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Phase 1 From KP notes > Cardiovascular > Flashcards

Cardiovascular Flashcards

(85 cards)

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1
Q

What percentage of the blood is in the cellular phase? What percentage of this are erythrocytes?

A

45% and 99%

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2
Q

What percentage of the blood is in the fluid phase?

A

55%

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3
Q

How many litres of blood do we have?

A

5 litres

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4
Q

What is haemocrit?

A

The percentage of red blood cells in the blood by volume (45% or 0.45)

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5
Q

What is haematopoesis?

A

Process by which red blood cells are created. Continues throughout life

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6
Q

Where does haematopoesis occur in adults?

A

Bone marrow

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7
Q

Where does haematopoesis occur in the foetus?

A

Liver and spleen and other organs

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8
Q

How long do platelets live for?

A

7-10 days

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9
Q

How long do erythrocytes live for?

A

120 days

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10
Q

How long do white blood cells live for?

A

6 hours

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11
Q

Where are the precursor cells of red blood cells located in adults and children?

A

Bone marrow of axial skeleton (skull, neck, thorax and spine) for adults, bone marrow of all bones for children

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12
Q

Describe the locations in which red blood cells are progressively produced in utero

A

Yolk sac, liver, spleen, bone marrow

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13
Q

Are precursor cells found in the blood?

A

No

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14
Q

What is it called when precursor cells are found in the blood

A

Leukaemia

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15
Q

What stimulates precursor stem cells to proliferate and differentiate?

A

Hormonal growth factors

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16
Q

Which hormonal growth factor stimulates
a) red blood cells
b) white blood cells
c) platelets

A

a) EPO (erythropoietin)
b) G-CSF (granulocyte colony stimulating factor)
c) TPO

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17
Q

Which direction will the oxygen dissociation curve shift when
a) pH decreases
b) temperature decreases

A

a) right
b) left

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18
Q

What is a young red blood cell called?

A

Reticulocyte

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19
Q

What does a red blood cell contain?

A

Plasma membrane
Enzymes of glycolysis
Haemoglobin
Cytoplasm

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20
Q

What does haemoglobin do?

A

Carry oxygen from lungs to tissues, where it transfers oxygen to myoglobin in muscles

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21
Q

Describe the structure and function of haemoglobin

A

2 alpha chains
2 beta chains
4 haem groups
Quaternary structure

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22
Q

Describe blood typing

A

Some individuals have the gene that codes for the A antigen on the surface of their erythrocytes (Type A)
Some individuals have the gene for the B antigen (Type B)
Some have the gene for both and these antigens are codominant (Type AB)
Some have the gene for neither (Type O)

Type A = anti-B antibodies in the blood
Type B = anti-A antibodies in the blood
Type AB = neither of these
Type O = anti A and anti B antibodies on the surface of the erythrocytes

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23
Q

Which blood group is the
a) universal donor?
b) universal recipient?

A

a) O
b) AB

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24
Q

Is the O antigen dominant or recessive?

A

Recessive

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25
What type of antibodies are being described when it comes to red blood cells?
Anti-erythrocytes antibodies natural antibodies
26
Why do problems occur when an incompatible blood transfusion is given?
Antibodies (be specific about which ones) in the recipients blood attack the antigens (again, be specific) on the donor's erythrocytes
27
What do Rhesus positive and negative mean?
D antigen is present/ absent
28
What is anaemia?
Reduction in haemoglobin in the blood
29
What is the range of normal haemoglobin values?
12.5-15.5 g/dL
30
What is polycthaemia?
Abnormally high haemoglobin levels
31
What causes polycthaemia?
Smoking, lung diseases, inefficient lungs - less oxygen is exchanged so more haemoglobin is required
32
What are the symptoms of anaemia?
Tiredness, lethargy, malaise, reduced exercise tolerance, shortness of breath on exertion, angina
33
What are the signs of anaemia?
Pallor, pale mucus membranes and palmar creases (pink hands), glossitis (sore tongue), angular stomatitis (cracking at the corners of the mouth), kylonychia (spoon shaped nails)
34
Different types/ classifications of anaemia?
Iron deficiency, B12/ folate deficiency, anaemia of chronic disorder, haemolysis, bone marrow failure/ infiltration
35
Describe why an iron deficiency causes anaemia
Iron is required for haemoglobin production A lack of iron results in the reduced production of red blood cells
36
What is MCV, and what are the normal values?
Mean corpuscular volume Measure of the size of erythrocytes, and 89 +-7 fl (82-96fl)
37
What happens to MCV in an iron deficient anaemic patient?
Decreases to below 80fl
38
What causes iron deficiency anaemia?
Bleeding - Occult gastrointestinal (most common type of bleeding) - Menorrhagia (heavy periods) Dietary - Not enough iron in the diet - Most common cause of iron deficiency anaemia
39
What is macrocytic anaemia, and what causes it?
MCV of erythrocytes is above 100fl (large erythrocytes) It is a symptoms of B12 and folate deficiency - can occur without anaemia (raised MCV and normal haemoglobin levels) and this is caused by liver disease, alcohol and hypothyroidism - vitamin B12 and folate are needed for DNA synthesis - when deficient in them, fewer erythrocytes can be made in the bone marrow - therefore, fewer, larger erythrocytes are released - deficiency affects all dividing cells but bone marrow is active so is affected first
40
What causes B12 deficiency?
Stomach damage - intrinsic factor is required for the absorption of B12 in the terminal ileum - produced by gastric parietal cells in the stomach - damaged stomach means fewer gastric parietal cells - less absorption of B12 - anaemia occurs
41
What is pernicious anaemia?
Autoimmune disease Antibodies made against gastric parietal cells which produce intrinsic factor Less intrinsic factor is produced Less B12 can be absorbed Liver has 4 year store of B12 so slow onset
42
Causes of folate deficiency?
Found in fruit and vegetables - malabsorption due to coeliac disease - not eating enough fruit and veg - increased need due to haemolysis
43
What is haemolysis?
Normal or increased cell production but decreased life span of erythrocytes
44
What are the congenital causes of haemolysis?
Spherocytosis - spherical blood cells - get stuck in blood vessels easily - dominant but variable penetrance Pyruvate kinase deficiency - converts phosphoenolpyruvate to pyruvate - less ATP production - build up of phosphoenolpyruvate G6PD deficiency Sickle Cell Anaemia - sickle shaped erythrocytes become stuck in blood vessels easily Thalassaemia - mutation in haemoglobin chains
45
Acquired caused of haemolysis
Autoimmune - immune system attacks own blood cells - can be triggered by a blood transfusion due to the presence of foreign antibodies Mechanical - fragmentation of erythrocytes by mechanical heart valve or intravascular thrombosis in DIC (disseminate intravascular coagulation) Haemolytic disease of the foetus and newborn
46
What is haemolytic disease of the foetus and newborn?/ Rhesus disease
Mother is rhesus negative but the first child is rhesus positive - mother is exposed to the baby's blood in pregnancy - mother recognises and makes antibodies against the baby's rhesus positive erythrocytes - mother is sensitised to rhesus positive blood - first baby is unaffected as it takes time to produce the antibodies - second rhesus positive baby is affected - antibodies are produced immediately, and destroys the baby's erythrocytes - results in haemolysis of the foetus/ newborn's red blood cells - anaemia and jaundice occur
47
Features of neutrophils: How numerous in comparison to other leucocytes? Lifespan? Which hormone controls rate of production? Function?
Most numerous white blood cell 10 hours Phagocytose and kill bacteria Release - chemotaxins (signal more white blood cells to come to the site) - cytokines (inflammatory response)
48
What is caused by a lack of neutrophils?
Recurrent bacterial infections
49
Functions of B and T lymphocytes?
Immunity Some generate antibodies against specific foreign antigens e.g bacteria and viruses Others are immunological memory - generates immunity and allows vaccination
50
Features of B lymphocytes: Where are they formed? Where are they stored? What is their function?
Made in bone marrow Stored in secondary lymphoid organs Differentiate into plasma cells and produce immunoglobulins when stimulated by a foreign antigen
51
Features of T lymphocytes
Made in bone marrow Mature in thymus Some are CD4 helper cells - help B cells in antibody generation, responsible for cellular or cell mediated immunity Some are cytotoxic cells (CD8) - T killer cells
52
What is acute leukaemia, and what does it cause?
Proliferation of primitive precursor cells usually found in bone marrow Causes... - anaemia: pallor and lethargy - neutropenia: infections - thrombocytopenia: excessive bleeding
53
What is acute myeloblastic leukaemia?
malignant proliferation of the precursor myeloblasts in the bone marrow primarily affects adults
54
what is high grade lymphoma?
lymphocytes in lymph nodes becoming malignant, very similar to leukaemia Classified as Hodgkins's disease and Non-Hodgkins lymphoma Disease usually of the lymph nodes that spreads to the liver, spleen, bone marrow and blood
55
How do you test platelet function function?
Prothombrin time - time taken for a clot to form in a blood sample
56
Describe the features of platelets
Cytoplasmic enucleate cells
57
What precursor cells form platelets?
megakaryocytes
58
Lifespan of platelets
5-10 days
59
What is the range of normal numbers of platelets?
140-400x10^9/l
60
What are the complication of reduced numbers of platelets?
Thrombocytopenia Risk of cerebral bleeding
61
What are the complications of high levels of platelets?
Thrombocytosis Arterial and venous thrombosis Increased risk of heart attack and stroke
62
What proteins can be found in the blood?
Coagulation proteins Plasma proteins
63
What is vitamin K and why is it needed?
Essential for the correct synthesis of coagulation factors 2,7,9 and 10 (remember as 1972)
64
Describe the circulation of coagulation proteins in the blood
Circulate in their inactive form
65
Describe the function of coagulation proteins
Make blood clot Convert soluble fibrinogen into insoluble fibrin
66
Describe the functions of plasma proteins
Carrier proteins for nutrients and hormones
67
What are coagulation proteins?
Enzymes made in the liver Key enzyme is thrombin (makes platelet plug)
68
How do plasma proteins circulate in the blood
In plasma component Soluble
69
Which is the most numerous plasma protein?
Albumin
70
where is albumin produced
liver
71
function of albumin
maintain oncotic pressure
72
sign of a lack of albumin
oedema
73
what does albumin carry?
fatty acids, steroids and thyroid hormones
74
what are immunoglobulins
antibodies produced by plasma cells
75
what are the classes of immunoglobulins?
IgG, IgM, IgA, IgE
76
most important immunoglobulin class?
IgG
77
What is haemostasis?
The arrest of bleeding
78
what are the two components of haemostasis?
coagulation of blood contraction of damaged blood vessels
79
why is blood usually fluid inside blood vessels?
the proteins of the coagulation cascade circulate in their inactive state until they are activated by tissue factor
80
what is tissue factor
a protein present on every cell apart from endothelial cells
81
what stimulates blood clotting?
when endothelium is punctured, blood comes into contact with tissue factor and clotting occurs
82
what is the term for when blood clots inside a vessel?
thrombosis
83
what is the coagulation cascade?
series of proteolytic enzymes that circulate in an inactive state being activated in a cascade sequence to generate thrombin thombrin cleaves fibrinogen to create fibrin polymerisation i.e a blood clot
84
what is the significance of thee coagulation cascade having multiple steps?
allows for biological amplification allows for regulation not an all or nothing response can be graduated in response to severity of challenge
85
function of platelets
responsible for primary haemostasis adhere to damaged endothelium and aggregate to form a platelet plug that blocks the hole in the vessel

Phase 1 From KP notes (6 decks)

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