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Y3 Haematology > RBC Physiology > Flashcards

RBC Physiology Flashcards

1
Q

Are are the 2 main components of blood?

A

Cells + liquid

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2
Q

What is the liquid component of blood called?

A

Plasma

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3
Q

What are the 3 main blood cell types? Which is commonest

A

Red cells (commonest)
White cells
Platelets

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4
Q

What is the term for blood cell production?

A

Haematopoiesis

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5
Q

What sort of stem cell produces blood cells?

A

Pluripotent - capable of any cell type

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6
Q

At birth where does haematopoiesis occur?

A

Liver, spleen, bone marrow

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7
Q

Where does haematopoesis occur in a child?

A

Bone marrow - decreasing number of active sites

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8
Q

Where does haematopoiesis occur in an adult?

A

Bone marrow of skull, sternum, pelvis, proximal femur

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9
Q

What are the 2 main progenitors in the haematopoietic tree?

A

Lymphoid and myeloid

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10
Q

What cell type do both lymphoid and myeloid progenitors produce?

A

Dendritic cells

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11
Q

What cell types do lymphoid progenitors give rise to?

A

T cells
B cells
NK cells

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12
Q

What cell types do myeloid progenitors give rise to?

A 
Erythrocytes
Platelets
Mast cells
Granulocytes
Macrophages
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13
Q

Put these stages of erythropoiesis in order:

  • Reticulocyte
  • Pronormoblast
  • Basophilic normoblast
  • Orthochromatic normoblast
  • Erythrocyte
  • Polychromatophilic normoblast
A

Erythropoiesis:

  • Pronormoblast
  • Basophilic/ early normoblast
  • Polychromatic/ intermediate normoblast
  • Orthrochromatic/ late normoblast
  • Reticulocyte
  • Erythrocyte
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14
Q

Which statements are true about reticulocytes:

  • Smaller that mature erythrocyte
  • Have a nucleus
  • Contain RNA remnants
  • Hypochromatic
  • Exist for a few days
  • Have just left the bone marrow
A

Which statements are true about reticulocytes:

  • Smaller that mature erythrocyte FALSE LARGER
  • Have a nucleus FALSE
  • Contain RNA remnants TRUE
  • Hypochromatic FALSE POLYCHROMATIC
  • Exist for a few days TRUE
  • Have just left the bone marrow TRUE
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15
Q

Name 3 causes of a raised reticulocyte count

A

Haemolysis
>12 hours after acute blood loss
Following Fe supplement in Fe deficiency

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16
Q

In a patient with a raised reticulocyte count, what tests are useful for determining the cause?

A

Look for Hb breakdown products

Seen in haemolysis

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17
Q

When do normoblasts loose their nucleus?

A

When optimal Hb content

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18
Q

Where are normoblasts found?

A

In the bone marrow

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19
Q

What is the consequences of a RBC having no nucleus?

A

Can’t divide
Can’t replace damaged protein
Limits lifespan
Fits more Hb in

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20
Q

What term describes the shape of a RBC? What is the importance of this shape?

A

Biconcave
Can withstand high arterial pressure
Contains Hb
>SA for gas exchange

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21
Q

What are 3 functions of RBCs?

A

Delivers O2
Hb H+ buffer
Transport CO2

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22
Q

What is the name of the enzyme that generates bicarbonate?

A

Carbonic anhydrase

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23
Q

Where is Epo produced? And in what circumstances?

A

By kidneys

If they sense hypoxia

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24
Q

What effects does Epo have?

A

Stimulates erythroid hyperplasia to increase marrow activity

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25
Q

Why is energy production in the RBC limited?

A

No mitochondria

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26
Q

How do RBCs produce energy?

A

Glycolysis

AKA Embden-Meyerhof pathway

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27
Q

What are the net products of glycolysis?

A

ATP + NADH

28
Q

What is the function of NADH in RBCs?

A

Prevents Fe2+ oxidation to Fe3+ metHb, can’t carry O2

29
Q

What is the Rapapoport-Lubering shunt?

A

Alternate route for glucose to pyruvate via 2,3-DBG

when does it happen? maybe in oxidative environment?

30
Q

What is the allosteric effect?

A

When 1 oxygen binds to a Hb subunit the shape changes to increase the affinity for O2

31
Q

Where are old / abnormal RBCs removed? What cell type is responsible for this?

A

Spleen

Macrophages

32
Q

Macrophages recycle old red cells. What are the globin chains recycled to?

A

Amino acids

33
Q

Macrophages recycle old red cells. What are the heme chains recycled to?

A

Brown to iron + bilirubin

Iron transferred back to barrow erythroblasts

Heme converted to bilirubin

34
Q

What are the intermediate steps of heme conversion to bilirubin?

A

Heme to porphyrin to bilverdin to bilirubin

35
Q

What happens to bilirubin after it leaves the spleen?

A

Conjugated in liver, then excreted in bile

36
Q

Reactive oxygen species are made in a ______ environment

A

Oxygen rich

37
Q

Reactive oxygen species free radicals oxidise things they shouldn’t such as …

A

DNA

38
Q

Name 2 free radicals

A

Hydrogen peroxide

Superoxide

39
Q

What thing removes the free radical hydrogen peroxide?

A

Glutathione and G6PD enzyme

40
Q

What thing remove the superoxide free radical?

A

Superoxide dismutase enzyme

41
Q

CO2 transport:

30% as _____
60% as _____
10% as _____

A

30% carbamino-Hb
60% bicarbonate
10% dissolved

42
Q

What cycle is B12 responsible for?

A

Methionine cycle

43
Q

What cycle overlaps with the methionine cycle?

A

Folate cycle

44
Q

B12 and folate both aid in what in the RBC?

A

DNA synthesis

45
Q

What are the main components of Hb?

A

Haem + globin chain

46
Q

What is a haem group made of?

A

Iron + porphyrin ring

47
Q

What is the function of iron in Hb?

A

Binds oxygen

48
Q

What are the globin chains in adult haemoglobin HbA?

A

2 alpha chains

2 delta chains

49
Q

What are the globin chains in fetal haemoglobin HbF?

A

2 alpha

2 gamma

50
Q

How does fetal haemoglobin differ in function from adult haemoglobin?

A

Increased saturation at same partial pressure of oxygen

51
Q

What effect does chronic anaemia have on the oxygen Hb dissociation curve? What molecule in the RBC is attributed to this?

A

Shifts curve right (double check this)

Increased 2,3-DPG

52
Q

How many molecules of oxygen can 1 molecule of Hb carry?

A

4

53
Q

Free haemoglobin binds to Fe3+ producing what?

A

MetHb which can’t carry O2

54
Q

What are the types of granulocyte? Which is commonest?

A

Neutrophil commonest
Eosinophil
Basophil

55
Q

What are the 2 states of iron in the most?

A

Fe2+ (ferric)

Fe3+ (ferrous)

56
Q

What are the location of iron within the body?

A 
Most in Hb
Parenchyma
Myoglobin
Enzymes
Macrophages
Marrow
57
Q

Where is iron absorbed?

A

Duodenum

58
Q

What food interferes with Fe absorption?

A

Tannins in tea

others

59
Q

Iron in the liver is bound to what protein?

A

Ferritin

60
Q

Iron in macrophages is bound to what protein?

A

Ferritin

61
Q

What protein is responsible for transporting iron throughout the circulation?

A

Transferrin

62
Q

What protein is responsible for Fe transport out of cells to transferrin?

A

Ferroportin

63
Q

Where does transferrin transport iron from? Where to?

A

From macrophages / intestine / hepatocyte

To tissues expressing transferrin receptors (erythroid marrow)

64
Q

Serum ferritin is raised in malignancy and sepsis since it is an ______

A

acute phase protein

65
Q

What protein is a negative regulator of Fe uptake? What is its function?

A

Hepcidin

Degrades ferroportin

66
Q

What effect does iron deficiency have on hepcidin?

A

Decreases

67
Q

Where is hepcidin produced?

A

Liver

Y3 Haematology (15 decks)

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