A&P 2 chapter 17 (blood)

What is the average normal pH range of blood? a.) 4.65-4.75 b.) 8.35-8.45 c.) 7.35-7.45 d.) 7.75-7.85

7.35-7.45

bilirubin is released into the bloodstream as old or damaged RBCs are broken down by macrophages. which organ is responsible for removing bilirubin from the blood stream? a.) spleen b.) pancreas c.) kidneys d.) liver

As RBCs are broken down, the heme of their hemoglobin is split off from globin. Its core of iron is salvaged and stored for reuse. The balance of the heme group is degraded to bilirubin, a yellow pigment that is released into the blood. Liver cells pick up the bilirubin and in turn secrete it (in bile) into the intestine, where it is metabolized to urobilinogen. Most of this degraded pigment leaves the body in feces, as a brown pigment called stercobilin.

What enzyme removes unneeded clots after healing has occurred? a.) plasminogen b.) fibrin c.) plasmin d.) thrombin

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.

Why is liver dysfunction associated with bleeding disorders? a.)The liver is the primary source of calcium ions, which are required for all phases of hemostasis. b.)The liver synthesizes vitamin K, which is needed to produce four of the clotting factors. c.)The liver is the primary source of platelets, which are needed in sufficient numbers to produce the platelet plug. d.)The liver is the primary source of clotting factors, which are required in sufficient numbers for coagulation.

Bleeding disorders can occur when the liver cannot synthesize its usual supply of procoagulants. Most clotting factors are plasma proteins synthesized by the liver. They are numbered I to XIII according to the order of their discovery; as a result, the numerical order does not reflect their reaction sequence. All (except tissue factor) normally circulate in blood in inactive form until mobilized. Although vitamin K is not directly involved in coagulation, this fat-soluble vitamin is required for synthesizing four of the clotting factors.

A patient has a suspected electrolyte imbalance, what blood test would reveal an electrolyte imbalance? a.) platelet count b.) comprehensive medical panel (CMP) c.) differential white blood cell count d.) complete blood count (CBC)

CMP is a blood chemistry profile that measures various electrolytes, glucose, and markers of liver and kidney disorders.

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

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

How many oxygen molecules can be transported by one hemoglobin molecule? a.) 2 b.) 4 c.) 8

Each iron atom on a heme group can bind reversibly with one oxygen molecule.

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

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

hemostasis is important for______ a.) stoppage of bleeding b.) RBC production c.) RBC recycling d.) WBC production

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.

Your patient has a hematocrit of 56%. You recall from your anatomy and physiology class that high hematocrits are often a sign of blood doping by athletes. However, your patient is an elderly man suffering from the flu. What is most likely accounting for his elevated hematocrit? a.) he recently donated blood b.) he is leaking blood into his abnormal activity c.) your patient is on chemo and it is causing him to produce too many RBCs d.) he is dehydrated from the flu

If your patient is severely ill and not drinking enough fluids, especially if he has a fever, the ratio of cells to fluid will be shifted.

Which of the following leukocyte is not correctly matched with its function? a.) basophils: inflammation b.) neutrophils: produce antibodies c.) lymphocytes: immune response against viral infections d.) monocytes: develop into macrophage

Neutrophils are active phagocytes that ingest bacteria and some fungi. Antibodies are produced by certain types of leukocytes.

Which granular leukocytes act as our body's bacteria killers and would dramatically increase in number during a bacterial infection? a.) neutrophils b.) lymphocytes c.) basophils d.) monocytes

Neutrophils are classified as granulocytes (they contain visible cytoplasmic granules). They are our body's bacteria slayers, and their numbers increase explosively during acute bacterial infections. Neutrophils are active phagocytes; they are especially partial to ingesting bacteria.

What is the name of the protein found in erythrocytes that transports respiratory gases and provides the red color? a.) antibody b.) fibrinogen c.) albumin d.) hemoglobin

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

Which of these makes up the greatest portion of whole blood by volume? a.) plasma b.) platelets c.) leukocytes d.) erythrocytes

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

Which of the following is FALSE regarding the role of platelets in hemostatic reactions? a.)Platelets release chemicals that attract and bind other platelets. b.)Platelets adhere to exposed collagen fibers. c.)Platelets do not stick to intact endothelial cells. d.)Platelets release the only chemical factors that can initiate coagulation.

Platelet chemicals initiate the intrinsic pathway, but tissue factors released from damaged endothelium start the extrinsic pathway for coagulation in motion.

In a centrifuged sample of blood, what should not be in the plasma portion of the sample? a.) electrolytes b.) platelets c.) albumin d.) fibrinogen

Platelets are dense enough that they should be in the buffy coat layer of centrifuged blood.

Which step of hemostasis involves activation of formed elements in the blood? a.) fibrin mesh formation b.) vascular spasm c.) fibrinolysis d.) platelet plug formation

Platelets are formed elements that are activated by damaged tissue. Platelets form a temporary plug preventing blood loss.

Which of the following is not a function of blood? a.) hemeostatic regulation b.) protection from infection c.) hormone production d.) transport of metabolic waste

The blood does not produce hormones but does provide for their transport throughout the body.

Which of the following is NOT regulated by blood? a.) body temp b.) nutrient levels c.) pH levels d.) fluid volume

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

Erythropoietin (EPO) stimulates the developmental process shown here. What part of the body does erythropoietin (EPO) target to increase erythropoiesis? a.) liver b.) bone marrow c.) kidneys d.) lungs

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

What is the complete hemoglobin molecule composed of? a.) heme groups and iron ions b.) iron ions and polypeptide chains (globins) c.) heme groups and polypeptide chains (globins) d.) polypeptide chains (globins), heme groups, and iron ions

The complete hemoglobin molecule is composed of four globin polypeptides (2 alpha and 2 beta chains), four heme groups, and four Fe2+ ions.

What enzyme is responsible for dissolving the blood clot after regeneration of the vessel wall is complete? a.) plasmin b.) fibrinogen c.) thrombin d.) plasminogen

The critical natural "clot buster" is a fibrin-digesting enzyme called plasmin, which is produced when the plasma protein plasminogen is activated. Plasminogen is incorporated into a forming clot, where it remains inactive until appropriate signals reach it. Fibrinolysis begins within two days and continues slowly over several days until the clot finally dissolves.

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

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 stercobilin.

Which part of the hemoglobin molecule binds carbon dioxide for transport? a.) iron b.) amino acids of globin c.) heme group d.) spectrin

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.

Jenny, a healthy young woman, had a battery of tests during a physical for a new job. Her RBC count was at the higher end of the normal range at that time, but four weeks later it was substantially elevated beyond that. When asked if any circumstances had changed in her life, she admitted to taking up smoking. How might her new habit explain her higher RBC count? a.)Cigarette smoke contains toxins that promote the proliferation and differentiation of proerythroblasts in red bone marrow. b.)Several compounds found in cigarette smoke have been found to stimulate secretion of EPO, which is the main regulator of erythropoiesis. c.)The frequent hypoxia resulting from inhalation of oxygen-poor smoke is causing secondary polycythemia. d.)The nicotine contained in the cigarette smoke is causing polycythemia vera, which can result in a hematocrit as high as 80%.

The inhaled cigarette smoke contains less oxygen than clean air, which reduces oxygenation of the blood. As oxygen delivery to the kidneys decreases, the kidneys respond by secreting more EPO, which targets the red bone marrow and stimulates erythropoiesis. The resulting increase in RBC count is known as secondary polycythemia.

Which type of leukocyte provides protection against parasitic worms? a.) neutrophil b.) eosinophil c.) basophil d.) lymphocyte

The most important role of eosinophils is to lead the counterattack against parasitic worms, such as flatworms and roundworms that are too large to be phagocytized.

What protein involved in coagulation provides the activation for the final step in clotting? a.) fibrinogen b.) prothrombin activator c.) thrombin d.) fibrin

Thrombin catalyzes the conversion of fibrinogen into fibrin. This is the final step in coagulation.

In 1998, the U.S. Food and Drug Administration approved the nation's first commercial surgical glue to control bleeding during certain surgeries. Called Tisseel, it forms a flexible mesh over an oozing blood vessel to help stem bleeding within five minutes. This sealant is made from two blood proteins that naturally cause blood to clot when they react together. What are these two proteins? a.)thrombin & fibrinogen b.)prostacyclin & thromboxane A2 c.)procoagulants & anticoagulants d.)tissue plasminogen activator & plasminogen

Thrombin catalyzes the transformation of the soluble clotting factor fibrinogen into fibrin. The fibrin molecules then polymerize (join together) to form long, hair-like, insoluble fibrin strands. The fibrin strands glue the platelets together and make a web that forms the structural basis of the clot.

Mrs. Ryan, a middle-aged woman, appears at the clinic complaining of multiple small hemorrhagic spots in her skin and severe nosebleeds. While taking her history, the nurse notes that Mrs. Ryan works as a rubber glue applicator at a local factory. Rubber glue contains benzene, which is known to be toxic to red bone marrow. Which bleeding disorder is likely to result from the toxic effects of benzene? a.)erythroblastosis fetalis b.) hematoma c.)thrombocytopenia d.)hemophilia

Thrombocytopenia is characterized by a low number of circulating platelets. In severe cases, it causes spontaneous bleeding from small blood vessels all over the body. Since platelets are produced in red bone marrow, thrombocytopenia can arise from any condition that suppresses or destroys red bone marrow, such as bone marrow malignancy, exposure to ionizing radiation, or certain chemicals (such as benzene).

Which blood component primarily contributes to plasma osmotic pressure? a.) albumin b.) gamma globulin c.) blood borne nutrients d.) electrolytes

albumin

which of the following is not a formed element in whole blood? a.) platelets b.) erythrocytes c.) leukocytes d.) albumin

albumin; it is a protein found in the plasma

Which of the following is NOT a typical plasma protein? a.) albumin b.) fibrinogen c.) erythropoietin d.) globulins

erythropoietin

Diapedesis is the process by which red blood cells move into tissue spaces from the interior of blood capillaries a.) true b.) false

false

Each hemoglobin molecule can transport two molecules of oxygen. a.) true b.) false

false

The immediate response to blood vessel injury is clotting. a.) true b.) false

false

The normal RBC "graveyard" is the liver. a.) true b.) false

false

The primary source of RBCs in the adult human being is the bone marrow in the shafts of the long bones. a.) true b.) false

false

Which plasma constituent is the main contributor to clotting? a.) alpha globulins b.) fibrinogen c.) beta globulins d.) albumin

fibrinogen comprises 4% of plasma and is an important part component in the process of clotting

which of the following plasma proteins is improperly matched? a.) alpha globulin: transport of metal ions and fat-soluble vitamins b.) gamma globulins: lipid transport c.) albumin: osmotic pressure d.) fibrinogen: clotting

gamma globulins are also called immunoglobulins (or antibodies) and are part of the immune response

Which of the following is NOT a functional characteristic of WBCs? a.) granulosis b.) positive chemotaxis c.) diapedesis d.) ameboid motion

granulosis

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

hematocrit is highest

Which of the choices below is the parent cell for all formed elements of blood? a.) normoblast b.) polymorphonuclear cell c.) megakaryocyte d.) hematopoietic stem cell

hematopoietic stem cell

which of the following does not stimulate erythrocyte production? a.) hyperventilating b.) erythropoietin c.) a drop in blood oxygen levels d.) testosterone

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? a.) an increased number of RBCs b.) decreased tissue demand for oxygen c.) moving to a lower altitude d.) hypoxia of EPO producing cells

hypoxia of EPO producing cells

With a patient that is administered an injection of erythropoietin (EPO) you would expect to see ________. a.) increased WBC count b.) decreased hematocrit c.) decreased WBC count d.) increased hematocrit

increased hematocrit

Choose the correct statement. a.) it is composed of 4 protein chains and 4 heme groups b.) when hemoglobin is not bound to oxygen it appears blue c.) it is found in the plasma d.) it can bind a max of 3 oxygen

it is composed of 4 protein chains and 4 heme groups

What organ in the body regulates erythrocyte production? a.) kidney b.) brain c.) pancreas d.) liver

kidney

Lipids (either nutrients or hormones) are insoluble in water but are found traveling in the plasma of the blood. Which of the following is the most likely explanation for this? a.) enzymes in lipids convert lipids to soluble forms b.) lipids are carried only in the lymph which is primarily composed of unsaturated fats c.) lipids are carried in plasma bound soluble plasma transport proteins d.) lipids are carried inside blood cell

lipids are carried in plasma bound soluble plasma transport proteins

All of the following can be expected with polycythemia EXCEPT ________. a.) high blood pressure b.) high hematocrit c.) low blood viscosity d.) increased blood volume

low blood viscosity

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

lower immunity

What type of connective tissue cells are similar to basophils in that they contain granules that release histamine to mediate the inflammatory response? a.) adipocytes b.) mast cells c.) fibroblasts d.) macrophages

mast cells

The cells responsible for producing platelets are called ________. a.) megakaryocytes b.) monoblasts c.) myeloblasts d.) lymphoid stem cells

megakaryocytes

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

one is faster than the other

Which body activity would be most affected if a patient lacked an adequate number of erythrocytes (anemia)? a.) oxygen transport b.) clotting c.) immune response d.) hormone transport

oxygen transport

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

percentage of erythrocytes in a whole blood sample

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

prolonged or excessive fever

What triggers erythropoietin (EPO) release that leads to the production of new red blood cells? a.) reduced availability of oxygen b.) too many platelets c.) a high hematocrit d.) excess oxygen in the bloodstream

reduced availability of oxygen

Blood doping refers to the practice of ________ before an athletic event. a.)training at high altitude to increase red blood cell production b.)injecting performance-enhancing steroids into the blood c.)removing, storing, and re-injecting a person's red blood cells d.)injecting high amounts of oxygen into the blood stream

removing, storing, and re-injecting a person's RBCs

which of the formed elements is present in the greatest concentration? a.) erythrocytes b.) agranular leukocytes c.) platelets d.) granular leukocytes

the erythrocytes (RBC's) makes up about 45% of whole blood

which of the following is not a normal characteristic of blood? a.) more viscous than water b.) neutral pH of 7.0 c.) 5 million erythrocytes per microliter d.) tastes metallic or salty

the pH of blood is between 7.35 and 7.45. blood with a pH of 7.0 would be considered acidic; this would be a sign of acidosis

Which of these is true of the materials making up the buffy coat in centrifuged blood? a.) they are denser than plasma and erythrocytes b.) they are denser than erythrocytes but less dense than plasma c.) they are less dense than both d.) they are intermediate in density between both

they are intermediate in density between both

Clotting factor activation turns clotting factors into enzymes. a.) true b.) false

true

In clotting, prothrombin activator catalyzes prothrombin into thrombin, which in turn converts fibrinogen into fibrin. a.) true b.) false

true

Leukopenia is an abnormally low number of leukocytes. a.) true b.) false

true

When erythrocytes are destroyed, some of the heme is converted into bilirubin and then secreted as bile. a.) true b.) false

true

White blood cells are produced through the action of colony-stimulating factors. a.) true b.) false

true

Mature erythrocytes do NOT contain mitochondria or a nucleus. a.) true b.) false

true.Erythrocytes lack a nucleus and most organelles (including mitochondria), which provides additional space for hemoglobin. Bounded by a plasma membrane, erythrocytes are little more than "bags" of hemoglobin, the protein that functions in the transport of oxygen and carbon dioxide. The lack of mitochondria also prevents these cells from using the oxygen they are transporting. Without a nucleus, erythrocytes cannot grow, divide, or synthesize new proteins. The latter results in a relatively short lifespan.