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PR3154 Midterms > IC2 > Flashcards

IC2 Flashcards

1
Q

what is the function of blood

A

1) transport
2) regulation
- temperature by redistributing heat
- ion and pH composition in the interstitial fluids
3) protection
- blood loss
- infections

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2
Q

what is hematocrit and what are the percentages for males and females

A

relative vol of RBCs out of the total blood volume.
M= 44-46%
F=40-42%
appx

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3
Q

what are the 4 layers of blood and what are their percentages

A

1) plasma 55%
2) leukocytes
3) platelets
both form the buffy coat. this is <1%
4) rbc or erythrocytes 45%

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4
Q

what is the % composition of plasma

A

water 92%
protein 7
solutes <1

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5
Q

what are the proteins in plasma and their functions?

A

albumin,
- trnasport of lipid solube substacnes like drugs, hormones
- maintain osmotic pressure due to negative charge that pull water back into the blood vessels

globulins,
- clotting and immune function
fibrinogen
- clotting

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6
Q

function of erythrocytes (and what they contain)

A

contain
hemoglobin to transport o2
carbonic anhydrase to transport co2

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7
Q

shape and size of erythrocytes

A

7.5um diameter
1-2um thickness
flexible
biconcave disk with large surface area to volume ratio and easy diffusion of o2

appx >97% hemoglobin.

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8
Q

how much o2 can 1 erythrocyte transport

A

10^9

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9
Q

what is the lifespan of RBC

A

100-120 days or 3-4months

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10
Q

describe hemoglobin

A

4 chain = 2 alpha 2 beta
each binded to 1 heme pigment
= contains Fe which binds to oxygen,

therefore one hemoglobin = transport 4 molecules of oxygen.

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11
Q

how much o2 can water transport in blood (free o2) and how much increase with hemoglobin?

A

around 5ml/L
increase 40 fold with hemoglobin

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12
Q

what is the rate of RBC replacement (erythropoiesis)

A

2-3 x 10^6 RBC/second

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13
Q

what is the place of erythropoiesis according to age

A

fetus = yolk sac, then liver, spleen, lymph node.
<5 = all of bone marrow
5-20 = bone marrow of the sternum, vertebrae, ribs, proximal ends of long bones
>20 = bone marrow of the sternum, vertebrae, ribs.

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14
Q

how is erythropoiesis controlled (include pathology)

A

controlled by release of erythropoietin by the kidneys.
triggered by
- hypoxia
- less o2 avail
- anemia
- increase tissue demand for o2
- reduced blood flow to kidney
- blood donation.

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15
Q

describe erythropoesis and the rbeakdown of rbc

A

phase 1: ribosome synthesis in early erythroblasts
2: hb accumulate in late erythroblasts and normoblasts
3: ejection of nucleus from normoblasts and formation of reticulocytes.

aged rbc get engulfed by macrophages of liver, spleen, bone marrow. haemoglobin is broken down into:
1) heme
(i) iron = stored as ferritin (released to blood from liver), hemosiderin
(ii) bilirubin (yellow) = blood from liver = bile = intestines = stercobilin = faeces. (related to jaundice)
2) globin> amino acids

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16
Q

what is anemia and what are the symptoms

A

reduction of RBC or reduction in the o2 carrying capacity of hb.
usually presents with low metabolism, = fatigue, paleness, SOB, chills

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17
Q

explain:
nutritional anemia

A

dietary deficiency = iron, folic acid, needed for erythropoiesis

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18
Q

explain:
aplastic anemia

A

failure of bone marrow to make sufficient rbc

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19
Q

explain:
renal anemia

A

kidney disease = lack of erythropoietin

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20
Q

explain:
anemia caused by malaria

A

plaasmodium falciparum amplify in RBC = rupture.

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21
Q

explain:
haemorrhagic anemia

A

loss of blood

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22
Q

explain:
sickle cell anemia

A

mutation in beta globin gene = hemoglobin aggregate in low o2 conditions = present = rupture RBC membrane.

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23
Q

explain:

thalessemia

A

thalessemia = low production of hemoglobin (hereditary)

24
Q

explain
pernicious anemia

A

lack of vitb12 or intrinsic factor

25
Q

what is polycythemia/erythremia and what are the side effects

A

too much rbc, too high hematocrit

primary - : caused by tumor/tumor like condition in the bone marrow = overproduction = 7-7x10^9 rbc/ml

others: altitude training, cancer.

may also be caused by dehydration

causes blood to become viscous = plug capillaries = poor o2 delivery

26
Q

explain erythroblastosis fetalis

A

in erythroblastosis fetalis = rhesus factor positive rbc of fetus destroyed by anti-rh antibodies of rh- mother.

27
Q

what is normal reticulocyte count in percent

A

0.8-1 percent

28
Q

what is MCV

A

mean corpuscle volume
refers to avg vol or size of your rbc

29
Q

what is MCH

A

mean corpuscular hemoglobin
refers to avg amt of hemoglobin in rbc

30
Q

what is MCHC

A

mean corpuscular hemoglobin concentration
refers to avg conc of hemoglobin in rbc (amt/vol)

31
Q

what is RCW

A

red cell distribution width
refers to how the rbc size varies
if high == early indicator of anemia

32
Q

leukopenia vs leukocytosis?

A

leukopenia = too few WBC. may cause by opportunistic infections. may be result of radiation, chemotherapy, chemicals, viral infections…

leukocytosis = WBC > 1.1 X 10^7/ml

32
Q

what are leukemia and lymphomas?

A

cancer of the white blood cells,
wbc up to 5x10^8/ml (normal is 4-11 x 10^6)

33
Q

what are the three phases of hemostasis (and time taken)

A

1) vasoconstriction or vasospasm: IMMEDIATE
2) platelet plug: seconds
3) fibrin clot: minutes

34
Q

how long for clot retraction AND repair (and what happens)

A

20min to 1h
1-2 weeks

clot retraction: clot stabilised by squeezing serum from fibrin clot.

repair: PDGF stimulates vascular smooth muscle cells to build new vessel walls.
VEGF stimulates endothelial cells to multiply and restore inner endothelial lining

35
Q

what happens during the vasoconstriction phase?

A

endothelial cells of opposite sides may stick together. endothelial cells contract to expose basal lamina. reduces blood loss, but not sufficient.

vasoconstriction initiated by sympathetic nerves. mediated by vascular smooth muscle cells.

last for 30mins to sometimes hours
providing time for platelet and coagulation phase.

36
Q

what happens during the platelet phase

go in detail

A

damaged endothelial wall exposes collagen, causing platelets to bind to the collagen (through von willebrand factor produced by platelets) = activates platelet = morphological change = release of platelet factors (platelet agonists: ADP, thromboxane A2) = ADP attracts and activates more platelets, while tbx a2 promotes aggregation and further vasoconstriction=fibrinogen links platelets through glycoprotein receptors.

37
Q

properties of platelets
including organelles and other cell content

A

fragmenets of megakaryocytes (1 megakaryocytic = 2000-3000 platelets).

platelets lack nuclei, contain contractile proteins (actin, myosin), and organelles (mitochondria = release ADP, ER/golgi = storage of ca2+ and synthesis of enzymes), enzyme systems (for prostaglandins), growth fators (PDGF, VEGF for endothelial cells to mend and grow and platelets to clot), factor xiii (fibrin stabilising factor).

38
Q

detail the coagulation cascade
all three pathways

A

intrinsic pathway:
exposure to collagen fibres/exposure to foreign surface:
- platelet phospholipids = 12 to 12a = 11 to 11a = in the presence of ca2+, 9 to 9a
(4, 9, 11, 12 and 8 )

extrinsic:
damaged tissues release tissue factor/thromboplastin(factor 3) = 7 to 7a
(3, 7)

in the presence of ca2+ and 8a (intrinsic) or ca2+ and 7a (extrinsic), 10 to 10a = in the presence of ca2+ and 5a, prothrombin = thrombin, which causes conversion of fibrinogen to fibrin AND fibrin to fibrin meshwork (stabilise fibrin mesh) (in the presence of 13a)

39
Q

what is factor 4, 3, 2, and 1

A

4 = calcium ion
3 = tissue factor or thromboplastin
2 = prothrombin
1 = fibrinogen

40
Q

which clotting factors require vitamin k

A

2, 7, 9, 10

41
Q

what are the clotting factors form 1 to 13

A

foolish people try climbing long slopes after Christmas some people have fallen
1 = fibrinogen
2 = prothrombin
3 = tissue factor
4 = calcium
5 = labile factor
(6 no longer used_
7 = stable factor
8 = antihemophilic
9 = Christmas factor
10 = stuart prower
11 = plasma thromboplastin
12 = hageman factor
13 = fibrin stabilising

42
Q

which factors are not made in the liver

A

3 = dmaaged tissue or activated platelets

4 = diet, bone, platelet

8 = platelets, endothelial cells

43
Q

what are the other moa of thrombin

A

enhances its own generation from prothrombin via positive feedback

activates factor 13 to stabilise fibrin mesh

enhances platelet activation and aggregation = stimulating release of pf3 from platelets to activate intrinsic pathway

stimulate conversion of fibrinogen to fibrin

44
Q

how fast does intrinsic pathway occur and what are the triggers

VS extrinsic pathway

A

intrinsic= internal damage causing exposure to collagen OR exposure to foreign surface like glass
(internal damage)
occurs in minutes

vs

extrinisic = tissue exposed secondary to external trauma; damaged tissue releases tissue factor.
(external damage)
occurs in seconds

45
Q

how is blood clotting regulated describe the two molecules

A

prostacyclin: released by intact endothelial cells thus inhibiting platelet activation and limiting the spread of clotting.

serotonin = high concentrations inhibit ADP

blood clot itself alsolimits sprea dof thrombin and other procoagulants

46
Q

what are endogenous anticoagulants

A

antithrombin 3, heparin, thrombomodulin, tissue plasminogen activator, smooth surface of endothelial

47
Q

what are artificial anticoagulants

A

chelators (citrate, edta), VKA, DOAC

48
Q

how does fibrinolysis occur

A

plasminogen trapped inside the clot is inactive

tissue and vascular endothelial cells release tissue plasminogen activator to cleave the inactive plasminogen to the protease plasmin = digest fibrin = dissolve clot = removed by macrophages.

49
Q

what factors cause the different types of hemophilia

A

A: 8
B: 9
C: 11

50
Q

what are some blood clotting disorders

A

hemophilia, thrombocytopenia, vit k deficiency (required to produced factors 2,7,9,10), liver disease (required to produce most clotting factors and also produce bile to absorb vitK)

51
Q

what are the blood coauglation tests

A

PTT, PT, INR

52
Q

what does PTT measure, indication, normal range, uses what

A

intrinsic and common pathway (1,2,5) (8,9,10,11,12)

for monitoring heparin therapy

normal range 25-39

uses: citrated plasma, ca2+, phospholipid, kaolin clay(stimulate foreign surface)

53
Q

what does PT measure, indication, normal range, uses what

A

extrinsic and common pathway (1,2,5) (7, 10)

for monitoring warfarin therapy

normal range 12-15

uses citrated plasma, ca2+, tissue factor

54
Q

what is inr and what is normal range

A

pt of patient to pt of healthy person

normal 0.9-1.3

PR3154 Midterms (8 decks)

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