state the normal hematocrit values and be able to calculate them:
hematocrit (packed cell volume): the % of whole blood volume composed of RBC
normal values men: 42% - 52%
normal values women: 37% - 48%
PCV/TV x 100
HCT rule of thumb: HCT/3=15g/100ml Hgb
state the normal hemoglobin values and be able to calculate them:
normal values men: 13 - 18 g/dL
normal values women: 12 - 16 g/dL
Explain the process for erythropoiesis:
formation in the bone marrow, 3-5 day process
1. pluripotent stem cell becomes a erythrocyte colony-forming unit
2. ECFU has receptors for erythropoienin (EPO), which stimulates ECFU to transform into a erythroblast
3. erythroblasts makes hemoglobin, loses nucleus
4. the lost nucleus makes the cell a reticulocyte ( a temp. network of ribosome clusters), then lose ribsomes
5. mature erythrocyte
list the requirements for erythropoiesis:
EPO: erythropoetin, hormone from kidney's to stimulate the process
Fe++: to make Hgb
vitamins: B12/folate for cell divsion
amnio acids
lipids
describe the the role of erythrocytes in maintaining homeostasis:
Hypoxemia: inadequate O2 transport
1. sensed by the liver/kidneys
2. kidneys secrete erythropoient
3. EPO stimulates red bone marrow
4. accelerated erythropoiesis
5. increase RBC count
6. increase O2 transport
effectors: altitude, excerise, blood loss
describe what happens to erythrocytes and their components when they die:
Expired erythrocytes break up in the liver/spleen
cell fragments are phagocytized
hemoglobin degraded: hemolysis
hemolysis breakdown for iron: stored, reused, lost during mensies or injury
hemolysis breakdown into bleliverdin: further in to bilirubin, then secreted into bile, then into feces
describe the common erythrocyte disorder polycythemia:
excess # of RBC, and increase blood viscosity
describe the common erythrocyte disorder anemia:
RBC deficiency
nutritional (Fe++, B12, folate) decreased
decreased erthropoiesis
decreased blood volume
decreased oxygen
describe the common erythrocyte disorder sickle cell disease:
recessive allele of Hgb
Hgb doesnt bind O2 well, RBC is sickle shaped, and blocks the vessels
define antigen:
a molecule that triggers an immune response
define antibodies:
a globulin that binds to a foregin antigen and cases an immune response
describe the ABO blood group:
blood grouping based on the presences or absence of A or B antigens
describe the Rh blood group:
numerous RBC antigens of which are C, D and E. antigen D is the far most reactive so a person is concered Rh+ if they have the D antigen, if they are lacking the D antigen they are considered Rh-
define agglutination:
antibodies bind to antigens and cause RBCs to clump
describe how aggultination casues a transfusion rxn and the consequence:
transfusion rxn aggultination is caused by mismatched blood, the RBCs blocks the vessels, the RBC is destroyed, releasing Hgb, and leads to renal failure
state the universal donor based on transfusion of packed red blood cells:
Type O
state the universal recipient based on transfusion of packed red blood cells:
Type AB
Define hemolytic disease of the newborn (HDN) as it relates to Rh differences between mother and child:
1st pregancy exposes mother to Rh+ fetal blood, she produces anti D antibodies. If she becomes pregnant with an Rh+ fetus a 2nd time, her anti D antibodies may pass thru the palcenta and agglutinate the fetal erythrocytes, the agglutinated RBCs hemolyze and the babe is born with server anemia called HDN
Discuss how HDN can be prevented:
give Rh immune globulin, RhoGAM, the immune globulin binds fetal RBC antigens so they cannot stimulate her immune system to produce anti D
discuss how transfusion rxns can be prevented:
If not an exact match for whole blood, must give packed cells to eliminate antibodes
give packed RBCs with a minimum of plasma
describe the structure, fxn, and classification of leukocytes:
structure: has nucleus, lysosomes, and organelles
fxn: protection against infection and other diseases
classification: white blood cells, 5000-10,000 WBC/microliter, plus more in connective tissue
describe the microscopic appearance, abundance, classification, and fxn of neutrophils:
microscopic appearance:visible nucleus,3-5 lobes when mature, cytoplasm - fine reddish to violet (lilac) specific granules
abundance: 60-70% of the WBCs, 4000 cells/microliter
classification: granuloctye
fxn: destroy bacteria
describe the microscopic appearance, abundance, classification, and fxn of eosinophils:
microscopic appearance: nucleus- 2 large lobes, cytoplasm - large orange (red)/pink granules
abundance: 2-4% of WBCs, 170 cells/microliter
classification: granuloctyes
fxn: phagocytize antigen-antibody complexes, allergens and inflammatory chemicals, releases enzymes that weaken, destroy parasites
describe the microscopic appearance, abundance, classification, and fxn of basophils:
microscopic appearance: nucleus- large, pale (obscured from view), cytoplasm - abundant dark violet granules
abundance: 0.5 - 1 % of WBCs, 40 cells/microliters
describe the common leukocyte disorder of leukemia:
much greater >>10,000 WBC/microliter, disease condidtions - cancer of hemopoietic tissues, increased immature WBC, replace normal RBC, WBC, platelets - patients immune is compromised, anemic and hemorrhagic ( impaired clotting ability)
describe the structure and fxn of thrombocytes (platelets):
structure: nucleus- none, cytoplasm - has organelles
fxn: hemostasis (cessation of bleeding)
*not a cell per se, but cell fragments
* # RBC > # platelets > # WBC
* ~ 130,000-400,000/microliter
Explain the process of thrombopoiesis:
hemopoietic (pluirpotent, stem cells) produce receptors for the hormone throbopoietin, and become megakaryoblasts
then become meagkaryocyte, it then sprouts long tendrils called proplatelets that protrude into the blood.
the blood flow shears off the proplatelets, which break up into platelets in the bloodstream
*20-40% stored in spleen
*lifespan - 10 days
Explain the mechanisms that regulate vascular spasm:
promopt constriciton of the broken vessel
triggered by: injury, pain
vasoconstriction: platelets release serotonin, so vascular spasm is maintained long enought for other two hemostatic mechanisms to come into play
Explain the mehcanisms that regulate platelet plug formation:
a broken vessel exposes its collagen fibers of its wall to the blood
platelets adhere to the vessel, contract, and draw the walls of the vessel together
degranulation: excotyosis of their cytoplasm, realease factors that promote hemostasis
Distinguish between aggultination and coagulation:
aggultination: clumping of cells or molecules to anitbodies, each antibody molecule binds to two or more antigen molecules and sticks them together
coagulation: the clotting of blood, to convert the plasma protein fribrinogen into fibrin, a sticky protein that adheres to the vessel wall
Name the goal (end product) of coagulation:
to convert the plasma protein fibrinogne into fibrin, a sticky protein that adheres to the walls of a vessel
in general terms distinguish between extrinsic, intrinsic, and common pathways of clot formation:
extrinsic: indicicated by damaged tissue (not the blood itself)
intrinsic: uses only clotting factors from blood itself
common pathway: both extrinsic and instrinsic verge into common pathway
* both mechansims active when bleeding - positive feedback
list the clotting factors:
procoagulatns: "inactive", most produced by the liver, always exist in plasma usually in an inactive state
vitamin K
Ca2+
* each factor amplifies or produces more factors in sucessive steps
*procoagulants are proteins
describe the mechanisms and importance of clot rxn:
platelets pull on the fibrin threads and draws the edges of the broken vessels together
clot becomes more compact within about 30 minutes
describe the mechanisms and importance of vessel repair:
platelets and endothelial cells secrete a stimulatn named platelet-derived growth factor (PDGF)
PDGF stimulates fibroblasts to multiply, repair damaged blood vessel
describe the mechanisms and importance of fibrinloysis:
fibrinlyosis: the dissolution of a clot
plasminogen, a fibrin-dissolving enzyme that breaks up the clot is activated
define thrombus:
a stationary blood clot
define embolus:
traveling blood clot
may lodge in heart, brain, kidneys
define anticoagulants:
prevents blood clots
describe the cause and effect of hemophilia:
cause: sex linked recessive, hereditary
effect: clotting factor deficiency, (A - VIII, B- IX, C - XI)
excertion causes internal bleeding
summarize factors that prevent coagulation:
cuomadin (warferrin) inhibits vitamin K
aspirin, prvents platelet aggergation
The percentage of blood volume made up of erythrocytes is the:
plasma
colloid osmotic pressure
buffy coat
hemoglobin concentration
hematocrit
hematocrit
Serum is equivalent to blood plasma except serum does not have:
clotting proteins
antibodies
nutrients
nitrogenous wastes
any plasma proteins
clotting proteins
Which of the following is TRUE?
Leukocytes have organelles but platelets do not.
Leukocytes have a nucleus but erythrocytes do not. Erythrocytes have organelles but leukocytes do not.
Erythrocytes have a nucleus but platelets do not.
Leukocytes have a nucleus but erythrocytes do not.
___________ is a molecule secreted by the kidneys that stimulates erythrocyte production.
ferritin
erythropoietin
folic acid
albumin
hemoglobin
erythropoietin
A disease that produces an unusually high number of leukocytes in the blood is called:
___________occurs when blood cells and platelets get trapped together by a sticky protein called fibrin, whereas __________ occurs when antibodies bind to
multiple antigens at once thus clumping many cells together.