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Year 3 - Haematology > Physiology > Flashcards

Physiology Flashcards

1
Q

How long do red cells live?

A

120 days

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2
Q

How long do platelets live?

A

7 days

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3
Q

How long do granulocytes live?

A

7 hours

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4
Q

Where and when does haemopoeisis begin?

A

Yolk sac

3 weeks gestation

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5
Q

What are the two main properties of stem cells?

A

Self-renewal

Proliferation

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6
Q

What do stem cells divide into?

A

Progenitor cells

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7
Q

What regulates red cell growth?

A

Glycoproteins

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8
Q

Give examples of red cell growth factors

A

IL-3, 6, 7, 11, 12
EPO
Flt3

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9
Q

Which growth factors control platelet growth?

A

TPO

IL6, 11

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10
Q

What is primary haemostasis?

A

Formation of the platelet plug

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11
Q

What is secondary haemostasis?

A

Formation of the fibrin clot

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12
Q

Which factors prevent platelet adhesion to endothelium under normal circumstances?

A

Heparan sulphate
Thrombomodulin
PGI2 and NO
Plasminogen activator

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13
Q

What is exposed when the vessel wall is damaged?

A

vWF, collagen and proteins

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14
Q

Which glycoprotein complex creates a binding site for vWF?

A

IIa-IIIb

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15
Q

What do platelets release on adhesion that allows glycoprotein IIa-IIIb complex to bind to fibrinogen?

A

ADP and TXA2

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16
Q

What is the role of fibrinogen in primary haemostasis?

A

Binds platelets together to form activated aggregates

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17
Q

What is the first thing which starts the coagulation cascade?

A

Damage causes exposure of tissue factor

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18
Q

What does TF bind to?

A

Factor VII

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19
Q

What does the TF-VII complex activate?

A

V and X

Some IX

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20
Q

What happens when factor X is activated?

A

Tissue factor pathway inhibitor is released

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21
Q

What is the role of tissue factor pathway inhibitor?

A

Prevent more X and IX becoming active

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22
Q

What activates thrombin?

A

Xa and Va

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23
Q

What does thrombin activate?

A

Fibrinogen to fibrin
VIII
IX

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24
Q

Which factors are involved in the intrinsic pathway?

A

XII, X, XI, VIII

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25
Q

Which factors are involved in the extrinsic pathway?

A

TF, VII, V

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26
Q

What is the role of calcium in the formation of the fibrin clot?

A

Sticks to negatively charged phospholipids to allow more platelet adhesion

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27
Q

What is the role of factor XIII?

A

Stabilise the fibrin clot by forming cross links

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28
Q

What is anti-thrombin III?

A

Serine protease inhibitor

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29
Q

What is the role of protein C?

A

Inactivates factors V and VIII

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30
Q

Protein C is vitamin K dependent

true/false

A

True

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31
Q

Protein S is vitamin K dependent

true/false

A

False

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32
Q

What is the role of protein S?

A

Enhances binding of protein C to phospholipid

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33
Q

What do endothelial cells release in order to activate plasminogen to plasmin?

A

tPA

tissue plasminogen activator

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34
Q

What is the role of tPA?

A

Convert plasminogen to plasmin

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35
Q

What is the role of plasmin?

A

Breaks down fibrinogen and fibrin

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36
Q

What occurs as a result of fibrin breakdown?

A

Fibrin degradation products

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37
Q

What is d-Dimer a breakdown product of?

A

Fibrin cross-links

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38
Q

Haemophilia A is a deficiency of which factor?

A

VIII

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39
Q

Haemophilia B is a deficiency of which factor?

A

IX

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40
Q

Give examples of causes of multi-factor deficiency

A

DIC
Liver disease
Increased fibrinolysis

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41
Q

Which pathway does PT test?

A

Extrinsic and final common

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42
Q

Describe PT measurement

A

TF and Ca2+ added to plasma and time taken to clot measured

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43
Q

Give example of what may cause an increased PT?

A

Liver disease
Warfarin therapy
Vit K deficiency
Factors II, VII, IX, X deficiency

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44
Q

What pathways does APTT test?

A

Intrinsic

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45
Q

Describe APTT test

A

Ca2+, phospholipid and an activator added to plasma and time taking to clot measured

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46
Q

Give examples of what would prolong APTT?

A

Haemophilia A or B
Heparin
Factor deficiency
Some small effect with Warfarin

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47
Q

What does thrombin time measure?

A

Time taken for convert fibrinogen to fibrin

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48
Q

What would prolong thrombin time?

A

Heparin

Dysfibrinogenaemia

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49
Q

What shape is a red cell?

A

Biconcave disc

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50
Q

What is the red cells only source of energy?

A

Glycolysis

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51
Q

What keeps the membrane in place?

A

Protein spars

Ankyrin

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52
Q

Describe the structure of Hb

A

Tetrameric

2 alpha 2 beta

53
Q

What forms the porphyrin ring of Hb?

A

Haem and fe2+

54
Q

Where are red cells mostly destroyed?

A

Spleen

55
Q

What do reticulocytes contain that erythrocytes don’t?

A

Ribsomal RNA

56
Q

Where is the gene for EPO?

A

Chromosome 7

57
Q

Where is EPO produced?

A

Peritubular cells of kidneys

Some in liver

58
Q

When is EPO produced?

A

In response to hypoxia

59
Q

What is the role of EPO?

A

Stimulate growth of erytrhoblasts

60
Q

Which molecule reduces Fe3+ to Fe2+?

A

GSH

Glutathione

61
Q

When GSH reduces Fe3+, GSH becomes…

A

GSSG

62
Q

What converts GSSG back to GSH?

A

NADPH

63
Q

Which molecule replenishes GSSG stores?

A

G6PD

glucose-6-phosphate dehydrogenase

64
Q

Where is most of the CO2 in the body carried?

A

Bound to bicarbonate

65
Q

Where is 30% of the CO2 in the body carried?

A

Hb and carbamino-Hb

66
Q

What is CO2 converted into in the red cell?

A

Carbonic acid

67
Q

What converts CO2 to carbonic acid?

A

Carbonic anhydrase

68
Q

What is carbonic acid in the red cell converted to?

A

H+ and bicarb

69
Q

Describe the O2 binding curve

A

Sigmoidal

70
Q

Increase in 2,3-DPG shifts the oxygen-binding curve to the….

A

Right

71
Q

Increase in temperature shifts the oxygen binding curve to the….

A

Right

72
Q

Increase in pH shifts the oxygen binding curve to the….

A

Left

73
Q

How much oxygen does a fully saturated Hb molecule carry?

A

1.34ml

74
Q

What do neutrophils develop from?

A

Myeloblasts

75
Q

What do myeloblasts develop into?

A

Promyelocytes

76
Q

What do promyelocytes develop into?

A

Myelocytes

77
Q

What do myelocytes develop into?

A

Neutrophils

78
Q

Describe neutrophils

A

Multi-lobed nucleus with granules

79
Q

What is found in the granules of a neutrophil?

A

Lysozyme, lactoferrin and collagenase

80
Q

What is the main function of a neutrophil?

A

Kill bacteria, fungi and damaged cells

Chemotaxis

81
Q

In which scenarios would neutrophils be increased?

A

Infection, trauma, infarction

82
Q

Describe an eosinophil

A

Granulocyte with a bi-lobed nucleus

83
Q

What colour do eosinophils’ granules stain?

A

Bright red/orange

84
Q

What is the function on an eosinophil?

A

Allergic reaction

Defence against parasites

85
Q

In which scenarios would eosinophils be increased?

A

Asthma, atopic rhinitis, and other allergic conditions

Some malignancies

86
Q

Describe a basophil

A

Large, deep-purple stained granules which obscure the nucleus

87
Q

What do basophil granules contain?

A

Heparin, histamine and some enzymes

88
Q

What causes release of histamine from basophils?

A

IgE binding to surface Fc receptors

89
Q

In which scenarios would basophils be increased?

A

Myeloproliferative disorders

90
Q

Describe a monocyte

A

Large, single nucleus

91
Q

What is a monocyte a precursor of?

A

Macrophages and dendritic cells

92
Q

What is the function of a monocyte?

A

Phagocytose invaders

Attract other cells

93
Q

Why would monocytes be increased?

A

Chronic bacterial infection

Myelodysplasia

94
Q

Describe a lymphocyte

A

Central, dark nucleus with a thin rim of cytoplasm

95
Q

Describe an activated nucleus

A

Large, blue-staining cytoplasm

96
Q

What is the function of a lymphocyte?

A

Respond to infection

97
Q

When would lymphocytes be increased?

A

Viral infection

98
Q

What is the main role of a basophil?

A

Modulate hypersensitivity reactions

99
Q

What is the role of B cells?

A

Make antibodies

Involved in humoral immunity

100
Q

What is the precursor to red cells?

A

Erythroblasts

101
Q

What is the pre-cursor to white cells?

A

Myeloblasts

102
Q

When does the liver start haemopoeisis?

A

week 6 gestation

103
Q

When does the spleen get involved in haemopoeisis?

A

week 16 gestation

104
Q

Where is the most common site for bone marrow aspiration?

A

PSIS

105
Q

What is the normal range for the myeloid : erythroid ratio?

A

1.5:1 - 3.3:1

106
Q

What are proplatelets?

A

Branching processes of megakaryocytes which reach out into sinusoidal blood vessels

107
Q

What regulates neutrophil precursor maturation?

A

G-CSF

108
Q

What is plasma?

A

The liquid component of blood which contains fibrinogen

109
Q

What is the main role of the erythrocyte?

A

Transport O2 from lungs to tissues

110
Q

When does haemopoeisis begin to occur in the liver?

A

Week 6

111
Q

When does haemopoeisis being to occur in the spleen?

A

Week 12

112
Q

What changes occur during growth than limits adult haemopoeisis sites?

A

Active red marrow in kids is gradually replaced by fat (yellow marrow)

113
Q

Where does haemopoeisis occur in adult long bones?

A

Trabecular area

114
Q

Where is TOP produced?

A

Liver

115
Q

Outline the developmental stages of neutrophil growth

A

Promyelocyte > myelocyte > metamyelocyte > neutrophil

116
Q

Give the stages of cell growth and development of monocytes

A

Monoblast > promonocytes > marrow monocytes > blood monocytes (then tissue macrophages

117
Q

What does an elevated RDW indicate?

A

Variation in cell size

118
Q

What is the normal level of reticulocyte?

A

<2%

119
Q

What does ESR measure?

A

Acute phase response to pathological processes by red cells (rate of red cell decline)

120
Q

Where is CRP made?

A

Liver

121
Q

How long do reticulocytes last in the circulation before maturing to erythrocytes?

A

1-2 days

122
Q

Where does Hb synthesis occur?

A

Mitochondria

123
Q

What is the major rate limiting step of Hb synthesis?

A

Conversion of glycine and succinic acid to delta-aminolaevulinic acid by ALA synthase

124
Q

Which vitamin is cofactor for the conversion of glycine and succinic acid to delta-ALA?

A

B6

125
Q

What are the two confirmations of Hb?

A

T (taut) and R (relaxed)

126
Q

What is the T conformation of Hb?

A

No O2 boudn

Globin chains held together by electrostatic bonds

127
Q

What is the R conformation of Hb?

A

O2 bound

Remaining O2-binding sites more exposed to give a higher affinity for oxygen

128
Q

How does 2,3-BPG affect Hb O2 binding?

A

Reduces it

Year 3 - Haematology (17 decks)

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