Red blood cells Flashcards

(49 cards)

1
Q

how is oxygen moved in circulation

A

cooperativity and allosteric effect (more O2 bound in lungs and deposited in tissue)

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2
Q

how is oxygen carried in blood

A

poorly soluble in plasma - normal arterial blood flow carries 70x more O2 on haemoglobin than plasma

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3
Q

what is a key feature of haemoglobin binding to oxygen

A

must be weak enough to be reversible (mechanisms at muscles to reduce affinity)
cooperativity and right shifting of binding curve

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4
Q

what makes up the majority of RBCs

A

95% dry weight is haemoglobin

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5
Q

what is the structure of haemoglobin

A

each subunit has a ham group (616 Da) and and a large globin peptide (17000 Da)
Allosteric properties = cooperativity

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6
Q

what is a ham group

A

each haemoglobin and myoglobin has 1 ham group (carries O2)

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7
Q

what is the structure of a haem

A

porphyrin ring, rigid, 2D, highly coloured due to electron sharing
conjugated to iron ion (ferrous aka Fe2+)

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8
Q

how do haemoglobin’s 4 sub units interact

A

cooperativity
each sub unit has 1 oxygen molecule on its haem
each sub unit influences its 3 neighbours
O2 binding increases affinity leading to more binding and the same for release

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9
Q

what is the structure of haemoglobin

A

healthy adults HbA (2 a and 2 B subunits) aka maternal Hb
Foetal HbF (2 a and 2 g sub units)
adults have 1% HbF (binds to oxygen more strongly than HbA)

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10
Q

How does CO2 and H+ affect binding to Hb

A

Bohr Effect
Increased CO2 decreases affinity for oxygen (decreases blood pH via carbonic anhydrase)
CO2 and H+ bind to different parts of Hb than O2

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11
Q

How is CO2 transported in blood

A

10% dissolved
22% carbamino
68% as HCO3-

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12
Q

how is CO2 transported as carbamino

A

CO2 + Hb-NH2 <=> Hb-NH-COOH

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13
Q

how is CO2 transported as HCO3-

A

CO2 in, CO2 + H20 <=> H2CO3 <=> H+ + HCO3-, Cl- exchange (chloride shift) via band 3 protein

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14
Q

what is chloride shift

A

more chloride in venous blood than arterial

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15
Q

how does oxygen binding compare between myoglobin and haemoglobin

A

myoglobin - hyperbolic

haemoglobin - sigmoidal

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16
Q

what causes a rightward shift in oxygen affinity (decrease)

A

CO2 H+ Cl- 2,3-DPG (diphosphoglycerate) and muscle activity

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17
Q

how does 2,3 DPG lower oxygen affinity

A

binds to Hb
found in erythrocytes at 5mM
tiny molecule compared to Hb
HbF has a lower affinity than HbA so has a higher affinity for oxygen

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18
Q

how do oxygen saturation curves compare for material and foetal Hb

A

Myoglobin exponential
HbF sigmoidal (higher than HbA)
HbA sigmoidal

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19
Q

how does oxygen concentration vary in active muscles

A

O2 low, CO2 high, blood slightly acidic, temp high, myoglobin
as blood runs along capillary O2 leaves Hb, CO2 and H+ bind (RHS shift of oxygen saturation)
HCO3- leaves Plasma and Cl- enters

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20
Q

what is breathing controlled by

A

O2, CO2 and H+

plasma O2 must drop precipitously before respiration drive increases

21
Q

what is the main driver to increase respiration rate

A

H+ in CSF (H+ in blood is slow into CSF but CO2 quicker so can make HCO3- and H+)
CO2 response same as H+ (blood based, signal from carotid arch)

22
Q

what detects the increase of H+ in the CSF

A

medullary receptors sample from interstitial and CSF fluid

23
Q

what is the structure of erythrocytes

A

definite/ mature

biconcave disc, red when oxygenated, anucleate, no organelles, contains Hb

24
Q

what is the function of erythrocytes

A

bag of Hb to transport CO2 and O2
survive for 120 days
very flexible (fold and stack in blood vessels)

25
how many erythrocytes are there
per um of blood they are the most numerous (5 million compared to 9000 leukocytes and 7000 platelets)
26
what is haematocrit/ PCV
40-52% MALES and 36-48% FEMALES (amount in blood) | 13-17 g/dl MALES and 12-16 g/dl FEMALES
27
what is the mean cell Hb (MCH)
27-34 pg
28
what is the mean corpuscular volume (MCV)
80-100 fL
29
Where does erythrogenesis occur
after birth - bone marrow only after 20 y/o membranous bones only in embryo - liver, spleen, lymph nodes, yolk sac
30
how does erythropoiesis occur
haematopoetic stem cell to burst forming unit erythroid to colony forming unit erythroid to erythroblasts to reticulocytes to erythrocytes up to R in bone marrow B to Eblasts is erythropoietin dependant Eblasts to R is iron dependant
31
what is erythropoietin
A cytokine/ hormone to drive erythropoiesis | made in kidney (response to hypoxia)
32
how can erythropoietin be used medically
used to stimulate erythropoiesis (severe risks of severe target effects) performance enhancing drugs for athletes
33
what are reticulocytes
``` RBC precursor (before complete extrusion of nucleus and organelles) 2 days in blood then definitive RBC ```
34
how can reticulocyte be used as a diagnostic tool for anaemia
indicate bone marrow activity high in haemolytic anaemias (homeostatic response) low when erythropoiesis is low machine counts and detects those with low basophilic material (eg DNA) in them
35
what is methamoglobinaemia
Hb cannot transport O2 | Fe in Hb is oxidised (Fe3+) instead of ferrous (Fe2+)
36
what causes methamoglobinaemia
due to congenital globin mutations (HbM), hereditary decrease of NADH, toxic substances
37
what causes CO poisoning
CO displaces O2 from Hb (same bind site as affinity is 250x stronger so low levels can displace more 02) PO2 blood dissolved in blood normal lethal
38
what are the symptoms of CO poisoning
bright red blood, brain affected 1st = disorientation
39
how is CO poisoning treated
95% oxygen/5% carbon dioxide (drives Hb to T configuration) | allows for CO to be displaced
40
what is polycythaemia
increase number of RBCs therefore viscosity of blood so clogs blood vessels
41
what are the types of polycythaemia
physiologic - high altitude Polycythaemia vera - neoplasm, often asymptomatic, risk of thrombotic events, no cure so treat with venesection (all ages but increases with it, possibly genetic)
42
what is iron required for
to produce RBCs, 65% of all iron in adults is in RBC Hb
43
where is Fe stored
stored intracellularly as ferritin and haemosidesin (30%) | stored in reticulo endothelial system (liver, spleen, RBCs, bone marrow, macrophages and monocytes)
44
what causes anaemia
deplete in all stores only a small % of dietary iron absorbed lose 1mg a day (more in pregnancy, menstruation and peptic ulcer)
45
what is vitamin B12 and folic acid used for
important for rapidly dividing tissue (essential for DNA thymidine) nuclear maturation fails (RBCs, skin, gametogenesis) leads to fragile cells
46
what causes vitamin b12 and folic acid deficiency
diet, malabsorption, lack of utilisation | eg vegan, pernicious anaemia, pregnancy, haemolytic anaemia, lymphoma, old age, institutions, famine
47
how can vitamin b12 and folic acid deficiency be treated
with vitamins | oral folic acid or intramuscular hydroxocobalamin
48
what is iron deficiency
hypo chromic microcytic anaemia | cells keep dividing but cannot fill up with Hb
49
what is vitamin b12 and folic acid deficiency
megaloblastic anaemia pernicious anaemia cells keep filling up with Hb but cannot divide fast enough