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PHARM 111 > Blood > Flashcards

Blood Flashcards

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1
Q

What is included in the formed elements of blood? (3)

A
  1. Erythrocytes/RBCs
  2. Leukocytes/WBCs
  3. Platelets
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2
Q

What is the Buffy coat and what percentage of blood volume does it take up?

A

Buffy coat = leukocytes and platelets

makes up <1% of whole blood

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3
Q

What is hematocrit and what can it be used for?

A

The level of RBCs in the whole blood

Can be used to determine oxygen carrying capacity

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4
Q

What are the main physical characteristics of blood?

A
  1. Colour varies between scarlet and dark red
  2. pH = 7.35-7.45
  3. Temperature = 30 degrees C
  4. Accounts for ~8% of body weight
    - -> 5-6L for males, 4-5L for females
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5
Q

What is the main component of blood plasma?

A

90% water

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6
Q

Other than water, what makes up blood plasma?

A

6-8% proteins

2-3% other (organic solutes, electrolytes and gasses)

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7
Q

What is the most common protein found in blood and what does it do?

A

Albumin –> 60%

Mainly contributes to osmotic pressure and can also carry proteins

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8
Q

What is the second most common type of proteins in blood plasma, their subtypes and what do they do?

A

Globulins –> 36%

  1. Αlpha, beta: produced by the liver, binds and transports hydrophobic components
  2. Gamma: antibodies released by plasma cells, come from T cells
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9
Q

What is another word for gamma globulins?

A

Immunoglobulins

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10
Q

What is the least common protein found in blood and what does it do?

A

Fibrinogen –> 4%

produced in the liver and forms fibrin threads of a blood clot

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11
Q

What are the main characteristics of Erythrocytes?

A
  • biconcave disk with resilient and flexible shape
  • anucleate and no organelles
  • filled with Hb to transport O2 (97%)
  • 2.5 um tall and 7.5 um diameter
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12
Q

What is spectrin and what does it do?

A

A tetramer protein linked to the cytoplasmic side of the RBC to allow them to change shape; important in squeezing through tight spaces

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13
Q

How do the structural characteristics of RBCs contribute to their ability to transport gas?

A
  1. Biconcave shape = more surface area to transport
  2. Amount of Hb (97%) = more O2 transporting proteins
  3. ATP generated anaerobically so no O2 is used
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14
Q

How many molecules of O2 can be transported by 1 Hb molecule?

A

4

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15
Q

What is contained in the heme group in Hb protein and what does the heme group do?

A

Heme groups contain an atom of iron which can bind to one O2 molecule (there are 4 heme groups per Hb molecule)

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16
Q

Where are the different phases of RBC production throughout the lifespan? (4)

A
  1. Yolk Sac → blood in ‘islands’ in the yolk sac, no leukocytes
  2. Hepatic/spleen phase → primitive nucleated RBCs, fetal Hb
  3. Bone marrow phase → mature RBCs, leukocytes ~12 weeks
  4. Adult phase → pelvis, vertebrae, skull, ribs, ends of long bones (axial skeleton)
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17
Q

What is the significance of gamma globin chains?

A

They are found in high levels in the fetus because they are “greedy for O2” and must get it from the mother → after birth they are no longer required because the baby can breathe on its own

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18
Q

What is erythropoiesis and what are the three phases?

A

Erythropoiesis = creation of RBCs

Phase 1: ribosome synthesis

Phase 2: Hb accumulation

Phase 3: Ejection of nucleus

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19
Q

What is required for Erythropoiesis?

A
  • proteins
  • lipids
  • carbohydrates
  • iron
  • Vitamin B12
  • folic acid (vitamin B9)
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20
Q

Where is iron stored in the body?

A

In hemoglobin (65%) → liver, spleen, bone marrow

Intracellular iron → protein iron complexes; ferritin, hemosiderin

Circulating iron → loosely bound to protein transferrin (in blood stream)

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21
Q

What are the steps in the regulation of erythropoiesis? (6)

A
  1. Low O2 in blood stimulates kidneys to produce EPO (erythropoietin)
  2. EPO levels rise
  3. EPO and other materials promote Erythropoiesis in red bone marrow
  4. New RBCs enter bloodstream; live for ~120 days
  5. Aged/damaged RBCs engulfed by macrophages
  6. Raw materials made available in blood for RBC synthesis
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22
Q

What is Bilirubin?

A

A molecule broken down from the Heme group of Hb; picked up in the blood from the liver, secreted into small intestine in bile, metabolized to stercobilin by bacteria and excreted in feces

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23
Q

What are some of the symptoms associated with anemia?

A
  • fatigue
  • paleness
  • shortness of breath
  • chills
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24
Q

What are the three types of anemia resulting from insufficient levels of RBCs?

A
  1. Hemorrhagic anemia → result of acute or chronic blood loss
  2. Hemolytic anemia → prematurely ruptured RBCs
  3. Aplastic anemia → destruction or inhibition of red bone marrow
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25
What are the two types of anemia caused by decreased Hb content?
1. Iron-deficiency anemia → could be caused by not eating enough iron-filled foods, inability to absorb iron properly, or secondary result of hemorrhagic anemia 2. Pernicious anemia → Vitamin B12 deficiency
26
What are the treatments for pernicious anemia?
Intramuscular injection of B12, application of Nascobal
27
What causes sickle cell anemia?
Defective gene coding; point-substitution mutation in the beta chain of Hb (Glu 6 → Val)
28
What is the result of sickle cell anemia?
In low O2 concentrations, Hb aggregates and the cell will become sickle shaped, rigid and lose elasticity; this could cause a block in vessels and interrupt delivery of O2
29
What is the life expectancy for a sickled red blood cell?
20 days (the normal life span is ~120)
30
What is polycythemia and what would its effect be on the hematocrit?
An increase in the proportion of blood volume occupied by RBCs Hematocrit would be larger
31
What is the difference between absolute and relative polycythemias?
Absolute → increase in the mass of RBCs (actually more cells) Relative → decrease in the volume of plasma (could be from dehydration)
32
What are the two main types of absolute polycythemias?
1. Primary (also polycythemia vera) 2. Secondary (elevated EPO by natural or blood doping)
33
What is leukocytosis?
WBC count over 11,000 cells/um Indicator of infection in the body
34
What are the types of WBCs/Leukocytes and which are most abundant?
Neutrophils - most abundant (50-70%) Lymphocytes - (25-45%) Monocytes - (3-8%) Eosinophils - (2-4%) Basophils - least abundant (0.5-1%)
35
Which WBCs are the granulocytes and which are the agranulocytes?
Granulocytes: Neutrophils, Eosinophils, and basophils Agranulocytes: Lymphocytes and monocytes
36
What are some of the characteristics of granulocytes?
* contain cytoplasmic granules that stain acidic, basic, or both * larger and shorter lived than RBCs * Lobed nuclei * Phagocytic cells
37
What does a neutrophil look like and what does it do?
They contain both acidic and basic staining granules so they look pale in a histological slide, they have a multi-lobed nucleus → slays bacteria
38
What are the funtional proteins contained in Neutrophils?
Peroxidases, hydrolytic enzymes and defensins (antibiotic-like proteins)
39
What is Extravasion?
Process of a neutrophil leaving the bloodstream to combat bacteria
40
What does an eosinophil look like and what does it do?
Has acidic, red staining granules and a bilobed nucleus → combat multicellular parasites and help control mechanisms of allergy and asthma
41
What does a basophil look like and what does it do?
Has basic, dark staining granules and a multi-lobed U or S shaped nucleus → vasodilator and attracts other WBCs to an area
42
What are the granules made of in a basophil?
Histamine (inflammatory chemical)
43
What does a lymphocyte look like?
Dark purple spherical nucleus with thin cytoplasm
44
What are the types of lymphocytes?
1. T cells → function in the immune response 2. B cells → make plasma cells that produce antibodies
45
What does a monocyte look like and what does it do?
These are the largest leukocytes and they have a kidney shaped nucleus → they differentiate to macrophages when they leave circulation, highly mobile, can activate lymphocytes
46
What is diapedesis?
The process of a cell leaving the blood circulation
47
What does a platelet look like and what does it do?
Cell fragments with no nucleus, contain granules, mitochondria, glycogen and cytoskeleton → make blood clots
48
What are the types of granules in a platelet and what do they contain?
Αlpha granules → clotting factors containing serotonin, Ca2+, enzymes, ADP and platelet-derived growth factor (PDGF) Dense core → histamine
49
What keeps platelets inactive?
NO and prostacyclin (PGI2 - prostaglandin I2)
50
What is leukopoiesis and what stimulates it?
Leukopoiesis = production of leukocytes Stimulated by interleukins and colony stimulating factors (CSFs or CFUs) to produce WBCs in the bone marrow
51
What are the three steps in Hemostasis?
1. Vascular spasm 2. Platelet plug formation 3. Coagulation
52
What are the three stimuli that would cause a vascular spasm?
1. Direct injury to vascular smooth muscle 2. Chemicals released by endothelial cells and platelets 3. Reflexes from local pain receptors
53
What is the role of CD39?
reduces ADP to AMP so that it does not activate platelets
54
What is the role of vWF?
vWF = von Willebrand factor Increases bond of platelet plug by binding to both collagen and platelets
55
What chemicals to the platelets release once bound to collagen?
ADP, serotonin, and thromboxane A2
56
What is the role of serotonin and TxA2 in platelet plug formation?
Stimulate vasoconstriction, reducing blood flow to wound
57
What is the role of ADP and TxA2 in platelet plug formation?
Causes all of the platelets to be sticky and attach to each other
58
What are the three steps of coagulation?
1. Prothrombin activator formed 2. Prothrombin converts to thrombin 3. Thrombin catalyzes joining of fibrinogen into fibrin mesh
59
What complexes together to form prothrombin activator?
Factor X, Ca2+, platelet factor 3 (PF3- phosphatidylserine), and factor V
60
What happens when thrombin is in the presence of Ca2+?
Activates factor XIII → cross links fibrin, strengthens and stabilizes the clot
61
What triggers the activation of the intrinsic pathway?
Vessel endothelium ruptures which exposes collagen
62
What triggers the extrinsic pathway?
Tissue cell trauma exposes blood to tissue factor (TF)
63
Explain the steps of the intrinsic pathway in terms of mobilization of factors
1. XII becomes activated 2. Activated XII activates XI 3. Activated XI, Ca2+, and activated VII activates IX 4. Activated IX, PF3 and VIII make a complex 5. The complex activates factor X 6. Factor X, Ca2+, PF3 and factor V activate prothrombin
64
Explain the steps of the extrinsic pathway of coagulation in terms of mobilization factors
1. Tissue Factor, Ca2+ and factor VII makes a TF/VII complex 2. Complex activates factor X 3. Factor X, Ca2+, PF3 and factor V activate prothrombin
65
What are the steps in clot repair?
1. Fibroblasts form a connective tissue patch 2. Platelet derived growth factor (PDGF) stimulates rebuilding of blood vessel wall 3. Vascular endothelial growth factor (VEGF) stimulates endothelial cells to grow and repair lining
66
What mechanisms stop clots from becoming too large?
Removal of clotting factors and inhibition of activated clotting factors
67
What inhibits thrombin activity and how?
FIBRIN → anticoagulant which prevents thrombins positive feedback effects and its ability to speed up the production of prothrombin activator (by factor V)
68
What inactivates thrombin that is not absorbed?
antithrombin III and heparin
69
What prevents platelet adhesion?
* Smooth endothelial lining of blood vessels * Heparin, NO, and PGI2 (secreted by endothelial cells) * Vitamin E quinone (potent anticoagulant)
70
What is a thrombus and what are the implications?
Thrombus = clot that develops and persists in an unbroken blood vessel → can block circulation causing cell death
71
What is the name for a clot that develops and persists in the vessels of the heart?
Coronary thrombosis
72
What is an Embolus and what are some different types?
Embolus = freely floating thrombus in the blood stream Pulmonary emboli → can impair the ability of body to obtain O2 Cerebral emboli → can cause strokes
73
What is hemophilia and what are the differences between types A, B and C?
Hemophilia = hereditary bleeding disorder caused by lack of clotting factors A → deficiency of factor VIII (most common - 83%) B → deficiency of factor IX C → deficiency of factor XI
74
What is the most mild type of hemophilia and why?
Type C → not likely to effect the fast acting extrinsic pathway
75
What are the characteristics of RBC glycoprotein antigens?
They are: 1. unique to the individual 2. recognized as foreign if transfused into another individual 3. promotes agglutination and are referred to as agglutinogens
76
What is the difference between agglutinogens and agglutinins?
Agglutinogens are the antigens on the surface of RBCs Agglutinins are the antibodies floating in the plasma \*the anti-A and anti-B antibodies will be found where their corresponding antigens are not (Anti-A antibodies are found in the B blood type with the B antigens)
77
What happens when an Rh- individual receives Rh+ blood? What happens on second exposure?
First exposure → anti-Rh antibodies form (they do not form spontaneously) Second exposure → transfusion reaction
78
What does RhoGAM do?
Prevents an Rh- mother from becoming sensitized while pregnant with an Rh+ baby → it binds to RBCs and prevents problems from blood mixing
79
What happens during a transfusion reaction?
* Donor's cells attacked by the recipients agglutinins causing: * diminished O2 carrying capacity * clumped cells that impede blood flow * ruptured RBCs release Hb into bloodstream → precipitates into kidneys causing renal failure

PHARM 111 (5 decks)

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