Lecture 08 Flashcards
6 steps of regulation of erythropoiesis
less hemoglobin available for O2 transport
reduced supply of O2 to kidney
increase production& release of erythropoietin
increase production of erythrocyte precursors in the bone marrow
increase discharge of young erythrocyte/ reticulocyte in bone marrow
more hemoglobin for O2
5 steps of general pattern of hematopoiesis
pluripotent stem cell
erythropoietin stimulate proliferation of committed stem cell/ myeloid stem cell/ RBC precursor
erythropoietin accelerate maturation of committed stem cell/ myeloid stem cell/ RBC precursor
reticulocyte
mature RBC
hormonal effect on hematopoiesis
testosterone
increase release erythropoietin
increase sensitivity of RBC precursor to erythropoietin
estrogen
opposite effect
process of destruction of RBC
recognized as old RBC, removed from circulation at the level of spleen& liver by macrophage
macrophage engulf w/ pseudopod, use enzyme to break down component, recycle useful material
where does 3 main componenet of hemoglobin go
globin
AA pool, reuse to make protein
Fe
transferrin pick up Fe, allow move safely in circulation, carry to liver/ spleen/ wall of gut for storage, attach to ferrin at these region, when need again, pick up by transferrin
heme
convert to bilirubin, slightly yellow- plasma is pale yellow
convert to biliverdin in liver- bile is green
most secrete into gastrointestinal tract with bile- feces dark color
3 cause of jaundice
neonatal jaundice in baby: excess RBC got from mother, excess hemolysis, more heme to recycle, more bilirubin
liver damage: not able to process bilirubin, not able to move to intestine
bile duct obstruction(eg.gall stone): lock the path for bile to move
what is relative polycythemia
decreased plasma V
2 types absolute polycythemia
physiological
higher O2 need/ lower O2 availability
eg.high altitude, increased physical activity, chronic lung disease, heavy smoking
pathological
tumor of cells producing EPO
unregulated RBC production by bone marrow
eg.polycythemia vera due to stem cell dysfunction
3 problem of polycythemia
increase blood viscosity, slow blood flow, more blood clot
classification on morphologic of RBC
size: microcytic, normocytic, macrocytic
color: hypochromic, normochromic, hyperchromic
3 classification on etiologic
diminished production
ineffective maturation
increased RBC destruction/ reduced RBC survival
3 types of diminished production
aplastic/ hypoplastic anemia
normocytic, normochromic
stimulation failure anemia
normocytic, normochromic
iron deficiency anemia
microcytic, hypochromic
etiology of pernicious anemia
stomach removed/ vitamin B12 deficiency/ do not have intrinsic factor to prevent vitamin B12 destroy in gastric acid& carry through to the ileum at end of small intestine
2 types ineffective maturation
maturation failture anemia
macrocytic, normochromic
pernicious anemia
macrocytic, normochromic
3 types of hemolytic anemia& eg
abnormal RBC membrane structure(eg.hereditary spherocytosis)/
abnormal enzyme system/
abnormal Hb structure(eg. sickle cell disease镰刀性贫血, thalassemia地中海贫血)
