Physiology Flashcards

(75 cards)

1
Q

Name the different types of blood cells

A
  • white
  • red
  • platelets
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2
Q

What is haematopoiesis

A
  • production of blood from bone marrow

- derived from pluripotent stem cells

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3
Q

What is red cells dervived from?

A
  • pluripotent stem cells
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4
Q

Where does haematopoiesis occur in the embryo? and then when at birth?

A
  • embryo = yolk sac, then liver, then bone marrow

- adult = bone marrow, liver, spleen

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5
Q

Which bone marrow is responsible for the production of red blood cells?

A
  • the axial skeleton
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6
Q

Explain the formation of blood cells from the stem cells?

A
  • proliferation
  • differentiaion
  • haematopoietic trees
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7
Q

What are the 2 main routes in the haematopoietic tree and their final product

A
  • cmp (myeloid) -> granulocytes, erythrocytes, platelets, macrophages
  • CLP (lymphoid) -> B cells, T cells and NK cells
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8
Q

What state do most stem cells lie in?

A
  • quiescent state
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9
Q

Term given to red cell production, different from blood cell production

A
  • erythropoiesis
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10
Q

What is the primary cell called of erythropoiesis?

A
  • pronormoblast
  • early normoblast
  • intermediate normoblast
  • late normoblast
  • reticulocyte
  • erythrocyte
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11
Q

What is the difference between a reticulocyte and a erythrocyte?

A
  • a reticulocyte is more immature and contains a nucleus and is found in bone marrow
  • erythrocyte has no nucleus and has entered blood streem
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12
Q

Explain platelet formation

A
  • nucleus replicated but no cell division
  • forms a megakaryocyte
  • budding off -> platelets released
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13
Q

3 main granulocytes?

A
  • eosinophils
  • basophills
  • neutrophils
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14
Q

Describe neutrophils

A
  • most numerous white cell
  • fine granules
  • lobbed nucleus
  • short lived
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15
Q

What may cause an increase in neutrophils?

A
  • infection
  • trauma
  • infarction
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16
Q

Describe the appearance of eosinophils

A
  • bi-lobbed
  • bright red granules
  • involved in hypersensitivity
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17
Q

Describe appearance of basophils?

A
  • large purple granules
  • basic staining
  • release histamine
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18
Q

Monocytes vs macrophages

A
  • monocytes = in the blood stream

- macrophages = in the tissue

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19
Q

Describe the appearance of lymphocytes

A
  • big nucleus
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20
Q

3 ways of sampling blood in haematology?

A
  • immunophenotyping
  • bio-assay
  • bone marrow samples
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21
Q

Explain immunophenotyping

A
  • looking at surface proteins of cells

- much quicker method

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22
Q

Structure of RBC

A
  • 2 alpha
  • 2 beta
  • 4 porphyrin rings with Fe2+
  • biconcave
  • no nucleus
  • no mitochondria
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23
Q

Why are RBC limited to 120days?

A
  • they have no nucleus or mitochondria

- unable to repair proteins

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24
Q

What is present on the cell membrane of a RBC

A
  • Sodium potassium ATP pump
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25
What is the disadvantage of Fe3+
- unable for O2 to bind - must be in Fe2+ form NADH generated in glycolysis helps protect Fe2+
26
Role of haemoglobin
- delivers oxygen to tissue - acts as a buffer for H+ ions - Co2 transport
27
Explain the stem cell process
- multipoint haematopoetic cell - common myeloid progenitor cell (CMP) - common lymphoid progenitor celll (CLP)
28
What do CMP cells become
- erythrocytes - platelets - macrophages - basophils - eosinophils - neutrophils
29
What do CLP cells become
- NK cells - b cells - t cells
30
B cells further differentiate into what?
- plasma cells
31
What happens to red blood cells as they mature?
- they become smaller in size
32
Where is hypoxia sensed and what is the consequence
- sensed in the kidney - erythropoietin hormone secreted - stimulation of RBC formation
33
Where does normal RBC breakdown occur
- the spleen or liver
34
Explain RBC breakdown
- haemoglobin - heme and globin - globin - amino acids - heme - porphyrin (bilirubin) and iron
35
What is heme broken down to
- porphyrin (bilirubin) | - iron
36
Glycolysis role in the formation of RBC
- Generates ATP - generated NADH (Prevents Fe2+ oxidising to Fe3+) - free radical formation
37
Free radical formation may cause what?
- dangerous - can cause Fe2+ to become Fe3+ - can damage cell membrane - NADH acts as an electron donor to prevent Fe oxidation
38
Name a reactive oxygen species
- hydrogen peroxide
39
What is the risk associated with hydrogen peroxide
- damage to proteins
40
What is vital for protection of hydrogen peroxide (reactive oxygen species)
- glutathione (GSH) | - Forms water and an oxidised GSH (GSSG)
41
How is oxidised glutathione regenerated to glutathione
- NADPH
42
What is the rate limiting step in the hexose monophosphate shunt
- G-6-PD | - Glucose 6 phosphate dehydrogenase
43
Role of NADPH in GSSG
- Recycles to for GSH
44
How is carbon dioxide transported
- dissolved - carbamino compound in Hb - bicarbonate
45
What enters the RBC when CO2 leaves in order to preserve the potential
- Cl-
46
Explain the oxygen dissociation curve
- sigmoid - allosteric cooperative binding - a drop in Po2 at a lower level results in a greater % saturation drop than a higher
47
What can cause the oxygen dissociation curve to shift to the right and what will that cause
- increase in temp - decrease pH - Increase 2,3-BPG - causes oxygen to be released at a tissue level - lesser % saturation bound
48
What can cause the oxygen dissociation curve to shift to the left and what are its consequences
- decrease temp - increaser ph - decreased 2,3-BPG - Less o2 released at same PO2 - Greater % saturation bound
49
Describe fetal Hb compared to adult
- 2 alpha and 2 gamma | - greater o2 saturation in haemoglobin at the same o2
50
Explain the affect of 2,3-BPG on the oxygen dissociation curve
- increased 2,3BPG = Shift to the right - more released - less bound - decreased 2,3-BPG = shift to the left - less released - more bound
51
What affect on 2,3-BPG will occur in chronic anaemia?
- up regulation
52
What is termed the machinery of RBC
- The erythron
53
Raw materials of RBC production
- iron - b12 - folate
54
What is released from the kidneys due to low oxygen levels
- erythropoietin
55
Which stem cell has the higher self-renewing ability and why is that useful
- the long term stem cells | - good for transplant patients
56
Pathway of RBC production from pronormoblasts
- pronoromblast - early normoblast - intermediate normoblast - late normoblast - reticulocyte - erythrocyte
57
Why is iron essential?
- oxygen transport - electron transport - present in haemoglobin, myoglobin, enzymes
58
Iron dangerous?
- oxidative stress | - free radical formation
59
Where does iron absorption take place?
- in the duodenum | - uptake into cells of duodenal mucosa
60
What enhances iron uptake?
- haem irons - ascorbic acid - alcohol
61
What reduces iron uptake?
- tannins - phylate - caclcium
62
What reduces Fe3+ to Fe2+
- duodenal cytochrome B
63
What transports Fe2+ from the lumen of duodenum into duodenal cells?
- Divalent metal transport 1
64
What transports iron from the duodenal cell into the body?
- ferroprotein
65
What regulates iron
- hepcidin - negative regulator - levels decrease in anaemia = increase iron absorption
66
How can iron status be analysed?
- functional iron (hb concentration) - transport iron (transferrin saturation) - storage iron (ferritin)
67
When might ferritin be increased?
- inflammation or malignany | - increased in anaemia of chronic disease
68
Microcytic anaemias are deficiencies in _____ synthesis
- haemoglobin
69
What is sideroblastic anaemia?
- excess iron build up in the mitochondria and not incorporated into haemoglobin
70
How is iron deficiency anaemia defined?
- anaemia + low iron
71
Explain pathophysiology of anaemia of chronic disease?
- increased ferritin - increased plasma hepcidin - decreased iron release from macrophages
72
Causes of primary iron overload
- hereditary haemochromatosis
73
Explain hereditary haemochromatosis?
- HFE gene - increased Hepcidin - increased iron absorption
74
Treatment of primary haemochromatosis?
- venesection
75
Treatment of iron overload?
- iron chelating agents | e. g. desferrioxamine