Blood

Question 1

Describe the composition of blood (with percentages)

Answer 1

Plasma 55%
Buffy coat <1%
Erythrocytes 45%

Question 2

What are the features of albumin?

Answer 2

Globular protein
Synthesised in the liver
Plasma concentration of 35-50mg/ml
19 day half life
60% of plasma

Question 3

What is the function of albumin?

Answer 3

Maintains oncotic pressure
Controls pH
Binding and transport

Question 4

What are the components of plasma (with percentages)?

Answer 4

Albumin 60%
Globulins 35%
Fibrinogen 4%
Other 1%

Question 5

What are globulins and the types?

Answer 5

Antibodies and transport proteins
Alpha 1, alpha 2, beta and gamma

Question 6

What are agglutinogens?

Answer 6

Specific proteins located on the RBC wall (basis for blood group classification)

Question 7

What are agglutinins?

Answer 7

Plasma antibodies that act against agglutinogens not present on a persons own RBCs

Question 8

What percentage of the population are of each blood type?

Answer 8

A 42%
B 10%
AB 4%
O 44%

Question 9

What blood types can Type a recieve?

Answer 9

A/O

Question 10

What blood types can type B recieve?

Answer 10

B/O

Question 11

What blood types can Type AB recieve?

Answer 11

They are the universal recipient

Question 12

What blood type can Type O receive?

Answer 12

Only O

Question 13

What does rhesus group mean?

Answer 13

Rhesus group positive types have the rhesus antigen on the RBCs
(More common in the west than in Asia or Africa)

Question 14

What is the function of fibrinogen?

Answer 14

Basically a clotting factor

Question 15

Where do all blood cells arise from?

Answer 15

Haematopoietic stem cells

Question 16

Where are blood cells produced?

Answer 16

Bone marrow

Question 17

What is the process of blood cells differentiating called?

Answer 17

Haematopoiesis

Question 18

Which types of white blood cells are derived from myeloblasts?

Answer 18

Basophils
Neutrophils
Eosinophils
Monocytes

Question 19

What are the two responses of a transfusion reaction?

Answer 19

Humoral
Acute haemolytic

Question 20

What happens in the haemolytic disease of the newborn?

Answer 20

If a rhesus negative mother is pregnant with a rhesus positive child
When there is exposure of the foetus red blood cells to the mothers red blood cells, the mothers body produces rhesus positive antibodies
Then when pregnant again with a rhesus positive child, the mothers immune system attacks the child

Question 21

What symptoms does the child have if they have haemolytic disease of the newborn?

Answer 21

They are small and anaemic

Question 22

What are the steps in primary haemostasis?

Answer 22

Damage to blood vessel wall
Vasoconstriction
Platelets adhere to the wall and become activated
Platelets release their granules (cont. platelet activators, coagulation factors, vasoconstrictors)
Platelet plug forms

Question 23

What are the steps in secondary haemostasis?

Answer 23

Due to coagulation cascade fibrin cross linking occurs

Question 24

When is tranexamic acid used to prevent the inhibition of clots forming?

Answer 24

Trauma management
Post partum haemorrhage

Question 25

Define clot

Answer 25

General term for mass of coagulated blood

Question 26

Define thrombus?

Answer 26

Formation of a blood clot in life and in situ

Question 27

Define embolus

Answer 27

Detached intravascular material that is carried from origin to distant site

Question 28

What are the three components of Virchow’s triad

Answer 28

Stasis Vessel wall injury Hypercoagulability

Question 29

What is factor V Leiden?

Answer 29

It’s a thrombophilia (hyoercoagulable state) Results from a mutant form of factor 5 resistant to protein C So factor 5 isn’t degraded so increased risk of thrombosis

Question 30

What is antiphospholipid syndrome?

Answer 30

It’s an autoimmune condition causes thrombophilia Can be primary or secondary depending on whether there is a secondary condition

Question 31

Compare and contrast arterial and venous thromboses

Answer 31

Arterial due to endothelial injury - venous due to stasis Arterial is high pressure and high stress - venous is low pressure and low flow Arterial is a platelet rich thrombus - venous is a red blood cell rich thrombus Arterial adheres to the vessel wall - venous is loosely attached and friable

Question 32

How does the wells score work?

Answer 32

Add up the points, if 1 or under then not likely of deep vein thrombosis, if 2 or above dvt is likely

Question 33

What does it mean if d-dimer levels are increased?

Answer 33

D-dimer is the substance that breaks down clots so if it is increased it’s because there is a high quantity of clots that need to be broken down

Question 34

What can cause a false positive of d-dimer test?

Answer 34

Liver disease, inflammation, malignancy, trauma, pregnancy, recent surgery, advanced cancer

Question 35

What is a pulmonary embolism?

Answer 35

A blockage of an artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream

Question 36

What are the presenting symptoms of pulmonary embolus?

Answer 36

Dyspnoea (difficulty breathing) Tachypnoea (rapid breathing) Pleuritic chest pain (stabbing pain in chest) Cough Haemoptysis (coughing up blood) Collapse Sudden death

Question 37

What does the plasma do?

Answer 37

Transports nutrients, hormones, metabolic waste Regulates pH, body temperature, cell water content Reservoir for substances such as water/electrolytes

Question 38

What are the features of albumin?

Answer 38

Globular protein Synthesised in the liver 19 day half life

Question 39

What are the features of albumin?

Answer 39

Globular protein Synthesised in the liver 19 day half life