[2] Lecture 14-blood And Hemostasis Flashcards
(119 cards)
1
Q
Blood is ___ % of the body’s weight
A
8
2
Q
Ph range of blood
A
7.35-7.45
3
Q
Blood - formed elements [calls/PLTs] =
A
Plasma
4
Q
Plasma w/o blood-clotting proteins:
A
Serum
5
Q
3 layers in heparinized and centrifuges blood:
A
Supernatant
Buffy coat
Precipitate
6
Q
Supernatant
A
Plasma
7
Q
Buffy coat
A
Leukocytes
8
Q
Precipitate
A
Sedimented red blood cells
9
Q
Average male blood stats
A
5-6 L
44-54% formed elements
47% hematocrit
10
Q
Average Female blood stats
A
4-5 L
38-48% formed elements
42% hematocrit
11
Q
3 types of blood proteins:
A
Fibrinogens
albumins
Globulins
12
Q
Made in liver
Function in blood clotting
Target for thrombin
A
Fibrinogen
13
Q
Made in liver
Exert major osmotic pressure on blood vessel walls
A
Albumin
14
Q
Immunoglobulins
A
Globulins
15
Q
Hormone that increases # of RBC-erythrocytes
A
Erythropoietin
16
Q
4-5 x10^3/µL in males
3.5-5x10^3/µL in females
A
Norm RBC count
17
Q
What organ produces erythropoietin?
A
Kidney
18
Q
RBC are devoid of:
A
Granules and organelles
19
Q
Major contents of RBCs:
A
Lipids, ATP, Carbonic anhydrase, hemoglobin
20
Q
Proteins in RBCs:
A
50% are integral membrane proteins
Spectrin and actin are peripheral proteins
21
Q
RBC have been useful for studying what?
A
Cortical cytoskeleton
22
Q
Why’re RBC membranes and proteins easily isolated?
A
No nucleus or organelles
23
Q
Principal determinant of cell shape in RBC?
A
Cortical cytoskeleton
No cytoskeletal components
24
Q
Major structural protein in RBCs and is a member of the calponin family of actin-binding proteins.
A
Spectrin
25
This is a tetramer of 2 polypeptide chains, alpha and beta.
Ends of the tetramers asso. W/ short actin filaments
Spectrin
The asso. Results in spectrin-actin network.
26
Links the spectrin-actin network and the plasma membrane by binding to spectrin and a transmembrane protein [band 3]
ankyrin
27
Another link that binds spectrin-actin junctions and the transmembrane protein glycophorin
Protein 4.1
28
Difference btw ankyrin and protein 4.1:
Protein 4.1 links glycophorin
Ankyrin links to band 3 [anion transport channel w/ HCO3-
29
Protein 4.1 can also be called:
Beta sheet domain
30
Polymorphonuclear leukocytes (PMNs)
Neutrophils
31
```
7-9µm
3-5 nuclear lobes
Active amoeboid
phagocytes
Granulocyte containing lysozyme and other proteases and elastase and myeloperoxidases
```
Neutrophils
32
How long do neutrophils stay in circulation? After circulation?
10-12 hours in circulation
| 1-2 days out of circulation in tissue [out circulation]
33
How is neutrophil capable of destroying bacteria?
Secretion of enzymes by forming free radicals [superoxides] and release of lysozyme and lactoferrin [which destroy bacterial walls
34
What is the point of the nucleus of the neutrophil?
Barb= tells that it is female neutrophil. It shows inactive X chromosome.
Named after patient "barb" it was first noticed.
35
```
7-9 µm
Bilobed
Large, membrane-bound granules
Contains: serotonin, heparin, kallikrein
Can produce leukotrienes
```
Basophils
36
Heparin
Anticoagulant
37
Kallikrein
Attracts eosinophils
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What do leukotrienes do?
Increases vascular permeability
Slow contraction of smooth muscles
39
```
9-10µm
Bilobed nucleus
Respond to allergic rxn and parasites
Phagocytize antibody-antigen complexes and parasites
3 specific granules:
```
Eosinophil
40
3 specific granules for eosinophils:
Major basic protein (MBP)-parasite disruption
Peroxidase
Cationic protein: neutralizes heparin and anti-parasitic effect
41
Eosinophil is stained: color?
W/ eosin- stained
Pink.
Lighter than basophils
42
Large round sometimes slightly indented nucleus, fills most of cell
Variation in size from 6-18µm-small, medium, large
B and T
Lymphocytes
43
Precursor of plasma cell
B lymphocyte
44
Precursor of T lymphocyte.
T lymphocyte
45
How do T and B lymphocyte differ on microscope slide?
Cant distinguish difference
46
```
Largest leukocyte
9-12µM
Eccentrically located: one side of the cell
Kidney shaped nucleus
Granular cytoplasm d.t small lysosomes
Precursor of macrophages and osteoclasts
```
Monocytes
47
2µM
200,000-400,000 /mL of blood
Enhance aggregation by release of factors, and they promote clot formation, retraction,and dissolution
Platelets
48
Dervied from megakaryocytes
PLT's
49
How do platelets repair damage to endothelium?
By forming platelet plug
50
Adhesion of PLT involves:
Integrins
51
PLT release _____to increase PLT aggregation:
Thromboxane
52
Endothelial cells secrete ______ which decreases PLT aggregation
Prostacyclin
53
The elimination of bleeding
Hemostasis
54
Where does most effective mechanisms for hemostasis occur in vasculature?
Small vessels: capillaries, arterioles, and venules
55
Accumulation of blood in tissues
Hematoma
56
Hemostasis sequence of events:
1. constriction of vessel smooth muscle
2. constriction of vessels
3. slowing of blood
4. formation of PLT plug
5. blood clotting (coagulation)
57
Notable characteristic that intimates formation of PLT plug:
Injury to endothelial lining exposing the underlying collagen fibers
58
What do PLT's adhere to?
Exposed collagen fibers.
59
What is the chemical rxn that occurs in the PLT plasma membrane?
PLT release contents of their secretory vesicles, including ADP and cause conversion of arachidonic acid to thrombaxane A2
60
Sure her stimulates PLT aggregation
Thromboxane A2
61
ADP and other factors cause the PLT's to:
to aggreagate to form plug
62
A plasma protein, released from weibel-palate bodies in endothelial cells that facilitate the adherence of PLT's to the walls of the damaged blood vessel.
Von willebrand factor
63
Releases von willebrand factor
Weibel-palade bodies
64
Where is prothrombin and fibrinogen found?
In the blood of all norm individuals. It is in inactive form.
65
What activates prothrombin
Factor XII
66
What activates factor XII is activated ?
Contact w/ collagen in the damaged vessel.
67
Active form of prothrmbin
Thrombin
68
What catalyzes the conversion of fibrinogen to fibrin?
Thrombin
69
A mesh-work in which PLT's, blood cells, and plasma become entrapped to form the actual clot
Fibrin
70
Where is fibrinogen formed?
Liver
71
Fibrin mesh work forms in the presence of _______
Factor XIII
72
What activates factor XIII
Thrombin
73
Are Factor number sequential?
No they were numbered as they were discovered
74
Fibrinogen is split into a number of polypeptides by
Thrombin
75
Fibrinogen polypeptides are then chemically linked y the enzymatic action of:
Factor XIII
76
Dissolution of fibrin clots through activation of ___________________ and ___________
And what is this process called?
Plasminogen activator system ; Action of plasmin
This is called fibrinolysis
77
Produced by injured endothelial cells:
Tissue plasminogen activator
| T-Pa
78
t-Pa plays role in plasminogen activator system
Converts inactive plasmimnogen into enzymatic form plasminogen.
79
T-pa is activated by endothelial cell and by
Fibrin- so fibrin actually initiates its own destruction
80
What 2 substances dissolve clot?
Plasmin and t-PA
81
What event initiates the clotting process?
The activation of prothrombin to thrombin
82
Why is it called cascade?
Sequential activation of inactive proteins into active enzymes
83
Typically initiated by endothelium of the blood vessel exposing collagen fibers
Everything necessary for it to occur is already within the blood, including Ca+, req'd as a cofactor for many of the sequential steps in the clotting cascades.
LOCAL DAMAGES to endothelial surface
Intrinsic pathway- in the blood.
84
Involves the formation of tissue factor (thromboplastin or Factor III)
Activated by physical trauma
Extrinsic pathway
85
A membrane bound lipoprotein exporessed at sites of cell injury;
Derived from the plasma or organelle membranes of damaged cells in the disrupted tissue and enters into circulating blood.
Thromboplastin
86
Beginning of intrinsic pathway:
Exposed collagen fibers leads to activation of Factor XII (hageman factor)
87
Steps in intrinsic pathway:
1. Exp. collagen
2. Factor XII activation
3. Factor XI and kallikrein activation by XII
88
Involved in the formation of bradykinin and in the kinin cascade and in the conversion of plasminogen to plasmin
Kallikrein
89
Increases vascular permeability
Bradykinin
90
Can activate and feedback more hageman factor [factor XII]
Kallikrein
91
Thrombin involved in activating:
Factor XI and factor VIII
92
Factor XI activates
Factor IX
93
Factor IX combines w/ activated factor VIII and Ca+ to activate:
Factor X
94
Factor VIII is activated by:
Thrombin
95
What ion is needed in intrinsic pathway ?
Ca++
96
Steps of extrinsic pathway:
1. Damaged cell membrane release thromboplastin in blood
2. Thromboplastin activates factor VII
3. Factor VII and Ca+ activate factor X
97
Extrinsic and intrinsic lead to activation of what factor?
Factor X
98
Factor X + Factor ___ + ___+ = activated prothrombin
V; Ca++
99
Factor V is activated by
Thrombin
100
What factor is thrombin?
Factor II
101
Thrombin and Ca++ activates:
Fibrin and Factor XIII
102
Which factor is necessary in the cross-linking of fibrin polymers to stabilize the fibrin gel?
Factor XIII
103
Where are most clotting factors synthesized?
Liver
104
Vitamin k is necessary for which clotting factors (3):
VII, IX, X,
105
_____________ is activated by various cytokines released by mast cells, PLT's, and damaged tissue cells.
Homing mechanism
106
___ is released by endothelial cells and increases vascular permeability
NO
107
Leukocytes must do what to be involved in homing mechanism?
Leave laminar flow and move toward the endothelium of the vessel wall
108
What're the 2 phases involving cellular adhesion molecules:
Selectin and integrin phase
109
What is on exterior of leukocyte for binding during homing mechanism?
Sialyl lewis-x antigens [oligosaccharide ligands]
They bind to p-selectin binding on endothelial cell surface
110
Steps of selectin phase in leukocyte extravasation
1. Sialyl lewis-x antigen binds to selectin on cell surface.
2. These oligosaccharides bind to CRD on p-selectins
3. Binding of ligands to p-selectins causes leukocytes to roll along endothelium
111
P-selectins on endothelial cell surface and bind to oligosaccharides of leukocyte (sialyl lewis-x antigens) are activated by:
Inflammatory signaling
112
Leukocyte extravasation integrin phase:
1. Integrins are activated on leukocyte membrane
- -bind to ICAM-1and2 on endothelial cells
2. Integrins ß1 and ß2 are activated on leukocyte membrane
- -bind to VCAM and ICAM on endothelial cell membranes
3. Integrins interacting w/ endothelial ligands promote the transendothelial migration of leukocytes.
113
Antibody induced hemolytic disease in the newborn that is caused by blood group incompatibility btw mom and fetus
Erythroblastosis fetalis
114
Incompatibility occurs when fetus inherits RBC antigenic determinants that're foreign to the mother ___ and ___ blood group antigens are of particular interest.
ABO and Rh
115
The major cause of Rh incompatibility
D antigen
116
Why does erythroblastosis fetalis no occur during 1st pregnancy?
IgM is produced- too large to cross the placenta [to harm fetus].
During 2nd preg, B cells have formed IgG response to D antigen which can cross the placenta.
117
Rh _______ mothers are given anti-D globulin soon after delivery of an Rh ______ baby.
Neg; pos
118
_____________________ mask the antigenic sites on the fetal RBCs that may have leaked into the maternal circulation during childbirth.
Anti-D antibodies
119
Hemolysis in erythroblastosis fetalis results in:
- Hemolytic anemia which causes hypoxic injury to the heart and liver
- jaundice which causes damage to the CNS
- hyperbilirubinemia
