Week 11 - Blood

Question 1

What percent of body mass is the blood?

Answer 1

8% - 4-6 Litres

Question 2

What are the main proteins in plasma and their percentage?

Answer 2

• Albumin 58%
• Globulins 38%
• Fibrinogen 4%

Question 3

How big is a red blood cell?

Answer 3

8 Microns

Question 4

Give the order of WBC and their percentage within the blood from highest to lowest

Answer 4

Neutrophils - 50-70%
Lymphocytes - 20 - 30%
Monocytes - 2 - 8%
Eosinophils - 2 - 4%
Basophils - < 1%

Question 5

What percent RBC do men and women have?

Answer 5

Men - 40-54%

Women - 38-46%

Question 6

What is polycythemia ?

Answer 6

Too many RBC which increases blood viscosity

Question 7

What BC are derived from the myeloid stem?

Answer 7

Myeloblast - Basophil, neutrophil, eosinophil and Monocyte - macrophage and dendritic cells
Megakaryocyte - Thromboyles
Erythrocytes
Mast cells

Question 8

What BC are derived from the lymphoid stem?

Answer 8

Natural Killer cells

Small Lymphocytes - T-lymphocytes, B lymphocytes- Plasma cells

Question 9

Describe progenitor and precursor cells

Answer 9

Progenitor - won’t undergo further division

Precursor - Undergo more differentiation - not mitosis

Question 10

What are erythropoietin and thrombopoetin associated with?

Answer 10

Erythropoeitin = RBC - Kidney
Thrombopoetin = Platelets - Liver - Increases clotting for chemotherapy patients

Question 11

What are granulocytes used for as supplement?

Answer 11

Increases WBC formation after chemotherapy to support the immune system

Question 12

What does iron overload lead to?

Answer 12

Tissue damage - all tissues - Fe2+ and Fe3+ binds to cells and damages them

Question 13

Describe the globin from RBC death

Answer 13

Globin - amino acids which are reused for protein synthesis

Question 14

Describe heme from RBC death and its metabolism in relation to iron

Answer 14

Fe3+ transferrin - Ferrin stored in the liver- then to the bone marrow via endocytosis and globin and b12 and erythropoietin - erythropoiesis to form new RBC

Question 15

Describe heme from RBC death and its metabolism in relation to bilirubin

Answer 15

Heme - biliverdin - bilirubin in the liver - to the bile duct - bilirubin and bacteria in the small intestine -
Urobillogen to kidneys
Sterobilin to faces

Question 16

Describe erythropoiesis

Answer 16

Pre-cursor cell type - pro erythroblast produce cells to make haemoglobin then -
Reticulocytes which eject nuclei and pass into the blood and from RBC

Question 17

What WBC type is activated by IgE ?

Answer 17

Basophils

Question 18

Describe WBC uses

Answer 18

Mast cell - dilates blood vessels + induces inflammation
Macrophage - phagocytic cell - from blood vessel to tissue
Monocyte - differentiates to macrophages- stored in the spleen and moved to infected area
Neutrophil - first responders
Basophil - Defence against parasites and allergic reaction response
Eosinophil - Release toxins to kill bacteria - cause tissue damage

Question 19

Describe neutrophil migration

Answer 19

Chemotaxis 
Rolling 
L-selection 
Shed and bind to E-selection
Adhesion 
Diapedis

Question 20

Describe the complete blood count and what high / low levels indicate

Answer 20

Neutrophils - 
High - infection 
Low - radiation exposure/ lupus 
Lymphocyte -
High - viral incfection, some leukaemia 
Low - Prolonged illness and immunosuppression 
Monocyte -
High - Viral/fungal infection, TB
Low - Bone marrow suppression 
Eosinophils - 
High - allergic reactions, parasites 
Low - drug toxicity and stress
Basophils - 
High - allergic reactions and leukaemia 
Low - Pregnancy, ovulation and stress

Question 21

Describe platelet formation

Answer 21

Controlled by thrombopoetin

Haemopoetic stem cells - megakaryoblasts - megakaryocytes - platelets

Question 22

What are the three steps for platelet formation?

Answer 22

Activation
Adhesion
Aggregation

Question 23

What is haemostasis?

Answer 23

Vascular spasm
Platelet plug formation
Blood Clotting

Question 24

Describe platelet use and formation of a blood clot upon damage

Answer 24

• Damage to endothelial cells
• Sub epithelial scaffolding occurs
• Collagen and von willeband factor causes platelets to bind and starts activation process
• Secretion by platelets - dense granules, serotonin and ADP - causes morphological changes needed for aggregation and creates cascade so increased activation of platelets
• Fibrinogen helps activation
• Thrombus forms involving thrombin - protease to activate fibrin
• Forms a functional blood clot

Question 25

What are two platelet disorders?

Answer 25

• Bernard- soulier a gene abnormality - Ib/v/IX

- GI anzmann thrombasthenia - IIb/IIIa

Question 26

Describe the intrinsic coagulation cascade

Answer 26

Damage 
- Factor 12 - 12a 
- Factor 12a initiates Factor 11 to 11a 
- Factor 11a initiates Factor 9 to 9a 
- Factor 9a initiates Factor10 to 10a
Common - 10a activates prothrombin to thrombin which activates fibrinogen to fibrin to the blood clot formation

Question 27

Describe the extrinsic coagulation cascade

Answer 27

Damage
Tissue thromboplastin activates factor 10
Common - 10a activates prothrombin to thrombin which activates fibrinogen to fibrin to the blood clot formation

Question 28

Describe vitamin K importance

Answer 28

Important in RBC production and also in cascade involved in activation in factor 10

Question 29

Describe how clots heal damage to tissue

Answer 29

• Fibrin threads attached to the damaged surface of blood vessel contracts as platelets pull on them
• fibrinolysis dissolves clots and disco;ved clots as sites repair
• Inactive plasminogen is incorporated into the clot
• Activated into plasmin by thrombin and + PA
• Plasmin digests fibrin threads and inactivates fibrinogen, prothrombinand FV and FXII

Question 30

Describe the 4 main leukaemia types

Answer 30

Acute lymphoblastic - short onset - lymphoid stem cells found in mainly children
Acute myelogenous leukaemia - all ages
Chronic lymphoblastic leukaemia - adults age 55+
Chronic myelogenous leukaemia - prolonged onset, myeloid stem cells in mostly adults