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KINE 4010 B > November 8, 2023 > Flashcards

November 8, 2023 Flashcards

1
Q

Given the following:

➢{Hb} is 14g/100mls blood
➢Arterial blood Hb is 90% saturated based on the arterial PO2
➢Venous blood Hb is 60% saturated at the resting venous PO2

Calculate the (a-v) O2 difference

A

Aterial:
1.34(0.9) = 1.206mls O2/g Hb
14g Hb/100mls x 1.206mls O2/g Hb
= 16.884 vols%

Venous:
1.34(0.6) = 0.804mls O2/g Hb
14g Hb/100mls x 0.804mls O2/g Hb
= 11.256 vols%

(a-v)O2 difference:
16.884 - 11.256
= 5.63 vols%

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2
Q

Use words to describe why a superbly trained athlete can experience hypoxemia during intense exercise

ANSWER QUESTIONS AT BEGINNING OF EACH LECTURE

A
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3
Q

what is the response of the kidney and bone marrow to reduced O2 delivery?

A

increase EPO secretion and RBC production

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4
Q

how does the kidney and bone marrow negative feedback loop work when there is reduced tissue O2 delivery

A
  1. reduced O2 carrying capacity
  2. kidney secretes Erythropoietin (EPO)
  3. EPO stimulates bone marrow to produce RBCs
  4. Increased O2 carrying capacity
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5
Q

How does EPO affect stem cells

A
  1. EPO stimulates the differentiation of stem cells into erythroblasts and further into erythrocytes
  2. Precursors that lead to RBCs

3.Proliferation of erythroblasts

4.Maturation (enucleation) of reticulocytes into the RBC (removal of nucleus)

page 116

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6
Q

what is Aplastic Anemia and how does it occur

A

Occurs when the bone marrow is destroyed by radiation or chemicals (insecticides, herbicides, organic solvents, paint removers, and other toxic chemicals); since RBCs are made in bone marrow you will become anemic

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7
Q

how is Aplastic Anemia treated

A

requires a bone marrow transplant

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8
Q

in what scenario is Aplastic Anemia done on purpose

A

Sometimes done on purpose, as with chemotherapy to treat blood cancers(i.e. lymphomas); destroy stem cells, then replace it

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9
Q

how are anemias characterized?

A

low Hct and Hb

Impaired endurance performance (fatigue)

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10
Q

how is Aplastic anemia induced:

A

chemically induced

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11
Q

how is Sickle cell anemia induced:

A

genetically induced

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12
Q

how is Pernicious anemia induced:

A

surgically or diet induced

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13
Q

how is Iron-deficiency anemia induced:

A

diet induced

(meat and fish are important sources of Fe; the redder the meat or fish, the more iron)

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14
Q

what are the results of 2 weeks of iron deficiency:

➢VO2 Max
➢Hematocrit
➢Mitochondrial enzymes
➢Endurance

A

➢VO2 max decreases about 50%
➢ Hematocrit decreases 60% (100 to 40)
➢ Mitochondrial enzymes decrease about 80% (100 to 20)
➢ Endurance totally diminishes

graph on page 118

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15
Q

what are the results of Dietary iron repletion over 7 days after having 2 weeks of iron deficiency:

➢VO2 Max
➢Hematocrit
➢Mitochondrial enzymes
➢Endurance

A

➢VO2 max is closely related to O2 transport capacity (related to Hct)

➢ Mitochondrial enzymes and endurance take a few days to increase

➢ All increase to about normal within a week

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16
Q

how does Vitamin B12 affect RBC

A

Stimulates RBC synthesis

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17
Q

what does a lack of Vitamin B12 do

A

Lack of Vitamin B12 causes anemia

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18
Q

where can Vitamin B12 in the regular diet

A

found in fish, meat, yogurt, milk, etc.

19
Q

what diet is deficient in Vitamin B12

A

It is deficient in the vegan diet

20
Q

what is Pernicious Anemia

A

deficiency in Vitamin B12

21
Q

How does Vitamin B12 lead to RBC synthesis once ingested

A
  1. Parietal cells in the stomach secrete IF (intrinsic factor)
  2. IF binds ingested vitamin B12 (B12 can’t be absorbed without IF)
  3. IF-B12 complex is absorbed by the gut by endocytosis and travels to the bone
    marrow
  4. Vit B12 stimulates RBC synthesis in bone marrow cells
22
Q

what is the primary cause of Pernicious Anemia

A

Lack of parietal cells result in a lack of B12 being taken up (can be sufficient in diet just not being absorbed because no IF meaning not being taken up into bone
marrow)

The primary cause of pernicious anemia is a deficiency of intrinsic factor, a protein produced by the stomach lining. Intrinsic factor is necessary for the absorption of vitamin B12 in the small intestine. Without sufficient intrinsic factor, vitamin B12 cannot be effectively absorbed, leading to a B12 deficiency.

23
Q

what is Sickle Cell Anemia

A

Sickle cell anemia: a genetic disease due to a ‘point mutation’ in the beta globin gene; it affects 0.14% of the African American population in the US

24
Q

how many globin subunits are in adults Hb?

How many polypeptide chains?

A

In adults Hb, there are 2 alpha and 2 beta globin subunits

(4 polypeptide chains)

25
Q

how many amino acid chains does the alpha globin subunit have?

How many does the beta-globin subunit have?

A

The alpha globin subunit has 141 amino acid chains

beta globin subunit has 146 amino acids

26
Q

what is each globin subunit bound to

A

Each subunit is bound to heme, which contains a central iron atom which binds O2

27
Q

3 nucleotides = ______ amino acids

A

3 nucleotides = 1 amino acids

28
Q

what is a ‘point mutation’

A

a change in a single nucleotide base (ex: ATCG) within the DNA sequence of a gene.

29
Q

How does Sickle Cell Anemia happen

A

a change in a single nucleotide base in the codon for glutamate results in amino acid switch in the primary structure (valine instead of glutamate)

this causes Beta globin proteins that are mutated, to polymerize(combine together) the cell at a low PO2 →

this leads to distorted RBC shape and stiff cells which plug capillaries, then break (hemolysis), and this leads to anemia

30
Q

how many nucleotides in the B-globin gene are required to code for the functional protein

A

3x146

31
Q

what subunits are expressed in fetal Hb

A

alpha2, gamma2

Gamma are expressed in children

32
Q

what subunits are expressed in adult Hb

A

alpha2, beta2

Beta and alpha are expressed in adults

33
Q

when Gamma gene shut off

A

Gamma gene is shut off postnatally

34
Q

what is Hydroxyurea

A
  1. a drug that increases the production of fetal Hb by inducing gamma (y) subunit expression
  2. this competes with the beta subunit during Hb synthesis and ‘replaces’ it, leading to more Hb F (fetal) in the blood
35
Q

Fetal Hb does not have the mutated beta globin subunit which causes sickling

A

Fetal Hb does not have the mutated beta globin subunit which causes sickling

36
Q

does Hb F or Hb adult have stronger affinity for O2

A

Hb F has a stronger affinity for O2

37
Q

The Function of Myoglobin (Mb)

and

How does it work

A

An iron containing protein which binds O2 and is found in muscle

Mb stores O2 and facilitates its diffusion within the muscle cell to the mitochondria

38
Q

which has a higher O2 affinity Mb or Hb

A

Mb has a higher affinity for O2 than Hb does

39
Q

why is Mb Important in aquatic animals

A

Important in aquatic animals so they can store sufficient O2 to remain underwater for long periods of time

not so much in other mammals for endurance purposes

40
Q

explain the Mb “knockout” animal (mouse) experiment

A

removed Mb from mouse

results showed:

Heart and skeletal muscle become pale

However, endurance performance was not impaired

41
Q

how is Mb useful as a diagnostic tool

A

It is supposed to be in muscle, and if you find it in the blood, this means it has leaked out (rhabdomyolysis) - muscle injury has taken place

Breakdown product of released myoglobin (ferrihemate) is toxic to kidney epithelial cells, and can cause acute renal failure

Because myoglobin is also found in high concentration in the heart, it is a sensitive marker for cardiac muscle injury, making it a potential marker for
heart attack in patients with chest pain

42
Q

Describe some characteristics of Restrictive Lung disease (stiff lung):

compliance:
elasticity:
examples of Restrictive disease:
air inspiration/expiration:

A

Decreased compliance

increased elasticity

Pulmonary fibrosis, pulmonary edema

Hard to get air in, decreased volume of air per breath

43
Q

Describe some characteristics of Obstructive Lung Disease (COPD):

compliance:
elasticity:
examples of obstructive disease:
air inspiration:
Tidal volume:

A

Increased compliance

decreased elasticity (floppy lung)

Emphysema, bronchitis (small airway, obstructive diseases, causes often related to smoking)

Asthma (large airway, obstructive disease)

Easy to get air in, difficult to get air out

Smaller tidal volume

KINE 4010 B (32 decks)

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