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: Level II: Reviewing Concepts (Bloom's Taxonomy: Knowledge) 87) Name the two mechanisms and the factors involved that limit the extent of blood clotting within a vessel.

: 1. inhibition of platelet adhesion: protacyclin 2. inhibition of coagulation cascade: plasminogen and plasmin and anticoagulants Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) 88) Name the five types of white blood cells. Which type develops into macrophages? Which white blood cells are collectively known as phagocytes and why?

: 1. lymphocytes 2. monocytes 3. neutrophils 4. eosinophils 5. basophils; monocytes develop into macrophages; neutrophils, monocytes, and macrophages are collectively known as phagocytes because they engulf and ingest foreign particles such as bacteria. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level IV: Quantitative Problems (Bloom's Taxonomy: Evaluation) 113) Sonja is 28 years old and weighs 132 lb (2.2 lb = 1 kg). Calculate the following values for her, assuming she is an average healthy adult. A. What is her approximate blood volume? B. What is her approximate plasma volume? C. Assuming a normal hematocrit, what is her volume of cellular elements? D. What is her typical RBC count? E. WBC? F. Differential count? G. Platelets? H. What hemoglobin level would you expect to find?

: A. 132 lbs = 60 kg. Blood volume is approximately 7% of body weight: 60 kg × 0.07 = 4.2 kg = 4.2 L. B. If her hematocrit were 40%, then her plasma volume = 60% of her blood volume = 0.6 × 4.2 = 2.5 L. Normal hematocrits may range from 37% to 47% in females. C. With a hematocrit of 40%, her packed cell volume would be 1.6 L. D. Values are found in Figure 16.3: RBC count = 3.9 to 5.6 × 106. E. WBC = 4,000 - 11,000. F. Ranges of normal are presented in Figure 16.3. G. Platelets = 200,000 - 500,000. H. Hemoglobin = 12 to 16 g/dL blood. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.3

: Level III: Problem Solving (Bloom's Taxonomy: Application) 112) Below are results of a blood analysis for a patient undergoing chemotherapy. The left two sets of bars, labeled "Min" and "Max," represent the target values for each cell type. The other sets of bars depict the results of blood counts done on the corresponding days after chemotherapy was administered. Please answer the following questions. A. According to the graph, which type of formed elements reached normal values first? B. Which kind came closest to its maximum value? C. On Day 10, which of the following sets of symptoms/characteristics would the patient most likely exhibit? 1. pale and easily fatigued 2. likely to bruise easily or bleed excessively 3. be at high risk for infections Explain your choice.

: A. platelets B. RBCs C. 3, because the WBC count is the most below minimum values, and it is the WBCs that fight infection. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level II: Reviewing Concepts (Bloom's Taxonomy: Knowledge) Match each leukocyte to its normal percentage in a differential cell count. A. 50-70% B. 20-40% C. 2-8% D. 1-4% E. < 1% 86) neutrophils

: (A) 50-70% Section Title: Blood Cell Production Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 18) Diseases that involve the presence of too many white blood cells have been identified as well as diseases that involve too few white blood cells. A) True B) False

: (A) True Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) Match the following plasma proteins with the correct function. A. albumins B. globulins C. fibrinogen D. transferrin E. antibodies 43) contribute(s) significantly to osmotic pressure of plasma

: (A) albumins Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) Match the name of the pathological condition with its description. A. hereditary spherocytosis B. polycythemia vera C. iron-deficiency anemia D. sickle cell disease E. anemia 54) a genetic condition where red blood cells have deficient cytoskeletons

: (A) hereditary spherocytosis Section Title: Red Blood Cells Learning Outcome: 16.5

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) Match the following terms with the correct descriptions. A. lymphocytes B. erythrocytes C. eosinophils D. platelets E. neutrophils 52) Often called immunocytes, these cells direct the activities of the immune system.

: (A) lymphocytes Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: (B) erythrocytes Section Title: Red Blood Cells Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) Match the following plasma proteins with the correct function. A. albumins B. globulins C. fibrinogen D. transferrin E. antibodies 47) a category that includes clotting factors and enzymes

: (B) globulins Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) Match the name of the pathological condition with its description. A. hereditary spherocytosis B. polycythemia vera C. iron-deficiency anemia D. sickle cell disease E. anemia 56) a stem cell dysfunction that produces too many blood cells

: (B) polycythemia vera Section Title: Red Blood Cells Learning Outcome: 16.5

: Level II: Reviewing Concepts (Bloom's Taxonomy: Knowledge) Match each leukocyte to its normal percentage in a differential cell count. A. 50-70% B. 20-40% C. 2-8% D. 1-4% E. < 1% 85) monocytes

: (C) 2-8% Section Title: Blood Cell Production Learning Outcome: 16.2

: (C) eosinophils Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: (C) fibrinogen Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) Match the name of the pathological condition with its description. A. hereditary spherocytosis B. polycythemia vera C. iron-deficiency anemia D. sickle cell disease E. anemia 57) Caused by a dietary deficiency, this condition results in red blood cells that are small and pale.

: (C) iron-deficiency anemia Section Title: Red Blood Cells Learning Outcome: 16.5

: Level II: Reviewing Concepts (Bloom's Taxonomy: Knowledge) Match each leukocyte to its normal percentage in a differential cell count. A. 50-70% B. 20-40% C. 2-8% D. 1-4% E. < 1% 84) eosinophils

: (D) 1-4% Section Title: Blood Cell Production Learning Outcome: 16.2

: (D) platelets Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) Match the name of the pathological condition with its description. A. hereditary spherocytosis B. polycythemia vera C. iron-deficiency anemia D. sickle cell disease E. anemia 55) genetic condition resulting in crescent moon-shaped red blood cells

: (D) sickle cell disease Section Title: Red Blood Cells Learning Outcome: 16.5

: (D) transferrin Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.1

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) Match each leukocyte to its normal percentage in a differential cell count. A. 50-70% B. 20-40% C. 2-8% D. 1-4% E. < 1% 83) basophils

: (E) < 1% Section Title: Blood Cell Production Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 36) Platelets function in A) transporting chemicals important for clotting. B) forming temporary patches in injured areas. C) contraction after clot formation. D) initiating the clotting process. E) All of the answers are correct.

: (E) All of the answers are correct Section Title: Platelets and Coagulation Learning Outcome: 16.4

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) 81) Tom suffers from a severe liver disease. Which of the following symptoms would you expect to see as a result of this condition? A) decreased clotting ability B) decreased blood osmotic pressure C) increased levels of bilirubin in the blood D) accumulation of fluid in the tissue spaces of the extremities E) All answers are correct.

: (E) all answers are correct Section Title: Platelets and Coagulation Learning Outcome: 16.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) Match the name of the pathological condition with its description. A. hereditary spherocytosis B. polycythemia vera C. iron-deficiency anemia D. sickle cell disease E. anemia 53) general term for the condition of low hemoglobin in the blood

: (E) anemia Section Title: Red Blood Cells Learning Outcome: 16.5

: (E) antibodies Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) Match the following terms with the correct descriptions. A. lymphocytes B. erythrocytes C. eosinophils D. platelets E. neutrophils 50) Phagocytic, these cells make up the majority of WBCs.

: (E) neutrophils Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension) 77) What are the three major steps of hemostasis?

: 1. vasoconstriction 2. temporary blockage of a break by a platelet plug 3. blood coagulation, or formation of a clot that seals the hole until tissues are repaired Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension) 73) Red blood cells in the circulation live for about ________. The short life span is due to ________.

: 120 days; increasing fragility of the older red blood cells, which may rupture as they squeeze through capillaries Section Title: Red Blood Cells Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 19) The average life span of a red blood cell is

: 4 months. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 26) A normal adult hematocrit would be approximately ________%.

: 45% Section Title: Red Blood Cells Learning Outcome: 16.3

Human Physiology: An Integrated Approach, 6e (Silverthorn) Chapter 16 Blood 1) The total volume of blood in the body of a 70-kg man is approximately ________ liters.

: 5-6 Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 60) Blood is approximately ________% plasma by volume.

: 55 Section Title: Blood Cell Production Learning Outcome: 16.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 7) The percentage of cells in blood-producing tissues that become white blood cells is about ________%.

: 75 Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level III: Problem Solving (Bloom's Taxonomy: Synthesis) 105) Mike has classical hemophilia, a clotting disorder, but his case is considered "mild." His levels of factor VIII are 28% of normal. He is usually OK going about the activities of normal daily living. He plays slow pitch softball and enjoys swimming and horseback riding, and is an exceptionally active individual who believes "why walk when you can run?" He has noticed that once he has one injury, he will have "bleeds" more readily, and has to restrict his own activities to give himself time to heal. Why would he have to "slow down" longer than a person without hemophilia?

: A level of 28% suggests that Mike's body synthesizes factor VIII much more slowly than normal. Thus once he is injured, he depletes his limited supply more quickly and takes longer to replenish it. Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level III: Problem Solving (Bloom's Taxonomy: Synthesis) 103) In the disease mononucleosis ("mono"), the spleen enlarges because of increased numbers of cells, phagocytic as well as others. Common symptoms of this disease include pale complexion, a tired feeling, and a lack of energy sometimes to the point of not being able to get out of bed. What might cause these symptoms?

: A major function of the spleen is to destroy old, defective, and worn-out red blood cells. As the spleen increases in size, so does its capacity to eliminate red blood cells, and this produces anemia. The decreased number of red blood cells decreases the blood's ability to deliver oxygen to the tissues and thus metabolism is slowed down. This would account for the tired feeling and lack of energy. Because there are fewer red blood cells than normal, the blood circulating through the skin is not as red, and so the person has a pale skin coloration. Section Title: Blood Cell Production Learning Outcome: 16.3

: Level III: Problem Solving (Bloom's Taxonomy: Application) 110) What nutrients are required for red blood cell synthesis and why? What is blood doping? How is it detected? How is blood doping different from simply good nutrition?

: Amino acids for globin synthesis, iron for heme synthesis, folic acid and vitamin B12 for DNA synthesis are among the nutrients required. Blood doping is using a treatment to increase the oxygen-carrying capacity of blood, such as receiving a transfusion of red blood cells or administering hormones that stimulate red blood cell production. Hemoglobin concentration in the blood is elevated above normal in dopers, as is hematocrit. Reticulocyte count indicates an accelerated rate of red blood cell production, which would be expected with use of erythropoietin or similar drugs. These drugs/hormones can be detected in the blood. Good nutrition should ensure that hematocrit and hemoglobin are at their maximum, but nutrition is not sufficient to elevate these parameters above normal. Section Title: Red Blood Cells Learning Outcome: 16.3

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application) 99) Define anemia, and explain how it is the same or different from hypoxemia. Give examples of three different types of anemia and a brief synopsis of each kind. Is sickle cell disease a true anemia? Explain your answer. When sickle cell disease is fatal, what is the cause of death?

: Anemia is a condition in which the blood's hemoglobin content is too low. Hypoxemia means low oxygen in blood, which could be due to an impaired respiratory system and can therefore occur independent of anemia. Because oxygen binds to hemoglobin, individuals with anemia cannot transport as much oxygen to the tissues, resulting in fatigue and weakness. This may be especially noticeable with exercise. Some major causes of anemia are summarized in Table 16.3 in the chapter. Sickle cell disease is considered an anemia because the amount of normal hemoglobin is low. Death is related to hypoxia-caused tissue damage. Section Title: Red Blood Cells Learning Outcome: 16.5

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application) 100) A dead human body has been discovered in the woods near your home. No, you are not a homicide suspect; rather you are an expert hematologist, and the body is still warm. Implausibly, this adult corpse has no gender cues (no sexual organs, and skeletal features that are in between those expected for males or females). How can you assist the detectives in determining the gender of this person, using the hematology lab in your garage?

: Assuming you can collect and centrifuge the blood soon, prior to clotting and decay, a hematocrit may provide clues. While a differential white cell count is independent of gender, hematocrit, hemoglobin concentration, and red cell count are all slightly lower in females. See Figure 16.3 in this chapter. Section Title: Blood Cell Production Learning Outcome: 16.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension) 74) ________, ________, and ________ are called granulocytes because ________.

: Basophils, eosinophils, neutrophils, they contain cytoplasmic inclusions that give them a granular appearance Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 9) Which of the following statements about colony-stimulating factors (CSFs) is FALSE?

: CSFs are made by epithelial cells. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application) 90) Define, compare, and contrast "clot busters" and anticoagulants; describe how each works.

: Clot busters are enzymes that destroy clots that have already formed, while anticoagulants prevent clots from forming in the first place. Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 76) What is a differential white cell count and when is it used?

: Differential white cell count estimates the relative numbers of the five types of white blood cells. It is used by clinicians for diagnosis. See discussion under "Colony-Stimulating Factors Regulate Leukopoiesis." Section Title: Red Blood Cells Learning Outcome: 16.2

: Level III: Problem Solving (Bloom's Taxonomy: Application) 108) An individual who becomes dehydrated will have an elevated hematocrit. Explain how dehydration leads to an elevated hematocrit although blood cell production is normal.

: Hematocrit = packed red blood cell volume/total blood volume. A dehydrated person will have a lower plasma volume, but red blood cell volume will remain constant. This results in an elevated hematocrit and the condition known as relative polycythemia. Section Title: Red Blood Cells Learning Outcome: 16.3

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application) 98) What is the difference between hemostasis and homeostasis, or are they the same?

: Hemostasis is the process that minimizes blood loss from the body. Homeostasis is the process that maintains normal physiology. Hemostasis is a type of homeostasis. Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) 93) Blood clotting is considered to be an example of a positive feedback situation. Explain why this is so, and demonstrate the appropriate steps or areas of hemostasis as part of your explanation.

: In the blood clotting process, each step triggers a new step(s), by activating enzymes or putting components together that were previously separated. Some of the products formed "feed back" to enhance earlier reactions, sustaining the cascade until some components are completely consumed. See Figure 16.9 in the chapter. Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level III: Problem Solving (Bloom's Taxonomy: Synthesis) 104) Erythropoietin (EPO) was first isolated from the urine of anemic patients who had high circulating levels of the hormone. Despite the presence of the hormone that stimulates red cell production, however, these patients were unable to produce adequate amounts of hemoglobin or red cells. Give some possible reasons that the patients' own EPO was unable to correct their anemia.

: Some other factor that is essential for red blood cell synthesis must be lacking. These would include iron for hemoglobin production, folic acid, and vitamin B12. Section Title: Blood Cell Production Learning Outcome: 16.2

: Level III: Problem Solving (Bloom's Taxonomy: Application) 111) How does altitude affect blood composition and why? How would athletes' performance be affected if they live, train, and compete at different altitudes? Explain your answer, using different scenarios. Is such training a type of doping? Explain.

: Spending several days at higher than normal altitude will stimulate erythropoiesis, due to the lower oxygen concentration in the air, which when breathed would result in hypoxemia. Athletes would be less competitive if they competed at a higher altitude than that in which they lived or trained, and more competitive if they lived and trained at a higher altitude than that in which they competed, at least in theory. While students may not know this, experimental results support the best regimen for maximizing performance at a low-altitude competition to be living at high altitude but training at low altitude. Neither living and training high nor living and training low achieved the same results. High-altitude training is necessary, however, for high-altitude competition. This is a matter of opinion, but most people would probably argue that these training regimens are natural, and therefore not a type of doping. Section Title: Red Blood Cells Learning Outcome: 16.4

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) 97) List any five nutrients important for blood cell synthesis and briefly explain the role of each.

: Table 16.3 in the chapter lists B12, folic acid, and iron and a brief explanation of each one's role. The student savvy in metabolism will also note the need for the amino acids for the protein chain synthesis, and energy nutrients in order to supply adequate ATP for these synthetic reactions to occur, as well as the vitamins necessary for the TCA cycle and other aspects of metabolism, including niacin, riboflavin, and pantothenic acid. Section Title: Red Blood Cells Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 30) The process of red blood cell production is called

: erythropoiesis. Section Title: Red Blood Cells Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 65) The hormone that regulates the production of red blood cells is ________.

: erythropoietin Section Title: Blood Cell Production Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 12) Red blood cell production is regulated by the hormone

: erythropoietin. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 42) Tissue factor is released in the

: extrinsic pathway. Section Title: Platelets and Coagulation Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 71) The dissolution of fibrin by plasmin is known as ________.

: fibrinolysis Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 21) A hemoglobin molecule is composed of

: four protein chains and four heme groups Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 37) Platelets are

: fragments of large cells. Section Title: Platelets and Coagulation Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 28) The percentage of whole blood occupied by red blood cells is the

: hematocrit. Section Title: Red Blood Cells Learning Outcome: 16.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension) 59) Active bone marrow is red because of the presence of ________ whereas inactive marrow is ________ because of an abundance of adipocytes.

: hemoglobin, yellow Section Title: Blood Cell Production Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 23) The majority of the protein inside a red blood cell is

: hemoglobin. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 17) The primary stimulus for the release of erythropoietin is

: hypoxemia and low oxygen levels in the tissues. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 63) The term used for a cytokine that is released by one white blood cell that acts on another is ________.

: interleukin Section Title: Blood Cell Production Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 22) The porphyrin ring of heme contains an atom of

: iron. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 67) The condition where the skin and the whites of the eyes appear slightly yellow is called ________.

: jaundice Section Title: Red Blood Cells Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 15) The primary organ where erythropoietin is produced is the

: kidney. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 13) Thrombopoietin is produced in the

: liver and kidney. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 5) Monocytes leave the circulation to go to the tissues, where they are called

: macrophages. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) 82) Meghan thinks she has an abscessed tooth (a bacterial infection). If she does, what type of white blood cell would you expect to see in elevated numbers in a differential count?

: neutrophils Section Title: Blood Cell Production Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 29) Red blood cell production increases when

: oxygen levels in the blood decrease. Section Title: Red Blood Cells Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 70) In hemostasis, vasoconstriction is rapidly followed by mechanical blockage of the hole by a ________.

: platelet plug Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 6) The cell that is the progenitor of all the types of blood cells is called the

: pluripotent hematopoietic stem cell. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 62) In healthy adults, blood cell production occurs only in the ________.

: red bone marrow Section Title: Blood Cell Production Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 14) In normal adults, red blood cells are formed in

: red bone marrow. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 38) The extrinsic pathway of coagulation is activated by the

: release of tissue factor by a damaged endothelium. Section Title: Platelets and Coagulation Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 34) Which of the following is/are vasoconstrictors?

: serotonin and thromboxane A2 Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 27) Under normal circumstances, aged and damaged erythrocytes are broken down by the

: spleen. Section Title: Red Blood Cells Learning Outcome: 16.3

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 25) A hematocrit is used to indicate

: the ratio of red blood cells to the total blood volume and the packed cell volume. Section Title: Red Blood Cells Learning Outcome: 16.3

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) 80) Persons who suffer from hemophilia A fail to produce a functional factor VIII; as a result,

: they do not have a functional intrinsic pathway. Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 64) The growth and maturation of megakaryocytes is regulated by the glycoprotein ________.

: thrombopoietin (TPO) Section Title: Blood Cell Production Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 69) Plasminogen is activated by an enzyme called ________.

: tissue plasminogen activator Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 66) The carrier protein that transports absorbed iron through the blood is ________.

: transferrin Section Title: Red Blood Cells Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 33) The carrier protein that transports absorbed iron through the blood is

: transferrin. Section Title: Red Blood Cells Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 72) The two main components of plasma are ________ and ________. Name two other components found in plasma.

: water, proteins; other components found in plasma include: dissolved organic molecules, ions, trace elements and vitamins, and dissolved oxygen and carbon dioxide. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 2) Plasma is mostly

: water. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 16) A unique aspect of hematopoiesis is that

: white blood cell development varies with the specific needs of the body. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level III: Problem Solving (Bloom's Taxonomy: Application) 101) What is jaundice? What substance is present in abnormal levels? What can cause jaundice to occur? What difference may impede a doctor's ability to diagnose jaundice between people of European compared to African ancestry?

: Jaundice simply means yellowing of skin and the whites of the eyes. It results when bilirubin levels in the blood become elevated (hyperbilirubinemia); superficial blood vessels allow the imparting of yellow color to skin and eyes. During erythrocyte breakdown, the heme is converted in the spleen and liver to a colored pigment called bilirubin. Bilirubin is carried by plasma albumin to the liver where it is metabolized and incorporated into bile (see Fig. 16.8 in the chapter). Bile is secreted into the digestive tract, and the bilirubin metabolites leave the body in the feces. Small amounts of other bilirubin metabolites are filtered from the blood into the kidneys, where they contribute to the yellow color of the urine. The accumulation of bilirubin can occur from multiple causes. Newborns, whose fetal hemoglobin is degraded and replaced with adult hemoglobin, are particularly susceptible to jaundice, so doctors closely monitor bilirubin levels in the first weeks of life. Another common cause of jaundice is liver disease, where the liver is unable to process and/or excrete bilirubin. People with darker skin don't display the yellowing to the same extent as lighter-skinned people, but the yellowing in the eyes should be about the same. Section Title: Red Blood Cells Learning Outcome: 16.4

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) 94) Give two morphological characteristics of erythrocytes. Why is each advantageous to the cell?

: Lack of a nucleus and the biconcave shape contribute to flexibility for moving through narrow capillaries and disk shape which aides in responding to osmotic changes. Section Title: Red Blood Cells Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 10) ________ are a group of diseases characterized by the abnormal growth and development of white blood cells, and ________ are diseases where patients have too few white blood cells.

: Leukemias, neutropenias Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) 89) A person who goes from sea level to a city that is 5000 feet above sea level will show an increased hematocrit within 2 to 3 days. Draw the reflex pathway that links the hypoxia of high altitude to increased red blood cell production.

: Low atmospheric at high altitude → low arterial → sensed by kidney → erythropoietin synthesized and released → acts on bone marrow to increase production of red blood cells. Section Title: Blood Cell Production Learning Outcome: 16.3

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) 95) Make a map using the following terms: bile, bilirubin, ferritin, heme, hemoglobin, intestine, iron in diet, kidney, plasma, spleen, transferrin. You may also add additional terms.

: Maps will vary. See Figure 16.6c in the chapter. Section Title: Red Blood Cells Learning Outcome: 16.2

: Level III: Problem Solving (Bloom's Taxonomy: Application) 106) Mike has classical hemophilia, a clotting disorder, but his case is considered "mild." Contrary to popular belief, Mike doesn't usually have problematic bleeding episodes related to cutting himself; a more severe problem for him would be brought on by a sprained ankle or by having a full body impact, like falling off a horse and landing hard on the ground, injuries considered "closed." With what you have learned about blood coagulation, can you explain how this could be so? Assuming Mike is lacking factor VIII, which pathways does he depend on?

: Only the intrinsic pathway requires factor VIII for activation; the extrinsic pathway and the common pathway are unaffected by the lack of factor VIII. The extrinsic pathway is activated by tissue damage, so even in a person with hemophilia, these may function at close to normal levels. Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) 96) Name the process of red blood cell production, the hormone that controls it, the source of that hormone, and the stimulus for its production. Why was the hormone so difficult to isolate and identify?

: Production of red blood cells is called erythropoeisis. It is stimulated by the kidney-produced hormone erythropoietin, in response to hypoxia. It was difficult to isolate and identify because it is made on demand rather than stored, and thus is not present all the time. Section Title: Red Blood Cells Learning Outcome: 16.2

: Level III: Problem Solving (Bloom's Taxonomy: Application) 102) How would the process of red blood cell production be affected by constricting the arteries that supply blood to the kidney? Explain your answer. Name three other situations that would similarly affect the process of red blood cell production.

: Red blood cell production would be increased. Constricting arteries would reduce blood flow; thus, the kidney would experience hypoxia. The kidney produces the hormone erythropoietin, which stimulates red blood cell production, in response to hypoxia. Increased red blood cell production would also result from anemia, extended presence at high altitude, and following hemorrhage. Section Title: Blood Cell Production Learning Outcome: 16.3

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) 92) Summarize the steps of the coagulation cascade.

: See Figure 16.10 in the chapter. Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level II: Reviewing Concepts (Bloom's Taxonomy: Comprehension) 91) Summarize the steps of hemostasis.

: See Figure 16.8 in the chapter. Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 75) Name two cytokines involved in hematopoiesis. What is the name of the cytokine that plays an important role in the immune system?

: See Table 16.2 in the chapter. Interleukins play an important role in the immune system. Section Title: Red Blood Cells Learning Outcome: 16.2

: Level III: Problem Solving (Bloom's Taxonomy: Application) 107) Cancer chemotherapy is designed to destroy cancer cells, but adversely affects healthy tissues as well; thus the oncologist has the difficult task of killing the cancer without killing the patient. What side effects are expected from destruction of blood cells?

: Side effects include anemia from loss of red blood cells, impaired immune function from loss of white blood cells, and impaired coagulation from loss of megakaryocytes. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level IV: Quantitative Problems (Bloom's Taxonomy: Application) 114) A study was done in 1998 by Dr. Benjamin Levine to explore the role of altitude training in athletic performance. First he trained athletes at low altitude, then measured their finish times in a 5 kilometer run. Then the athletes were placed into one of the following groups: I, living and training at high altitude; II, living at high altitude and training at low; or III, living and training at low altitude. The athletes were then retested in another low-altitude 5 K race. In this study, what are the control and experimental data? What are the dependent and independent variables? The results are expressed as average change in speed of each group. I: -3.4 sec., II: +13.4 sec., III: -26.7 sec. Graph and interpret the results. Did the results surprise you? Why or why not? Propose some explanations for the lower performance by the live high-train high group. Why wasn't there a live low-train high group?

: The control data are the running times of the athletes after baseline training at low altitude. The experimental data are the running times of the athletes after the additional training at various altitudes. The independent variable is altitude; the dependent variable is running time. A bar graph showing the baseline and postaltitude training results as a pair of bars for each group would be appropriate. The best training regimen was living high and training low, and the worst was living low and training low. Many would probably predict the best performance by the group that both lived and trained high, because they were constantly in a relatively hypoxic environment, which may have produced the greatest increase in hematocrit. Training at high altitude clearly did not allow for the best performance, possibly because the lower oxygen environment limited the ability to train at maximum potential. Living low and training high would likely show the worst performance, because even sedentary living at high altitudes produces an increase in hematocrit; only training at high altitude would be insufficient to produce an altitude-related increase. Section Title: Red Blood Cells Learning Outcome: 16.3

: Level III: Problem Solving (Bloom's Taxonomy: Application) 109) Explain how anticoagulant drugs can be useful to heart attack or stroke patients.

: The ischemia that accompanies a "heart attack" or stroke may be prevented by the administration of anticoagulants, which prevent clot formation. Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level II: Reviewing Concepts (Bloom's Taxonomy: Application) 79) How would a decrease in the concentration of iron in the blood affect the process of hemostasis?

: There would be no effect. Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 11) ________ regulates the growth and maturation of megakaryocytes.

: Thrombopoietin Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 40) The common pathway of coagulation begins with the

: activating of a clotting factor that converts prothrombin to thrombin. Section Title: Platelets and Coagulation Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 39) The intrinsic pathway of coagulation is activated by the

: activation of proenzyme exposed to collagen. Section Title: Platelets and Coagulation Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 3) The most abundant proteins in blood plasma are

: albumins. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 35) Which of the following are the two anticoagulants produced by the body?

: antithrombin III and heparin Section Title: Platelets and Coagulation Learning Outcome: 16.6

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 4) Mast cells in tissues are considered to be a type of

: basophil. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension) 78) The usual treatment for neonatal jaundice is exposing the infant to certain wavelengths of light. The infant wears only a diaper and undergoes the light treatment continuously for several days, even at night. Why can the infant's treatement then be discontinued?

: because the transition between fetal hemoglobin to adult is complete Section Title: Red Blood Cells Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 68) The condition where the skin and the whites of the eyes appear slightly yellow is due to high blood levels of the substance ________.

: bilirubin Section Title: Red Blood Cells Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 20) The function of red blood cells is to

: carry oxygen from the lungs to the body's cells. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 24) The function of hemoglobin is to

: carry oxygen. Section Title: Red Blood Cells Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 58) Plasma consists of blood minus ________ and ________.

: cells, platelets Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.1

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 31) Each red blood cell is shaped as a biconcave disk. This allows it to

: change its shape to squeeze through narrow openings and shrink or swell slightly in response to osmotic conditions. Section Title: Red Blood Cells Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Comprehension) 61) Hormones called ________ are involved in regulation of white blood cell populations.

: colony-stimulating factors Section Title: Blood Cell Production Learning Outcome: 16.2

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 41) The process of fibrinolysis

: dissolves clots. Section Title: Platelets and Coagulation Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 32) Excess iron in the body is

: eliminated in the feces. Section Title: Red Blood Cells Learning Outcome: 16.4

: Level I: Reviewing Facts and Terms (Bloom's Taxonomy: Knowledge) 8) Colony-stimulating factors are cytokines made by

: endothelial cells, fibroblasts from bone marrow, and white blood cells. Section Title: Plasma and the Cellular Elements of Blood Learning Outcome: 16.2

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