Test 3 Study Guide Part 2 Flashcards

1
Q

Hematopoiesis:

  • Define:
  • origin in early fetus:
A
  • Define:
    Production of any blood cell type (leukocytes, rbcs, platelets)
  • origin in early fetus:
    Yolk sack
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2
Q

Myeloid tissue:

  • define:
  • Where is it located?
A
  • define:
    The tissue in which hematopoiesis occurs in the adult (it is part of the bone marrow)
  • Where is it located?
    Ribs, skull, pelvis, spine, upper ends of humerus and femer
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3
Q

Lymphocytes are produced in the bone marrow, but that is not the only place they can amplify, explain.

A

The original cells differentiate within the bone marrow. Immune stimulation can cause mitotic division in the lymphoid tissue (lymph nodes, tonsils, spleen, thymus)

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4
Q

Comparative survival rates of granular vs agranular leukocytes:

A

Agranular: 100 - 300 days
Granular: 12 hrs - 3 days

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5
Q

What organ produces Erythropoietin?
In response to what?
What is the acronym for Erythropoietin?

A

Kidney (kidney disease can cause anemia because of this)
Low oxygen levels (high altitude is a common one, so is anemia)
EPO

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6
Q

Methods for blood doping:

- Why is blood doping dangerous

A

Erythropoietin
Take EPO long before race. Take some blood. Freeze it. Centrifuge it before race, inject it into your arm.
- Why is blood doping dangerous?
It spikes your hematocrit so high that you’re at risk of blood becoming overly thick

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7
Q

Thrombopoietin (TBO) and thrombocyte regulation:

A

Liver predominantly produces thrombopoietin but the kidney’s help.
They produce thrombopoietin at a constant rate.
Both thrombocytes and the megakaryocytes have receptors for TBO.
When thrombocyte levels are low, less TBO is bound to thrombocytes and more is able to enter the bone marrow and stimulate megakaryocytes.
Conversely when thrombocyte levels are high less TBO is available to enter bone marrow, and megakaryocytes will not be be stimulated, causing platelet levels to drop.

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8
Q

Leukopoiesis:

  • Regulation:
  • Two important factors:
A
  • Regulation:
    Is complex an regulated by many cytokines
  • Two important factors:
    G-CSF: granulocyte colony-stimulating factor
    GM-CSF: granulocyte/monocyte colony stimulating factor
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9
Q

Why are antigens called antigens?

A

Antibody generating (antigens)

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10
Q

The two arms antibody can lead to clumping. What is the term for clumping?

A

Agglutination

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11
Q

What are the four types of the ABO system?

A

A (A antigen)
B (B antigen)
AB (AB antigen)
O (A=no antigen)

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12
Q

Forward blood-typing:

- reagents:

A

Antibody against antigen A is added to one sample of blood
Antibody against antigen B is added to another sample of blood
If both solutions agglutinate: genotype AB
If A has RBC agglutinate: A_ (where _ cannot be B)
If B has RBC agglutinate: B_ (where _ cannot be A)
if neither clots: OO

reagent anti-A antiserum (antibodies against antibody A)
reagent anti-B antiserum (antibodies against the B antigen)

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13
Q

Reverse blood typing is done how?

A

People will often have antibodies against the ABO antigens that they themselves do not have.
By adding the patients plasma to RBCs known to have A or B antigens and watching for agglutination.

If A agglutinates, the person does not have A antigen
If B agglutinates, the person does not have B antigen
People with OO can theoretically agglutinate both
People with AB will theoretically not agglutinate either RBC

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14
Q

What blood typing decides who you can give plasma to?

A

reverse blod typing.
You can give plasma to anyone as long as the plasma does not have antibodies against that persons ABO antigen type. A type AB can donate plasma to anyone. A type O may only be able to donate plasma to other type Os.

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15
Q

What decides who you can give packed cells to?

A

You can give packed cells to anyone who doesn’t have antibodies against their antigens. AB can receive anytime of packed cells (because they will have antibodies to none of them.

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16
Q

When you test blood cells of the donor against the patients plasma to see if the patients blood has antibodies against the donors RBCs.

A

Major cross match:

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17
Q

What happens if you give blood cells to a patient with antibodies against them?
What is it called?

A

The cells will lyse upon entry.

A transfusion reaction.

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18
Q

transfusion reaction:

- symptom:

A
- symptoms:
pee red due to hemolysis
some agglutination
fever, chills
kidney failure
shock
coagulation abnormalities (clotting in some regions, internal bleeding elsewhere)
Sense of impending doom
sometimes death
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19
Q

Who are the universal donors of packed red blood cells:

Who are the universal recipients of packed red blood cells?

A
Type O (no antigens to be targeted by host antibodies)
Type AB (no antibodies against any potential incoming blood antigen)
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20
Q

Who are the universal donors of plasma:

Who are the universal recipients of plasma:

A
Type AB (no antibodies, so no antigens can be targeted when donated)
Type O (no antigens for incoming plasma antibodies to target)
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21
Q

Explain the Rh system:

A

There is a D antigen (genotypically D and d, where D is dominant for the antigen and d produces no detectable product).
If you have the D antigen you are Rh+, if not you are Rh-.

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22
Q

Can Rh+ blood be donated to Rh- (assuming ABO system compatibility).
Aka are there naturally occurring antibodies?

A

Once. There are no naturally occurring antibodies, and antibodies will only be produced after the first exposure to Rh positive blood.

23
Q

How is D antigen Rh+ detected?

A

Forward typing confirms D_ or dd.

24
Q

Do maternal and fetal RBCs mix?

A

No. Except sometimes at birth when the uterus/placenta tears.

25
Q

Hemolytic Disease of the Newborn:

- explain disease not treatment

A

The mother is Rh- and the baby is Rh+ (or another antigen incompatibility) during her first pregnancy.
During birth the uterus tears, and the mother produces antibodies against the antigens she encounters in the babies blood.
If future babies have these antigens, her antibodies will cross the placental lining and lyse these cells.
The mothers liver will clean out the bilirubin produced while the fetus is in the womb.
Upon birth the babies liver is not adequate to clean up bilirubin, and its conc. will spike potentially causing kernicterus

26
Q

Kernicterus:

A

bilirubin can cross babies BBB. This will cause staining of the brain and neural damage.

27
Q

Treatments for Hemolytic Disease of the Newborn:

A

Phototherapy (treats mild jaundice): baby is put under blue light which breaks down bilirubin to less toxic chemicals in the skin.
Exchange blood transfusion: the babies blood cell type is temporarily switched to O negative. (Donor cells persist for several months, antigens will be gone by then)

28
Q

Prevention of Hemolytic disease of the newborn:

  • What prevents it?
  • How does it work?
A
  • What prevents it?
    RhoGam (anti D antibodies), given at 28 weeks and 72 hours after the incompatible Rh positive baby is born.
  • How does it work?
    Two theories:
  • antigen blocking: you cannot see the antigen because they are covered by RhoGAM antibodies
  • Negative feedback of antibodies to the lymphocytes: anti D antibodies from the RhoGAM signal to the mother to never try to make antibodies because they have already been made
29
Q

If you are sensitized to the D antibody as an Rh negative woman (hemolytic disease of the newborn), can you be desensitized?

A

No.

It’s a permanent condition.

30
Q

What ABO type does a mother usually have is HDN is related to ABO typing?

A

Type O, and she produces antibodies against type A or type B

31
Q

Hemostasis:

A

Stopping of blood flow

32
Q

What allows thrombocytes to recognize that the blood vessel has been breached?

A

Exposure of collagen to the thrombocytes. Normally structural fibers like collagen are behind endothelial cells.

33
Q

Hematoma:

A

Blood escapes into the tissue (a goose egg)

- they go away overtime

34
Q

How long do platelets survive in the plasma?

What removes platelets?

A

5 - 9 days (1 week)

Spleen

35
Q

Vasoconstriction to reduce blood loss:
- Which vessels do not constrict:
-

A
  • Which vessels do not constrict:

All vessels except capillaries

36
Q

Thrombocytopenia:

  • Define:
  • What occurs as a result:
  • Causes:
A
  • Define:
    Low levels of thrombocytes
  • What occurs as a result:
    leaks will occur (integrity and health of the innermost lining of blood vessels (endothelium)
  • Causes:
    Leukemia (causes death of cells within the bone marrow by outcompeting their growth), drug, excessive clotting (uses up thrombocytes)
37
Q

Hapten:

A

a hapten is essentially an antigen but is so small it cannot cause an antibody response. If however it binds to a larger, carrier molecule, then it can be recognized with its carrier molecule and destroyed by the immune system.

38
Q

thrombocytopenia purpura:

A

A thrombocytopenia resulting in a purple coloration

39
Q

Drug induced thrombocytopenia purpura:

A

If the drug is a hapten, it may bind to a platelet making a hapten platelet complex.
This complex can then be targeted and destroyed

40
Q

What is a common drug which causes Drug induced thrombocytopenia purpura:

A

Penicillin

41
Q

Idiopathic thrombocytopenia purpura (ITP):

A

thrombocytopenia purpura of unknown cause

42
Q

Purpura:

A

Bruising

43
Q

Petechia:

A

Little pin prick bleeds

44
Q

Epistaxis:

A

Nose bleed

45
Q

Signs of thrombocytopenia:

A

purpura, petechia, epistaxis

46
Q

Platelets have contractile filaments:

- What are they used for?

A

Shrink the wound.

Clot retraction is caused by these contractile filaments (help brings the skin back together)

47
Q

Aspirin and platelets:

A

Platelets are permanently deactivated by aspirin.

48
Q

What is the primary sealer of breaks in vessel walls?

What does it mean to be the primary sealer?

A

thrombocytes (platelet plug formation)

It means the platelet plug can stop the bleeding, but it won’t be sufficient to keep it stopped.

49
Q

How do you test hemostatic function (how fast platelets will cause clotting):

A

You cut the skin, and use a paper to check whether the blood is fluid. It normally takes 3-5 minutes for clotting to occur.

50
Q

What do endothelial cells secrete and what do they do?

A

Prostacyclin
Nitric oxide
Both act as vasodilators, in addition both inhibit the aggregation of platelets to each other.

51
Q

What do endothelial cells secrete and what do they do?

A

Prostacyclin
Nitric oxide
Both act as vasodilators, in addition both inhibit the aggregation of platelets to each other.

52
Q

CD39:

A

Faces the blood, breaks down ADP in the blood to AMP and Pi (ADP is released by platelets and promotes platelet aggregation)

53
Q

Why do platelets release ADP?

A

To promote platelet aggregation

54
Q

Aspirin inhibits:

A

Cycloxygenase