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Hematology > Unit 6 - Red Cell Structure & Physiology > Flashcards

Unit 6 - Red Cell Structure & Physiology Flashcards

1
Q

Size of RBC

A

7-9 um

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2
Q

RBCs can squeeze through small micro vessels as small as ___ in the spleen

A

3 micrometers

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3
Q

For normal function, the RBC structure must have

A

1) Intact, functioning membrane
2) Normal internal metabolism
3) No nucleus for repairs

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4
Q

RBC membrane structure components

A

Lipid Bilayer
Protein layers that transverse lipids
Protein cytoskeleton

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5
Q

Components of the lipid bilayer

A

Cholesterol
Phospholipids

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6
Q

Phospholipids composed of hydrophobic and hydrophilic parts

A

Hydrophobic tails - Interior
Hydrophilic heads - exterior

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7
Q

How much cholesterol on lipid bilayer is in proportion to plasma cholesterol

A

in equilibrium with plasma cholesterol

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8
Q

Components of proteins that transverse the lipid bilayer

A

Glycophorins
Band 3 protein

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9
Q

Glycophorin types

A

A, B, C

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10
Q

Three domains of the types of glycophorins

A

Cytoplasmic - Interior
Hydrophobic - Middle
Extracellular - Exterior

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11
Q

Where is glycophorin C in the membrane of the RBC?

A

Outside, its heavily glycosylated

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12
Q

What do extracellular glycophorins do

A

Carry RBC antigens
Negative charge (Zeta potential) that keeps RBCs apart

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13
Q

What does Band 3 protein do

A

Anion exchange protein 1
Channel for chloride <–> bicarbonate (CO2 exchange)

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14
Q

Components of membrane cytoskeleton

A

Spectrin
Ankyrin
Actin
Tropomyosin
Bands 4.1, 4.2, 4.9

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15
Q

Where is the RBC Cytoskeleton

A

Underneath the lipid bilayer

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16
Q

What does the RBC cytoskeleton do

A

Maintain RBC shape
Pliability to squeeze through capillaries and survive turbulence

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17
Q

What is the main protein of the cytoskeleton

A

Spectrin

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18
Q

What is spectrum composed of

A

alpha and beta chains twisted together

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19
Q

What is the shape of spectrin

A

Arranged in lattice of hexagons to allow it to recoil like a spring

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20
Q

Where is spectrin and what holds it there?

A

Attached to the bilipid layer by ankyrin and band 4.2

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21
Q

What does ankyrin do

A

Anchors spectrin

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22
Q

Another name for ankyrin

A

Band 2.1

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23
Q

What do actin and tropomyosin do

A

Muscle like filaments that stabilize RBC cytoskeleton

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24
Q

What do Bands 4.1, 4.2, 4.9 do

A

help with stabilization

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25
Deformability of RBC depends on
1) Biconcave shape 2) Viscosity of internal solution (mostly hgb) 3) Elastic properties of RBC membrane
26
What does the lipid bilayer rely on for repair?
Plasma lipids
27
What does an increase of plasma lipids do to RBC
Changes the membrane
28
What are typical shape changes due to plasma lipids
Codocytes (target) Acanthocytes (spur)
29
Anions and water flow freely across the membrane via what structures?
Protein band 3 Water channel protein
30
What do cations require for permeability?
Cation pump and ATP
31
What do cation pumps do
Sodium pumped out Potassium drawn in
32
What are the main cation pumps in RBC membrane
Na/K Ca-ATPase
33
Are calcium and magnesium intracellular or extracellular?
Intracellular
34
What occurs if the cation pump fails?
Sodium builds up in the cell Water accumulates in cell Sphere shape Hemolysis
35
What is the cause of cell pump function decreasing
insufficient ATP from insufficient glucose metabolism
36
Erythrocyte function in addition to O2 and CO2 transport
Membrane permeability to maintain ion balance Buffer function of hgb via bohr effect Bicarb formation and dissociation into carbonic acid and hydrogen
37
Requirements for function of RBC
Energy supply Membrane integrity Normal hgb Pyridine nucleotides (NAD/NADH)
38
How do RBCs generate ATP?
Glycolysis
39
What do pyridine nucleotides do
Prevent oxidant injury Reduce methemoglobin to hemoglobin
40
Red Cells perform their function without
Nucleus Mitochondria Protein synthesis
41
Red cells are totally dependent on ___ for energy
Plasma glucose
42
Red cells use oxygen to generate ATP
False, only anaerobic glycolysis
43
When RBCs are chemically damaged, how are they repaired?
RBC enzymes
44
Major categories of RBC metabolism
Glycolysis --> ATP NAD/NADH metabolism to reduce methemoglobin Leubering Rapoport Shunt
45
Two different glycolysis pathways for RBC ATP generation
Embden Meyerhoff Pathway Hexose Monophosphate Shunt
46
Two NAD/NADH metabolism routes for RBC metabolism
Hexose Monophosphate Shunt Methemoglobin Reductase Pathway
47
Anaerobic glycolysis for energy
Embden Meyerhoff Pathway Hexose Monophosphate Shunt
48
90% of cellular glucose processed using which pathway?
Embden Meyerhoff Pathway
49
Glycolytic Pathway (embden meyehoff)
Glucose-->Pyruvate--> Lactate ATP generated for energy NADH generated for methemoglobin reduction
50
Why is NADH important?
Methgb is oxidized hgb when exposed to Oxygen Methgb can't carry oxygen so reversal is important
51
What generates NADH?
G-6PD
52
5-10% of cell's glucose processed through
Hexose monophosphate shunt
53
Hexose monophosphate shunt produces
NADPH2
54
NADPH function
Converts oxidized glutathione to reduced glutathione Reduced glutathione neutralizes oxidation
55
Methemoglobin Reductase Pathway
Enzyme takes NADH and reduces methemoglobin
56
Diseases/Drugs that interfere with the methemoglobin reductase pathway cause what?
Cyanosis
57
Leubering Rapoport Shunt
Generates 2,3 DPG Needed for hgb to exchange oxygen
58
G6PD deficiency
Glutahtione can't be generated Hgb is oxidized Hgb denatures --> Heinz bodies --> removed by spleen
59
What inclusion is associated with G6PD deficiency?
Heinz Bodies
60
What stain allows us to see Heinz bodies
Supravital
61
How much of hgb is methemoglobin normally
Normal for 2% of hgb to become methgb per day
62
Without enzyme, how much does methemoglobin build up to?
20-40%
63
Pyruvate kinase deficiency
Pyruvate can't be converted to lactate Less ATP generated RBC weak (cation pumps) Hemolytic anemia ensues
64
WHy do infants get slight anemia after birth?
High RBC counts because Hypoxic in utero High oxygen after birth --> low EPO Slight anemia until EPO recovers
65
Why do males have higher RBC counts
Testosterone magnifies EPO effect
66
What hormones have an effect of EPO
Thyroid Pituitary Adrenals
67
Chemical signal for senescence to phagocytes
Exposure of phosphatidylserine on RBC surface
68
Extravascular hemolysis is what percent of normal destruction
90%
69
Intravascular hemolysis is what percent of normal destruction
10%, old RBCs
70
Where does most extravascular hemolysis take place
In spleen by phagocytes also in marrow by phagocytes
71
Hgb made up of
Heme + Globins
72
Heme made up of
Iron and protoporphyrin ring
73
Globins made up of
Amino acids
74
HEme recyclin
Fe --> Transferrin --> marrow Porphyrin ring --> bilirubin + urobilinogen
75
Haptoglobin
Picks up free hemoglobin to prevent loss through kidneys
76
Where does haptoglobin take hgb
Back to the liver for processing, same as extravascular
77
What happens if haptoglobin is consumed and there is still excess free hemoglobin
Oxidized to methgb, broken down to heme + globin
78
Hemopexin
Carries heme to liver for processing
79
If hemopexin is all used up, what carries heme in its place?
Albumin, forms methemalbumin until hemopexin is produced
80
IF hemolysis is beyond normal capacity, where is it going to go?
Hemoglobin shows up in urine
81
Hemosiderinuria
when IV hemolysis sever, iron laden renal tubule cells can slough off Stain cells in urine sediment with Prussian blue Better indicator of sever IV hemolysis than hgb in urine

Hematology (12 decks)

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