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Physiology > The RBC > Flashcards

The RBC Flashcards

1
Q

The biconcave shape of a RBC functions to do what 3 things?

A
  • Maximize SA
  • Maximize gas diffusion
  • squeeze through sinusoids
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2
Q

Where is the blood produced in the following stages of life:

a. middle trimester
b. last month of gestation
c. birth to 5 years
d. >20 years

A

a. liver/spleen
b. bone marrow
c. all bones
d. vertebrae, sternum, ribs, ilium

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3
Q

Where is RBC produced in an adults? (4)

A
  • vertebrae
  • sternum
  • ribs
  • ilium
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4
Q

What is the primary stimulator of erythropoiesis?

A

EPO

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5
Q

Where is EPO produced?

A

kidney

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6
Q

What are reticulocytes?
How many days do they spend in the bone marrow?
How many days do they circulate in blood before they mature?

A
  • immature RBCs
  • stays in bone marrows 3 days
  • circulates in blood stream for 1 day before maturing
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7
Q

What % of circulating RBCs are reticulocytes?

A

1%

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8
Q

How long are erythrocytes in circulation for?

How are they recycled?

A
  • 90 to 120 days

- Macrophages in the spleen filter out the RBC and recycle the iron and heme

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9
Q

How much blood needs to be made every day to maintain homeostasis?

A

1%

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10
Q

If i start with a HCT of 40 and today I stop making RBCs in 1 month what will my HCT be?

A

HCT = 28

  • 30 days* 1% per day = 30% lost
  • 30% of 40 = 12
  • 40-12 =28
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11
Q

What is the reticulocyte count in men vs premenopausal women?

A
  • men = 1.5%

- pm women = 2.5%

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12
Q

What causes secretion of EPO?

A

-decreased tissue oxygenation in the kidney

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13
Q

What 2 places is EPO produced?

A
  • liver: 10%

- kidney: 90%

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14
Q

What is the 3 step process of EPO secretion?

A
  • peritubular epithelial hypoxia
  • increases transcription of HIF-1
  • increases transcription of EPO
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15
Q

Maximum EPO production occurs within how much time?

How about maximum increase in RBC production?

A
  • 24 hrs

- 5 days

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16
Q

What 3 diseased states might increase EPO secretion? (3)

A

-COPD, smoking, MI

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17
Q

What diseased state might decrease EPO secretion? (1)

A

chronic kidney disease

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18
Q

What are the 3 functions of RBC?

A
  • pH buffer
  • CO2 transport
  • O2 transport
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19
Q

1 HgB molecule is comprised of what?

A
  • 4 heme molecules

- 4 hemoglobin chains

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20
Q

Each HgB molecule can bind to how many oxygen molecules?

A

4 O2 molecules

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21
Q

HgB affinity is affected by what 2 things?

A
  • temperature

- pH

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22
Q

What type of HgB allows fetal red cells to bind with greater affinity O2 molecules?

A

HgB F

23
Q

What type of HgB replaces HgB F after birth?

A

HgB A

24
Q

What change in the amino acid change results in a hemoglobin S molecule?

A

glutamine acid -> valine

25
Q

Carries to this disease are resistant to malaria and to coronary heart disease.

A

B-Thalassemia

26
Q

How does RBC act as a pH buffer?

A

by converting CO2 into HCO3-

27
Q

How does HgB F help in sickle cell disease?

A

it decreases the production of HgB S which decreases the probability of the cells deforming and becoming sickle.

28
Q

Why is there no HgB formation in mature erythrocytes?

A

Erythrocytes have no nucleus

29
Q

The vast majority of total body iron is stored in what?

A

HgB

30
Q

How much iron does a normal person hold in the body?

A

4-5 grams

31
Q

Iron is transported by what protein?

A

transferrin

32
Q

What is the simple storage form of iron?

A

ferritin

33
Q

What happens to the greater % of daily iron intake?

A

excreted in feces

34
Q

What molecule is responsible for the regulation of iron uptake?

A

hepcidin

35
Q

On average normal iron loss is greater in male or female?

A

female

36
Q

Abnormal iron loss can occur in what 3 situations?

A
  • hemolysis
  • acute blood loss
  • chronic blood loss
37
Q

In iron deficiency anemia what are the RBC characteristics?

A

microcytic, hypochromic

38
Q

Deficiency in what 2 vitamins leads to flimsy, large RBCs that are prone to rupture?

A
  • Vitamin B12

- Folate

39
Q

What molecule is necessary for the absorption of vitamin B12?

A

intrinsic factor

40
Q

For vitamin B12 deficiency to be clinically evident how many years of decreased absorption is necessary?

A

1-4 yrs

41
Q

Where can we obtain folate from?

A

green leafy vegetables

42
Q

RBCs usually self destruct in what organ?

A

spleen

43
Q

when a RBC dies the porphyrin ring is converted into what?

A

bilirubin

44
Q

What are 5 causes of microcytic anemia?

A
  • thalassemia
  • anaemia of chronic disease (ACD)
  • iron deficiency anemia
  • lead poisoning
  • sideroblastic anaemia
45
Q

What are the 4 reasons of normocytic anemia?

A
  • acute blood loss
  • bone marrow failure
  • Chronic disease
  • Destruction (hemolysis)
46
Q

What is the most common cause of macrocytic anemia?

A

Vitamin B12/folate deficiency

47
Q

What type of anemia might present as pancytopenia?

A

aplastic anemia

48
Q

What reading is important in distinguishing between vitamin b12 and folate deficiency?

A

methylmalonic acid will be higher in vitamin b12 deficiency

49
Q

what type of anemia is usually a result of inflammation?

A

ACD

50
Q

Secondary polycythemia (aka erythrocytosis) is a result of what?

A

increase in RBCs in response to prolonged hypoxia

51
Q

Primary polycythemia (aka polycythemia vera) is a result of what?

A

increase production of erythrocytes due to a neoplastic disorder.

52
Q

What lab count is necessary to first diagnose polycythemia?

A

a hematocrit >50%

53
Q

If there is a normal red cell volume but an elevated hematocrit what is the most common etiology?

A

dehydration

Physiology (4 decks)

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