Blood Lecture 1 / Ch 4 Red Blood Cells Flashcards Preview

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Flashcards in Blood Lecture 1 / Ch 4 Red Blood Cells Deck (35)
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1
Q

Symptoms of Polycythemia Vera?

A
  • Night Sweats
  • Itching after hot bath
  • Splenomegaly
  • Plethora (Facial Redness)
  • Hemorrhage or thrombosis
  • Blurred Vision
  • HTN
2
Q

Prognosis for pts with PV is ?

A

10 - 16 yrs

3
Q

Anemia

A

Hgb in males < 13

Hgb in females < 11

4
Q

Symptoms of Anemia ?

A
  • Dyspnea
  • Weakness
  • Pale
  • Palpitations
  • Headaches
  • Sluggishness

Older Population:

  • Cardiac Failure
  • Angina pectoris
  • Confusion
  • Claudication (Impaired blood
    flow) in the legs
5
Q

Treatment for Anemia ?

A
  • Increase RBC in circulation
  • Administration of recombiant
    Erythropoietin
6
Q

Site in which O2 binds to Hgb?

A

Heme molecule

7
Q

The exchange of O2 and CO2 occurs approximately how many times in the average life span of a RBC?

A

200,000

8
Q

Affinity definition

A

tendency to bind, hold, pick up or to release O2

9
Q

↑ CO2
↓ Ph ( Increased H+ content)

This occurs in metabolically active tissues, what can we expect of Hgb affinity?

A

Hgb would have less affinity for O2

10
Q

↓ CO2
↑ Ph (Decrease H+ content)

This occurs in the lungs, what can we expect of Hgb affinity?

A

Hgb would have an increase in affinity for O2

11
Q

Bohr effect definition

A

The influence of pH and CO2 on Hgb’s affinity to bind and to release O2

12
Q

Hgb concentrations for:

  • Females
  • Males
  • Newborns
A
  • Females : 12-16
  • Males 13.5-18
  • Newborns 15-24
13
Q

4 phases of fetal hemoglobin development.

A
  1. Gower I
  2. Gower II
  3. Portland
  4. Hgb F
14
Q

How do adult and fetal Hgb differ?

A

Hgb F is designed to extract O2 from maternal cells at the placenta. They have a greater affinity for O2 than Hgb A.

15
Q

Hgb Alpha polupeptide chains contain how many amino acids?

A

141

16
Q

Hgb Bravo polupeptide chains contain how many amino acids?

A

146

17
Q

HgbS = Sickle-cell anemia

A

– Predominantly among
African American
– Causes hemolysis

18
Q

HgbF Present from ?

A

G4 to 6mo old

19
Q

Heterozygous individuals for HgbS

A

Asymptomatic

20
Q

Homozygous individuals for HgbS

A

They have 2 defective genes that code for the Hgb molecule.

21
Q

HgbS results from what?

A

Substitution of the amino acid VALINE by GLUTAMIC ACID in position 6 in the beta chain.

22
Q

What causes the sickle shape of the cell?

A

HbS transports O2 normally but deoxyhemoglobin S crystallizes and takes on the classic sickle shape.

23
Q

Complications caused by HgbS?

A
  • Discomfort
  • Joint Pain
  • Retinal degeneration
  • Ulcerations of lower legs
  • Infarctions of organs: Spleen and Liver.
  • Priapism
24
Q

Thalassemias

Individuals whose Hgb molecues show production of only 1 type of polypeptide chain.

A
  • Genetic disorders in the production of α or β Hgb polypeptide chains
  • Prevalent in persons with
    Mediterranean or Asian
    ancestry.
  • Low Hgb
  • Fatigue
25
Q

Individuals that produce only Alpha chains is said to have what?

A

Beta Thalassemias

minor

26
Q

Individuals that produce only Beta chains is said to have what?

A

Alpha Thalassemias
(major)
- Blood transfusions required

27
Q

2,3 DPG
AKA
2,3 (diphosphoglycerate)

A
- Produced by the breakdown 
  of glucose.
- Allows Hgb to release O2 to 
  the tissues more easily. 
- Reversible storage Lesion 
- Bound 1:1 to Hgb
28
Q

Hct index of the RBC in adults.

A

Males: 38 - 54%
Females: 38 - 46%
Infants: 55-68%

  • This means that 38 - 54% of whole blood in a male is made up of red cells.
29
Q

A transfusion of 1 unit of packed red cells would change the Hct by how much?

A

0.03 - 0.04

3 - 4%

30
Q

When a Red cell ruptures, Hgb is released as what?

A

Plasma-Free-Hemoglobin

PFH

31
Q

Generally PFH is metabolized in the liver into primarily what?

A

Bilirubin by the Kupfer Cells (macrophages)

32
Q

In blood plasma, haptoglobin binds free hemoglobin (Hb) released from erythrocytes with high affinity and thereby inhibits its oxidative activity.Plasma Haptoglobin can bind the first 100 mg PFH / 100 ml of blood (safe solution)
• Once Haptoglobin is over whelmed, PFH diffuses into
tissues and renal tubules
If 300-500 ml blood is hemolyzed, what can we expect?

A
  • Jaundice
  • Renal failure
  • CV collapse
  • Decreased ABP
  • Renal tubules blockage by precipitation of Hgb.
33
Q

Adult Female Hgb / Hct

A

12 - 16 - 38 - 46

34
Q

Adult Male Hgb / Hct

A

13.5 - 18 - 38 - 54

35
Q

Infant Hgb / Hct

A

15 - 24 - 55 - 68