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Physiology/Pathophysiology I > Intro to Blood > Flashcards

Intro to Blood Flashcards

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1
Q

Plasma Protein Functions

A 
Immune Functions
Blood Buffers (Acid Base Balance)
Enzymes
Hemostasis
Osmotic Pressure & Fluid balance
Transport/Carry other molecules
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2
Q

Plasma Protein Types

A

Albumin
Globulins
Fibrinogen

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3
Q

Albumin Values

A 
4.5 gm/dL
62% Total plasma protein
MW 66,000
14-17 grams produced daily by liver (9% total)
Principle protein responsible for COP
Transports free fatty acids & bilirubin
Binds with variety of drugs
Secondary carrier: heme, thyroxin, cortisol
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4
Q

Globulin Values

A

All proteins except fibrinogen and albumin

  1. 5 gm/dL
  2. 2% total protein
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5
Q

Fibrinogen Values

A

300 mg/dL (0.3 g/dL)

4% of total protein

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6
Q

Colloid Osmotic Pressure (gm/dl, mmHg, %total osmotic P)

A

Albumin: 4.5g/dL, 21.8 mmHg, 77.9%
Globulins: 2.5g/dL, 6.0 mmHg, 21.4%
Fibrinogen: .3 gm/dL, 0.2 mmHg, 0.7%

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7
Q

Globulin Types

A

Alpha 1- 4% of total
Alpha 2- 8% of total
Beta- 12% of total
Gamma/Immunoglobulins- 16% of total; 1.5 gm/dL

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8
Q

Globulin Functional Grouping

A

Plasma Proteolytic Proteins
Plasma Protease Inhibitors
Carrier Proteins
Acute Phase Proteins

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9
Q

Plasma Proteolytic Systems

A

Complement System

Kinin System (forms bradykinin by kallikreins)

Blood Coagulation System (thrombin converts fibrinogen to fibrin)

Fibrinolytic System (produce plasmin from plasminogen which breaks down fibrin)

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10
Q

Plasma Protease Inhibitors Function

A

Prevent the action of or slow down the action of various proteins

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11
Q

Plasma Protease Inhibitor Types

A

Alpha 2 Macroglobulin- 250mg/dL, 3.5umol; inhibits plasma, thrombin, kallikrein

Antithrombin III- 15 mg/dL, 2.5umol; inhibits thrombin, factor Xa, IXa; prevents coagulation, heparin induces effect

C1 inhbitor- 18 mg/dL, 1.5 umol, inhibits activated C1r, C1s, kallikrein; rises in tissue inflammation or injury

Alpha 2 Plasmin Inhibitor- 7mg/dL, 1.0umol, inhibits plasmin, also called alpha 2 antiplasmin

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12
Q

Carrier Protein Examples

A

Albumin
Haptoglobin
Hemopexin

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13
Q

Haptoglobin

A

Transports plasma hemoglobin from lysed erythrocytes
Plasma concentration: 130 mg/dL
Produced by liver
Binds up to 3 gm of Hb- 5x normal released on daily basis
Combo binds to receptor sites in liver where iron is reprocessed

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14
Q

Hemopexin

A

Transports heme from plasma hemoglobin
Plasma concentration: 50-100 mg/dL
Complex removed from circulation and iron reprocessed
If binding capacity exceeded- metheme binds with albumin to form methemalbumin
Complex not filtered by normal glomerulus

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15
Q

Acute Phase Proteins Form When….

A

Tissue injury or infections produce inflammation
Interleukin 1 (IL-1) formed (induce systemic response)
Systemic acute response- fever, increased release certain hormones, increased production acute phase proteins

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16
Q

Acute Phase Protein Examples

A

Hemostatic Factors- fibrinogen, van Willebrand factor
C3 and factor B components of complement
Haptoglobin
Protease inhibitors- alpha1-antichymotrypsin; alpha2-antiplasmin
C-reactive protein- binds to altered cell membranes; activate complement pathway

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17
Q

Hypoproteinemia Causes

A 
Decreased protein intake (malnutrition)
Decreased protein production (liver problems)
Decrease protein absorption
Excretion of protein
Hemodilution (Perfusionist)
Cut HCT 50% cuts protein 50%
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18
Q

Hypoproteinemia Affects

A 
Acid-base balance
Clotting mechanisms
Enzyme-dependent Reactions
Fluid balance
Transport problems
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19
Q

How many liters in a kilogram?

A

1L = 1 kg

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20
Q

Hyperproteinemia Cause & Affect

A

Increased plasma proteins
Causes: Multiple myeloma- abnormal production of paraproteins
Affects: Hyperviscosity- increase chance of clot

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21
Q

Paraproteins

A

Abnormal immunoglobulin produced as a result of malignances of the spleen, liver, and bone marrow

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22
Q

Red Blood Cell Dimensions

A 
Shape: Bioconcave Discoid
Diameter: 8.1 microns
Greatest thickness: 2.7 microns
Least thickness: 1 micron
Area: 138 microns^2
Volume: 95 microns^3
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23
Q

Life Cycle of Red Blood Cell

A

120 days; production affected by arterial pO2

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24
Q

Reticulocytes

A

Immature red blood cells

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25
How are old damaged red blood cells removed?
Macrophages in liver and spleen
26
Ghosts/Red Cell Stroma
remnants of ruptured red blood cells
27
Red Blood Cell Contents (& Percentages)
Hemoglobin-25% Water- 70% Other constituents- 5% (No nucleus/other organelles)
28
Ionic Concentrations of RBCs
``` Sodium: 18mEq/L Potassium: 81 mEq/L Chloride: 52 mEq/L Bicarbonate: 19mEq/L Protein: 5 mMol/L ```
29
How many molecules of hemoglobin in each RBC?
300 million
30
Hemoglobin Structure
4 individual polypeptide chains of amino acids (2 alpha chain (141 AA's) and 2 beta chains (146 AAs) heme molecule attached to each chain each heme molecule can bind with one molecule of oxygen
31
Saturation
Percentage of heme molecules bound with oxygen Oxyhemoglobin vs. deoxyhemoglobin
32
Affinity
how easy it is for the heme molecules to bind (or release) oxygen high affinity- easy to bind, hard to release low affinity- hard to bind, easy to release relationship shown by oxyhemoglobin dissociation
33
Oxyhemoglobin Dissociation Curve | Causes of decreased affinity (shift to right)
Increase PCO2 (Bohr Affect) Decrease pH Increase temperature
34
Oxyhemoglobin Dissociation Curve | Causes of increased affinity
Decrease pCO2 Increase pH Decrease Temperature
35
What percent of total O2 content of blood is dissolved in the plasma?
2%
36
What is the only form of O2 that produces a partial pressure?
Dissolved blood in the plasma
37
Henry's Law
02dis=(PO2)(0.003 mlO2/dL/mmHg)
38
How much of O2 content of blood reversibly bound to Hb inside the RBC?
98%
39
Methemoglobin
Fe2+ oxidized to Fe3+ forms Methemoglobin | Does not bind with O2
40
Methemoglobin reductase
enzyme normally present in RBC that keeps iron in reduced state
41
Methemoglobin Causes....
Oxidation by nitrites or sulfonamides | congenital deficiency of methemoglobin reductase
42
Fetal Hemoglobin
Gower I, Gower II, Portland, HbF Production starts in fourth month in utero Hb A replaces all fetal Hb between 3rd-6th months after birth
43
Hemoglobin S
Sickle Cell Anemia Beta chain substitution of valine for glutamic acid in position six African Americans Homozygous vs. heterozygous (100% HbS vs. 40% HbS, 60% HbA)
44
What happens to sickle cells?
Structural change triggered by low O2 content Change reversible or permanent Sickle cells easily hemolyze; trapped in microvasculature
45
HbS Results
Retinal degeneration; ulcerations of low extremities; organ infarction
46
Causes of RBC Hemolysis
Immune Response from transfusion Sepsis, bacterial or viral infection RBC membrane stress from mechanical causes Medications/toxins (alcohol) Aging cells Activation of complement system by antigen-antibody complexes Enzyme deficiencies
47
Types of WBCs
Granulocytes Monocytes - will eventually become macrophages (3-8%) Lymphocytes (20-25%)- T cells; B cells (new antibodies)
48
Types of Granulocytes
Neutrophils (60-70% of WBC count) Eosinophils (2 to 4%) Basophils (.5 to 1%)
49
What concentration do Neutrophils respond to?
Respond to 1 nM (1 billionth of a mole) concentration chemotactic molecules
50
Neutrophil Structure
5,500/uL 10-15 microns in diameter Polymorphonuclear- 2 to 5 lobes on the nuclear Lives 10-12 hours in blood before moving into tissue 5-6 days in tissue Immature neutrophils released into circulation called Bands After release: 50% vascular system, 50% attach to endothelial lining of capillaries (margination)
51
Major Basic Protein (MBP)
chemical released by eosinophils; binds to antigen and lyses the antigen's membrane
52
Eosinophils Structure
Approximately 10 to 760/ uL 12 to 17 microns in diameter Life span of 12 to 24 hours Mature in bone marrow-circulate for day then enter tissue spaces (skin, bronchi, bronchioles)
53
Basophil Structure
Least common WBC- 10 - 250 uL 5 to 7 microns in diameter Found in tissue called mast cells
54
Monocytes Structure
20 to 1000/ uL 12 to 20 microns in diameter- very big Mature into macrophages (histocytes)
55
Histocytes
Macrophages
56
Lymphocytes
``` Lymphoid lineage progenitor cells Most complex of WBC 650 to 4500/ uL- T cells 75% of total 5 to 12 microns in diameter Specific test distinguish between T and B cells ```
57
Platelets
2 to 4 microns diameter Arise from myeloid lineage progenitor cells Produced in bone marrow by fragmentation of megakaryocytes
58
Hematopoiesis
blood cell formation | 1 trillion new cells produced daily
59
Overview of Hematopoiesis in Bone Marrow
Sternum, ribs, vertebrae, proximal ends of long bones in adults; bone marrow of femur & tibia in children
60
Cytokines
hematopoietic growth factors which are glycoprotein molecules Released by many cells Controls growth/differentiation of stem &progenitor cells Regulates immune response Involved with inflammation Aids in function of mature blood cells
61
Myeloid Progenitor
Can differentiate into red blood cells, platelets and certain white blood cells (granulocytes, monocytes/macrophage)
62
Lymphoid Progenitor
can differentiate into lymphocytes (specific white blood cell)
63
All blood components are tested for
``` Hep B surface antigen Antibody to hep b core antigen Antibody to hep c virus Antibody to human T cell lymphotrophix virus type 1 and 2 Antibody to HIV types 1 and 2 HIV antigen Alanine aminotransferase- liver fcn ```
64
Citrate anticoagulants
Commercially prepared Used only to store blood and blood components Contains: citrate, phosphate, dextrose, adenine

Physiology/Pathophysiology I (5 decks)

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