Plasma Composition - Goueli

Question 1

What is responsible for plasma protein production?

Answer 1

Liver synthesizes and releases more than 90% of plasma proteins

Question 2

Plasma Proteins include

Answer 2

Albumin, Fibrinogen, Globulins, Prohormones

Question 3

Albumin

Answer 3

A protein that stays in the blood vessels, which plays a direct role in maintaining the oncotic pressure

Question 4

Oncotic Pressure

Answer 4

The pressure related to the draw of fluid as it relates to the plasma protein pressure

Question 5

How will fluids flow into the interstitial space?

Answer 5

High Hydrostatic Pressure

Low Plasma Protein Concentrations in the Blood Vessels

Question 6

Equation for Cardiac Output

Answer 6

Stroke Volume X Heart Rate X Systemic Vascular Resistance

Question 7

Describe the factors in the equation of life = Delivery of Oxygen to Tissues depends on…

Answer 7

Hemoglobin, Cardiac Output, Oxygen Saturation in the Blood

Question 8

Why do erythrocytes have a large ratio of surface area to volume?

Answer 8

Allows for rapid oxygen absorption or release

Question 9

Hematopoiesis

Answer 9

Stem cells proliferate and differentiate into any blood cells

Question 10

Hypoxia Inducible Factor

Answer 10

Induces the kidney to release EPO to stimulate the bone marrow to make hemoglobin

Question 11

Function of Erythopoetin

Answer 11

Increases cell division rates in erythroblasts and in stem cells that produce erythroblasts to speed up maturation of RBCs by accelerating the rate of Hb synthesis

Question 12

Why do RBCs lack mitochondria and how can they make energy?

Answer 12

Ensures that oxygen will be carried to peripheral tissues rather than “stolen” by mitochondria
Anerobic Glycolysis

Question 13

Pyruvate Kinase Deficiency

Answer 13

ATP generated via glycolysis is decreased by 50%
Ranges from severe hymolytic anemia to jaundice
Treatment: Folic Acid Supplements, Splenectomy

Question 14

To bind oxygen, the iron of hemoglobin must be in what state?

Answer 14

Ferrous (2+) State

Question 15

Acquired Methemoglobinemia

Answer 15

Ingestion of certain oxidants (nitrates, aniline, sulfonamides, quinones) that can be treated by the administration of reducing agents such as ascorbic acid or methylene blue

Question 16

Glutathione Peroxidase

Answer 16

Found in cytosol and mitochondria to remove H2O2 that is not in the peroxisomes (where selenium is used)

Question 17

What is the RBCs chief defense against damage by reactive oxygen species?

Answer 17

Glutathione Cycle in the Pentose Phosphate Pathway

Question 18

G6PD (Glucose-6-Phosphate Dehydrogenase Deficiency)

Answer 18

Enzyme that catalyzes the first step of the pentose phosphate pathway (Reducing power for NADP+), but RBCs don’t have a nucleus and can’t make more G6PD, so once the G6PD is used up, the oxidative damage accumulates and lyses the RBC.

Leads to hemolytic anemia. Provides resistance to malaria.

THIS IS X-LINKED!!!!!

Question 19

Symptoms of G6PD Deficiency

Answer 19

Hemolytic Anemia

Dark urine, pale skin, jaundice, organomegaly, fever, tachycardia

Question 20

Peripheral Smear of G6PD Deficiency

Answer 20

Heinz Bodies, Bite Cells, Blister Cells

Question 21

What is the cause of Hereditary Spherocytosis?

Answer 21

Defect in erythrocyte cytoskeleton proteins

Question 22

What happens in cirrhosis and why do patients with cirrhosis develop ascites (build up of fluid in the peritoneal cavity)?

Answer 22

Reduced albumin protein production + Reduced oncotic pressure = Increased hydrostatic pressure that will cause fluid to flow into the interstitial space

Question 23

Methemoglobinemia and Benzocaine: what happens when they interact?

Answer 23

Acquired Methemoglobinemia
Results from the conversion of iron to Fe3+ from a single AA substitution in the heme binding pocket
Can be treated with reducing agents

Question 24

How is G6PD genetically transmitted?

Answer 24

X-linked disease, common in African decent due to malaria protection

Question 25

When talking about the Oxygen-Hemoglobin curve, what causes the curve to shift to the Right?

Answer 25

Increased Temperature (denatures oxygen-iron bond)
Proton Concentration Increases (H+) –> Lower pH
High CO2
Increased 2-BPG
==> Leads to release of oxygen from hemoglobin (lower affinity = Bohr effect)

Question 26

When talking about the Oxygen-Hemoglobin curve, what causes the curve to shift to the Left?

Answer 26

Decreased Temperature
Decreased CO2
Decreased 2-BPG
Decreased Proton Concentration (H+) –> Higher pH
==> Leads to increased affinity for hemoglobin to oxygen