LearnSmart Chapter 18. The circulatory system: blood
List in order, the stages of erythropoiesis. Start with the least differentiated cell type and end with erythrocytes.
1. Hemopoietic stem cells 2. Colony-forming units 3. Erythroblasts 4. Reticulocytes 5. Erythrocytes
Place the main steps of WBC development in order, starting with the least differentiated cell type
1. Hemopoietic stem cells (HSE) 2. Colony forming units (CFU) 3. Precursor cells (myeloblast, lymphoblast, monoblast) 4. Mature cell
What are some functions of macrophages?
-Destroy foreign antigens -Present antigens -Phagocytize dead cells
How do reticulocytes differ from mature red blood cells?
-Reticulocytes have polyribosomes, RBC's do not -RBC's are more numerous, only 0.5% to 1.5% of circulating blood are reticulocytes
List, in order, the events that occur during fibrinolysis.
1. prekallikrein is converted to kallikrein 2. kallikrein catalyzes the formation of plasmin 3. plasmin dissolves the blood clot
Place the steps of hemostasis in the correct order, starting with what happens first
1. vascular spasm 2. platelet plug formation 3. blood coagulation
Adult hemoglobin consists of which of the following?
2 alpha and 2 beta chains
How long does erythropoiesis take to complete?
3-5 days
A single molecule of hemoglobin can transport how many molecule(s) of oxygen?
4
How many heme groups are there in each hemoglobin molecule?
4
What is the normal lifespan of platelets?
5 to 6 days
How many leukocytes are found in a normal sample of blood?
5,000-10,000 WBCs/microliter
Which test provides information about RBC, WBC and platelet count?
CBC
Name the enzyme that catalyzes the reaction combining water and CO2 to form carbonic acid.
Carbonic anhydrase
The intrinsic mechanism of coagulation is triggered by which of the following?
Clotting factors in the plasma
Which statement about clotting factors is true?
Clotting factors initiate a cascade of reactions
Which term refers to the contribution of protein to the osmotic pressure of blood?
Colloid osmotic pressure
Which term refers to the contribution of protein to the osmotic pressure of the blood?
Colloid osmotic pressure
Describe normal erythrocytes.
Contain hemoglobin to transport gases like oxygen. Have a biconcave shape.
What is the main goal coagulation?
Conversion of fibrinogen into fibrin
Antagonizes vitamin K
Coumadin/warfarin
Which would directly reduce blood viscosity?
Decreased hematocrit Protein deficiency
Histamine is secreted by basophils. What is the physiological role of histamine?
Dilates blood vessels
Match the following blood disorders with their definitions.
Disseminated intravascular coagulation (DIC) -Clotting and hemorrhaging, limited food one organ of occurring throughout the body Infectious mononucleosis -Epstein-Barr virus affects B-lymphocytes. It is transmitted by kissing. Causes fever, fatigue, sore throat. Septicemia -Bacteria in the bloodstream accompanying infection elsewhere in the body. Thalassemia -Hereditary anemia common in people of Mediterranean descent; Alpha or beta hemoglobin is abnormal
People with blood type O are considered universal ___.
Donor
Binds calcium ions and prevent them from participating in the coagulation reactions
EDTA
In addition to water, blood plasma consists of which of the following?
Electrocytes and nutrients Albumins, globulins, and fribrinogen
Which term refers to a blood clot that breaks loose and travels through bloodstream?
Embolus
A(n) ___ is a blood clot that breaks loose and travels in the bloodstream.
Embolus (also known as thromboembolus)
Match each type of leukocyte to its percentage of total WBCs in healthy individuals.
Eosinophils: 2-4% of WBCs Neutrophils: 60-70% of WBCs Basophils: <0.5% of WBCs Lymphocytes: 25-33% of WBCs Monocytes: 3-8% of WBCs
The cell indicated by the arrow is a(n) ___, also known as a red blood cell, the most abundant formed elements in the blood.
Erythrocyte
Agglutinogens are antigens found on the surface of which cell type?
Erythrocytes
The hematocrit is the percentage of the blood volume composed of which of the following?
Erythrocytes
Which formed elements of the blood transports oxygen?
Erythrocytes
Hemipoiesis is the production of all formed elements. The term ___ is defined as the production of red blood cells specifically.
Erythropoiesis
Anemia may occur in patients with failure due to decreased production of which of the following?
Erythropoietin
Which is a hormone that stimulates erythrocyte production?
Erythropoietin
The extrinsic mechanism of coagulation is initiated by which of the following?
Factors released by damaged blood vessels (thromboplastin)
True or false: A, B, AB, and O are the only blood groups.
False
True or false: There is no treatment or preventative treatments for the hemolytic disease of the newborn (HDN).
False
True or false: all clotting deficiencies are hereditary
False
True or false: all the components of blood originate in the bone marrow.
False
True or false: coagulation involves only two chemical reactions
False
True or false: hypoxemia can occur transiently, but it is always associated with disease conditions.
False
True or false: one colony stimulating factor increases the production of all types of leukocytes.
False
What is the storage form of iron that is formed in the liver by the binding of excess iron to apoferritin?
Ferritin
A blood clot is based on a mesh framework of the protein ___.
Fibrin
The meshlike framework of a blood clot is formed by a sticky protein called ___.
Fibrin
What is the function of fibrin?
Fibrin creates the framework of a blood clot
Antibodies are examples of which of the following?
Gamma globulins
Why does erythropoiesis decrease with age?
Gastric atrophy may occur, reducing intrinsic factor secretion The kidneys atrophy and produce less EPO Elderly people tend to get less exercise and eat less well
Iron is transported from the stomach to the intestine bound to a protein called ___.
Gastroferritin
Neutrophils, basophils, and eosinophils are the three types of leukocytes classified as ___.
Granulocytes
Match each alpha globulin go its role.
Haptoglobulin- transports hemoglobin released by dead erythrocytes Ceruloplasmin- transports copper Prothrombin- promotes blood clotting
The three components of the circulatory system are the blood vessels, the blood, and the ___.
Heart
The cardiovascular (not circulatory) system includes which of the following?
Heart Blood vessels
When they are in the tissues, masses of clotted blood are called ___.
Hematomas
Contains erythrocytes
Hemmatocrit
Sickle-cell disease and thalassemia are hereditary defects in which of the following?
Hemoglobin
Match each type of hemoglobin with its description.
Hemoglobin HbA- the most common type in the adult; contains two alpha globin chains and two beta globing chains Hemoglobin HbA2- about 2.5% of adult hemoglobin; contains two alpha globin chains and two delta globin chains Hemoglobin HbF- fetal hemoglobin; contains two alpha globin chains and two gamma globin chains; it binds oxygen tightly
Which clinical measurement express the blood's ability to carry oxygen?
Hemoglobin concentration Hematocrit RBC count
Iron is crucial component of which of the following?
Hemoglobin, cytochromes, myoglobin
Which is a sex-linked blood clotting disorder that is more common in men than women?
Hemophilia
Which term refers to the production of blood, especially the formed elements?
Hemopoiesis
Which term refers to the multi potent stem cells in bone marrow?
Hemopoietic stem cell
What are some risks associated with polycythemia?
High blood pressure Increased blood viscosity Increased blood volume
The extrinsic pathway of coagulation begins when which factor combines with factor VII?
III
Which can cause anemia?
Inadequate hemoglobin synthesis Hemorrhage Increased hemolysis
Which can cause anemia?
Increased hemolysis Hemorrhage Inadequate hemoglobin synthesis
Release of factor XII by platelets initiates the ___ mechanism of coagulation.
Intrinsic
What are heme groups?
Iron-containing groups that bind oxygen
How does aspirin prevent clotting?
Is suppresses formation of thromboxane A2
What is the fate of bilirubin in the intestine?
It is converted to urobilinogen
Which are the functions of the circulatory system?
It neutralizes toxins and helps to destroy pathogens. It carries oxygen from the lungs to the peripheral tissues and CO2 from the peripheral tissues to the lungs. It helps to stabilize fluid distribution in the body.
Why is the liver considered part of the circulatory system?
It produces most of the plasma proteins
What is the functional role of platelet-derived growth factor (PDGF)?
It stimulates mitosis in smooth muscles and fibroblasts
The cancerous disease called ___ results in large numbers of leukocytes and their undifferentiated precursors being released into the blood.
Leukemia
The alternate term for a white blood cell (WBC) is ___.
Leukocyte
The Buffy coat (indicated by the blue arrow) is about 1% of the blood volume and it is composed of which of the following?
Leukocytes and platelets
The term ___ is used to describe a WBC count over 10,000 cells/microliter.
Leukocytosis
Match the blood cell disorder with its description.
Leukopenia - total WBC count below 5,000 WBCS/uL Leukocytosis- total WBC count above 10,000 WBCs/uL Leukemia- cancer of hemopoietic tissues resulting in high numbers of leukocytes Polycythemia- abnormally high red blood cell count
Decreased blood osmolarity could cause which of the following?
Low blood pressure Edema
Lymphoblasts give rise to which of the following?
Lymphocytes
The formed elements of the blood are platelets, erythrocytes, and five types of leukocytes which include eosinophils, basophils, neutrophils, monocytes, and ___.
Lymphocytes
Platelets contain which of the following?
Lysosomes Granules Mitochondria
Place the events of heme disposal in order, starting with what happens first.
Macrophages remove the iron Macrophages converts the heme into biliverdin A yellow-green pigment called bilirubin is formed
Albumin plays a role in which of the following?
Maintenance of osmolarity pH buffering of plasma Solute transport
Match the precursor with the cell(s) that arise from each.
Monoblast-monocyte Myeloblast-granulocytes Lymphoblast-lymphocytes Erythroblast-erythrocytes
Which type of precursor cell produces monocytes?
Monoblasts
How does the body use iron?
Nearly all cells use Fe2+ to make electron-transport molecules (cytochromes) in their mitochondria. The muscles use Fe2+ to make the myoglobin. The bone marrow used Fe2+ for hemoglobin synthesis.
List the leukocytes from most abundant to least abundant (in healthy individuals)
Neutrophils Lymphocytes Monocytes Eosinophils Basophils
Urea is an example of which of the following?
Nitrogenous waste
A patient's blood does not agglutinate when either anti-A or anti-B antiserum is added to the slide (indicated in the figure). Name the patient's blood type.
O
Which values are correct for human blood?
Osmolarity- 280-296 mOsm/L Total WBC count: 5,000-10,000/ ul pH: 7.35 - 7.45 Volume in females- 4-5 L; volume in males: 5-6 L
A lack of intrinsic factor and/or vitamin B12 may cause the form of anemia called ___ anemia.
Pernicious
Fluid portion of the blood
Plasma
What is serum?
Plasma from which fibrinogen has been removed
Cell fragments produced from megakaryocytes are called ____.
Platelets
As platelets aggregate during the second step of homeostasis, which of the following events occur?
Platelets degranulate resulting in release of thromboxane A, ADP and serotonin
What begins the intrinsic pathway of coagulation?
Platelets release factor XII
Which condition is associated with high blood volume, high blood pressure and high blood viscosity?
Polycythemia
Platelet repulsion, dilution, and substances such as heparin or antithrombin help do what?
Prevent inappropriate clotting
What is the role of plasma cells in blood?
Produce gamma globulins
What is the role of plasma cells in the blood?
Produce gamma globulins
Which is not true regarding the life cycle of erythrocytes?
Production of red blood cells takes about one month. (FALSE) About 20 mL of packed RBCs are produced per day. (TRUE) An erythrocyte lives for an average of 120 days. (TRUE) About one million red blood cells are formed per second. (TRUE)
Blood vessel linings are very smooth and coated with the chemical ___, which prevents platelet adhesion and unwanted clotting.
Prostacyclin
Edema and ascites can both occur due to which of the following?
Protein deficiency
The blood type AB is sometimes called the universal ___.
Recipient
Platelets perform which of the following functions?
Release vasoconstrictors Promote clotting and also initiate dissolution Release factors that attract WBCs
The process by which clots become more compact is called clot ___.
Retraction
Which of the following is characteristic of lymphocytes?
Round dark violet staining nucleus, with a light blue cytoplasm
Which condition can be caused by emphysema, high altitude, hypoxemia, or dehydration?
Secondary polycythemia
Which of the following are functions of lymphocytes?
Serve in immune memory Coordinate actions of other immune cells Destroy cancer cells, cell infected with viruses, and foreign cells "Present" antigens to activate other cells of immune system
___ is the most common ion found in the plasma and is the solute with the greatest influence on osmolarity of the blood.
Sodium
Which organ stops producing RBCs at birth, but continues to produce lymphocytes in the adult?
Spleen
Iron need to be in the Fe2* form to be absorbed. Which of the following converts Fe3+ to Fe2+?
Stomach acid
The hematocrit and hemoglobin concentration are clinical data that describe which of the following?
The amount of oxygen the blood can carry
Following the first pregnancy with an Rh+ fetus, the immune system of an Rh- woman produces anti-D antibodies. During her pregnancy the baby is at risk of developing Hemolytic disease of the Newborn (HDN), but only if which of the following is true?
The baby's blood is Rh+
What is colloid osmotic pressure?
The contribution of protein to the total blood osmotic pressure
Which statements are true regarding coagulation?
The extrinsic mechanisms requires fewer steps to activate factor X The extrinsic mechanism requires less time to form a blood clot compared to the intrinsic mechanism In most cases of bleeding, both the extrinsic and intrinsic mechanisms work simultaneously to contribute to homeostasis
What is factor X?
The first factor shared by the extrinsic and intrinsic pathways
Why can liver disease impede blood clotting?
The liver synthesizes most clotting factors
What is viscosity?
The resistance of a fluid to flow due to particle cohesion
What is true about vitamin B12, copper and folic acid?
They are all required for erythropoiesis
Which statements are true about neutrophils?
They are most abundant leukocyte They have multi loved nuclei when mature
What is the special characteristic of stem cells that make them desireable for therapeutic use?
They can give origin to many different tissue types
What role do the kidneys play in erythrocyte homeostasis?
They detect hypoxemia and secrete erythropoietin (EPO)
Which of the following are characteristic of monocytes?
They differentiate into macrophages and phagocytize pathogens. The nucleus is large and clearly visible, ovoid, kidney-shaped, or horseshoe-shaped.
How do spectrin and actin function in mature red blood cells?
They five the cell resilience and more durability
Which statement is true about erythrocytes?
They lack internal organelles and perform anaerobic fermentation
What role do macrophages play in RBC death and disposal?
They separate the heme from the globin of hemoglobin, and hydrolyze globin into free amino acids
Antithrombin is a plasma protein produced by the liver that works to deactivate ___.
Thrombin
The process of platelet formation is called ___.
Thrombopoiesis
What is the purpose of a differential WBC count?
To determine the number and ratio of each type of leukocytes in a sample
Transferrin does which of the following?
Transports iron into the blood
True or false: Agglutination would be expected if a recipient had type A blood and the donor had type B blood.
True
True or false: Iron deficiency anemia can be caused by poor nutrition or blood loss.
True
True or false: both erythropoiesis and leukopoiesis begin with the same pluripotent stem cell
True
True or false: transfusion reactions occur when antibodies in the recipient's blood bind to the antigens on the donor's RBCs and agglutinate the donated blood.
True
Individuals with which blood types will have anti-A agglutinins in their plasma?
Type B Type O
An individual with neither A nor B red blood cell antigens has which ABO blood type?
Type o
What are the possible causes of hypoplastic or aplastic anemia?
Viruses Drugs and poisons (arsenic, mustard gas) Radiation Autoimmune diseases
List the components of blood.
White blood cells Red blood cells Platelets Plasma
The clinical values for the RBC and hemoglobin content of the blood differ significantly between women and men. Choose three factors from the list below that help explain the difference.
Women sustain menstrual losses Men have less body fat Androgens stimulate RBC production
Which lists the correct order of events for the intrinsic pathway of coagulation?
XII activated XI which activated IX and VIII which finally activated factor X
Factor ___ cross-links fibrin threads into a fibrin polymer.
XIII
Red blood cells have specific antigens on their surfaces called ___. These antigens determine blood type.
agglutinogens
Which term describes lymphocytes and monocytes?
agranulocytes
What do hemopoietic tissues produce?
all formed elements of blood
Name the compounds that are converted into bile pigments in the liver.
bilirubin and biliverdin
Contains WBC and platelets
buffy coat
leukocytes called _______ function to destroy large parasites such as hookworms and tapeworms
eosinophils
Hypoxemia, resulting from hemorrhage, high altitude, or emphysema, may stimulate _____.
erythropoiesis
The release of clotting factors by damaged blood vessels and perivascular tissues initiates the ___ pathway of coagulation
extrinsic
Which plasma component is not present in serum?
fibrinogen
Antibodies belong to which class of plasma proteins?
gamma globulins
Name the protein that binds oxygen and buffers blood pH.
hemoglobin
Which term refers to limiting blood loss from an injured vessel?
hemostasis
keeping in mind the structure of hemoglobin, name the nutrient that is critical for hemoglobin synthesis.
iron
Leukocytes called ___ have diverse functions such as secretion of antibodies, destruction of cancer cells, and destruction of cells infected with viruses.
lymphocytes
A _____ is a giant precursor cell with a multilobed nucleus which fragments to form platelets
megakaryocyte
The formation of blood cells in the bone marrow is called ___ hemopoiesis.
myeloid
_____ is the fluid component of blood, a complex mixture of water, proteins, nutrients, electrolytes, wastes, hormones and gases.
plasma
When collagen in the wall of a blood vessel is exposed as a result of injury, _____ grow long, spiny pseudopods, which adhere to the vessel and draw its walls back together.
platelets
Which term refers to an excess of red blood cells?
polycythemia
What is leukopoiesis?
production of white blood cells
Factor X combines with factors III and V to produce ___, which in turn converts prothrombin to thrombin.
prothrombin activator
Where are mature leukocytes usually found?
residing in the connective tissues
Blood loss stimulates accelerated erythropoiesis. This may cause an increase in which of the following?
reticulocytes
What is hemolysis?
rupture of red blood cells
Old blood cells usually die as they pass through what organ?
spleen
The enzyme ___ converts fibrinogen into fibrin.
thrombin
___ is a condition in which the platelet count is less than 100,000
thrombocytopenia
Which protein transports iron in the blood?
transferrin
What is polycythemia?
A condition where there are too many red blood cells
Bone marrow transplants are a treatment option for several conditions such as leukemia. Which of the following statements are true?
A graft-versus-host response may occur It is difficult to find compatible donors Up to one-third of patients die from complications
Which ABO blood type is sometimes called the universal recipient?
AB
Which blood type is the least common in the United States?
AB
What is the first response to a blood vessel injury?
vascular spasm
What are some causes of hypoxemia?
Abrupt increases in activity level Emphysema COPD
Jaundice is a yellowing of the skin due to which of the following?
Accumulation of bilirubin
A(n) ___ leukemia appears suddenly, progresses rapidly, and causes death within a few months if it is not treated. ___ leukemia, on the other hand develops more slowly and may go undetected for many months.
Acute, chronic
Which term refers to the clumping of cells that occurs when an antibody binds to more than one antigen-bearing cell?
Agglutination
Which term refers to antibodies that bind proteins expressed on the surface of RBCs?
Agglutinin
What's re the three types of plasma proteins?
Albumins Globulins Fibrinogen
List the types of globulin found in the plasma.
Alpha Gamma Beta
Hypoxia, decreased blood osmolarity, and decreased blood viscosity are all consequences of which disorder?
Anemia
What is the last common leukocyte?
Basophils
What is the function of gastroferritin?
Binds Fe2+ and Carrie it time the small intestine
Hematology refers to the study of which of the following?
Blood
Why is thrombosis is more likely to occur in veins that in arteries.
Blood flows more slowly in veins and does not dilute thrombin and fibrin as rapidly
Which term refers to clusters of stem cells that form in the yolk sac, then migrate into the embryo to colonize the liver, spleen, thymus and bone marrow?
Blood islands
Carbohydrates, proteins, and water (as well as some other nutrients) are transported from the digestive system to the body's cells in which of the following fluids?
Blood plasma
Which of the following may cause hemolytic anemia?
Blood type incompatibilities Snake and spider venom Sickle cell disease, thalassemia, malaria Penicillin allergy
Hemostasis usually involves which mechanism(s) of coagulation?
Both extrinsic and intrinsic
Place the steps of iron metabolism in order. Start with iron intake, and finish absorption from the digestive tract
1. A mixture of Fe2+ and Fe3+ in ingested 2. The stomach acid converts Fe3+ to Fe2+ 3. Fe2+ binds to gastroferritin 4. Gastroferritin carries Fe2+ to intestine for absorption
List in order the events of platelet plug formation.
1. Contact with collagen of a broken vessel or another rough surface 2. Platelets grow long spiny pseudopods 3. Platelets stick to each other 4. The pseudopods then contract and draw the vessel walls together 5. This mass of platelets forms a platelet plug
Individuals with blood type B and blood type O will both have which type of agglutinin in their plasma?
Anti-A
What are agglutinins?
Antibodies that bind to RBC antigens
A person is considered Rh- positive (Rh+) if he has which antigen?
Antigen D
What is the most common Rh antigen?
Antigen D
A person's specific blood type is based on which of the following?
Antigens expresses in the RBC plasma membrane
The complete cessation if erythropoiesis due to the destruction of myeloid tissue is associated with which type of anemia?
Aplastic
Suppresses the formation of the eicosanoid thromboxane A2
Aspirin
