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Hematology > Unit 6 - Red Cell Structure & Physiology > Flashcards

Unit 6 - Red Cell Structure & Physiology Flashcards

1
Q

Size of RBC

A

7-9 um

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2
Q

RBCs can squeeze through small micro vessels as small as ___ in the spleen

A

3 micrometers

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3
Q

For normal function, the RBC structure must have

A

1) Intact, functioning membrane
2) Normal internal metabolism
3) No nucleus for repairs

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4
Q

RBC membrane structure components

A

Lipid Bilayer
Protein layers that transverse lipids
Protein cytoskeleton

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5
Q

Components of the lipid bilayer

A

Cholesterol
Phospholipids

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6
Q

Phospholipids composed of hydrophobic and hydrophilic parts

A

Hydrophobic tails - Interior
Hydrophilic heads - exterior

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7
Q

How much cholesterol on lipid bilayer is in proportion to plasma cholesterol

A

in equilibrium with plasma cholesterol

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8
Q

Components of proteins that transverse the lipid bilayer

A

Glycophorins
Band 3 protein

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9
Q

Glycophorin types

A

A, B, C

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10
Q

Three domains of the types of glycophorins

A

Cytoplasmic - Interior
Hydrophobic - Middle
Extracellular - Exterior

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11
Q

Where is glycophorin C in the membrane of the RBC?

A

Outside, its heavily glycosylated

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12
Q

What do extracellular glycophorins do

A

Carry RBC antigens
Negative charge (Zeta potential) that keeps RBCs apart

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13
Q

What does Band 3 protein do

A

Anion exchange protein 1
Channel for chloride <–> bicarbonate (CO2 exchange)

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14
Q

Components of membrane cytoskeleton

A

Spectrin
Ankyrin
Actin
Tropomyosin
Bands 4.1, 4.2, 4.9

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15
Q

Where is the RBC Cytoskeleton

A

Underneath the lipid bilayer

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16
Q

What does the RBC cytoskeleton do

A

Maintain RBC shape
Pliability to squeeze through capillaries and survive turbulence

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17
Q

What is the main protein of the cytoskeleton

A

Spectrin

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18
Q

What is spectrum composed of

A

alpha and beta chains twisted together

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19
Q

What is the shape of spectrin

A

Arranged in lattice of hexagons to allow it to recoil like a spring

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20
Q

Where is spectrin and what holds it there?

A

Attached to the bilipid layer by ankyrin and band 4.2

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21
Q

What does ankyrin do

A

Anchors spectrin

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22
Q

Another name for ankyrin

A

Band 2.1

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23
Q

What do actin and tropomyosin do

A

Muscle like filaments that stabilize RBC cytoskeleton

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24
Q

What do Bands 4.1, 4.2, 4.9 do

A

help with stabilization

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25
Q

Deformability of RBC depends on

A

1) Biconcave shape
2) Viscosity of internal solution (mostly hgb)
3) Elastic properties of RBC membrane

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26
Q

What does the lipid bilayer rely on for repair?

A

Plasma lipids

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27
Q

What does an increase of plasma lipids do to RBC

A

Changes the membrane

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28
Q

What are typical shape changes due to plasma lipids

A

Codocytes (target)
Acanthocytes (spur)

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29
Q

Anions and water flow freely across the membrane via what structures?

A

Protein band 3
Water channel protein

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30
Q

What do cations require for permeability?

A

Cation pump and ATP

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31
Q

What do cation pumps do

A

Sodium pumped out
Potassium drawn in

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32
Q

What are the main cation pumps in RBC membrane

A

Na/K
Ca-ATPase

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33
Q

Are calcium and magnesium intracellular or extracellular?

A

Intracellular

34
Q

What occurs if the cation pump fails?

A

Sodium builds up in the cell
Water accumulates in cell
Sphere shape
Hemolysis

35
Q

What is the cause of cell pump function decreasing

A

insufficient ATP from insufficient glucose metabolism

36
Q

Erythrocyte function in addition to O2 and CO2 transport

A

Membrane permeability to maintain ion balance
Buffer function of hgb via bohr effect
Bicarb formation and dissociation into carbonic acid and hydrogen

37
Q

Requirements for function of RBC

A

Energy supply
Membrane integrity
Normal hgb
Pyridine nucleotides (NAD/NADH)

38
Q

How do RBCs generate ATP?

A

Glycolysis

39
Q

What do pyridine nucleotides do

A

Prevent oxidant injury
Reduce methemoglobin to hemoglobin

40
Q

Red Cells perform their function without

A

Nucleus
Mitochondria
Protein synthesis

41
Q

Red cells are totally dependent on ___ for energy

A

Plasma glucose

42
Q

Red cells use oxygen to generate ATP

A

False, only anaerobic glycolysis

43
Q

When RBCs are chemically damaged, how are they repaired?

A

RBC enzymes

44
Q

Major categories of RBC metabolism

A

Glycolysis –> ATP
NAD/NADH metabolism to reduce methemoglobin
Leubering Rapoport Shunt

45
Q

Two different glycolysis pathways for RBC ATP generation

A

Embden Meyerhoff Pathway
Hexose Monophosphate Shunt

46
Q

Two NAD/NADH metabolism routes for RBC metabolism

A

Hexose Monophosphate Shunt
Methemoglobin Reductase Pathway

47
Q

Anaerobic glycolysis for energy

A

Embden Meyerhoff Pathway
Hexose Monophosphate Shunt

48
Q

90% of cellular glucose processed using which pathway?

A

Embden Meyerhoff Pathway

49
Q

Glycolytic Pathway (embden meyehoff)

A

Glucose–>Pyruvate–> Lactate
ATP generated for energy
NADH generated for methemoglobin reduction

50
Q

Why is NADH important?

A

Methgb is oxidized hgb when exposed to Oxygen
Methgb can’t carry oxygen so reversal is important

51
Q

What generates NADH?

A

G-6PD

52
Q

5-10% of cell’s glucose processed through

A

Hexose monophosphate shunt

53
Q

Hexose monophosphate shunt produces

A

NADPH2

54
Q

NADPH function

A

Converts oxidized glutathione to reduced glutathione
Reduced glutathione neutralizes oxidation

55
Q

Methemoglobin Reductase Pathway

A

Enzyme takes NADH and reduces methemoglobin

56
Q

Diseases/Drugs that interfere with the methemoglobin reductase pathway cause what?

A

Cyanosis

57
Q

Leubering Rapoport Shunt

A

Generates 2,3 DPG
Needed for hgb to exchange oxygen

58
Q

G6PD deficiency

A

Glutahtione can’t be generated
Hgb is oxidized
Hgb denatures –> Heinz bodies –> removed by spleen

59
Q

What inclusion is associated with G6PD deficiency?

A

Heinz Bodies

60
Q

What stain allows us to see Heinz bodies

A

Supravital

61
Q

How much of hgb is methemoglobin normally

A

Normal for 2% of hgb to become methgb per day

62
Q

Without enzyme, how much does methemoglobin build up to?

A

20-40%

63
Q

Pyruvate kinase deficiency

A

Pyruvate can’t be converted to lactate
Less ATP generated
RBC weak (cation pumps)
Hemolytic anemia ensues

64
Q

WHy do infants get slight anemia after birth?

A

High RBC counts because Hypoxic in utero
High oxygen after birth –> low EPO
Slight anemia until EPO recovers

65
Q

Why do males have higher RBC counts

A

Testosterone magnifies EPO effect

66
Q

What hormones have an effect of EPO

A

Thyroid
Pituitary
Adrenals

67
Q

Chemical signal for senescence to phagocytes

A

Exposure of phosphatidylserine on RBC surface

68
Q

Extravascular hemolysis is what percent of normal destruction

A

90%

69
Q

Intravascular hemolysis is what percent of normal destruction

A

10%, old RBCs

70
Q

Where does most extravascular hemolysis take place

A

In spleen by phagocytes
also in marrow by phagocytes

71
Q

Hgb made up of

A

Heme + Globins

72
Q

Heme made up of

A

Iron and protoporphyrin ring

73
Q

Globins made up of

A

Amino acids

74
Q

HEme recyclin

A

Fe –> Transferrin –> marrow
Porphyrin ring –> bilirubin + urobilinogen

75
Q

Haptoglobin

A

Picks up free hemoglobin to prevent loss through kidneys

76
Q

Where does haptoglobin take hgb

A

Back to the liver for processing, same as extravascular

77
Q

What happens if haptoglobin is consumed and there is still excess free hemoglobin

A

Oxidized to methgb, broken down to heme + globin

78
Q

Hemopexin

A

Carries heme to liver for processing

79
Q

If hemopexin is all used up, what carries heme in its place?

A

Albumin, forms methemalbumin until hemopexin is produced

80
Q

IF hemolysis is beyond normal capacity, where is it going to go?

A

Hemoglobin shows up in urine

81
Q

Hemosiderinuria

A

when IV hemolysis sever, iron laden renal tubule cells can slough off
Stain cells in urine sediment with Prussian blue
Better indicator of sever IV hemolysis than hgb in urine

Hematology (12 decks)

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