopoietic progenitors are detectable as early as week _ of life
Circulating haemopoietic progenitors are detectable as early as week 5 of life
53
What is the first site of erythroid activity? When does this activity stop?
Yolk sac | Stops by week 10
54
When does the liver begin erythroid activity?
Week 6
55
When does the spleen begin erythroid activity?
Week 12
56
When does the bone marrow begin erythroid activity?
Week 16
57
List the main bony sites of haemopoiesis post-natally
Tibia and femur Vertebra Sternum Ribs
58
Osteoblasts form/resorb bone and osteoclasts form/resorb bone
Osteoblasts form bone and osteoclasts resorb bone
59
What part of long bones - epiphysis, metaphysis or diaphysis - involves the most haemopoiesis?
Metaphysis
60
What is "red" and "yellow" marrow?
Red marrow: haemopoietically active Yellow marrow: fatty and inactive With age, yellow marrow replaces red marrow
61
What regulates neutrophil maturation?
Granulocyte-colony stimulating factor (G-CSF)
62
How is haemopoiesis assessed?
Blood count Cell indices Morphology (blood film) Bone marrow examination
63
What specialist tests can be done to analyse haemopoietic precursor cells?
Immunophenotyping Cytochemistry Clonogenic assay Animal modelling
64
Where are haemopoietic stem cells of lymphoid cells located?
Liver in foetus | Bone marrow post-natally
65
Where are precursor lymphoid cells located?
``` Bone marrow (B-cells) Thymus (T-cells) ```
66
List the main peripheral (secondary) lymphoid tissues
Spleen Lymph nodes Tonsils
67
What are the functions of the lymphatic system?
Return lymph (tissue fluid) to circulation in homeostasis Prevent accumulation of fluid in tissues (oedema) Filter lymph of toxins
68
What is haemostasis?
Cessation of bleeding whilst maintaining vascular patency
69
List the main components/processes of normal haemostasis
Formation of platelet plug (primary haemostasis) Formation of fibrin clot (secondary haemostasis) Fibrinolysis Anticoagulation
70
What is the lifespan of a platelet?
7-10 days
71
Following endothelial vessel wall damage, collagen is exposed and releases which factor to attract platelets to adhere?
Von Willebrand Factor
72
Why is platelet plug formation impaired in older people, causing easy bruising?
Lose collagen from vessel wall with age - less Von Willebrand Factor and thus less platelet adherance and aggregation
73
List some consequences of failure of platelet plug formation
Spontaneous bleeding Purpura Mucosal bleed (epistaxis, GI, conjunctival) Haemorrhage
74
What is the main screening test/investigation for primary haemostasis?
Platelet count
75
Which factor is released from damaged vascular endothelium during fibrin clot formation? Which factor does it activate?
Tissue factor | activates factor VIIa
76
Which factors are activated by factor VIIa, VIII and IXa in fibrin clot formation?
V | Xa
77
What is the effect of factors V and Xa in the propagation step of fibrin clot formation?
Encourage formation of thrombin from prothrombin
78
What is the effect of thrombin in fibrin clot formation?
Encourages formation of fibrin from fibrinogen
79
Single clotting factor deficiency is usually hereditary - give an example of a condition
Hereditary haemophilia
80
Multiple clotting factor deficiency is usually acquired - give an example of a condition
Disseminated intravascular coagulation
81
Describe the fibrinolytic pathway (breakdown of a clot)
Tissue plasminogen factor causes plasmin formation from plasminogen Plasmin causes breakdown of fibrin to fibrin degradation products (D-dimers)
82
What are the main screening tests/investigations for secondary haemostasis?
``` Prothrombin time (PT time) Activated partial thromboplastin time (APTT) ```
83
If the PT time is prolonged and the APT time is normal, which factors are causing the problem?
Tissue factor | VIIa
84
If the PT time is normal and the APT time is prolonged, which factors are causing the problem?
VIII | IXa
85
Warfarin affects the PT time and heparin affects the APT time. True/False?
True

3MB Haematology (12 decks)

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