1. Where are plasma proteins synthesized?
    In the liver
  2. Proteins are limited to compartments and exert _______ pressure
  3. What are the major functions of plasma proteins?? (3)
    • 1- transportation
    • 2- drug binding
    • 3- regulating temperature
  4. True or false, mature RBCs do not have a nucleus, mitochondria, or ER.
  5. Iron ions in the Hb are in the ________ state
    reduced ferrous (Fe2+)
  6. RBCs are produced in:
    First trimester?
    Second trimester?
    Thrid trimester?
    ~20 yrs?
    • 1- yolk sac
    • 2- liver,spleen, lymph nodes
    • 3- bone marrow
    • 4- tibia, humerus
    • 5- sternum, vertebrae, ribs
  7. RBC growth/reproduction are controlled by?
    Growth inducers (IL-3)
  8. What stimulates RBC production? (2)
    • 1- any decrease in O2 (hypoxia)
    • 2- erythropoietin
  9. Where is erythropoietin formed?
    Mainly the kidneys and some in the liver
  10. True or false, adult Hb has a higher affinity for oxygen than fetal Hb.
    False, fetal Hb requires a higher affinity for oxygen than adult Hb
  11. What 2 vitamins are required for DNA synthesis in Hb?
    • 1- Folic acid
    • 2- Vitamin B12
  12. Fe2+ in each heme group binds to how many O2?
    only 1, BUT 1 Hb binds to 4O2 (heteroTETRAmeric)
  13. Oxygen binds to Hb in ____levels in the lungs and releases in ____levels in the tissues

  14. ____% of total body iron is bound to Hb

    ____% of total body iron is stored in the liver bound to ferritin

  15. Iron enters the ______ in the RBC where it is synthesized into ______ and released as free iron

  16. What is the role of transferrin?
    It TRANSFERS iron from the GI tract to erythrocyte membranes in the bone marrow where it is endocytosed
  17. RBCs ____ in the spleen then they squeeze through the ________

    recticular mesh (aka red pulp)
  18. What phagocytizes Hb?
    macrophages in the spleen & bone marrow


    kupffer cells in the liver
  19. Anemia is the deficiency of Hb to carry O2 by? (2 things)
    decreased RBC production

    decreased Hb in RBCs
  20. What causes sickle-cell anemia?
    An amino acid change in the Hb causing the Hb to crystalize
  21. What 2 types of anemia are caused by vitamin deficiencies?
    Pernicious anemia (B-12 not absorbed right)

    Sprue (lack of B-12 and folic acid)
  22. What is clot retraction?
    Shrinking of a blood clot over a number of days that depends on the release of coagulation factors
  23. What is the role of PGI2 in platelet aggregation?
    It inhibits platelet aggregation

    It is released by UNDAMAGED tissue
  24. What is the role of TXA2 in platelet aggregation?
    It is released by DAMAGED tissue to induce aggregation
  25. Calcium is required at which steps in the clotting cascade?
    • Factor 9 --> 9a
    • Factor 10 --> 10a
    • Prothrombin (2) ---> Thrombin (2a)
    • Fibrinogen monomer --> Fibrin (1a)
  26. What are the 3 essential steps in the clotting cascade?
    • 1-trauma
    • 2- conversion of prothrombin to thrombin
    • 3- conversion of thrombin to fibrinogen to insoluble fibrin
  27. Which pathway in the clotting cascade is the fasest?
    Extrinsic, it goes from factor 7 --> 10
  28. Which pathway in the clotting cascade has positive feedback?
  29. Calcium removal can ______ clotting, especially calcium citrate and calcium oxalate.
  30. What does activated protein C inhibit?
    Factor 8a and 5a
  31. What inactivates heparin?
  32. What cells secrete heparin?
    Mast cells and basophils
  33. What is the role of plasmin in clot removal?
    Plasmin breaks down fibrin into soluble fibrin fragments

    Plasmin is activated via tissue plasminogen activators (t-PA)
  34. A vitamin k deficiency affects the synthesis of what?
    • Prothrombin (2)
    • Factors 7, 9, and 10
  35. Hemophilia is caused by a deficiency in what factor(s)?
    • 85% is factor 8
    • 15% is factor 9
  36. What are the 2 main causes for inappropriate clotting?
    • 1- AP (athrostatic plaque)
    • 2- slow moving blood
  37. How does Coumadin (warfarin) prevent clotting?
    It decreases levels of Factors 7, 9, 10 and compete with vitamin K
  38. How does cerumen (ear wax) function in pathogen defense?
    It traps dust and repels insects
  39. What do sebaceous glands contain?
    lactic acid and fatty acid
  40. How do nose hairs function in pathogen defense?
    They filter and warm the air
  41. True or false, vaginal secretions after menstruation become more basic.
    false, they become more ACIDIC
  42. Blood draining through the GI tract filters through the ______.
    Liver (full of immune cells)
  43. What enzyme in mother's milk transfers antibodies from mother to child?
  44. What 2 mechanisims prevent pathogen invasion?
    Phagocytosis (inate)

    Antibodies (aquired)
  45. Monocytes turn into ______ in the tissues.
  46. ________ and _______ move via chemotaxis and phagocytize.

  47. Which granulocytes have multi-lobed nuclei?

    Eosinophils & basophils have bi-lobed nuclei
  48. Lymphocytes enter the blood through the lymph via _______.
  49. Which WBC is able to phagocytize more bacteria a neutrophil or a macrophage?
    A macrophage ~100 bacteria and is larger

    A neutrophil ~3-20 bacteria
  50. What is margination?
    Is when the adhesion molecules tether the neutrophils to the surface near the infection allowing for diapedesis.
  51. What is the role of integrin in margination?
    It is the adhesion molecule that stabilizes neutrophil binding allowin diapedesis
  52. What are the 5 substances responsible for inflammation?
    TNF, IL-1, GM-CSF (granulocytes/monocytes), G-SCF (granulocytes), M-CSF (monocytes)
  53. What are interferons?
    They are cytokines that inhibit viral replication in host cells
  54. Eosinophils are made in response to ______ infections and are attracted through chemotaxis via _____________

    eosinophil chemotactic factor
  55. Basophils bind to _____ antibodies triggering release of _______, _________, __________, and _________ enzymes
    • IgE
    • histamine
    • bradykinin
    • serotonin
    • lysosomal
  56. What is leukopenia?
    Cancerous mutations of WBC precursors that result in uncontrolled WBC production
  57. How do eosinophils kill?
    Via hydrolytic enzymes and ROS's
  58. Aquired immunity is mediated via which 2 lymphocytes?

  59. How to t-lymphocytes work?
    they attack antigenic material directly (cell-mediated immunity)
  60. Where do t-lymphocytes migrate to for maturation?
    the Thymus
  61. Where are b-lymphocytes made?
    Before birth- in the liver

    After birth- bone marrow
  62. B-lymphocytes bind to what?
    surface-expressed antibodies
  63. T-lymphocytes bind to what?
    surface receptor proteins
  64. What is the role of macrophages in lymphocyte activation?
    They present antigenic material directly via cell-to-cell contact (APC complex)

    secrete IL-1 that promotes production of lymphocyte clones
  65. Helper cells secrete _______ after activation via _____ which enhances activation of ___-lymphocytes
    • lymphokines
    • MHC
    • B
  66. What happens to the b-lymphocytes that do not become plasma cells?
    They remain dormant until activated via a specific antigen (memory cells)
  67. Immunization prepares the immune system for ______ response
    second degree
  68. Antibodies are ____ ______ called immunoglobulin
    gamma globulins
  69. Which portion of the antibody determines antigenic specificiy?
    The heavy chain variable portion
  70. Which 2 types of antibodies are the most important against bacteria & viruses?
    IgG and IgM
  71. Which antibody is involved in allergic reactions?
  72. What are the 5 classes of antibodies?
    • IgG
    • IgA
    • IgM
    • IgE
    • IgD
  73. What is agglutination in antibody action?
    When large invaders become bound via antibodies into a clump
  74. What is antibody lysis?
    When the antibody ruptures the cell membrane
  75. What is antibody neutralization?
    When the antibody covers and inactivates toxic sites on the invader
  76. Which factors in the complement system form the MAC attack complex (lytic complex)?
    C5b, 6, 7, 8, and 9
  77. What triggers the complement system cascade?
    The stem portion of the antibody binds to C1 and triggers the cascade
  78. Which complement factor causes chemotaxis of neutrophils and macrophages?
  79. Which complement factors activate mast cells and basophils?
    C3a, C4a, and C5a
  80. What is the only function of dendritic cells?
    antigen presentation via adhesion molecules
  81. Where is MHC-1 found and how does it function?
    On all nucleated cells

    Presents antigens to cytoxic t-lymphocytes
  82. Where is MHC-2 found and how does it function?
    only found on APCs

    presents to helper-t cells
  83. What are the 4 type sof t-lymphocytes?
    • Helper
    • Cytotoxic
    • Suppressor
    • NK (Natural Killer)
  84. Which type of lymphocytes does AIDS affect?
    Helper-T cells
  85. Which type of lymphocytes attack transplanted tissues? (kideny transplant)
    Cytotoxic T-cells
  86. True or false, MHCs are involed in presenting antigens to NK cells.
    False, NK cells are NOT antigen specific
  87. What is the function of Helper T-cells? (3)
    • 1- activation of suppressor and cytotoxic cells
    • 2- stimulation of b-lymphocyte growth
    • 3- differentiation into plasma cells
  88. What is passive immunity?
    Injection of antibodies produced from another source or specifically activated t-lymphocytes or both
  89. Which cells function in anaphylaxis?
    Eosinophils and mast cells
  90. What is a xenograft?
    transplantation between different species
  91. What is the most common type of transplantation?
    Allograft (between same species)
  92. How do cortisollglucocorticoids function?
    They supress growth of lymphoid tissues and decrease formation of lymphocytes
  93. What is the only combination that is Rh+?
    D, all other are Rh- (C, E, c, d, e)
  94. What is erythroblastis fetalis?
    When the mother Rh+ has and Rh- baby
  95. What causes jaundice?
    hemolyzed RBCs result in Hb recycling and bilirubin production which causes the skin discoloration
  96. What is opsonization?
    When the bactrium is "marked" for phagocytosis
  97. The AB blood group possesses:


    BOTH antigens

  98. The O blood group possesses:



    BOTH antibodies (Anti-A & Anti-B)
  99. The A blood group possesses:


    A antigen

    B antibody(anti-B)
  100. The B blood group possesses:

    ____ antigen(s)

    ____ antibody(s)
    B antigens

    A antibodies(anti-A)
  101. What do the platelets adhere to during plug formation?
    Collagen and von willbrand factor
  102. What are platelets formed from?
    They are fragments of megakaryocytes
  103. How are platelets removed?
    Via macrophages in the spleen (phagocytosis)
  104. Explain the positive feedback loop during platelet plug formation.
    The platelets secrete ADP and TXA2 which activate other platelets to come to site of injury
  105. What is blocked by Plavix?
  106. How do LMW heparins work?
    Increase the action of AT3 ON 10a but NOT on THROMBIN(2a)
  107. How does heparin work? (2)
    It increases the INACTIVATION of thrombin(2A)

    It acts with AT3 to affect 10a
  108. What is the alternate complement pathway?
    Activated without antibodies and is non-specific

    C3b connects bacteria for opsonization
  109. What is significant about Factor 5?
    It is inactive and thrombin feeds back in the positive feedback loop to speed clotting
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