A&P II - exam 1

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? -He is dehydrated from the flu. -Your patient is on chemo and it is causing him to produce too many red blood cells. -He is leaking blood into his abdominal cavity. -He recently donated blood.

- 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.

Mature red blood cells in the circulating blood are filled with __________. -hemoglobin molecules -mitochondria -smooth endoplasmic reticulum -nuclei and all other cellular organelles -lysosomes

- hemoglobin molecules

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

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

Identify the cell stage of erythropoiesis indicated by "D." -Polychromatic erythroblast -Hemocytoblast -Proerythroblast -Basophilic erythroblast -Orthochromatic erythroblast -Reticulocyte

- polychromatic erythroblast

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

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

Which of the following is a function of erythrocytes? -Transport oxygen and carbon dioxide -Phagocytize bacteria -Mount immune response -Kill parasitic worms -Release histamine

- transport carbon dioxide -Normal values for hemoglobin are 13-18 grams per 100 milliliters of blood (g/100 ml) in adult males, and 12-16 g/100 ml in adult females.

Aging red blood cells are fragmented and trapped mainly in the __________. -spleen -liver -kidneys -intestines

-Aging red blood cells (RBCs) are fragmented and trapped mainly in the spleen. Red blood cells have a useful life span of 100 to 120 days. Red blood cells are unable to synthesize new proteins, grow, or divide. Erythrocytes become "old" as they lose their flexibility, become increasingly rigid and fragile, and their hemoglobin begins to degenerate. They become trapped and fragment in smaller circulatory channels, particularly in those of the spleen. For this reason, the spleen is sometimes called the "red blood cell graveyard."

Your patient's complete blood count shows an elevated reticulocyte count. Which of the following conditions is LEAST consistent with this finding? -Sickle cell disease, a form of hemolytic anemia -Chronic blood loss from a bleeding ulcer -Aplastic anemia -Iron deficiency anemia after one month of treatment

-Aplastic anemia Reticulocytes are the last step in erythrocyte formation before maturity. In aplastic anemia, the bone marrow does not make precursors of any of the formed elements, so reticulocytes would not be present.

Which type of anemia results from the destruction or inhibition of the red marrow by drugs, chemicals, ionizing radiation, or viruses? -Aplastic anemia -Iron-deficiency anemia -Pernicious anemia -Renal anemia

-Aplastic anemia is a type of anemia that results from the destruction or inhibition of the red marrow by drugs, chemicals, ionizing radiation, or viruses. - In most cases, though, the cause is unknown. Because marrow destruction impairs formation of all formed elements, anemia is just one of its signs. Defects in blood clotting and immunity are also present. Blood transfusions provide a stopgap treatment until stem cells harvested from a donor's blood, bone marrow, or umbilical cord blood can be transplanted.

Erythroblastosis fetalis is caused by __________. -an Rh incompatibility between an Rh-negative mother and her Rh-positive baby during pregnancy -a loss of blood by the fetus -a malfunction of the thymus during fetal development -an increase in the number of erythrocytes in the newborn

-Erythroblastosis fetalis is caused by an Rh incompatibility between an Rh-negative mother and her Rh-positive baby during pregnancy. what you need to know: An important problem related to the Rh factor occurs in pregnant Rh− women who are carrying Rh+ babies. The first such pregnancy usually results in the delivery of a healthy baby. But, when bleeding occurs as the placenta detaches from the uterus, the mother may be sensitized by her baby's Rh+ antigens that pass into her bloodstream. If so, she will form anti-Rh antibodies unless treated with RhoGAM before or shortly after she has given birth. (The same precautions are taken in women who have miscarried or aborted the fetus.) RhoGAM is a serum containing anti-Rh antibodies. By agglutinating the Rh factor, it blocks the mother's immune response and prevents her sensitization. If the mother is not treated and becomes pregnant again with an Rh+ baby, her antibodies will cross through the placenta and destroy the baby's RBCs, producing a condition known as hemolytic disease of the newborn, or erythroblastosis fetalis. The baby becomes anemic and hypoxic. In severe cases, brain damage and even death may result unless transfusions are done before birth to provide the fetus with more erythrocytes for oxygen transport. Additionally, one or two exchange transfusions are done after birth. The baby's Rh+ blood is removed, and Rh− blood is infused. Within six weeks, the transfused Rh− erythrocytes have been broken down and replaced with the baby's own Rh+ cells.

Erythropoiesis is best defined as __________. -red blood cell production -leukocyte production -platelet production -albumin production

-Erythropoiesis is best defined as red blood cell production. Erythrocyte production, or erythropoiesis begins when a hematopoietic stem cell descendant called a myeloid stem cell transforms into a proerythroblast. Proerythroblasts, in turn, give rise to basophilic erythroblasts that produce huge numbers of ribosomes. During these first two phases, the cells divide many times. Hemoglobin is synthesized and iron accumulates as the basophilic erythroblast transforms into a polychromatic erythroblast and then an orthochromatic erythroblast. When an orthochromatic erythroblast has accumulated almost all of its hemoglobin, it ejects most of its organelles. Additionally, its nucleus degenerates and is pinched off, allowing the cell to collapse inward and eventually assume the biconcave shape. The result is the reticulocyte (essentially a young erythrocyte), so named because it still contains a scant reticulum (network) of clumped ribosomes.

Erythropoietin is made primarily by the __________. -kidneys -spleen -pancreas -pituitary gland

-Erythropoietin is made primarily by the kidneys. Erythropoietin (EPO), a glycoprotein hormone, stimulates the formation of erythrocytes. Normally, a small amount of EPO circulates in the blood at all times and sustains red blood cell production at a basal rate. The kidneys play the major role in EPO production, although the liver also produces some. When certain kidney cells become hypoxic (oxygen deficient), oxygen-sensitive enzymes are unable to carry out their normal functions of degrading an intracellular signaling molecule called hypoxia-inducible factor (HIF). As HIF accumulates, it accelerates the synthesis and release of erythropoietin. The drop in normal blood oxygen levels that triggers EPO formation can result from: -Reduced numbers of red blood cells due to hemorrhage (bleeding) or excessive RBC destruction -Insufficient hemoglobin per RBC (as in iron deficiency) -Reduced availability of oxygen, as might occur at high altitudes or during pneumonia

Choose the true statement about fetal hemoglobin. -Fetal hemoglobin has a higher affinity for oxygen than does adult hemoglobin. -Fetal hemoglobin is called hemoglobin A. -Fetal hemoglobin contains four alpha chains. -Fetal hemoglobin is produced until the baby is one year old.

-Fetal hemoglobin has a higher affinity for oxygen than does adult hemoglobin. The fetus forms a unique hemoglobin, hemoglobin F, that has a higher affinity for oxygen than does adult hemoglobin (hemoglobin A). It contains two alpha and two gamma (γ) polypeptide chains per globin molecule, instead of the paired alpha and beta chains typical of hemoglobin A. After birth, the liver rapidly destroys fetal erythrocytes carrying hemoglobin F, and the baby's erythroblasts begin producing hemoglobin A.

_______ is the hormone signal for increased production of platelets. A _____ an intermediate of the myeloid cell line, gives rise to granulocytes. The process of stopping bleeding after injury is called ________. ______ is the process of synthesizing new red blood cells in red bone marrow. A pulmonary ______ is a freely-moving clot that becomes lodged in a small lung vessel. A low white blood cell count is called _______. -embolism -leukopenia -erythropoiesis -hemostasis -myeloblast -thrombopoietin

-Thrombopoietin is the hormone signal for increased production of platelets. -A myeloblast, an intermediate of the myeloid cell line, gives rise to granulocytes. -The process of stopping bleeding after injury is called hemostasis. -Erythropoiesis is the process of synthesizing new red blood cells in red bone marrow. -A pulmonary embolism is a freely-moving clot that becomes lodged in a small lung vessel. -A low white blood cell count is called leukopenia.

Identify the cell stage of erythropoiesis indicated by "C." -Basophilic erythroblast -Hemocytoblast -Proerythroblast -Polychromatic erythroblast -Orthochromatic erythroblast -Reticulocyte

-basophilic erythroblast

Match the following disorder with the appropriate description: Sickle-cell anemia. -Caused by abnormal hemoglobin from a change in DNA, resulting in a change in one of the 287 amino acids -Caused by defective synthesis of heme groups and the production of nonfunctional hemoglobin molecules -Results from bleeding -Results from destruction or inhibition of the red marrow by certain bacterial toxins, drugs, and ionizing radiation -Can be a secondary result of hemorrhagic anemia, but it also results from inadequate diet or impaired absorption

-caused by abnormal change in DNA, resulting in a change in one of the 287 amino acids.

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

-fibrinogen Fibrinogen comprises 4% of plasma and is an important component in the process of blood clotting.

One molecule of hemoglobin can bind a maximum of __________ oxygen molecules. -four -two -six -eight

-four what to know: Globin consists of four polypeptide chains— two alpha (α) and two beta (β)—each binding a ringlike heme group. Each heme group bears an atom of iron set like a jewel in its center. A hemoglobin molecule can transport four molecules of oxygen because each iron atom can combine reversibly with one molecule of oxygen. A single red blood cell contains about 250 million hemoglobin molecules, so each of these tiny cells can scoop up about 1 billion molecules of oxygen!

Which of the following plasma proteins is improperly matched with its function? albumin: osmotic pressure alpha globulin: transport of metal ions and fat-soluble vitamins gamma globulins: lipid transport fibrinogen: clotting

-gamma globulins: lipid transport Gamma globulins are also called immunoglobulins (or antibodies) and are part of the immune response.

Match the following structure with its description: Endocardium. -Glistening white sheet of endothelium lining the inside of the heart -Middle layer of the heart, composed mainly of cardiac muscle -Thin, slippery, two-layer membrane -Loosely fitting superficial part of the sac enclosing the heart -Inner layer of pericardium (called the visceral layer)

-glistening white sheet of endothelium lining the inside of the heart

The percentage of total blood volume occupied by erythrocytes is known as the _____________. -hematocrit -erythrocyte sedimentation rate (ESR) -red blood cell count -reticulocyte count

-hematocrit -Erythrocytes normally constitute about 45% of the total volume of a blood sample, a percentage known as the hematocrit (he-mat′o-krit; "blood fraction"). Normal hematocrit values vary. In healthy males, the norm is 47% ± 5%; in females it is 42% ± 5%. Leukocytes and platelets contribute less than 1% of blood volume. Plasma makes up most of the remaining 55% of whole blood. -erythrocyte Sedimentation Rate (ESR) measures how quickly RBCs fall out of suspension.

Identify the cell stage of erythropoiesis indicated by "A." -Hemocytoblast -Proerythroblast -Basophilic erythroblast -Polychromatic erythroblast -Orthochromatic erythroblast -Reticulocyte

-hemocytoblast

What is the name of the protein found in erythrocytes that transports respiratory gases and provides the red color? fibrinogen hemoglobin antibody albumin

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

You are awaiting the white blood cell differential results for a patient who presented with a ruptured appendix and peritonitis. Which type of leukocyte do you expect to be most elevated over its normal value? Neutrophils Lymphocytes Eosinophils Monocytes

-neutrophils Neutrophils are the body's bacteria slayers, so you would expect more of them to be present during a serious acute bacterial infection like the one your unfortunate patient has.

Which of the following is NOT regulated by 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.

Identify the cell stage of erythropoiesis indicated by "E." -Orthochromatic erythroblast -Hemocytoblast -Proerythroblast -Basophilic erythroblast -Polychromatic erythroblast -Reticulocyte

-orthochromatic erythroblast

The terms biconcave and anucleate apply to __________. -red blood cells -white blood cells -leukocytes -platelets -thrombocytes

-red blood cells

Match the following disorder with the appropriate description: Hemorrhagic anemias. -Result from blood loss -Caused by defective synthesis of heme groups and the production of nonfunctional hemoglobin molecules -Result from destruction or inhibition of the red marrow by -certain bacterial toxins, drugs, and ionizing radiation -Caused by abnormal hemoglobin from a change in DNA, resulting in a change in one of the 287 amino acids

-result from blood loss -Hemorrhagic anemia (hem"o-raj'ik) is caused by blood loss. -Slight but persistent blood loss (due to hemorrhoids or an undiagnosed bleeding ulcer, for example) causes chronic hemorrhagic anemia. Once the primary problem is resolved, normal erythropoietic mechanisms replace the lost blood cells.

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

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

Which of the following is a characteristic of a mature erythrocyte? -It has a biconcave disc shape. -It has a nucleus. -It is composed mostly of albumin and water. -It has mitochondria.

A mature erythrocyte has a biconcave disc shape. Erythrocytes or (RBCs) are small cells, about 7.5 μm in diameter. They are shaped like biconcave discs—flattened discs with depressed centers. Mature erythrocytes are bound by a plasma membrane, but lack a nucleus (are anucleate) and have essentially no organelles.

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

AB Type AB blood is considered to be the universal recipient because neither anti-A or anti-B antibodies (agglutinins) are present.

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

B Agglutinogens are glycoproteins found on the surface of erythrocytes. Someone with type B blood has agglutinogen B (but not A) on the surface of their erythrocytes.

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.

Individuals with malaria have a better chance of surviving if they have which type of anemia? -Sickle-cell anemia -Hemorrhagic anemia -Iron-deficiency anemia -Aplastic anemia -Renal anemia

Individuals with malaria have a better chance of surviving if they have sickle-cell anemia. Sickle-cell anemia occurs chiefly in black people who live in the malaria belt of Africa and among their descendants. It strikes nearly one of every 500 African-American newborns. While individuals with two copies of the sickle-cell gene have sickle-cell anemia, individuals with only one copy of the gene (sickle-cell trait) have a better chance of surviving malaria. Their cells only sickle under abnormal circumstances, most importantly when they are infected with malaria. Sickling reduces the malaria parasites' ability to survive and enhances macrophages' ability to destroy infected red blood cells (RBCs) and the parasites they contain.

Pernicious anemia may result from __________. -the lack of vitamin B12 in the diet or a deficiency of the intrinsic factor needed to absorb B12 -abnormal production of hemoglobin caused by genetic defect the absence or depressed synthesis of globin chains -excessive bleeding -rupture of red blood cells caused by parasites

Pernicious anemia may result from the lack of vitamin B12 in the diet or a deficiency of the intrinsic factor needed to absorb B12. Pernicious anemia is an autoimmune disease that most often affects the elderly. The immune system of these individuals destroys cells of their own stomach mucosa. These cells produce a substance called intrinsic factor that must be present for vitamin B12 to be absorbed by intestinal cells. Without vitamin B12, the developing erythrocytes grow but cannot divide, and large, pale cells called macrocytes result. Treatment involves regular intramuscular injections of vitamin B12 or application of a B12-containing gel to the nasal lining once a week.

Identify the cell stage of erythropoiesis indicated by "F." -Reticulocyte -Hemocytoblast -Proerythroblast -Basophilic erythroblast -Polychromatic erythroblast -Orthochromatic erythroblast

The cell stage of erythropoiesis indicated by "F" is a reticulocyte.

The word root _______ means red or red blood cell. The word root________ means white or white blood cell. The word root_______ means embolus or wedge. The word root______ means blood. The word root_______ means bone marrow or spinal cord. The word root_______ means clot or associated with blood clotting. - erythro - leuko - embal - hemo - myelo -thromb

The word root erythro- means red or red blood cell. The word root leuko- means white or white blood cell. The word root embal- means embolus or wedge. The word root hemo- means blood. The word root myelo- means bone marrow or spinal cord. The word root thromb- means clot or associated with blood clotting.

Identify the leukocytes in the figure in order. a) neutrophil, eosinophil, basophil, lymphocyte, monocyte b) monocyte, eosinophil, lymphocyte, lymphocyte, neutrophil c) eosinophil, neutrophil, monocyte, basophil, lymphocyte d) neutrophil, basophil, eosinophil, monocyte, lymphocyte

a) neutrophil, eosinophil, basophil, lymphocyte, monocyte This is the correct order. Notice that A-C are granular, while D and E are agranular. The groups can then be distinguished by looking at cell size, granule color, and nucleus shape.

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

Another term for reduced hemoglobin is __________. -deoxyhemoglobin -oxyhemoglobin -carbaminohemoglobin -hemoglobin S

deoxyhemoglobin. -When oxygen detaches from iron, hemoglobin resumes its former shape, and the resulting deoxyhemoglobin, or reduced hemoglobin, becomes dark red. -Oxyhemoglobin is the oxygen-loaded form of hemoglobin.

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

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

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

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 is found in the plasma portion of blood. It can bind a maximum of three oxygen molecules.

it's composed of four protein chains & four heme groups

Match the following structure with its description: Fibrous pericardium. -thin, slippery, two-layer membrane -Loosely fitting superficial part of the sac enclosing the heart -Glistening white sheet of endothelium lining the inside of the heart -Inner layer of pericardium (called the visceral layer) -Middle layer of the heart, composed mainly of cardiac muscle

loosely fitting superficial part of the sac enclosing the heart

Match the following structure with its description: Myocardium -Glistening white sheet of endothelium lining the inside of the heart -Inner layer of pericardium (called the visceral layer) -Loosely fitting superficial part of the sac enclosing the heart -Middle layer of the heart, composed mainly of cardiac muscle -Thin, slippery, two-layer membrane

middle layer of the heart, composed mainly of cardiac muscle

On a blood smear slide prepared using Wright's stain, you observe a large cell with a U-shaped nucleus and pale-blue cytoplasm. This cell is most likely a(n) __________. basophil eosinophil lymphocyte monocyte

monocyte Monocytes are the largest leukocytes and have a "U" shaped nucleus and pale-blue cytoplasm.

From which cell do the granulocytes descend? Pathways of leucopoiesis. lymphoid stem cell myeloblast monoblast promonocyte

myeloblast All three types of granular leukocytes descend from myelocytes.

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

neutrophils: produce antibodies Neutrophils are active phagocytes that ingest bacteria and some fungi. Phagocyte's are cells that are capable of engulfing or absorbing bacteria and other small cells or particles. Antibodies are produced by certain types of leukocytes.

Which step of hemostasis involves activation of formed elements in the blood? fibrin mesh formation platelet plug formation fibrinolysis vascular spasm

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

the endocardium is composed of __________ - columnar epithelium -squamous epithelium -cuboidal epithelium -cardiac muscle cells

squamous epithelium

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

what part of the heart is considered the systematic circuit pump? - right atrium -left ventricle -left atrium -right ventricle

the left ventricle

Which of the following factors has the greatest effect on making red blood cells (RBCs) very efficient oxygen transporters? -They generate ATP by anaerobic mechanisms and do not consume any of the oxygen they carry. -They don't contain a nucleus. -They represent most of the formed elements in the blood. -They carry 20% of the carbon dioxide released by tissues back to the lungs.

they generate ATP by anaerobic mechanisms and do not consume any of the oxygen they carry. -The erythrocyte picks up oxygen in the capillaries of the lungs and releases it to tissue cells across other capillaries throughout the body. It also transports some 20% of the carbon dioxide released by tissue cells back to the lungs. Three structural characteristics contribute to erythrocyte gas transport functions: 1. Its small size and shape provide a huge surface area relative to volume (about 30% more surface area than comparable spherical cells). The disc shape is ideally suited for gas exchange because no point within the cytoplasm is far from the surface. 2. Discounting water content, an erythrocyte is over 97% hemoglobin, the molecule that binds to and transports respiratory gases. 3. Because erythrocytes lack mitochondria and generate ATP by anaerobic mechanisms, they do not consume any of the oxygen they carry, making them very efficient oxygen transporters.

What factor stimulates platelet formation? thrombopoietin G-CSF PDGF erythropoietin

thrombopoietin Platelet formation (thrombopoiesis) is stimulated by thrombopoietin.