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Advanced Patho UC Exam #2 > Structure & Function of the Hematologic System > Flashcards

Structure & Function of the Hematologic System Flashcards

1
Q

What is normal blood volume in adults?

A

around 6 quarts (5.5L) in adults

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2
Q

______ & ______ maintain the osmolarity and acid-base balance of the blood

A

ELECTROLYTES & PROTEINS

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3
Q

What is plasma made of? See picture on study guide

A

solution of protein (mainly synthesized in liver) and inorganic materials that is approx. 92% water, and 8% dissolved substances

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4
Q

Plasma makes up what % of blood volume

A

50-55%

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5
Q

Plasma proteins (the three most important, but there are four) & their functions

A
  • ALBUMINS - function as carriers, and CONTROL PLASMA ONCOTIC PRESSURE
  • CLOTTING FACTORS - mainly fibrinogen, which is the most abundant clotting factor and is the precursor to the fibrin clot
  • LIPOPROTEINS - triglycerides, cholesterol, and fatty acids
  • globulins are carrier proteins and immunoglobulins (Ig) (antibodies); primarily IgG - these are made by plasma cells, and are not synthesized in the liver
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6
Q

What is serum?

A

plasma w/o clotting factors - plasma that has been allowed to clot in the lab in order to remove fibrinogen and other clotting factors

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7
Q

What are pluripotential cells?

A

precursor cells in BM that can become any cell in the bloodline (RBC, WBC, or platelets)

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8
Q

Whole blood includes what two components?

A

plasma (water, proteins, other solutes) & formed elements (platelets, leukocytes, RBCs)

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9
Q

What is the most abundant of cells in the blood? % in men? % in women?

A

ERYTHROCYTES

M = 48%
W = 42%
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10
Q

Lifespan of RBCs? Why? Old ones removed by?

A

120 days - can’t undergo mitotic division so limited lifespan - removed by spleen when old

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11
Q

RBCs have ____ & _____ that increases surface area and allows them to squeeze through the microcirculation

A

biconcavity and reversible deformity

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12
Q

Leukocytes - Granulocytes include?

A

neutrophils, basophils, eosinophils, mast cells

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13
Q

Leukocytes - Agranulocytes include?

A

monocytes and macrophages (phagocytes) & lymphocytes (immunocytes)

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14
Q

Normal count for thrombocytes (platelets)

A

150,000-400,000

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15
Q

What are platelets made of? Where are they produced & stored?

A

irregularly-shaped cytoplasmic fragments formed by the fragmentation of megakaryocytes

Produced in BM and stored in the spleen where they are slowly released

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16
Q

Platelets are incapable of ______ d/t no nucleus or DNA. This means lifespan of? Removed by?

A

mitotic division
lifespan of 5-9 days
removed by spleen

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17
Q

Platelets also have _______ that secrete biochemical mediators when stimulated by ______. What are these pro-inflammatory mediators?

A
  • granules
  • simulated by injury to blood vessel
  • ADP, ATP, calcium, serotonin, histamine
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18
Q

What is the link b/w the hematologic and immune system?

A

lymphoid organs

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19
Q

Primary lymphoid organs?

A

BM and thymus

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20
Q

Secondary lymphoid organs?

A

spleen, lymph nodes, tonsils, Peyer patches of the small intestine

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21
Q

Largest lymphoid organ and its function?

A

spleen

  • site of fetal hematopoiesis
  • filters/cleans blood
  • mounts immune response
  • blood reservoir
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22
Q

Lymph nodes = first encounter b/w?

A

lymphocyte and antigen

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23
Q

macrophages reside in lymph nodes and…

A
  • filter the lymph of debris, foreign substances, and microorganisms
  • provide antigen-processing functions
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24
Q

What is hematopoiesis?

A

the process of blood cell (all) production in adult BM or in the liver and/or spleen of the fetus (mostly in spleen)

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25
Q

Two stages of hematopoiesis?

A

MITOSIS (PROLIFERATION) = stimulation of pluripotent cells that are similar to divide by mitosis

MATURATION (DIFFERENTIATION) = then become mature hematological cells

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26
Q

BM is also called?

A

MYELOID TISSUE (where hematopoietic stem cells are)

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27
Q

Red BM does what? Yellow BM does what?

A

Red produces RBCs, Yellow does not produce RBCs

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28
Q

A common myeloid progenitor cell can become…

*remember common myeloid vs. common lymphoid progenitor

A
  • megakaryocte –> thrombocytes
  • erythrocyte
  • mast cell
  • myeloblast (basophil, neutrophil, eosinophil, monocyte/macrophage)
29
Q

To become an RBC you go from common myeloid progenitor to _______ and then what?

Process of erythropoiesis

Where does EPO enter this scenario?

A

common myeloid progenitor to erythroid progenitor!

erythroid progenitor + EPO (ERYTHROPOIETIN) = committed proerythroblast (blast on the end means it’s committed to becoming that line)

erythroid progenitor –> committed proerythroblast –> normoblast (nucleus shrinks and is reabsorbed) –> reticulocyte (cell leaves BM and enters bloodstream) –> erythrocyte (cell achieves final shape and size; hemoglobin synthesis ceases)

*Remember as it loses its intracellular components it is also producing hemoglobin

30
Q

See hematopoiesis chart process slide 16

How many RBCs are stored? How much storage for granulocytes, and thrombocytes?

A

…No RBCs are stored, so ALL are functional

  • 50% stored, 50% functional WBCs (granulocytes)
  • 30% stored, 70% functional platelets (thrombocytes)
31
Q

FACTORS THAT INCREASE HEMATOPOIESIS (rem. this is development of ALL blood cells)

A
  • conversion of yellow BM (does not produce blood cells) to red BM by actions of EPO
  • faster differentiation of progenitor cells
  • faster proliferation of stem cells into progenitor cells
32
Q

Erythropoiesis maturation is stimulated by…what does it stimulate stem cells to form?

A

ERYTHROPOIETIN

  • STIMULATE STEM CELLS TO FORM PROERYTHROBLAST, WHICH ARE COMMITTED INTO PRODUCING ERYTHROID CELLS
  • THIS PROCESS PROMOTES RELEASE OF RETICULOCYTES

*in each step of erythropoiesis, the quantity of hemoglobin increases and the nucleus decreases in size

33
Q

Hormone released from the kidney in response to low renal oxygenation? What is it NOT released by?

Where is this also produced in small amounts?

A

ERYTHROPOIETIN (EPO)

  • it is NOT released by the number of RBCs but rather oxygen delivery
  • also produced in the liver (10%)
34
Q

The RBC production increases within _______ after EPO release? EPO lifespan? Increases RBCs in how many days?

A

production increases w/i 24 hours; lifespan of EPO is 4-12 hrs (short half life) for this reason might have to give dialysis or chemo pts several times/wk

-causes increased RBC number in 5 days

35
Q

EPO IS ALWAYS PRESENT IN THE _______

A

PLASMA

36
Q

Reticulocytes contain what? Make up what % of total RBCs? How many days after leaving the BM does it become a mature RBC?

A

contains polyribosomes (globin synthesis) and mitochondria (heme synthesis)

  • 1 to 2 days after leaving the BM matures into RBC and loses polyribosomes/mitochondria
  • make up about 1-2% of total RBCs
37
Q

Indicates whether new RBCs are being produced, and is a good indicator of erythropoiesis. What percent of total RBCs?

A

RETICULOCYTE COUNT

-which is normally 1-2% of total RBCs

38
Q

See slide 22…

A

negative feedback!

39
Q

Oxygen-carrying protein of the erythrocyte

A

hemoglobin

40
Q

A single erythrocyte contains as many as ______ hemoglobin molecules

A

300

41
Q

each hgb molecule has…

A

2 PAIRS of globin chains & 4 complexes of iron + heme

42
Q

what is heme? where is it synthesized?

A

large, flat, iron-protoporphyrin disk that is synthesized in the mitochrondria and can carry ONE MOLECULE OF OXYGEN

43
Q

Each heme can carry _____ molecule of oxygen….so there are _____ heme groups on one molecule of hgb, so one molecule of hgb can carry ______ molecules of O2

A

each heme can carry 1 molecule of O2, and since there are 4 heme groups on each molecule of hgb then it can carry 4 molecules of O2

44
Q

The most common globin chain found in hemoglobin?

A

Remember each hgb molecule has 2 pairs of polypeptide globin chains

Most common is Hgb A: 2 alpha and 2 beta chains

*for this course just understand that there are different chains, but don’t need to understand different types

45
Q

mature RBC includes what on the inside?

A

no nucleus, no mitochondria, only HGB and some enzymes surrounded by a membrane

46
Q

Since RBCs do not have mitochondria, they rely on what for energy?

A

glycolysis

47
Q

Deficiencies in two enzymes can cause anemias?

A

G6PD - involved in protecting RBC from oxidative stress

Pyruvate kinase - necessary for glycolysis - absence will result in damage to RBC

48
Q

What is an old RBC called?

A

senescent (old)

49
Q

What digests the old RBC?

A

macrophages in the spleen

50
Q

When an old RBC is broken down what happens to iron?

A

Iron IS LIBERATED FROM HEME, OXIDIZED AND RECYCLED (TRANSFERRIN TO FERRITIN)

51
Q

Process of bilirubin production and secretion of old RBC

A

Porphyrin of heme is metabolized to bilirubin – transported to liver and conjugated – excreted
as bile into intestine – transformed to urobilinogen – excreted with feces, some through kidneys

52
Q

Production of RBCs regulated by? How much produced and destroyed daily?

A

EPO

-1% produced/day and around 1% destroyed/day

53
Q

Normal hematocrit level for M & F?

A

M = 45%, W = 40%

% volume of blood that is RBCs

54
Q

Normal HGB levels M & F?

A

15-16 (male) gm Hb/100 mL blood

13-14 (female) gm Hb/100mL blood

55
Q

Around 67% of total body iron is bound to…

A

heme in RBCs (hemoglobin) and muscle cells (myoglobin)

56
Q

____mg of iron is required daily for erythropoiesis; ____mg of iron is dietary. The remainder is obtained from iron recycling

A

25mg of iron is required daily; 1-2mg of iron is dietary, and the remainder is obtained from iron recycling

57
Q

The major intracellular IRON STORAGE PROTEIN? Where is it produced?

A

FERRITIN - produced in the intestines

58
Q

TRANSFERRIN IS ________. What does it do? Where does it travel?

A

Transferrin is the iron bound to apotransferrin (precursor)

  • It TRANSFERS IRON in the circulation
  • IRON FOR HEMOGLOBIN PRODUCTION IS CARRIED BY TRANSFERRIN TO THE BM WHERE IT BINDS TO TRANSFERRIN RECEPTORS ON ERYTHROBLASTS
59
Q

What is apotransferritin? Where is it secreted from?

A

ferritin w/o attached iron (precursor)

liver secretes apotransfeerrin and then it binds with free iron and becomes trasnferrin

60
Q

See picture slide 33

A

…

61
Q

Iron absorption from where in the intestines? Around what amount?

A

duodenum and upper jejunum 1-1.5mg/day

62
Q

Iron absorption is enhanced by?

A

meat, poultry, fish

HCl

citrus also increases

63
Q

Iron absorption is inhibited by?

A

carbonates, tannate (tea), oxalate (spinach, rhubarb), phosphates (vegetables), clay

64
Q

menstruating women lose how much iron/period?

A

14mg/period on average

Lose on average 60mL of blood

65
Q

_____ secretes apotransferrin

A

liver

66
Q

Remember difference b/w apotransferrin and apoferritin

A

…

67
Q

see slide 35

A

…

68
Q

excess iron goes to

what is the stored form of iron called?

A

liver & BM where apoferritin becomes ferritin

*Hemosiderin (stored form of iron): small quantity (excess iron) collects in cells (insoluble/water
soluble)

Advanced Patho UC Exam #2 (5 decks)

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