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PHARM 111 > Blood > Flashcards

Blood Flashcards

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
Q

What are the two types of anemia caused by decreased Hb content?

A
  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
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26
Q

What are the treatments for pernicious anemia?

A

Intramuscular injection of B12, application of Nascobal

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27
Q

What causes sickle cell anemia?

A

Defective gene coding; point-substitution mutation in the beta chain of Hb (Glu 6 → Val)

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28
Q

What is the result of sickle cell anemia?

A

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

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29
Q

What is the life expectancy for a sickled red blood cell?

A

20 days (the normal life span is ~120)

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30
Q

What is polycythemia and what would its effect be on the hematocrit?

A

An increase in the proportion of blood volume occupied by RBCs

Hematocrit would be larger

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31
Q

What is the difference between absolute and relative polycythemias?

A

Absolute → increase in the mass of RBCs (actually more cells)

Relative → decrease in the volume of plasma (could be from dehydration)

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32
Q

What are the two main types of absolute polycythemias?

A
  1. Primary (also polycythemia vera)
  2. Secondary (elevated EPO by natural or blood doping)
33
Q

What is leukocytosis?

A

WBC count over 11,000 cells/um

Indicator of infection in the body

34
Q

What are the types of WBCs/Leukocytes and which are most abundant?

A

Neutrophils - most abundant (50-70%)

Lymphocytes - (25-45%)

Monocytes - (3-8%)

Eosinophils - (2-4%)

Basophils - least abundant (0.5-1%)

35
Q

Which WBCs are the granulocytes and which are the agranulocytes?

A

Granulocytes: Neutrophils, Eosinophils, and basophils

Agranulocytes: Lymphocytes and monocytes

36
Q

What are some of the characteristics of granulocytes?

A
  • contain cytoplasmic granules that stain acidic, basic, or both
  • larger and shorter lived than RBCs
  • Lobed nuclei
  • Phagocytic cells
37
Q

What does a neutrophil look like and what does it do?

A

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
Q

What are the funtional proteins contained in Neutrophils?

A

Peroxidases, hydrolytic enzymes and defensins (antibiotic-like proteins)

39
Q

What is Extravasion?

A

Process of a neutrophil leaving the bloodstream to combat bacteria

40
Q

What does an eosinophil look like and what does it do?

A

Has acidic, red staining granules and a bilobed nucleus → combat multicellular parasites and help control mechanisms of allergy and asthma

41
Q

What does a basophil look like and what does it do?

A

Has basic, dark staining granules and a multi-lobed U or S shaped nucleus → vasodilator and attracts other WBCs to an area

42
Q

What are the granules made of in a basophil?

A

Histamine (inflammatory chemical)

43
Q

What does a lymphocyte look like?

A

Dark purple spherical nucleus with thin cytoplasm

44
Q

What are the types of lymphocytes?

A
  1. T cells → function in the immune response
  2. B cells → make plasma cells that produce antibodies
45
Q

What does a monocyte look like and what does it do?

A

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
Q

What is diapedesis?

A

The process of a cell leaving the blood circulation

47
Q

What does a platelet look like and what does it do?

A

Cell fragments with no nucleus, contain granules, mitochondria, glycogen and cytoskeleton → make blood clots

48
Q

What are the types of granules in a platelet and what do they contain?

A

Αlpha granules → clotting factors containing serotonin, Ca2+, enzymes, ADP and platelet-derived growth factor (PDGF)

Dense core → histamine

49
Q

What keeps platelets inactive?

A

NO and prostacyclin (PGI2 - prostaglandin I2)

50
Q

What is leukopoiesis and what stimulates it?

A

Leukopoiesis = production of leukocytes

Stimulated by interleukins and colony stimulating factors (CSFs or CFUs) to produce WBCs in the bone marrow

51
Q

What are the three steps in Hemostasis?

A
  1. Vascular spasm
  2. Platelet plug formation
  3. Coagulation
52
Q

What are the three stimuli that would cause a vascular spasm?

A
  1. Direct injury to vascular smooth muscle
  2. Chemicals released by endothelial cells and platelets
  3. Reflexes from local pain receptors
53
Q

What is the role of CD39?

A

reduces ADP to AMP so that it does not activate platelets

54
Q

What is the role of vWF?

A

vWF = von Willebrand factor

Increases bond of platelet plug by binding to both collagen and platelets

55
Q

What chemicals to the platelets release once bound to collagen?

A

ADP, serotonin, and thromboxane A2

56
Q

What is the role of serotonin and TxA2 in platelet plug formation?

A

Stimulate vasoconstriction, reducing blood flow to wound

57
Q

What is the role of ADP and TxA2 in platelet plug formation?

A

Causes all of the platelets to be sticky and attach to each other

58
Q

What are the three steps of coagulation?

A
  1. Prothrombin activator formed
  2. Prothrombin converts to thrombin
  3. Thrombin catalyzes joining of fibrinogen into fibrin mesh
59
Q

What complexes together to form prothrombin activator?

A

Factor X, Ca2+, platelet factor 3 (PF3- phosphatidylserine), and factor V

60
Q

What happens when thrombin is in the presence of Ca2+?

A

Activates factor XIII → cross links fibrin, strengthens and stabilizes the clot

61
Q

What triggers the activation of the intrinsic pathway?

A

Vessel endothelium ruptures which exposes collagen

62
Q

What triggers the extrinsic pathway?

A

Tissue cell trauma exposes blood to tissue factor (TF)

63
Q

Explain the steps of the intrinsic pathway in terms of mobilization of factors

A
  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
Q

Explain the steps of the extrinsic pathway of coagulation in terms of mobilization factors

A
  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
Q

What are the steps in clot repair?

A
  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
Q

What mechanisms stop clots from becoming too large?

A

Removal of clotting factors and inhibition of activated clotting factors

67
Q

What inhibits thrombin activity and how?

A

FIBRIN → anticoagulant which prevents thrombins positive feedback effects and its ability to speed up the production of prothrombin activator (by factor V)

68
Q

What inactivates thrombin that is not absorbed?

A

antithrombin III and heparin

69
Q

What prevents platelet adhesion?

A
  • Smooth endothelial lining of blood vessels
  • Heparin, NO, and PGI2 (secreted by endothelial cells)
  • Vitamin E quinone (potent anticoagulant)
70
Q

What is a thrombus and what are the implications?

A

Thrombus = clot that develops and persists in an unbroken blood vessel → can block circulation causing cell death

71
Q

What is the name for a clot that develops and persists in the vessels of the heart?

A

Coronary thrombosis

72
Q

What is an Embolus and what are some different types?

A

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
Q

What is hemophilia and what are the differences between types A, B and C?

A

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
Q

What is the most mild type of hemophilia and why?

A

Type C → not likely to effect the fast acting extrinsic pathway

75
Q

What are the characteristics of RBC glycoprotein antigens?

A

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
Q

What is the difference between agglutinogens and agglutinins?

A

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
Q

What happens when an Rh- individual receives Rh+ blood? What happens on second exposure?

A

First exposure → anti-Rh antibodies form (they do not form spontaneously)

Second exposure → transfusion reaction

78
Q

What does RhoGAM do?

A

Prevents an Rh- mother from becoming sensitized while pregnant with an Rh+ baby → it binds to RBCs and prevents problems from blood mixing

79
Q

What happens during a transfusion reaction?

A
  • 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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