A & P II- Chapter 17

What protein involved in coagulation provides the activation for the final step in clotting? prothrombin activator fibrinogen thrombin fibrin

thrombin thrombin catalyzes fibrinogen into fibrin. This is the final step in coagulation.

What factor stimulates platelet formation? plasmin erythropoietin thrombopoietin interleukin 2

thrombopietin Platelet formation is stimulated by throbopoietin.

Which of the following would NOT lead to a bleeding disorder? vitamin K deficiency impaired liver function thrombocytopenia excess calcium in the diet

excess calcium in the diet Calcuim is essential for clotting pathways; a deficiency (not an excess) of calcium could lead to a bleeding disorder.

Which leukocyte might you expect to find in higher quantities in a person experiencing allergies? lymphocyte eosinophil basophil neutrophil

eosinophil Eosinophils have a role in causing allergies.

Which of the formed elements is present in the greatest concentration? granular leukocytes platelets agranular leukocytes erythrocytes

erythrocytes The erythrocytes (red blood cells) make up about 45% of whole blood.

Which plasma constituent is the main contributor to clotting? alpha globulins albumin fibrinogen beta globulins

fibrinogen Fibrinogen comprises 4% of plasma and is an important component in the process of blood clotting. Albumin, produced by the liver, makes up 60% of plasma proteins and is the main contributor to osmotic pressure.

Which of the following is not a phase of hemostasis? vascular spasm coagulation fibrinolysis platelet plug formation

fibrinolysis

How many oxygen molecules can be transported by one hemoglobin molecule? two eight four

four Each Fe2+ ion can bind to a single oxygen molecule.

Which of the following would NOT be a characteristic of normal blood? 5 million RBC per microliter pH of 7.4 sticky texture less viscous than water

less viscous than water Because of the amount of red blood cells, blood is more viscous than water.

All of the following can be expected with polycythemia except ________. low blood viscosity high hematocrit high blood pressure increased blood volume

low blood vsicosity

If a person is severely dehydrated you would expect to see all of the following except ________. higher blood viscosity lower immunity lower plasma levels higher hematocrit

lower immunity

A person with type O blood has _______. neither A nor B agglutinogens neither anti-A nor anti-B agglutinins O antigens O agglutinins

neither A nor B agglutinogens

When a person has an acute bacterial infection, such as bacterial meningitis or appendicitis, which type of leukocyte increases in number? neutrophils basophils lymphocytes eosinophils

neutrophils Neutrophils tend to increase in number in bacterial infections.

Which of the following is NOT regulated by the blood? fluid volume body temperature pH level nutrient levels

nutrient levels The blood transports nutrients through the body. However, the mechanisms that regulate these nutrients are not a part of the function of the blood.

1. : Free-floating thrombus in the bloodstream. 2. : Cancerous condition involving white blood cells. 3. : Platelet deficiency resulting in spontaneous bleeding from small blood vessels. 4. : Abnormal excess of erythrocytes resulting in an increase in blood viscosity. 5. : Condition in which blood has abnormally low oxygen-carrying capacity.

1. Embolus 2. Leukemia 3. Thrombocytopenia 4. Polycythemia 5. Anemia

1. : Nucleus has two lobes; contains granules of lysosomal enzymes; functions in attacking parasitic worms and plays complex roles in inflammatory diseases like allergies and asthma. 2. : Nucleus is multilobed; functions as a phagocyte; contains fine indistinct granules. 3. : Transports CO2 and oxygen. 4. : Contains a U- or an S-shaped nucleus; granules stain very dark; releases histamine and heparin. 5. : Largest of the WBCs; crucial in defense against viruses; associated with chronic infections.

1. Eosinophil 2. Neutrophil 3. Erythrocyte 4. Basophil 5. Monocyte

1. Produced by platelets. 2. A fibrous protein that gives shape to an RBC plasma membrane. 3. Hormone that stimulates production of RBC's. 4. Stimulates WBC production. 5. Natural anticoagulant found in basophils.

1. Prostaglandin derivates such as thromboxane A2 2. Spectrin 3. Erythropoietin 4. Interleukins and CSFs 5. Heparin

1. Fibrinogen: Thrombin catalyzes the activation of these molecules present in plasma. 2. Albumin: The major contributor to plasma osmotic pressure. 3. Albumin: Makes up most of plasma protein. 4. Fibrinogen: Forms the structural framework of a blood clot.

1. fibrinogen 2. albumin 3. albumin 4. fibrinogen

What is the average normal pH range of blood? 7.75-7.85 7.35-7.45 4.65-4.75 8.35-8.45

7.35-7.45

A person with type AB blood has _______. anti-A and anti-B antibodies A and B antigens A and B antigens and neither anti-A nor anti-B antibodies. neither anti-A nor anti-B antibodies

A and B antigens and neither anti-A nor anti-B antibodies

Which ABO blood type is considered to be the universal recipient? AB O B A

AB Type AB is considered to be the universal recipient.

Which of the following scenarios could result in HDN (hemolytic disease of the newborn)? AB-negative female pregnant with an AB-negative baby B-negative female pregnant with an AB-positive baby O-positive female pregnant with a B-positive baby A-positive female pregnant with a B-positive baby

B-negative female pregnant with an AB-positive baby Hemolytic disease of the newborn (HDN) can develop when an Rh negative mother carries an Rh positive fetus. HDN is unlikely to develop in an Rh negative female's first pregnancy with an Rh positive baby. Rather, it is in a subsequent pregnancy with an Rh positive baby that HDN can develop.

All lymphocytes are also leukocytes. True False

True Lymphocytes are specialized leukocytes. Lymphocytes include T cells, B cells, and natural killer cells.

During which event of hemostasis do clotting factors (procoagulants) assist with the transformation of blood from a liquid to a gel? A B C D

D The gelling of blood due to formation of insoluble fibrin occurs during the coagulation stage.

Each hemoglobin molecule can transport two molecules of oxygen. True False

False

Hemoglobin is made up of the protein heme and the red pigment globin. True False

False

The normal RBC "graveyard" is the liver. True False

False

The primary source of RBCs in the adult human being is the bone marrow in the shafts of the long bones. True False

False

Choose the incompatible transfusion. Donate type O blood to a recipient with type AB blood. Donate type B blood to a recipient with type AB blood. Donate type B blood to a recipient with type O blood. Donate type A blood to a recipient with type AB blood.

Donate type B blood to a recipient with type O blood. A person with type B blood can only give blood to people of type AB and B blood.

The immediate response to blood vessel injury is clotting. True False

False.

The process of fibrinolysis disposes of bacteria when healing has occurred. True False

False.

Which of the following is true of the structure of an erythrocyte? Erythrocytes can bend and twist to fit through vessels. Erythrocytes are cell fragments. Erythrocytes are larger than other cells in the blood. Erythrocytes are nucleated cells.

Erythrocytes can bend and twist to fit through vessels. Erythrocytes are held in shape by flexible proteins that allow the cell to bend, twist, and cup, but that will return it to its normal shape. This facilitates the movement of erythrocytes through capillaries that are sometimes smaller than they are.

Choose the statement that is true concerning hemoglobin. It is composed of four protein chains and four heme groups. When hemoglobin is not bound to oxygen, it appears blue. It can bind a maximum of three oxygen molecules. It is found in the plasma portion of blood.

It is composed of four protein chains and four heme groups.

Loss of fibrinogen within the plasma would most likely cause which of the following? fever with pain edema (swelling) pallor (pale skin) loss of blood clotting

Loss of blood clotting.

Which of these develops from lymphoid stem cells? granulocytes monocytes lymphocytes erythrocytes

Lymphocyte Both T and B lymphocytes arise from lymphoid stem cells.

Which blood type is generally called the universal donor? AB B O A

O

Which of the following represents a difference between extrinsic and intrinsic blood clotting pathways? One involves calcium ions, while the other does not. One is triggered by tissue damage, while the other cannot be triggered by tissue damage. One is faster than the other. One leads to the production of prothrombin activator and the other does not.

One is faster than the other The extrinsic pathway is faster than the intrinsic pathway.

A person with type B blood could receive blood from a person with either type B or type O blood. True False

True

Hemorrhagic anemias result from blood loss. True False

True

Leukopenia is an abnormally low number of leukocytes. True False

True

Which of the following is characteristic of all leukocytes? They are phagocytic. They are nucleated. They are the most numerous of the formed elements in blood. They have cytoplasmic granules.

They are nucleated.

A person exhibiting suppression of immunity, clotting disorder as well as low oxygen carrying capacity is likely suffering which of the following? hemorrhagic anemia pernicious anemia aplastic anemia iron deficiency anemia

aplastic anemia

Each hemoglobin molecule can carry ______________ oxygen molecule(s). four two one three

four

A person who lacks agglutinogen A but has agglutinogen B would have blood type __________. AB O B A

B Someone with type B blood only has agglutinogen B on their erythrocytes.

Which type of leukocyte is responsible for antibody production? lymphocytes monocytes eosinophils basophils

B Lymphocytes, which mature in the bone marrow and do not require exposure to thymosin in the thymus as T lymphocytes do, produce antibodies.

What is the name of the protein found in erythrocytes that transports respiratory gases? fibrinogen antibodies albumin hemoglobin

Hemoglobin Other than water, hemoglobin makes up almost the entire contents of an erythrocyte. It can bind both oxygen and carbon dioxide.

Why would there be cause for concern if a young pregnant mother is Rh-, her husband is Rh+, and this is their second child? If the second child is Rh+ and the mother did not take immunosuppressants, there is a chance that the child will develop erythroblastosis fetalis and die before birth. If the second child is Rh+ and the mother did not take RhoGAM, there is a chance that the child will develop hemolytic jaundice and die before birth. If the second child is Rh+ and the mother did not take immunosuppressants, there is a chance that the child will develop hemolytic jaundice and die before birth. There should be no concern, as antibodies do not cross the placenta. If the second child is Rh+ and the mother did not take RhoGAM, there is a chance that the child will develop erythroblastosis fetalis and die before birth.

If the second child is Rh+ and the mother did not take RhoGAM, there is a chance that the child will develop erythroblastosis fetalis and die before birth.

A patient complains of no energy, a chronic sore throat, a low-grade fever, and is tired and achy. His doctor notes an enlarged spleen upon examination. What diagnosis would you expect, and what definitive test would you request? The diagnosis is thalassemia. The test would be a hemoglobin concentration. The diagnosis is infectious mononucleosis. The test would be a differential white blood cell count to look for elevated numbers of monocytes and atypical lymphocytes. The diagnosis is infectious mononucleosis. The test would be a total white blood cell count. The diagnosis is anemia. The test would be a hematocrit. The diagnosis is anemia. The test would be a complete blood count.

The diagnosis is infectious mononucleosis. The test would be a differential white blood cell count to look for elevated numbers of monocytes and atypical lymphocytes.

A total WBC count and a differential WBC count have been ordered for Mrs. Johnson. What information is obtained from the differential count that the total count does not provide? The differential count determines an increase or decrease in number of WBCs. The total WBC count determines the relative proportion of individual leukocyte types. The differential WBC count looks for unusual leukocytes in the blood. The total WBC count indicates an increase or decrease in number of WBCs. The differential count determines the relative proportion of individual leukocyte types. The total WBC count indicates an increase or decrease in number of WBCs. The differential WBC count looks for unusual leukocytes in the blood. The total WBC count determines the relative proportions of individual leukocytes. The differential WBC count and total WBC cell count test results mean the same thing.

The differential count determines the relative proportion of individual leukocyte types. The total WBC count indicates an increase or decrease in number of WBCs.

Positive chemotaxis is a feedback system that signals leukocyte migration into damaged areas. True False

True

Mature erythrocytes lack a nucleus. True False

True One of the structural characteristics of erythrocytes is the lack of a nucleus. This leads to a biconcave disk shape in the cell that increases the surface area to volume ratio. Additionally, RBCs lack mitochondria.

Which statement is true? Type O is the universal recipient. Type AB is the universal donor. Type A blood cannot be given to people with type B blood. A person with type AB blood does produce agglutinins.

Type A blood cannot be given to people with type B blood. People with type B blood produce antibodies against A type blood, this transfusion would cause a cross reaction.

What part of the hemoglobin molecule is eventually metabolized to stercobilin in the feces? globin iron a portion of the heme group transferrin

a portion of the heme group The heme group has its iron removed and recycled, while the remainder is converted to bilirubin and makes its way to the liver, where it is passed to the intestine in bile. Bacteria metabolize the bilirubin into stercoblin.

Which of the following is NOT a formed element in whole blood? erythrocytes platelets leukocytes albumin

albumin albumin is a protein that would be found in the plasma.

A person with A+ blood has _______. Rh antigen on the surface of the red blood cells anti-B antibodies the A antigen on the surface of the red blood cells all of the above

all of the above.

Which part of the hemoglobin molecule binds carbon dioxide for transport? heme group iron spectrin amino acids of the globin

amino acids of the globin The heme groups and iron ions are binding points for oxygen, while carbon dioxide binds to and is carried by the globin polypeptides. The combined form is called carbaminohemoglobin.

With respect to ABO and Rh blood groups, there are __________ different blood types. four six ten eight

eight

During erythroblastosis fetalis, a Rh- mother's anti-Rh antibodies that have crossed the placenta will cause agglutination of the fetus's Rh+ RBCs. However, the reverse problem never happens when a Rh+ mother is pregnant with a Rh- fetus, that is, antibodies produced by the fetus cannot cause agglutination of the mother's Rh+ RBCs. This is true because ______. agglutinins are physically too large to pass across the placenta fetal antibodies are immature and non-functional antibodies that can cause this agglutination are not produced by a fetus the placenta is a barrier that prevents the passage of all antigens

antibodies that can cause this agglutination are not produced by a fetus. The fetus does not produce antibodies because the immune system is immature.

What part of the body does erythropoietin (EPO) target to increase erythropoiesis? lungs kidneys bone marrow liver

bone marrow The bone marrow, specifically red marrow, is the site of blood cell production and is stimulated by erythropoietin.

Athletes who choose to use industry-produced EPO as a performance-enhancing drug to increase the effects of their naturally-produced EPO, will experience ______. decreased production of EPO by their kidneys decreased erythropoiesis decreased reticulocyte counts None of the listed responses is correct.

decreased production of EPO by their kidneys EPO (erythropoietin) is a powerful hormone secreted by the kidney. Its synthesis is activated by renal tissue hypoxia and inhibited by normal tissue oxygenation.

Oxyhemoglobin _______. has a dull, brick-red color has a dull, brick-red color and has oxygen attached to the iron atom has a dull, brick-red color and has oxygen attached to the polypeptide chain of hemoglobin has oxygen attached to the iron atom has oxygen attached to the polypeptide chain of hemoglobin

has oxygen attached to the iron atom

What is a hematocrit? Hematocrit is the percentage of all formed elements in a whole blood sample. Hematocrit is the percentage of erythrocytes in a whole blood sample. Hematocrit is the percentage of leukocytes and platelets in a whole blood sample. Hematocrit is the percentage of plasma in a whole blood sample.

hematocrit Although the percent sign is usually omitted, the hematocrit, which in this figure is 45, is the percentage of erythrocytes in whole blood. The height of the erythrocyte layer is divided by the total height of the material.

Higher viscosity of blood will increase the amount of stress placed on the heart while it is pumping. Viscosity of blood is highest when ________. hemoglobin levels are lowest plasma levels are highest HbA1C levels are lowest hematocrit is highest

hematocrit is highest

What part of the pathway to produce platelets is shared with other formed elements? reticulocyte lymphoid stem cell megakaryoblast hematopoietic stem cell (hemocytoblast)

hematopoietic stem cell (hemocytoblast) The hematopoetic stem cell hemocytoblast is the stem cell for all blood-formed elements.

Abnormally low levels of erythrocytes caused by excessive bleeding is called______. thalassemia polycythemia hemorrhagic anemia sickle-cell anemia

hemorrhagic anemia hemorrhage leads to anemia because of a reduction of red blood cells.

Which of the following is NOT a function of blood? hormone production regulation protection distribution

hormone production The blood does not produce hormones.

Which of the following does NOT result in an increase in hemoglobin levels? hyperthyroidism congestive heart failure living at high altitudes polycythemia

hyperthyroidism

Which of the following does NOT stimulate erythrocyte production? erythropoietin a drop in normal blood oxygen levels testosterone hyperventilating

hyperventilating hyperventilating leads to an above-normal level of oxygen in the blood, which would not stimulate RBC production.

Which of the following might trigger erythropoiesis? hypoxia of EPO-producing cells decreased tissue demand for oxygen moving to a lower altitude an increased number of RBCs

hypoxia of EPO-producing cells

With a patient that is administered an injection of erythropoietin (EPO) you would expect to see ________. increased hematocrit decreased hematocrit increased white blood cell count decreased white blood cell count

increased hematocrit

With a patient administered an injection of colony stimulating factor (CSF) you would expect to see ________. increased white blood cell count decreased Red blood cell count decreased white blood cell count increased Red blood cell count

increased white blood cell count

What erythrocyte production disorder results from an autoimmune disease associated with vitamin B12 absorption? pernicious anemia hemorrhagic anemia aplastic anemia renal anemia

pernicious anemia A glycoprotein called intrinsic factor, produced by the stomach, is required to absorb adequate vitamin B12. Pernicious anemia results when the stomach does not produce adequate intrinsic factor, often because the cells that produce it are attacked by the body's immune system.

Which of the following is correctly matched? hemolytic anemia: results from inadequate iron intake aplastic anemia: results from excessive blood loss hemorrhagic anemia: red blood cells rupture pernicious anemia: results from a vitamin B12 deficiency

pernicious anemia: results from a vitamin B12 deficiency. Pernicious anemia does result from a vitamin B12 deficiency.

Which of these represents the majority of whole blood by volume? erythrocytes platelets plasma leukocytes

plasma Plasma typically constitutes 55% of whole blood, although this value can vary somewhat.

What "clot buster" enzyme removes unneeded clots after healing has occurred during fibrinolysis? fibrin plasmin plasminogen thrombin

plasmin As healing progresses, the clot retraction process reduces the size of the clot, while plasminogen is activated into plasmin that digests the fibrin in the clot.

Digesting a clot after it is formed requires activation of what plasma protein by tPA? fibrinogen plasmin thrombin plasminogen

plasminogen Plasminogen is the precursor to plasmin. It is activated by tPA, tissue plasminogen activator.

In a centrifuged sample of blood, what should NOT be in the plasma portion of the sample? platelets electrolytes albumin fibrinogen

platelets Platelets are dense enough that they should be in the buffy coat layer.

Which formed element can be described as membrane-enclosed cytoplasmic fragments? erythrocytes lymphocytes platelets monocytes

platelets Platelets can be referred to as cytoplasmic fragments because they form as packets of cytoplasm are pinched off the megakaryocyte.

Suppose that an individual injects himself with erythropoietin in order to raise his level of endurance, an act that is usually illegal in competitive sports. Which of the following could result? reduced tendency for blood to clot a lower hematocrit decreased blood viscosity polycythemia

polycythemia Erythropoietin causes an increase in release of erythrocytes, which, unless regulated, can induce polycythemia. EPO increases the hematocrit and the red cell mass and can lead to increased viscosity of the blood and an increased tendency to form clots.

Which of the following would you expect to have the least effect on hematocrit percentage? living at higher altitude dehydration injection with erythropoietin (EPO) prolonged or excessive fever

prolonged of excessive fever

Blood reticulocyte counts provide information regarding ________. rate of erythrocyte formation rate of platelet formation WBC ability to defend the body against disease clotting ability of the blood

rate of erythrocyte formation

What triggers erythropoietin (EPO) production to make new red blood cells? reduced availability of oxygen a high hematocrit excess oxygen in the bloodstream too many platelets

reduced availability of oxygen Reduced oxygen delivery to the kidneys will result in the release of erythropioetin (EPO), which in turn promotes the release of more erythrocytes from the bone marrow.

What is a young, anucleate erythrocyte called? polychromatic erythroblast reticulocyte proerythroblast hemopoietic stem cell (hemocytoblast)

reticulocyte Reticulocytes are a stage in erythrocyte development when the nucleus has just been lost. These are found in circulating blood, but they are typically only a small percent of total red cells.

Hemostasis is important for __________. white blood cell production red blood cell recycling red blood cell production stoppage of bleeding

stoppage of bleeding Hemostasis leads to stoppage of bleeding. The hemostasis response is fast, localized, and controlled. It involves clotting factors and substances released by damaged tissue and platelets.

Which of the following would provide no benefit to a person suffering any one of the various types of anemia? supplemental bilirubin injection treatment with synthetic erythropoietin supplemental oxygen delivered by mask blood transfusion

supplemental bilirubin injection

Bilirubin is created when red blood cells are recycled. How is it removed from the blood stream? the liver the pancreas the kidneys the spleen

the liver As RBCs are broken down, their hemoglobin is recycled. Bilirubin is a yellow pigment that results from the degradation of the heme groups and is released to the blood. The liver cells pick up the bilirubin and secrete it in bile. Once bile is secreted into the intestine, the bilirubin is converted to urobilinogen and is excreted with the feces.

If you centrifuge (spin) whole blood you will find the band of white blood cells and platelets (the Buffy coat) is much thinner than the packed red blood cells below it. This difference reflects the fact that ________. platelets are larger than white blood cells white blood cells are smaller than red blood cells platelets are larger than red blood cells white blood cells are fewer in number than red blood cells

white blood cells are fewer in number than red blood cells