Exam 1 Flashcards by MATI (blood)

plasma (fluid in extracellular matrix)

1. Hematocrit (% of whole blood consisting of RBCs)

   1. 37%-47% in females

   2. 42%-52% in males

   3. usually about 45% of whole blood

1. Buffy coat

   1. thin middle layer (< 1% of whole blood) consisting of WBCs and platelets

Plasma (55% of whole blood)

1. Blood is a viscous, opaque fluid with metallic taste

   1. About five times more viscous than water due mostly to RBCs

2. Color varies with oxygen content

   1. Scarlet (bright) red when oxygen rich

   2. Dark red when oxygen poor

3. pH 7.35–7.45

4. Makes up~ 8% of body weight; average volume:

   1. 5–6 L in males

   2. 4–5 L in females

1. they are cell fragments

2. Unlike leukocytes, erythrocytes and platelets are not true cells

a red heme pigment bound to the protein globin

Globin composed of four subunits (two alpha and two beta polypeptide chains)

1. a heme group with central iron ion attached to each subunit

   1. Each central iron can bind one O2

      1. Each Hb molecule can transport 4 O2

~ 250 million Hb molecules

O2 bound to iron-containing heme pigment

the bright red, oxygen-loaded form of hemoglobin that carries oxygen through the bloodstream from the lungs to the body's tissues

the dark red form of the protein hemoglobin when it is not bound to oxygen

a compound formed when carbon dioxide binds to the amino groups of hemoglobin in red blood cells

1. formation of blood cells which occurs in red bone marrow

2. composed of reticular connective tissue with large capillaries (blood sinusoids)

   1. Mature blood cells cross their porous walls to enter blood

1. In adults it is found in

   1. axial skeleton

   2. girdles

   3. proximal epiphyses of humerus and femur

1. Hematopoietic stem cells (hemocytoblasts)

   1. Hormones and growth factors which push cells to commit to specific blood cell pathways

      1. Committed cells CANNOT change pathways

immature bone marrow cells that develop into red blood cells, platelets, and specific types of white blood cells

the earliest recognizable precursor cells that develop into red blood cells

early, immature red blood cell precursor found in bone marrow during the formation of red blood cells

immature, nucleated red blood cells in bone marrow that actively produce hemoglobin

nucleated immature red blood cells in the final stage of development before the cells ejects its nucleus to become a reticulocytes

immature red blood cells produced in your bone marrow and released into the bloodstream before they fully mature to mature erythrocytes

tissue hypoxia (O2 deprivation)

increased blood viscosity

1. Decreased RBCs from hemorrhage or excessive destruction

2. Insufficient hemoglobin per RBC (as in iron deficiency)

3. Reduced O2 availability (as might occur at high altitude or during pneumonia)

Erythropoietin (EPO)

1. Constant, low levels in blood maintain basal rate of RBC production

2. Released by certain kidney cells as they become hypoxic (oxygen deprived)

   1. Oxygen-sensitive enzymes in cells cannot degrade hypoxia-inducible factor (HIF), which accumulates and stimulates secretion of EPO

1. Nutrients Amino acids, lipids, and carbohydrates

   1. Vitamin12B and folic acid are necessary for DNA synthesis for rapidly dividing cells such as developing RBCs

2. Iron:

   1. Essential for hemoglobin synthesis 65% found in hemoglobin

   2. Intestinal absorption precisely controlled as body stores fluctuate

two main protein complexes the body uses to store iron (protein-iron complexes)

a blood plasma protein that binds and transports iron throughout the body

1. Life span: 100–120 days

   1. RBCs are anucleate; they cannot synthesize new proteins, grow or divide

   2. Old RBCs become fragile, and Hb begins to degenerate

   3. Can get trapped and lyse in smaller circulatory channels, especially in the spleen

a yellowish waste product made when your body breaks down old red blood cells (RBCs OR erythrocytes)

1. anemia

2. polycythemia

1. Blood’s oxygen-carrying capacity is too low to support normal metabolism

2. Sign of disorder rather than disease itself

3. Affected individuals are fatigued, often pale, short of breath, and chilled

1. Blood loss

2. Not enough RBCs produced

3. Too many RBCs being destroyed

1. Hemorrhagic anemia

   1. Acute if blood loss is rapid (e.g., severe wound)

      1. Treated by blood replacement

   2. Chronic if blood loss is slight but persistent (e.g.,hemorrhoids, bleeding ulcer)

      1. Primary problem must be resolved to stop bloodloss

1. iron-deficiency anemia

2. pernicious anemia

3. renal anemia

4. aplastic anemia

1. the result of hemorrhagic anemia

   1. Also caused by low iron intake or impaired iron absorption

   2. RBCs small and pale due to limited H b synthesis, they are called microcytes

   3. Treated with iron-rich diet or supplements

red blood cells (RBCs) that are smaller than normal

1. an autoimmune disease that destroys stomach cells that produce intrinsic factor, which is needed to absorb vitamin B12

   1. Without B12, RBCs can enlarge but not divide, results in macrocytes

   2. Treated with B12 injections or nasal gel

   3. Lack of B12 in diet can cause anemia (can be a problem for vegetarians)

specialized protein produced in the stomach that helps your body absorb vitamin B12

abnormally large red blood cells (RBCs) with a volume greater than 100 femtoliters (fL)

1. caused by lack of EPO

   1. Often accompanies renal disease

   2. damaged kidneys produce little EPO

      1. Treated with synthetic EPO

1. may result from destruction or inhibition of red bone marrow

   1. Cause usually unknown, may result from certain drugs, chemicals, radiation, or viruses

   2. Affects all formed elements, results in anemia, clotting and immunity problems

   3. Treated with short term transfusions, long term transplanted stem cells

1. Hemolytic anemia

2. Thalassemia

3. Sickle-cell anemia

1. RBCs lyse prematurely, may be caused by:

   1. Blood transfusion reactions

   2. Certain bacterial or parasitic infections

   3. Hemoglobin abnormalities

      1. Usually, genetic disorder resulting in abnormal globin

         1. thalassemia and sickle-cell anemia

1. inherited blood disorder that causes your body to make less Hb than normal

2. typically, in Mediterranean ancestry

   1. One globin chain absent or faulty

   2. RBCs are thin, delicate, and deficient in Hb

   3. Many subtypes with severity ranging from mild to so extreme that monthly blood transfusions are required

1. Caused by mutated Hb, called Hemoglobin S (HbS)

2. With less bound O2 beta chains stick together and HbS becomes spiky, causing RBCs to become crescent shaped or “sickle”

3. Sickling can occur during exercise as more O2 is unloaded to active muscles, at high altitude, as less O2 is open to bind to HbS

1. it can cause RBCs to become deformed which would cause them to rupture easily and block small vessels, resulting in poor O2 delivery and pain

2. Occurs chiefly in people who live in the malarial belt of African and their descendants; affecting 1 in every 500 African American newborns

1. sickled cells rise rate at which macrophages destroy them and the parasites inside (if infected)

   1. people with 2 copies of the HbS gene have sickle-cell anemia

   2. Those with 1 copy (sickle-cell trait) have milder disease (cells only sickle if infected with malaria) have better chance of surviving malaria

1. many focus on prevention of sickling

   1. Acute sickling crisis treated with transfusions and pain management

   2. Drug hydroxyurea switches on gene for fetal hemoglobin (which does not become spiky and promote RBC sickling)

   3. Gene editing (via CRISPR) to correct mutation in patient

1. too many blood cells

2. Abnormal excess of RBCs

   1. increases blood viscosity, causing sluggish blood flow

1. Polycythemia vera

2. Secondary polycythemia

1. Bone marrow cancer leading to excess RBCs

2. Hematocrit may go as high as 80%

3. Treatment

   1. therapeutic phlebotomy (blood draw)

caused by any condition (like low O2 levels at high altitude) or medication that stimulates EPO production

1. the illegal practice of increasing the number of red blood cells (RBCs) in the body to improve athletic performance and endurance

2. also classified as artificially inducing polycythemia

1. Injecting the athlete with artificial EPO is one way to increase their hematocrit

2. remove, store, and reinfuse (new) the athlete’s RBCs so they show up on their hematocrit

1. EPO can increase hematocrit from 45% up to even 65%, with dehydration concentrating blood even more

2. Blood becomes like sludge and can cause clotting, stroke, or heart failure

3. The practice is unethical and has been banned from competitive sports

1. they are white blood cells or WBCs

2. they are crucial to our body's defense against disease

   1. Form a mobile army that protects body from harmful bacteria, viruses, parasites, toxins, and tumor cells

   2. Have special functional characteristics to carry out their roles

the passage of blood cells, especially white blood cells (leukocytes), through intact capillary walls into surrounding tissues

the directed movement of a cell or organism toward a higher concentration of a chemical stimulus, such as a nutrient or attractant

a crawling-like type of cell locomotion where a cell changes its shape by pushing out and pulling back temporary foot-like extensions called pseudopodia

1. neutrophils

2. eosinophils

3. basophils

1. Roughly spherical in shape with lobed, rather than circular, nuclei

2. Larger and shorter-lived than RBCs (in most cases)

3. Have visible cytoplasmic granules when stained with Wright’s stain

   1. Mix of red acidic (eosin) and blue basic (methylene blue) dyes

precursor cells in the bone marrow that develop into the white blood cells responsible for the body's immune response

immature bone marrow cells that develop into red blood cells, platelets, and specific types of white blood cells

a group of signaling proteins (cytokines) that white blood cells and other body cells use to communicate and regulate the immune system

specialized proteins that tell your bone marrow to produce white blood cells

1. leukemias

2. infectious mononucleosis

abnormally low WBC count (typically drug induced)

1. Group of cancerous conditions involving overproduction of abnormal WBCs

   1. Usually involve clones of single abnormal cell

1. acute

2. chronic

3. myeloid

4. lymphocytic

1. Acute (quickly advancing) leukemia derives from stem cells

   1. Primarily affects children

1. Chronic (slowly advancing) leukemia involves proliferation of later cell stages

   1. More prevalent in older people

Myeloid leukemia involves myeloblast descendants

Lymphocytic leukemia involves lymphocytes

1. Highly contagious viral disease caused by Epstein-Barrvirus

   1. Usually seen in young adults, sometimes called the "kissing disease”

   2. results in excess number of lymphocytes

an immature white blood cell that formed in the bone marrow

a specific type of white blood cell characterized by a multi-lobed nucleus and tiny granules filled with defensive enzymes

the rapid, temporary release of high levels of reactive oxygen species (ROS) by immune cells to kill engulfed pathogens

types of large white blood cells that find, engulf, and destroy germs, dead cells, and foreign debris in the body

1. the rapid series of reactions that stop bleeding

   1. Localized and carefully controlled

   2. Requires clotting factors and substances released by platelets and injured tissues

specialized proteins in your blood plasma that work together to form blood clots and stop bleeding when you are injured

1. prostacyclin

2. ADP

3. serotonin

4. thromboxane A2

a natural molecule in the body that widens blood vessels and stops blood cells from clumping together

a chemical messenger in the body that acts as both a neurotransmitter and a hormone to help regulate mood, digestion, sleep, and other vital functions

a hormone-like lipid substance produced by activated platelets that promotes blood clotting and narrows blood vessels

1. Actin and myosin in platelets contract within 30–60 minutes

2. Contraction pulls on fibrin strands, squeezing serum from clot

3. Serum is plasma minus the clotting proteins

4. Draws ruptured blood vessel edges together

1. a natural protein in your blood that tells cells to repair tissue, grow blood vessels, and build collagen

2. stimulates division of smooth muscle cells and fibroblasts to rebuild vessel wall

1. Process whereby clots are removed after repair is completed

2. Begins within two days and continues for several days until clot is dissolved

a plasma protein trapped in clot

a fibrin-digesting enzyme activated by chemical signals

an enzyme that breaks down blood clots

1. Swift removal and dilution of clotting factors

2. Inhibition of activated clotting factors

   1. Antithrombin III (plasma protein) inactivates unbound thrombin

   2. Heparin inhibits thrombin by enhancing activity of antithrombin III; also inhibits intrinsic pathway

1. Platelets do not cling to smooth, intact endothelial lining of blood vessel

2. Endothelial cells secrete antithrombic substances (nitric oxide and prostacyclin)

1. Thromboembolic disorders

2. Bleeding disorders

Characteristics of both disorders (widespread clotting and severe bleeding)

result in undesirable clot formation

abnormalities that prevent normal clot formation

1. clot that develops and persists in unbroken blood vessel

   1. May block circulation, leading to tissue death

a thrombus freely floating in the bloodstream

an embolus obstructing a vessel (e.g., pulmonary or cerebral embolism)

drugs that help prevent undesirable clotting

1. aspirin

2. heparin

3. warfarin

ant prostaglandin that inhibits thromboxane A2 ,blocking platelet aggregation

injectable used clinically for pre- and postoperative cardiac care as well as to prevent venous thrombosis

reduce risk of stroke in patients prone to atrial fibrillation in which blood pools in Heart

1. platelet deficiency

2. clotting factor deficiency

1. a deficient number of circulating platelets

   1. Due to conditions that suppress or destroy red bone marrow (e.g., bone marrow cancer, radiation, or drugs)

1. inability to synthesize procoagulants (clotting factors)

2. Causes include vitamin K deficiency, hepatitis, or cirrhosis

3. Liver disease can also prevent liver from producing bile, which is needed to absorb fat and vitamin K

1. several similar hereditary bleeding disorders

   1. Hemophilia A: most common type (77% of all cases) due to factor VIII (antihemophilic factor) deficiency

   2. Hemophilia B: factor IX deficiency

   3. Hemophilia C: less severe form; factor XI deficiency

foreign substances that trigger an immune response

RBC antigens that promote agglutination when mismatched transfused RBCs are perceived as foreign destroyed; a potentially fatal reaction

anti-A/B antibodies

1. an inherited protein found on the surface of human red blood cells

   1. 52 named Rh antigens; each is an Rh factor– Five (C, D, E, c, and e) are fairly common

   2. Rh+ indicates presence of D antigen

1. they are not spontaneously formed in Rh− individuals

   1. Anti−Rh antibodies form if Rh− individual receives Rh+ blood, or Rh− mom is carrying Rh+ fetus

      1. Second exposure to Rh+ blood will result in typical transfusion reaction

1. Hemolytic disease of newborn

   1. only occurs in Rh− mom with Rh+ fetus

1. 1st pregnancy: Rh− mom exposed to Rh+ blood of fetus during delivery; first baby born healthy, but mother synthesizes anti-Rh antibodies

2. 2nd pregnancy: Mom’s anti-Rh antibodies cross placenta and destroy RBCs of Rh+ baby

   1. Baby treated with prebirth transfusions and exchange transfusions after birth

1. an adverse or unwanted physical response that happens during or after a person receives blood or blood products

   1. occur if mismatched blood is infused

   2. Recipient’s plasma antibodies attack donor’s RBCs

1. RBCs first agglutinate and clog small vessels

   1. Reducing oxygen-carrying capacity of blood

   2. Decreasing blood flow beyond blockages

   3. RBCs then rupture (hemolysis) and release hemoglobin into bloodstream

   4. Hemoglobin in kidney tubules can lead to renal failure

1. Blood is mixed with antibodies against common antigens if antigen is present, clumping of RBCs occurs

2. compatibility is so critical, cross matching is also done

   1. Recipient’s serum mixed with donor’s RBCs to see if they agglutinate▪ Donor’s serum mixed with recipient’s RBCs to see if they agglutinate

1. a blood test that measures the percentage of each type of white blood cell in your body

1. measures the number of seconds it takes for the liquid part of your blood (plasma) to form a clot

   1. assesses hemostasis

1. measures the number of platelets (thrombocytes) in a specific amount of your blood

   1. assesses hemostasis

blood chemistry profile that checks various blood chemical levels and markers of liver and kidney disorders

1. a routine blood test that measures the types and numbers of cells in your blood to evaluate your overall health

   1. checks formed elements, hematocrit, hemoglobin

1. the main protein that carries oxygen in the body of a developing fetus during pregnancy

   1. has higher affinity for O2 than hemoglobin A formed after birth