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2nd yr- IBMS- Blood > Physiology of blood > Flashcards

Physiology of blood Flashcards

1
Q

Name the components of blood

A

1, White blood cells

  1. Red blood cells
  2. Platlets
  3. Plasma
  4. Buffy coat
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2
Q

What is the “Buffy coat” component of blood made up of?

A

Platlets and leukocytes

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3
Q

What percentage of blood is made up of platelets and leukocytes ?

A

less than 1%

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4
Q

What percentage of blood is made up of plasma?

A

55%

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5
Q

What percentage of blood is made up of the formed elements? ?

A

45%

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6
Q

What are the formed elements of blood?

A
  1. White blood cells
  2. Red blood cells
  3. Platelets
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7
Q

When blood is centrifuged what happens?

A

It splits up into its different elements
1st layer: Plasma
2nd layer: Buffy coat
3Rd: Erythrocytes

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8
Q

What is the function of blood?

A
  1. Delivers oxygen and removes carbon dioxide
  2. Maintains temperature, pH and fluid volume
  3. Provides protection from fluid loss
  4. Prevents infection
  5. Transports hormones and nutrients
  6. Transports waste products out of the body eg Urea
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9
Q

What is plasma made up of/

A

90% water

8% solutes

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10
Q

Name the solutes that make up plasma

A

Proteins like:

  1. Albumin (60%),
  2. Alpha and Beta globulins
  3. Gamma globulins,
  4. Fibrinogens

Gas
Electrolytes

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11
Q

Name the main protein the makes up plasma

A

Albumin

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12
Q

What is transported by the plasma?

A
  1. Organic nutrients eg carbohydrates, lipid, amino acids, vitamin
  2. Hormones
  3. Metabolic waste eg urea
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13
Q

What is haematopoiesis?

A

It is the process that forms blood

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14
Q

Which cells give rise to the formed elements of blood?

A

The haemocytoblasts (pluripotential hemopoietic stem cell (PHSC))

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15
Q

What is another name for haemocytoblasts?

A

pluripotential hemopoietic stem cell (PHSC)

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16
Q

How are haemocytoblasts transporter around the body?

A

They are pushed around by hormones and growth factors towards a certain pathway of differentiation depending on the body’s needs

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17
Q

Are Hemocytoblasts seen in blood films and cytology? why?

A

No as they are easily broken

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18
Q

Name the 2 different pathways Hemocytoblasts can take when differentiating

A
  1. The common myeloid progenitor

2. The common lymphoid progenitor

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19
Q

What does the common myeloid progenitor pathway lead to?

A

The formation of:

  1. Megakaryocytes which form platelet
  2. Erythrocytes
  3. Mast cells
  4. Myeloblasts which form basophil, neutrophils, eosinophils and monocytes
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20
Q

How are platelets formed from?

A

Megakaryocytes which is formed when Hemocytoblasts differentiate via the common myeloid progenitor pathway

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21
Q

What does the common lymphoid progenitor pathway lead to?

A
  1. Natural killer cells

2. Small lymphocytes which form t lymphocytes and B lymphocytes

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22
Q

What do red blood cells contain?

A

They contain haemoglobin

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23
Q

Why is haemoglobin important?

A

As it helps transport respiratory gases

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24
Q

How many red blood cells do we have?

A

Men have: 4.7-6.1 million per micro litre of blood

Females have: 4.2-5.4 million per micro litre of blood

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25
Q

How big are red blood cells?

A

Around 7.5 micrometers in diameter

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26
Q

What is special about the structure of red blood cells?

A

They lack mitochondria and don’t have a nucleus

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27
Q

What shape are ed blood cells and why is this important?

A

They are biconcave

This increases the surface area and increases flexibility

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28
Q

What is the benefit of red blood cells not having a mitochondria?

A

Give them more room to store ore haemoglobin

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29
Q

How are red blood cells produced?

A

Produced via haematopoiesis in bone

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30
Q

What is the lifespan of a red blood cell?

A

100-120 days

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31
Q

How are red blood cells destroyed?

A

Destroyed by macrophages in the spleen liver and bone §

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32
Q

Describe the structure of haemoglobin

A

It is made up of:
2 alpha chains
2 beta chains
1 iron containing haem group

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33
Q

What is erythropoiesis

A

How red blood cells form

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34
Q

What does erythropoiesis begin with?

A

Vitamin B12 and B9

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35
Q

Talk through the stages of erythropoiesis

A
  1. Hemocytoblast are activated by vitamin B12 and B9 to differentiate into Late normoblast
  2. Late normoblast leave the bone marrow
  3. The nuclei is lost and destroyed by macrophages forming a reticulocyte
  4. In 1-2 days the reticulocyte forms a erythrocyte (RBC)
  5. Eventually erythrocytes are destroyed by macrophages forming erythropoietin
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36
Q

What happens as Hemocytoblast differentiate?

A

The cell size decreases during maturation as RNA and DNA decreases
The nucleus gradually shrinks
The colour of the cell changes from blue to red

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37
Q

What are reticulocyte ?

A

An immature red blood cell

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38
Q

What percentage of circulating cells are reticulocyte ?

A

1%

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39
Q

What are erythrocyte ?

A

They are red blood cells

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40
Q

What is erythropoietin?

A

A hormone produced by destroyed red blood cells

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41
Q

Why is erythropoietin important?

A

As It pushes the Hemocytoblast to differentiate into late normoblast

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42
Q

Give some differences between Hemocytoblast and late normoblast

A
  1. Hemocytoblasts are bigger
  2. Hemocytoblast have ore RNA and DNA
  3. Hemocytoblast Has a bigger nucleus
  4. Hemocytoblast are red late normoblasts are blue
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43
Q

Where is erythropoietin released from?

A

The kidneys

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44
Q

When is erythropoietin released?

A

Realeased from the kidneys in repose to hypoxia

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45
Q

Wha can hypoxia be caused by

A
  1. Secondary to haemorrhage
  2. Loss of red blood cells
  3. Insufficient haemoglobin
  4. Reduced oxygen
  5. Increased damsons
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46
Q

What do erythropoietin stimulate?

A

Stimulates rapid maturation of committed red blood cells

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47
Q

What does the stimulation of erythropoietin lead to?

A

An increase in reticulocyte count circulating the body within 2 days

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48
Q

Why do men have more red blood cells than woman?

A

As testosterone enhances the production of erythropoietin leading to a higher RBC count in males

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49
Q

Talk through the stages of red cell death

A
  1. Macrophages break down RBCs into haem and globin
  2. Globing is broken down into amino acids and haem is broken down into down into Fe3+ (bound to transferrin) and biliverdin
  3. Iron is transported to the liver
  4. biliverdin is transported to the large intestine and ultimately exited out the body as faeces and urea
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50
Q

What do macrophages break RBCs into?

A

Haem and globin

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51
Q

Why is the iron broken down from haem bound to transferrin?

A

As iron is very reactive so when it binds to transferrin it not react with anything else

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52
Q

Talk through what happens to the iron element of haem when RBC death occurs?

A

Macrophages break down RBCs into haem

  1. Haem is broken down into Fe3+ which Is bound to transferrin
  2. This Fe3+ is transported to the liver and separated
  3. Then is reforms and moves out of liver where it travels around the body
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53
Q

Talk through what happens to the biliverdin element of haem when RBC death occurs?

A
  1. It is transported to the liver
  2. Then it is transported to the large intestine where is is changed by bacteria to form bilirubin
  3. bilirubin is then converted into urobilinogen and then Stercobilin
  4. urobilinogen is then transported to the kidney as urobilin
  5. urobilin leaves the kidneys as urea and Stercobilin leaves the body as faeces
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54
Q

What is anaemia?

A

It is a condition where a person has a decrease int eh number of red blood cells OR they have less than the normal quantity of haemoglobin in their blood

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55
Q

What anaemia due to?

A
  1. Excess blood loss
  2. Excess red blood cell destruction
  3. Deficient red blood cell production
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56
Q

What are the most common causes of iron deficient anaemia?

A
  1. Parasitosis
  2. Dietary deficiency
  3. Blood loss
  4. Malabsorption
  5. Pregnancy
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57
Q

Give some symptoms of iron deficient anaemia

A
  1. Tiredness
  2. Pale
  3. Light headedness
  4. Irritable
  5. Poor wound healing
  6. Beefy red tongue (glossitis)
  7. Burning mouth syndrome
  8. RAS
  9. Candidal infections
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58
Q

Name the different types of anaemia

A
  1. iron deficient anaemia

2. Pernicious Anaemia

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59
Q

What is Pernicious Anaemia?

A

It is vitamin B12 deficient anaemia

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60
Q

What is Pernicious Anaemia?

A

A lack of red blood cells due to a deficiency in vitamin B12

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61
Q

What can Pernicious Anaemia be due to?

A

Due to lack of intrinsic factors allowing absorption of vitamin B12

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62
Q

What can Pernicious Anaemia caused by?

A
  1. Autoimmune condition
  2. Tapeworms
  3. Poor diet
  4. Celiac
  5. Weight loss
  6. Neurological symptoms
  7. glossitis,
  8. angular cheilitis
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63
Q

How Is Pernicious Anaemia treated?

A

Treated with oral supplements and intramuscular B12 injections

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64
Q

What are Haemoglobinopathies

A

Conditions where there is something wrong with haemoglobin

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65
Q

Give examples of Haemoglobinopathies

A
  1. Sickle cell

2. Thalassaemia

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66
Q

What does sickle cell and Thalassaemia cause?

A

Leads to the production of abnormal RBSc that are broken down more quickly by the body

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67
Q

What can happen if you destroy more RBCs than you make?

A

You can get haemolytic anaemia

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68
Q

Is Sickle Cell Anaemia recessive or dominant?

A

Autosomal Recessive

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69
Q

What cases Sickle Cell Anaemia

A

Caused by a genetic mutation on chromosome 11 where the Glut protein is converted into Val at position 6
This produces a sickle component instead of a beta chain changing the shape of the RBC

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70
Q

How is sickle cel anaemia treated?

A

Treated with hydroxyurea to increase HbF production and prevent abnormal sickle cells being made

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71
Q

What does it mean if you are a Heterozygote for sickle cell anaemia

A

Means you have some sickle shaped RBC and some normal RBC

This is beneficial as it provides protection from malaria

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72
Q

Name the 2 different types of Thalassaemia

A

Alpha Thalassaemia

Beta Thalassaemia

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73
Q

What is alpha Thalassaemia

A

A reduction in alpha unit production

This leads to an excess of beta units

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74
Q

What is beta Thalassaemia?

A

A reduction in beta unit production

This leads to an excess of alpha units

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75
Q

Which type of Thalassaemia is more common?

A

Beta Thalassaemia

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76
Q

How many genes make up the alpha unit of RBCs?

A

2 genes so 4 alleles

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77
Q

How many genes make up the beta unit of RBCs?

A

1 gene so 2 alleles

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78
Q

If you lose one alpha unit allele what happens?

A

No problem

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79
Q

If you lose 2 alpha unit allele what happens?

A

May suffer from mild anaemia/microcytosis

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80
Q

If you lose 3 alpha unit allele what happens?

A

May suffer from severe anaemia

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81
Q

If you lose 4 alpha unit allele what happens?

A

Incompatible with life

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82
Q

What is microcytosis?

A

A condition where you have smaller red blood cells

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83
Q

Name the 5 different types of leukocytes from greater amount to least amount found in the blood

A
  1. Neutrophils (65%)
  2. Lymphocytes (25%)
  3. Monocytes (6%)
  4. Eosinophils (3%
  5. )Basophils (1%)
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84
Q

How big are leukocytes?

A

400-11000 cells mm^3

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85
Q

What happens when you have increased number of white blood cells

A

leukocytosis

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86
Q

When might someone have leukocytosis?

A

Seen in:

  1. Infections
  2. Neoplasia
  3. Autoimmune diseases
  4. Strenuous exercise
  5. Stress
  6. Allergies
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87
Q

What happens when you have a decreased number of white blood cells

A

You can get leukopenia

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88
Q

When might someone have leukopenia?

A

Seen in:

  1. Chemo therapy
  2. Radio therapy
  3. HIV/AIDS
  4. Some infections
  5. Mineral deficiency
89
Q

How big are neutrophils?

A

10-12 micrometres in diametre

90
Q

Name the main targets of neutrophils

A

Bacteria and fungi

91
Q

What type of nucleus do neutrophils have?

A

Multi lobes

92
Q

What type of granules do neutrophils have?

A

Fine granules that are faintly pink

93
Q

What is the life span of a neutrophil?

A

6hours - a few days

94
Q

How big are lymphocytes ?

A

7-8 micrometres (small)

12-15 micrometres (Large)

95
Q

Name the main targets of lymphocytes

A 
T cells 
B cells 
NK cells 
Bacteria 
Viruses 
Tumour cells
96
Q

What type of nucleus do lymphocytes have?

A

Deeply stained eccentric

97
Q

What type of granules do lymphocytes have?

A

They have NK cells and cytotoxic T cells

98
Q

What is the lifespan of a lymphocytes ?

A

Years for memory cells

Weeks for all other types

99
Q

How big are monocytes?

A

15-30 micrometers

100
Q

What is the function of monocytes

A

To migrate to become redden macrophages

101
Q

Describe the nucleus of a monocyte

A

It is kidney shaped

102
Q

Do monocytes have granules?

103
Q

What is the lifespan of a monocyte?

A

Hours-days

104
Q

How big are Eosinophils

A

10-12 micrometres in diamtre

105
Q

What is the function of Eosinophils

A

To indice teh allergic inflammatory response and attack parasites

106
Q

Describe the nucleus of Eosinophils

A

It is bilobed

107
Q

Describe the granules found in Eosinophils

A

They are fill of pink and orange

108
Q

What is gteh life span of Eosinophils

109
Q

What percentage of leukocytes are made up of Neutrophils

110
Q

What percentage of leukocytes are made up of Lymphocytes

111
Q

What percentage of leukocytes are made up of monocytes

112
Q

What percentage of leukocytes are made up of eosinophils

113
Q

What percentage of leukocytes are made up of basophils

114
Q

What is leukocytosis?

A

An increased number of white blood cells

115
Q

What is leukopenia

A

A decreased number of white blood cells

116
Q

How big are Basophils

A

12-15micrometres

117
Q

What is the function of Basophils

A

To please histamines for inflammatory response

118
Q

Describe the nucleus of Basophils

A

BI or Tri lobed

119
Q

Describe the granules found in Basophils

A

They are large an blue

120
Q

What is the life span of Basophils

A

Few hours- few days

121
Q

What is diapedesis?

A

It is how white blood cells leave the blood stream

122
Q

Name the steps involved in the leaving of a white blood cell from the blood steam

A
  1. Chemoattraction
  2. Rolling adhesion
  3. Tight adhesion
  4. Transmigration
123
Q

Talk through how a white blood cell leaves the blood stream

A
  1. It is chemo attracted to an area where it is needed
  2. They then get a rolling adhesion from the blood Flow where they stick on the side of the walls and roll
    3 .They then stop this is called tight adhesion
  3. They then slip between the endothelial cells this is called transmigration
124
Q

Where are monocytes found?

A

They are found in the bone marrow and blood

125
Q

Where are kupffer cells found?

126
Q

Where are histiocytes found?

127
Q

Where are microglia found?

A

Central nervous system

128
Q

Where are hofbauer cells found

129
Q

Where are intraglomerular mesangial cells found

130
Q

Where are osteoclasts found

131
Q

What are platelets?

A

Small fragments of megakaryocytic

132
Q

How is the formation of platelets regulated?

A

Regulated by thrombopoietin

133
Q

Describe how platelets look under a microscope

A

Theres a blue staining outer region filled with purple granules

134
Q

What do the granules in platelets contain?

A
  1. Serotonin
  2. Ca2+
  3. Enzymes
  4. ADP
  5. Platelet derived growth factor (PDGF)
135
Q

How big are platelets?

A

2-3 micrometres

136
Q

What shape are platelets cells?

A

Biconcave in shape

137
Q

What is the ratio of platelets to RBC?

A

1:10 TO 1:20

138
Q

How many platelets are found in the blood?

A

Around 250,000-500,000 cells/mm3

139
Q

What process occurs when you cut yourself?

A

Haemostasis

140
Q

Name the 4 steps of Haemostasis

A
  1. Vessel injury
  2. Vascular spasm
  3. Platlets plug formation
  4. Coagulation
141
Q

Talk through thstages of Haemostasis

A
  1. Vessel is damaged
  2. The damaged vessel constricts reducing blood flow in reposes to endothelial cell injury, smooth muscle injury, pain and platelets
  3. Platlets adere to damaged endothelium and then degranulate
  4. Platlets adhere to the collagen fibres in the wound becoming spiky and causing more platelets to stick to the plug and cause further vasoconstriction creating a feedback loop
  5. Clotting factors become activated and begin deposition of fibrin creating meshwork
  6. Coagulation reinforces the clot
142
Q

How is plug activation regulated?

A

Regulated by Von Willebrand factor which is found in plasma

143
Q

What is the clot formed by when you cut yourself

A

It is formed by the transformation of soluble fibrinogens to insoluble fibrin
RBCs and platelets stay trapped in the mesh

144
Q

What does blood clotting involve?

A

2 different pathways made up of a cascade of circulating proteins

145
Q

Name the two pathways that make up Haemostasis

A
  1. Intrinsic pathway

2. Extrinsic pathway

146
Q

What is the intrinsic pathway of Haemostasis activated by?

A

Activated by trauma inside the vascular system

147
Q

Give examples of stimuli that may activate the intrinsic pathway of Haemostasis

A
  1. Exposed endothelium
  2. Chemicals
  3. Collagen
  4. Negatively charged surfaces
148
Q

Which factors are involved in intrinsic Haemostasis

A

Factors VII, XI, IX an VIII

149
Q

What is the extrinsic pathway of Haemostasis activated by?

A

Activated by external trauma when blood leaves the vascular system

150
Q

Which factors are involved in extrinsic Haemostasis?

A

Factor VII

151
Q

Which of the 2 pathways of Haemostasis is faster?

A

Extrinsic Haemostasis is fast

152
Q

What is the purpose of the intrinsic and extrinsic pathways of Haemostasis

A

To turn soluble fibrinogen into insoluble fibrin creating a stable clot

153
Q

Give some disorders of Haemostasis

A
  1. Bleeding disorders

2. Thromboembolic disorders

154
Q

Name some bleeding disorders

A
  1. Thrombocytopenia
  2. Clotting Factor Deficiencies
  3. Impaired Liver Function
  4. Von Willebrand Disease
155
Q

What is Thrombocytopenia?

A

It is when a person has too few platelets

156
Q

What can Thrombocytopenia cause?

A

Spontaneous bleeding

157
Q

Why might a person with Thrombocytopenia suffer from spontaneous bleeding?

A

Due to suppression or destruction of bone marrow

158
Q

How do we diagnose Thrombocytopenia?

A

By checking a patients platelet count

If it is below 50,000/mm3 then the person may have Thrombocytopenia

159
Q

How is Thrombocytopenia treated?

A

Treated with transfusion of concentrated platelets

160
Q

How does Thrombocytopenia arise?

A

It can be idiopathic (spontaneous)

161
Q

What happens if someone liver function is impaired?

A

Their ability to produce procoagulant is impaired

162
Q

Given an example of procoagulants

163
Q

What can cause liver function impairment?

A

Vitamin K deficiency
Hepatitis
Cirrhosis
Injury

164
Q

What forms is vitamin K found in?

A

2 forms:

K1 and K2

165
Q

Why is vitamin k important?

A
  1. It allows for the synthesis of coagulation factors
  2. Allows binding of calcium to activate some of the coagulation factors
  3. It carboxylises glutamate redoes in protein which are needed for binding proteins to activate
166
Q

Why is the carboxylation of glutamate important?

A

As it is needed for binding proteins to activate

167
Q

What carboxylates glutamate residues found in proteins?

168
Q

Where is K1 found?

A

Found in leafy veg

169
Q

How do we get K2?

A

It is synthesised by flours in animal and human gut flors

170
Q

What is vitamin k used to reverse?

A

Warfarin overdoe

171
Q

Where is vitamin K stored?

A

stored in fatty tissues of the body

172
Q

Name the most common hereditary coagulation disease

A

Von Willebrand Disease

173
Q

State the different types of Von Willebrand Disease

A

Type 1: Autosomal dominant (Least severe)
Type 2: Autosomal dominant
Type 3: autosomal recessive (most severe)
4. Platelet type (autosomal dominant)

174
Q

Which of the 4 different types of Von Willebrand Disease is the most severe?

A

Type 3 the autosomal recessive type

175
Q

What is Von Willebrand Disease

A

A deficiency of Von Willebrand factor found in salsa and subendothelial connective tissue

176
Q

What is Von Willibrands factor?

A

It is essentially a binding molecule to make other molecules more stab

177
Q

What can Von Willibrands factor bind to?

A

Binds to Factor viii in circulation increasing its half life from 1-2 hour to 12 hours

178
Q

What does Von Willibrands factor do when it is released from damaged endothelial cells?

A

It allows links between platelets and vessel wall collagen

179
Q

What do Haemophilias include?

A

They include several similar heritor bleeding disorders

180
Q

Gives some symptoms ofHaemophilias

A

prolonged bleeding, especially into joint cavities

181
Q

How are Haemophilias treated?

A

Treated with plasma transfusion s and injection of missing factors

182
Q

Name the two main types of Haemophilias

A

Type a

Type b

183
Q

Which factor is deficient in type A Haemophilia?

A

Factor VIII

184
Q

How is Haemophilia A passed on?

A

It is X linked recessive

185
Q

How many males suffer from Haemophilia A

A

1 in every 5000

186
Q

What is another name for Haemophilia B

A

Christmas disease

187
Q

Which factor is deficient in Haemophilia b?

188
Q

How is Haemophilia B passed on?

A

It is X linked recessive

189
Q

How many males suffer from Haemophilia B

A

1 in every 30,000

190
Q

What is blood type cased on?

A

The precedence of 2 major antigens in Red blood cell membranes A and B

191
Q

What is an antigen ?

A

A protein on the surface of a cell membrane

192
Q

What are antibodies

A

Proteins made by lymphocytes in plasma which are made in repose to the precise of foreign antibodies

193
Q

Name the 4 different blood types

A

A, B , AB, O

194
Q

Which antigen is present in people with blood type A?

195
Q

Which antigen is present in people with blood type B?

196
Q

Which antigen is present in people with blood type AB?

A

Antigen A and B

197
Q

Which antigen is present in people with blood type o?

A

Neither A or B antigen (Universal donors)

198
Q

Which antibody is present in people with blood type A?

199
Q

Which antigen is present in people with blood type B?

200
Q

Which antigen is present in people with blood type AB?

A

No antibody (Universal receivers)

201
Q

Which antigen is present in people with blood type O?

A

Anti A and Anti B

202
Q

Give the genotype of a person with blood type A

A

IA, IA
OR
IA, IO

203
Q

Give the genotype of a person with blood type B

A

IB, IB
OR
IB, IO

204
Q

Give the genotype of a person with blood type AB

205
Q

Give the genotype of a person with blood type O

206
Q

Which of the 4 phenotypes for blood group is recessive?

207
Q

Which of the 4 phenotypes for blood group is dominant?

A

None of them both A and B share co dominants

208
Q

What does the Rh factor describe?

A

Describe the present of Rhesus antigen D

209
Q

Which is domient:

Rh+, Rh-?

210
Q

What problems can arise if a mother is Rh- and her foetus is Rh+

A

Can lead to anti-rhesus antibodies from mother attacking the foetal blood cells, causing haemolytic anaemia

211
Q

Which of the different blood groups is the most common?

A

O positive 37.4%

212
Q

What is the frequency of blood type O negative

213
Q

What is the frequency of blood type A positive

214
Q

What is the frequency of blood type A negative

215
Q

What is the frequency of blood type B positive

216
Q

What is the frequency of blood type B negative

217
Q

What is the frequency of blood type AB positive

218
Q

What is the frequency of blood type AB negative

2nd yr- IBMS- Blood (2 decks)

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