Topic 11 Cardiovascular System (Blood)
white blood cells exit capillaries to reach the connective tissue via a process known as _____________. however, they are able to move to the specific area they are needed via a process known as ________________
- diapedesis - chemotaxis
whereas RBC production was known as ______________, the production of WBCs is known as _______________-
- erythropoiesis - leukopoiesis
select all that apply which of the following bind to the N-terminus of hemoglobin subunits?
- glucose - carbon dioxide
select all the statements below that are true regarding hemolytic disease of the newborn?
- hemolytic disease of the newborn can only occur if the mother is Rh- - if an Rh- mother becomes sensitized, only her subsequent children with Rh+ blood will be affected
monocytes
- macrophage precursors - the largest of the WBCs
neutrophils
- most numerous of the WBCs - polymorphonuclear - are full of lysosomes and use phagocytosis to digest marked bacteria - elevated levels associated with acute infections
a sample of whole blood can be divided into two main things. in any order, what are those two things?
- plasma - formed elements
eosinophils
- secrete chemicals to destroy invading parasites (like worms) - elevated levels associated with allergic reactions/asthma
lymphocytes
- smallest of the WBCs - include B cells and T cells - primarily live in lymphoid tissues, but circulate in the blood
leukopenia
- the condition of having too few WBCs in circulation
select all the options below which are false of hemostasis
- when platelets begin to aggregate, a negative feedback loop begins to cause more platelets to aggregate - after damage to a vessel, the immediate reaction is vasodilation to bring more white blood cells in and prevent infection - aspirin is an effective "blood thinner" (anticoagulant) because it prevents the formation and release of ADP by platelet plugs
in a sample of blood that has been centrifuged, the buffy coat contains which of the following?
- white blood cells - platelets
basophils
-similar to the mast cells that live in the connective tissue - secrete a chemical (histamine) to help make blood vessels "leaky" - least numerous of the WBCs
match each blood type below with the appropriate traits 1. A 2. B 3. AB 4. O
1. has anti-B antibodies 2. has B antigens 3. universal recipient 4. universal donor
if someone had a hematocrit of 50%, approximately what percent of their blood would be water?
45%
which of the following binds to the iron atom in the heme group with the greatest affinity?
CO
which of the following associations is correct?
EPO production: kidneys
compare and contrast the features of red and white blood cells 1. RBC 2. WBC
RBC: - anucleate - 99.9% of all blood cells - primary site of action is in the blood WBC: - nucleate - primary site of action is in the loose connective tissue - 0.1% of all blood cells
which of the following is the best description of sickle cell anemia?
a genetic mutation of a single base pair causing substitution of the incorrect amino acid in the beta peptide chain of hemoglobin
a. how long do RBCs live? can you diagrammatically explain the fate and destruction of RBCs? b. what is hemolysis? c. do most RBCs succumb to this process?
a. 120 days b. hemolysis is the lysis of RBCs c. no. 90% are destroyed in the liver and the spleen
if an individual is type A+, what blood type(s) can they receive during a transfusion? B+? AB+? O+? if an individual is type A-. what blood type(s) can they receive during transfusion? B-? Ab-? O-?
a. A+ can receive: - A+ - O+ b. B+ can receive: - B+ - O+ c. AB+ can receive: - O+ - A+ - AB+ - B+ d. A- can receive: - A- - O- e. B- can receive: - B- - O- f. AB- can receive: - O- - A- - AB- - B-
a. what is the ABO blood group system? b. what are the blood types of this system? c. what is the most prevalent blood type? do you know your blood type? if so, what does this tell you about the antibodies in your plasma? the antigens on the surface of your RBCs?
a. ABO are the antigens present in the membranes of RBCs b. A, B, AB, O c. O+
a. if an individual is type A, what antibodies, if any, do they have in circulation? b. B? c. AB? d. O? e. which blood type is the "universal donor"? f. what does this mean? g. which blood type is the "universal recipient? h. what does this mean? i. what is a cross reaction?
a. B b. A c. none d. A and B e. O f. it means that they can give blood to anyone g. AB h. it means that they can receive blood from anyone I. a cross reaction is when the antigens interact with their same type of antibodies. this causes RBCs to undergo hemolysis
a. what RBC antigen is also known as the Rh factor? b. if an individual is Rh-, do they have D antigens on their RBCs? c. D antibodies in their plasma? d. why is it a potentially serious problem when an Rh+ mother is carrying an Rh+ fetus? e. what happens during the pregnancy? f. how about the second time this same mother gives birth to another Rh+ child? g. what is RhoGAM? h. when is it used? i. what conditions is it used to prevent?
a. D antigen b. No c. No d. the mother can become sensitized to the Rh antigen if there is hemorrhage e. all is fine f. mom's antibodies will pass the placenta bind to the baby's RBCs g. anti-D antibody h. 28 weeks and 72 hours after delivery I. hemolytic disease of newborn (HDN) or erythroblastosis fetalis
a. what is the major hormone that stimulates erythropoiesis? b. what cells secrete this hormone? c. under what circumstances is this hormone secreted? d. can you list some other hormones that stimulate this process as well? e. what is the name of the stem cell that gives rise to all blood cells, including platelets?
a. EPO b. JG apparatus cells in the kidney c. hypoxic condition d. testosterone, growth hormone, thyroid hormone e. pluripotent hematopoietic stem cell
a. where is the binding site for O2 on hemoglobin? b. what is hemoglobin referred to that has O2 bound to it? c. how many molecules of O2 bind to one hemoglobin molecule? d. where does CO bind on hemoglobin? e. what is the consequence of CO binding to hemoglobin?
a. Fe b. HbgO2 oxyhemoglobin c. 4 d. Fe e. oxygen will not bind (competitive inhibition)
a. what is HgbA1c, chemically speaking? b. what is it a measure of? c. what does it tell your physician about your blood glucose levels? d. what condition is it prognostic of?
a. HgbA1c is glycosylated hemoglobin b. it is a measure of blood sugar c. average glucose is in your blood over a period of 3-4 months d. diabetes
a. what is HgbS? what is responsible for the formation of Hgbs? b. which is more hydrophobic Hgb or HgbS? c. what is the lifespan of a sickle-cell RBC?
a. HgbS sickle-cell hemoglobin b. HgbS is more hydrophobic c. 10 days
a. where is the binding site for CO2 on hemoglobin? b. what is hemoglobin referred to that has CO2 bound to it? c. what affect does the binding of CO2 to hemoglobin have on its function? d. where is the binding site for H+ on hemoglobin? e. what affect does the binding of H+ to hemoglobin have on its function? f. where is the binding site for 2,3-BPG on hemoglobin? g. what affect does the binding of 2,3-BPG to hemoglobin have on its function?
a. N termini b. HbgCO2 carbaminohemoglobin c. decreases hemoglobin's affinity for oxygen d. R groups e. decreases hemoglobin's affinity for oxygen f. in the middle of hemoglobin g. decreases hemoglobin's affinity for oxygen
a. what is erythropoiesis? b. where does this process occur? c. what are the roles of amino acids, iron, and vitamin B12 in erythropoiesis? d. what hormone facilitates the absorption of vitamin B12 in the small intestine? e. where is this hormone secreted from? f. what condition results from a deficiency in this hormone?
a. RBC production b. bone marrow c. amino acids: to make protein (hemoglobin); iron: to bind oxygen; B12: a coenzyme for the process d. intrinsic factor e. stomach f. pernicious anemia
a. given what you know about evolution, can you explain why the gene for sickle-cell persists in places such as Sub-Saharan Africa despite the lethality of sickle-cell disease?
a. a carrier person is less likely to die by malaria because the parasites cannot live in low oxygen concentration in the RBCs. therefore, individuals with SS trait are more likely to pass on their DNA... and this gene
a. what is hemostasis? b. what role do platelets play in hemostasis? c. can you describe, in detail, the three steps of hemostasis?
a. a process which causes bleeding to stop, meaning to keep blood within a damaged blood vessel (the opposite of hemostasis is hemorrhage) b. platelets create a plug to stop the bleeding c. steps: 1. vasoconstriction (to reduce blood) 2. formation of a platelet plug (adhesion and aggregation) 3. blood coagulation (intrinsic and extrinsic clotting pathways)
a. what are the functions of albumin in plasma? b. what are the different types of globulins? c. what is an immunoglobin? what are their functions? d. what is the function of fibfibrinogen? e. what is a zymogen? f. what are the different types of regulatory proteins in plasma?
a. albumins are the major contributors to plasma osmotic pressure (i.e. blood colloid osmotic pressure) and they are also nonspecific transporters of lipid and steroid hormones in the plasma b. types of globulins: - transport globulins - immunoglobulins c. immunoglobulins are part of the immune system and they neutralize pathogens. d. fibrinogen is a soluble protein in the plasma from which fibrin is produced. it helps in the formation of blood clots when it is converted to its insoluble form- fibrin e. zymogen is an inactive enzyme f. regulatory proteins: - enzymes - proenzymes - hormones
a. lets say you traveled today to colorado to train for a competition at higher elevation. can you describe the process of erythropoiesis would be stimulated in your body in response to this high altitude? the cells of the juxtaglomerular (JG) apparatus are both chemoreceptive and mecanoreceptive cells? how do these cells work in a chemoreceptive fashion during this scenario?
a. at higher altitudes oxygen concentration decreases and this stimulates the body to produce more RBs. this will occur due to chemosensors that are located in the kidney (JG cells) and will sense for low oxygen concentration in the blood. in response, these cells secrete EPO that will stimulate stem cell differentiation into RBCs in the bone marrow
a. what is another name for a thrombus? b. can you briefly describe how a thrombus forms? c. what is an embolus? d. what is ischemia? e. how does an embolus relate to ischemia? stroke?
a. clot b. when a blood vessel is injured, the body uses platelets (thrombocytes) and fibrin to form a blood clot to prevent blood loss c. embolus is a small dislodged fragment of a blood clot d. ischemia is an inadequate blood supply to an organ or part of the body e. emboli can lead to ischemia (i.e. blocking small vessels in the brain and in the heart) and lead to stroke and MI
a. what is the function of electrolytes in the plasma? b. what are some organic nutrients in the plasma? c. organic wastes?
a. electrolytes are essential for vital cell function and osmotic pressure regulation b. organic nutrients: - fatty acids - carbohydrates - amino acids c. organic wastes: - urea - creatinine - uric acid
a. what happens during the healing process of a damaged blood vessel? b. after the vessel is healed, what is the function of tissue plasminogen activator (tPA)? plasmin?
a. endothelium regeneration (mitosis) and clot shrinkage (actin and myosin) b. clot dissolution: tissue plasminogen activator (tPA) converts plasminogen to plasmin; plasmin digests fibrin
a. what is the alternate name for a blood cell (RBC)? b. what is the name of an immature RBC? c. are these living and breathing cells? d. how many RBCs are in an average adult? e. do males or females have more? f. are they the most abundant cell in the human body? g. what is the function of the RBC? h. what protein is very abundant in RBCs? i. why are RBCs red? why do they appear pale in the center? j. can you explain the physiological importance of the biconcave disc shape of RBCs?
a. erythrocytes b. reticulocyte c. no d. 30 trillion e. males f. yes g. oxygen carrier h. hemoglobin i. they don't have hemoglobin in the center j. increase surface area and flexibility
a. what are the three components of formed elements? what percentage of whole blood does each component constitute?
a. formed elements: - platelets: 0.1% - white blood cells: 0.1% - red blood cells: 99%
a. what is a hematocrit (Hct)? how is a Hct determined? b. what are the three layers that a whole blood sample separates into during microcentrifugation? c. what is located in each layer d. what is a packed cell volume (PCV)? d. why a WBCs higher in centrifuged tube than RBCs?
a. hematocrit is a test to determine the percent of RBCs in circulation b. Hct is determined by microcentrifugation followed by dividing the volume of packed red cells by the total volume of the sample c. three layers: - plasma - buffy coat (WBCs/platelets) - erythrocytes (RBCs) d. PCV is the % of a sample of whole blood that is occupied by RBCs b. because they are less dense than RBCs
a. what is hemoglobin? b and c. how many N-termini and C-termini does this protein have? d. what is its general function? e. what are the two main components of heme? f. what is Hgb? g. HbgO2? h. HbgCO2? i. HgbA? j. HgbF? k. HgbS? l. HgbA1c? m. where does glucose bind on hemoglobin?
a. hemoglobin is a protein responsible for transporting oxygen in the blood b. 4 N-termini c. 4 C- termini d. hemoglobin's function is to transport oxygen e. heme is composed of porphyrin ring and ferrous iron f. Hgb deoxyhemoglobin in veins g. HbgO2 oxyhemoglobin in arteries h. HbgCO2 carbaminohemoglobin (it binds CO2) i. HgbA adult hemoglobin or maternal j. HgbF fetal hemoglobin k. HgbS sickle-cell hemoglobin l. HgbA1c glycosylated hemoglobin m. glucose binds to N termini
a. what is hemophilia? b. what is the difference between hemophilia A and B? c. what is an anticoagulant? d. how do anticoagulants affect the clotting cascade? e. under what circumstances would a physician anticoagulants? f. why are blood collection tubes lined with calcium chelators? heparin?
a. hemophilia is a medical condition in which the ability of the blood to clot is severely reduced b. the most common type of hemophilia is called hemophilia A. this means the person does not have enough clotting factor VIII (factor 8). a less common type is hemophilia B. this person does not have enough clotting factor IX (factor 9) c. anticoagulants prevent blood clots d. anticoagulants decrease calcium concentration e. stroke f. to prevent coagulation
a. what are the general functions of WBCs? b. where does "the work" of a WBC primarily take place? c. why is it generally bad if youre WBCs are active in your blood stream? d. what is diapedesis? e. positive chemotaxis? f. why and where do these processes occur?
a. immunity, defense, removal of waste b. loose connective tissue c. it is likely you have a body-wide, system infection - sepsis, which is potentially fatal d. WBSs crawling through the intact walls of the capillaries into the connective tissue e. movement of cells or organisms in response to chemicals (i.e. cytokines) f. capillaries and the tissues. this occurs to direct to WBCs to the site of infection
a. what is a sickle-cell crisis? b. what are the symptoms? c. complications? d. under what circumstances do these crises occur?
a. in a sickle-cell crisis, sickled RBCs impair blood flow and cause issues with perfusion to tissues b. breathing issues, pain, dizziness, etc c. blood clot formation d. low oxygen levels
a. how would you compare and contrast sickle-cell trait and sickle-cell disease? b. what kind of disorder is this, genetically speaking? c. does a carrier for this disorder have sickle-cell trait or sickle-cell disease? d. what is the life expectancy for an individual with sickle-cell trait? e. sickle-cell disease? f. what is the treatment for this disorder? g. is there a cure?
a. in a sickle-cell trait, you are a carrier for the disease in sickle cell disease you are homozygous for the allele b. a point mutation c. sickle-cell trait d. sickle-cell trait is personalized e. sickle-cell disease: 40-50 years f. blood transfusion or bone marrow transplant g. in general, no. in rare cases, a bone marrow transplant would be a potential cure
a. why is the automated method of determining a Hct more accurate than the manual way? b. what is the formula for a calculated Hct? c. how would you compare and contrast mean corpuscular volume (MCV) and PCV? d. are calculated Hcts typically lower or higher values than a manual Hct of the same individual? why?
a. in a traditional Hct, the value is typically overestimated as some plasma is trapped between the RBCs. since the automated way literally counts the # of RBCs and determines their mean corpuscular volume (MCV) b. #RBCs x MCV = Hct c. mean corpuscular volume (MCV) is the average volume of red cells. it can be directly meausred by automated hematology analyzer, or it can be calculated from hematocrit (Hct) and the red blood cell count d. manual counting is higher since we can also have plasma between the RBCs
a. where does erythropoiesis take place? b. what hormones stimulate erythropoiesis? c. what are different methods that individuals employ for blood doping? d. what is the physiological benefit of blood doping? e. other than the fact that blood doping is illegal, why is it an ill-advised practice in regards to cardiovascular health?
a. in the bone marrow b. erythropoietin (EPO), testosterone, growth hormone, thyroid hormone c. testosterone and EPO administation. they can also take blood out of their own body and then reinject it d. increased oxygen carrying capacity e. this can result in hypertrophic heart failure and hypertension
a. in terms of a clotting cascade, how is the intrinsic pathway activated? b. extrinsic? c. what molecule do these two pathways converge on and activate? d. can you sequentially describe the common pathway? e. what is the end result of the clotting cascade?
a. intrinsic pathway: collagen or other activators b. extrinsic pathway: tissue factor III c. active X d. prothrombinase converts prothrombin into thrombin. thrombin converts fibrinogen into fibrin e. the end result of this cascade is that fibrinogen, a soluble plasma protein, is cleaved into fibrin, a insoluble plasma protein. the fibrin proteins stick together (with platelets and some RBCs) forming a clot
a. what is a complete blood count (CBC)? b. considering everything involved in a CBC, what type of information does such a test provide a physician? c. what is a differential white blood cell count? d. how is it determined? what type of information does a "differential" provide a physician? e. what is leukopenia? f. how does it relate to anemia? g. what is leukocytosis? h. how does it relate to polycythemia?
a. it counts every type of cell (#WBCs, #RBCs, # platelets, hemoglobin, hematocrit) b. which cells are elevated or low and therefore it provides information on what type of infection might be present as well c. differential WBC count is the relative numbers of WBCs d. by counting 100 WBCs and identifying how many of each of the five types are encountered e. low WBCs f. anemia is low RBCs g. high WBCs h. polycythemia is high RBCs
a. what is another name for white blood cells (WBCs)? b. what are some features of a WBC you would use to contrast it to an RBC?
a. leukocytes b. they contain a nucleus and organelles
a. what is leukopoiesis? b. where does this process occur? c. what is the name of the "mother" stem cell that gives rise to all blood cells, including platelets? can you describe the basic steps in the production of each WBC during leukopoiesis?
a. leukopoiesis is WBC production b. bone marrow c. hemocytoblast (i.e. pluripotent hematopoietic stem cell)
a. what cells destroy RBCs? b. how do they "know" that it is time for a particular RBC to die? c. where are these cells located that destroy RBCs? d. what happens to the hemoglobin and heme (porphyrin ring and iron) of the RBC once it is phagocytosed? e. based on your knowledge of plasma proteins, how is iron transferred from the liver to bone marrow? f. what is bilirubin? g. what color is this molecule? h. what is jaundice? i. what conditions lead to jaundice? j. what are urobilins? k. what are stercobilins?
a. macrophages b. the RBCs start expressing sugars c. liver and spleen d. hemoglobin is degraded into amino acids which are recycled. heme is converted to bilirubin, which is not further metabolized e. by transferrin (globulin) f. bilirubin is the byproduct of heme g. yellow h. jaundice is accumulation of bilirubin in the extracellular fluid i. cirrhosis, premature childbirth j. urobilin is the yellow color in the urine k. urobilins and stercobilins is the brown color in the feces
a. what are the typical Hct ranges for females and males? b. why are male Hcts typically larger than female Hcts? c. what is the process by which RBCs are formed?
a. males (~39-50%) and females (~35-45%) b. males Hcts are typically larger than female Hcts because males produce more testosterone that induces erythropoiesis c. erythropoiesis
what are the five different white blood cells (WBCs)? what are their relative percentages? which is most abundant? least? which is the largest? smallest?
a. neutrophils: 50-70% b. eosinophils: 2-4% c. basophils: <1% d. lymphocytes: 20-30% e. monocytes: 2-8% f. largest: monocytes g. smallest: lymphocytes
a. suppose your doctor told you that you were anemic. is this a clear indicator that you have a low RBC count? b. if you were informed that you had low RBC count, would this be an indicator that you are anemic? c. what is the term for a high RBC count? d. what are the characteristics of a dehydration Hct? e. based on a manual calculation of a Hct from someone that is dehydrated, would the person appear to be anemic or polycythemic?
a. no, anemic is poor capacity to carry oxygen b. yes c. polycythemia d. low plasma e. polycythemic
a. what are the two components of whole blood? b. what percentage of whole blood does each component constitute?
a. plasma and formed elements b. plasma: 55%; formed elements: 45%
a. what are the three components of plasma? b. what percentage of plasma does each component constitute?
a. plasma components: - plasma proteins: 7% - other solutes: 1% - water: 92%
a. what are platelets? are they cells? b. where are they derived from? c. what is their general function?
a. platelets are small, colorless, disk-shaped cell fragments without a nucleus, found in large numbers in blood b. from megakaryocytes c. blood clotting, or hemostasis
a. what is primary polycythemia? b. what is secondary polycythemia? can you think of situations that would promote secondary polycythemia?
a. primary polycythemia is cancer in the bone marrow b. secondary polycythemia is the natural way of RBC production. occurs usually due to increased erythropoietin (EPO) production either in response to chronic hypoxia (low blood oxygen level) or testosterone
a. what are the primary functions of plasma? b. secondary? c. what is the difference between plasma and serum? d. under what circumstance would one get a plasma transfusion?
a. primary: - transportation - exchange b. secondary: - immunity - thermoregulation - coagulation - fluid volume balance - pH balance c. serum is that part of blood which is similar in composition with plasma but excludes clotting factors d. plasma transfusions are used to increase plasma volume, as during severe hemorrhage
a. what chemicals do normal, healthy endothelial cells secrete to prevent platelet adhesion and aggregation? b. what roles do ADP and thromboxane play in hemostasis? c. what affect does aspirin have on hemostasis specifically?
a. prostacyclin and nitric oxide b. adenosine diphosphate (ADP) attracts more platelets to the affected area c. aspirin acts by inhibiting the ability of the COX enzyme to synthesize the precursors of thromboxane with platelets
a. what role do neutrophils play in immunity (i.e. how do they attack/destroy pathogens/antigens)? b. what is respiratory burst? c. what role do eosinophils play in immunity? d. what conditions would result in elevated eosinophil levels? e. what role do basophils play in immunity? what are the contents of their granules? f. what are the functions of these compounds? g. what role do monocytes play in immunity? what role do lymphocytes play in immunity? what are the three functional classes of lymphocytes? what are the functions of each?
a. they circulate around our body in the bloodstream. and when they sense signals that an infection is present, they are the first cells to migrate to the site of the infection to begin killing the invading microbes. they destroy pathogens via phagocytosis and respiratory bursts b. respiratory burst (sometimes called oxidative burst) is the rapid release of reaction oxygen species (superoxide radical and hydrogen peroxide) c. they attack and phagocytose objects coated with antibodies d. autoimmune disease, allergies and cancer e. basophils appear in many specific kinds of inflammatory reactions, particularly those that cause allergic symptoms. basophils contain anticoagulant heparin, which prevents blood from clotting too quickly. they also contain the vasodilator histamine, which promotes blood flow to tissues f. phagocytosis g. 1) T cells: cell-mediated immunity 2) B cells: plasma cells; antibody-mediated immunity 3) NK cells: natural killer cells; immune surveillance
a. what are the platelets also referred to as? b. what cell are platelets derived from? c. what is the name of the hormone that stimulates their production?
a. thrombocytes b. megakaryocytes c. thrombopoietin (THPO)
a. what are the five types of WBCs? what are the characteristic(s) of WBCs is/are used to categorize them as granulocytes or agranulocytes? b. which are granulocytes? agranulocytes?
a. types of WBCs: - neutrophils: granulocytes - eosinophils: granulocytes - basophils: granulocytes - lymphocytes: agranulocytes - monocytes: agranulocytes b. granulocytes (membrane bound vesicle inside the cell)
why is blood such a good substance to regulate body temperature?
because water has a very high specific heat
upon the end of a RBCs life, the heme groups in every molecule of hemoglobin are eliminated from our bodies as waste. they are converted to a different molecule known as ______________ and then excreted into the digestive tract in bile
bilirubin
the process of making new RBCs is known as _____________
erythropoiesis
_______________ is the hormone that stimulates the process of RBC formation
erythropoietin
hemophilia B
factor IX
hemophilia A
factor VII
the body's process of stabilizing damage to small vessels and halting the flow of blood out of those vessels is known as:
hemostasis
what is the name of the chemical that coats the inner surface of test tube vials that prevent blood coagulation
heparin
which of the following is true regarding sickle cell anemia?
if you are heterozygous for the sickle cell allele, you will have sickle cell trait
select the option below that best describes ischemia
inadequate blood supply to a tissue or organ
what is the cause of pernicious anemia?
lack of intrinsic factor
which of the following statements is true?
plasmin digests fibrin
99.9% of the formed elements in blood are ___________
red blood cells
leukemia
the condition of having elevated levels of WBCs in circulation
if a person has an elevated hematocrit, which of the following would not be a plausible explanation?
they have anemia
what is the scientific name for the process of platelet formation?
thrombopoiesis
the hormone that stimulates the process of platelet formation is known as __________________-
thrombopoietin