Chapter 20 - Blood

iii) Formation of RBCs

1) "Erythropoiesis" -- entire process of RBC formation 2) RBC formation begins in the red bone marrow as "hematopoietic stem cells" and goes through several stages of development to become erythrocytes; entire maturation process requires approximately 4 days 3) RBCs are created and destroyed at approximately 200 billion per day in an adult; homeostatic mechanisms operate to balance the # of cells formed against the # of cells destroyed 4) All blood cells are derived from "hematopoietic stem cells" aka "HEMOCYTOBLAST". In RBCs, differentiation begins with the appearance of "proerythroblasts".

5d) Clot Dissolution

1) "Fibrinolysis" -- physiological mechanism that dissolves clots once it has formed 2) Plasmin - enzyme in the blood that catalyzes the hydrolysis of fibrin, causing it to dissolve; it is activated by chemicals released from damaged cells and acts slowly to dissolve the clot 3) Substances that generate plasmin can be used as a therapy to dissolve blood clots

iii) White Blood Cell Numbers

1) 1 mm cubic of normal blood usually contains 5000-9000 leukocytes, with different % for each type 2) WBC #s have clinical significance because they change with certain abnormal conditions Example: In acute appendicitis, % of neutrophils increases and so does the total WBC count. In fact, these characteristic changes may be the deciding points for surgery.

Infectious mononucleosis (MONO)

1) A common noncancerous WBC disorder appearing most often in adolescents & young adults between ages 15-25. It is caused by a virus found in the saliva of infected individuals. 2) Sx: Leukocytosis common early in disease 3) Sx: A large majority (60%) of the WBCs are large, atypical, abnormal lymphocytes that have abundant cytoplasm and a large nucleus 4) Other Sx: Fever, sore throat, rash, severe fatigue, enlargement of lymph nodes & spleen 5) Usually resolves without complications in 4-6 weeks, but fatigue may linger

Pernicious anemia

1) A disorder characterized by a low # of RBCs 2) Sometimes results from a dietary deficiency of vitamin B12, which helps us form new RBCs in bone marrow. 3) In many cases, results from stomach lining failing to produce INTRINSIC FACTOR -- the substance that helps vitamin B12 to be absorbed. 4) Tx involves IM injections of vitamin B12.

Aspiration biopsy cytology (ABC)

1) A procedure where a sample of myeloid tissue (bone marrow) is obtained from inside the pelvic bone (iliac crest) or the sternum. 2) Allows for examination of tissue that may help confirm or reject a tentative diagnosis (such as a blood disorder resulting from bone marrow failure)

Complete Blood Cell Count (CBC)

1) A useful & frequently performed clinical blood test 2) A collection of tests whose results can yield an enormous amount of information regarding a person's health. Standard RBC, WBC, & platelet counts, the differential WBC count, hematocrit, & hemoglobin content.

Thrombosis

1) Abnormal formation of clots. 2) Atherosclerosis is associated with an increased tendency towards this.

Aplastic anemia

1) Abnormally low number of RBCs 2) Most cases result from destruction of bone marrow by drugs, toxic chemicals, radiation, or even cancer. 3) Usually accompanied by decreased # of WBCs & platelets since these tissues are all affected together.

2) Eosinophils

1) Account for 2% to 5% of circulating WBCs; 2) Granules stain orange with acid dyes such as EOSIN. 3) Numerous in mucous membranes such as lining of respiratory and digestive tracts; 4) Although weak phagocytes; 5) Their major role: Release chemicals of immunity (i.e. cell toxins & regulators of body's immune response) from granules; 6) Main function: Provide protection against infections caused by parasitic worms and help regulate allergic reactions such as asthma

3) Basophils

1) Account for only 0.5%-1% of circulating WBCs (least numerous) 2) Stains dark purple with basic dyes 3) Motile and capable of diapedesis 4) Exhibit S-shaped by indistinct nuclei. 5) Cytoplasmic granules contain histamine (inflammatory chemical) and heparin (anticoagulant)

Heparin

1) Acts as an antithrombin 2) Injections of this are used to prevent clots from forming in vessels

1) Chronic lymphocytic leukemia (CLL)

1) Affects older ppl usually (65+); usually men as well 2) Malignant precursor B lymphocytes are produced in great numbers. 3) Early in disease, few symptoms are apparent, but blood tests can reveal it 4) When symptoms such as lymph node enlargement & fatigue do appear, they're often quite mild. 5) Many live many years after diagnosis with little or no treatment

Leukocytosis

1) An increase in the # of WBCs (abnormally high WBCs) 2) Much more common problem than leukopenia 3) Seen in most types of leukemia 4) Almost always accompanies bacterial infections

1) Composition of Blood

1) Blood - made up of plasma (55%) and formed elements (45%) 2) Blood - complex transport medium that performs vital pickup and delivery services for the body 3) Blood - keystone of body's heat-regulating mechanism

6) The Big Picture: Blood and the Whole Body

1) Blood plasma transports substances, including heat, around the body, linking all body tissues together 2) Blood tissue contains formed elements -- blood cells and platelets: i) RBCs assist in the transport of oxygen and carbon dioxide ii) WBCs assist in the defence mechanisms of the whole body iii) Platelets prevent loss of the fluid that constitutes the internal environment 3) Blood is needed by all organs and body systems to function properly, just as many body systems aid the functions of blood. 4) Blood is useless to the body unless it continues to flow around the body and performs its functions of transport, defense, and balance (or homeostasis).

4) Acute myeloid leukemia (AML)

1) Caused by pathologic transformation of myeloid stem cells 2) Onset is sudden, and once symptoms appear the disease progresses rapidly. 3) Most common symptoms: Anemia & fatigue, recurrent infections, bone & joint pain, spongy bleeding gums. 4) Prognosis is poor, with only about 50% of kids and 30% of adults achieving long-term survival. 5) Tx: Bone marrow & stem cell transplants

5b) Conditions That Oppose Clotting

1) Clot formation in intact vessels is opposed 2) Several factors oppose clotting: a) Perfectly smooth surface of the normal, healthy endothelial lining of blood vessels does not allow platelets to adhere (consequently, no platelet factors are activated & released) b) Antithrombins -- substances in the blood that oppose or inactivate thrombin; prevent thrombin from converting fibrinogen to fibrin (i.e. HEPARIN)

2) Acute lymphocytic leukemia (ALL)

1) Common in children, especially between 3-7 years old 2) Very curable/treatable in children, less so in adults 3) Onset of disease is sudden, symptoms include fever, bone pain, increased rates of infection. 4) Cancerous cells crowd out other bone marrow cells & decrease RBC + platelets + other nonmalignant lymphocyte production 5) People also develop anemia, swelling lymph nodes, spleen, and liver. 6) Tx: Chemotherapy, irradiation, bone marrow or stem cell transplants

3a) The ABO System

1) Every person's blood belongs to 1 of 4 ABO blood groups 2) Blood type refers to the type of cell markers/antigens present on RBC membranes: a) Type A - antigen A on RBCs b) Type B - antigen B on RBCs c) Type AB - both antigen A & B on RBCs; known as universal RECIPIENT d) Type O - neither antigen A or B on RBCs; known as universal DONOR

iv) Formation and Life Span of Platelets (~7 days)

1) Formation of platelets is referred to as "thrombopoiesis" 2) Begins with stimulation of precursor cells called megakaryoblasts & controlled y hormone thrombopoietin. 3) Formed in red bone marrow, lungs, and spleen by rupture/fragmentation of megakaryocytes OR megakaryoblasts (~2000-3000 platelets are released) 4) Mature megakaryocytes are huge cells, with up to 20 lobes, they're largely confined to red bone marrow although some are located in the lungs & spleen. 5) Platelets, like RBCs, have no nucleus

iv) Formation of WBCs

1) Granular and agranular leukocytes mature from the undifferentiated hematopoietic stem cell 2) Neutrophils, eosinophils, basophils, and a few lymphocytes and monocytes originate in red bone marrow; most lymphocytes and monocytes develop from hematopoietic stem cells in lymphatic tissue

2b) White Blood Cells (Leukocytes)

1) Granuloctyes (Neutrophils, Eosinophils, Basophils) 2) Agranulocytes (Lymphocytes, Monocytes) 3) WBC Numbers --> "Never Let Monkeys Eat Bananas". This mnemonic phrase may help us remember % values in decreasing order by class of WBC 4) Formation of WBCs

Mature RBCs

1) Have no nucleus and shaped like tiny biconcave disks 2) Do not contain ribosomes, mitochondria, and other organelles typical of most body cells 3) Primary component is hemoglobin 4) Are flexible and can change shape when pressures are applied, such as forcibly passing through blood capillaries (thanks to flexible spectrin fibers) 5) Most numerous of the formed elements. RBC numbers are more numerous in men than women; may be influenced by the stimulating effect of testosterone on RBC production

ii) Functions of Platelets

1) Important role in hemostasis and blood clotting/coagulation; secondary role in defending against bacterial attacks 2) Hemostasis -- refers to stoppage of blood flow; however, if injury is extensive, the blood-clotting mechanism is activated to assist

i) Structure

1) In circulating blood, platelets are small, nearly colourless bodies that appear as irregular spindles or oval disks 2) 3 important properties are agglutination, adhesiveness, and aggregation. 3) Classification of shape is impossible to determine b/c as soon as blood is removed from a vessel, platelets adhere to each other and to every surface they contact... and in doing so, thy assume various shapes & irregular forms. 4) Platelet counts in adults average 250,000/mm3 of blood, normal range is 150,000-400,000/mm3. No differences in sexes in platelet count.

Iron deficiency anemia

1) Iron is a critical component of hemoglobin molecule; wihtout it in the diet, body cannot make enough hemoglobin, resulting in this condition. 2) Most common nutritional deficiency in the world. An estimated 10% of population in developed nations and up to 50% in developing worlds suffer from this. 3) Tx: oral admin of iron-containing compounds,

2) Monocytes

1) Largest leukocytes 2) Dark, kidney-bean shaped nuclei surrounded by large quantities of distinctive blue-gray cytoplasm 3) Mobile and highly phagocytic cells, capable of engulfing large bacterial organisms & viral-infected cells

White Blood Cell disorders

1) Leukopenia 2) Leukocytosis 3) Lymphoid neoplasms 4) Myeloid neoplasms 5) Multiple myeloma 6) Leukemia: Chronic Lymphocytic, Acute Lymphocytic

iv) Destruction of RBCs

1) Life span of a circulating RBC averages 105 to 120 days 2) Macrophage cells (in liver/spleen) phagocytose the aged, abnormal, or fragmented RBCs 3) Hemoglobin is broken down, and amino acids, iron, and bilirubin pigment are released. 4) Iron is returned to bone marrow to make new hemoglobin. Bilirubin is transported to liver, and incorporated into bile for intestinal release, leaves body as part of our poop/feces. AAs are recycled to make new proteins.

Lymphoid neoplams

1) Lymphoid precursor cells that normally produce B lymphocytes, T lymphocytes or their descendent cell types.

1) Neutrophils

1) Make up approximately 65% of total WBC count in a normal blood sample 2) Highly mobile and very active phagocytic cells that can migrate out of blood vessels & into tissue spaces (DIAPEDESIS). Granules contain powerful lysosomes!! 3) Granules stain very light purple with neutral dyes 4) Also called polymorphonuclear leukocytes or POLYS, because their nuclei have 2,3, or more lobes.

5) Blood Clotting (Coagulation)

1) Mechanism of blood clotting 2) Conditions that oppose clotting 3) Conditions that hasten clotting 4) Clot dissolution

Nonelectrolytes

1) Molecules that do not ionize in solution 2) Examples: Glucose & lipids

Electrolytes

1) Molecules that ionize in solution 2) Examples: Protein & inorganic salts

3) Chronic myeloid leukemia (CML)

1) Occurs most common in 25-60 year olds 2) Results from cancerous transformation of granulocytic precursor cells in the bone marrow 3) Diagnosis often made by discovery of marked elevations of granulocytic WBCs in peripheral blood & extreme spleen enlargement 4) Tx: Imatinib (Gleevec) seeks out & blocks the flawed signals in CML cancer cells that cause runaway proliferation.

Leukopenia

1) Overall decrease in the # of WBCs (low WBC count, less than 5000 cells/mm3 of blood) 2) Ex: AIDS results in marked leukopenia

4) Blood Plasma

1) Plasma -- liquid part of blood; clear, straw-coloured fluid; made up of 90% water and 10% solutes 2) Solutes -- 6-8% of plasma solutes are proteins, consisting of 3 main compounds: i) Albumins (55%), ii) Globulins (38%), iii) Fibrinogen (7%). Blood solutes may be classified as electrolytes or nonelectrolytes 3) Plasma proteins have an essential role in maintaining normal blood circulation

i) Function of Red Blood Cells

1) RBC's critical role in the transport of oxygen and CO2 depends on hemoglobin 2) Carbonic anhydrase (CA) - enzyme in RBCs that catalyzes a reaction that joins CO2 and water to form carbonic acid 3) Dissociation of carbonic acid then generates bicarbonate ions (HCO3-) & hydrogen ions (H+), which diffuse out of the RBC and serve to transport CO2 in the blood plasma (since the CO2 is chemically incorporated in the HCO3- now). 4) Total surface area of all RBCs is larger than a football field, for the exchange of respiratory gases between hemoglobin in RBCs and interstitial fluid that bathes the body cells

Hemolytic anemia

1) Refers to variety of inherited blood disorders characterized by abnormal types of hemoglobin 2) Abnormal hemoglobin often causes RBCs to become distorted & easily broken. 3) Example: SICKLE CEL ANEMIA, THALASSEMIA (inherited as well, has a mild & severe form)

3b) The Rh System

1) Rh-positive blood - Rh antigen is present on the RBCs 2) Rh-negative - RBCs have no Rh antigen present 3) Anti-Rh antibodies are not normally present in blood; anti-Rh antibodies can appear in Rh-negative blood if it has come in contact with Rh-positive RBCs (either by transfusion of Rh+ blood or by carrying a Rh+ fetus) (Rh- pregnant woman has Rh+ baby, given to it by Rh+ father, then the Rh factor on the RBCs may stimulate the mother's body to form anti-Rh antibodies. If she has a second child and it's Rh+, the baby may develop a disease called ERYTHROBLASTOSIS FETALIS) Tx: RhoGAM -- a drug that stops mother from forming anti-Rh antibodies, which prevents possibility of harming next Rh+ baby she may have

5c) Conditions That Hasten Clotting

1) Rough spot in the endothelium (blood vessel lining) 2) Abnormally slow blood flow (this is why doctors insist bed patients must move or be moved frequently)

Folate deficiency anemia

1) Similar to pernicious anemia, because of a vitamin deficiency resulting in decreased RBCs 2) Folic acid (vitamin B9) is deficient... usually in people who are malnourished or alcoholics. 3) Tx: taking vitamin supplements until a balanced diet is restored

1) Lymphocytes

1) Smallest of the WBCs 2) 2nd most numerous WBC 3) Account for approximately 25% of circulating WBCs 4) 2 types of lymphocytes: T lymphocytes and B lymphocytes have an important role in immunity -- T lymphocytes function by attacking an infected or cancerous cell, and B lymphocytes (aka plasma cells) produce antibodies against specific antigens 5) Have large, spherical nuclei

Differential WBC count

1) Special type of count that reveals more information than simply the total # of all the different types of WBCs in a blood sample. 2) Reveals the PROPORTIONS of each type of WBC as a % of total WBC count. 3) Lab tech may count the first 100 WBCs seen in a blood smear, to estimate % of each type of WBC. 4) Can be a very valuable diagnostic tool, because all disorders do not affect each WBC type the same way 5) Example: Parasite infection may not cause an increase in the total WBC count, but often cause an increase in the proportion of EOSINOPHILS present. The reason? This type specializes in defending against parasites!

3) Blood Types (Blood Groups)

1) The ABO system 2) The Rh system

Hemocytoblast (hematopoietic stem cell)

1) The original stem cell from which all formed elements of the blood are derived. 2) There are 5 precursor cells, which ultimately produce the different components of the formed elements: i) Proerythroblast --> erythrocytes ii) Myeloblast --> granulocytes (baso,eosino,neutrophils) iii) Lymphoblast iv) Monoblast v) Megakaryoblast --> platelets

Polycythemia

1) When bone marrow produces an excess of RBCs 2) The blood of individuals with this condition may contain so many RBCs that it may become too thick to flow properly

iii) Platelet plug formation

1) Within 1-5 seconds after injury to a vessel waller, platelets adhere to damaged endothelial lining and to each other, forming a platelet plug, that helps stop the flow of blood into the tissues 2) Temporary platelet plug is an important step in hemostasis 3) "Sticky platelets" form physical plug and secrete several chemicals (i.e. ADP, thromboxane, arachidonic acid) involved in the coagulation process. These chemical affect both local blood flow (by vasoconstriction) and platelet aggregation at site of injury.

ii) Hemoglobin

1) Within each RBC are approximately 200-300 million molecules of hemoglobin 2) Hemoglobin is made up of 4 globin (protein) chains, with each attached to a central heme group. Each heme group contains 1 iron atom. So there are 4 iron atoms in a single hemoglobin. 3) Hemoglobin is able to unite with 4 oxygen molecules to form oxyhemoglobin to allow RBCs to transport oxygen where it is needed 4) Hemoglobin can also combine with CO2 to form "carbaminohemoglobin". For this reaction, the Globin part, rather than heme part, makes the combining possible. 5) A male has a greater amount of hemoglobin than a female (14-16 g/100mL vs. 12-14 g). 6) Anemia*

i) Blood Volume

1) Young adult male has approximately 5-6 litres of blood; female has 4-5 litres. 2) Blood volume varies according to age, body type, sex, and method of measurement 3) Blood comprises 8% of our total body weight. The remaining 92% is from other fluids & tissues.

Type O blood contains Antibodies A & B. Thus when someone is accepting type O blood, aren't they accepting antibodies A & B into their system... and depending on what blood type they have, isn't there going to be agglutination? Or is this overlooked because the amount of agglutination would be so insignificant???

???

Erythropoietin (EPO)

A glycoprotein hormone released by kidneys that stimulates red bone marrow to accelerate its production of RBCs. Controlled by negative feedback loop. It is usually released by KIDNEYS during times of oxygen deficiency/reduced blood oxygen. With increasing # of RBCs, oxygen delivery to tissues increases, and less of this is produced, and then less is available to stimulate RBC production in the red bone marrow.

Erythroblastosis Fetalis

A hemolytic condition caused by a mother's Rh antibodies reacting with the baby's Rh+ cells

Transfusion reaction

A potentially fatal event that occurs when agglutinogens (antigens) and agglutinins (antibodies) mix after a blood transfusion and result in the agglutination (clumping) of the donor & recipient blood

RBC Disorders

A) Anemia: 1) Anemia resulting from changes in RBC numbers 2) Anemia resulting from changes in hemoglobin

2) Formed Elements of Blood

A) Red blood cells, RBCs (erythrocytes) i) Description of mature RBCs ii) Function of RBCs iii) Hemoglobin iv) Formation of RBCs v) Destruction of RBCs B) White blood cells, WBCs (leukocytes) i) Granulocytes: Neutrophils, Eosinophils, Basophils ii) Agranulocytes: Lymphocytes, Monocytes iii) WBC Numbers iv) Formation of WBCs C) Platelets i) Structure ii) Functions of Platelets iii) Platelet plug formation iv) Formation and life span of platelets (avg of 7 days)

Agglutinins

Antibodies

Agglutinogens

Antigens

Myeloid neoplams

Appear as a result of malignant transformation of myeloid stem or precursor cells that normally produce granulocytic WBCs, monocytes, RBCs, & platelets

Intrinsic clotting pathways

Begins with chemicals present in the blood. Damage to the endothelial lining of blood vessels exposes collagen fibers, which in turn causes the activation of a number of coagulation factors present in plasma. Sticky platelets lead to reactions that end up producing prothrombin activator.

Multiple myeloma

Cancer of antibody-secreting B lymphocytes called PLASMA CELLS. It is one of the most common & most deadly forms of blood-related cancers in people 65+ years old. The cancerous transformation of plasma cells results in impairment of bone marrow function, production of defective antibodies, recurrent infections (from neutropenia), anemia, & the painful destruction & fracture of bones in the skull & throughout the skeletal system

Extrinsic clotting pathways

Chemicals released from damaged tissues that are outside or extrinsic to the blood trigger the cascade of events that ultimately result in formation of prothrombin activator.

Table 20-1

Classes of Blood Cells 1) Cell Type: 7 types 2) Description: Size, shape, straining 3) Function 4) Life span (Generally, agranulocytes survive longest, months/years; granulocytes live for few days; RBCs survive 105-120 days, platelets live for few days)

Formed Elements

Composed of: 1) Platelets/Thrombocytes ( <1% ) 2) Leukocytes ( <1% ) --> [Neutrophils (60-70%), Lymphocytes (20-25%), Monocytes (3-8%), Eosinophils (2-4%), Basophils (0.5-1%)] 3) Erythrocytes ( >99% )

Plasma

Composed of: 1) Water (91%) 2) Proteins (7%) --> albumins, globulins, fibrinogen, prothrombin 3) Other solutes (2%) --> ions, nutrients, waste products, gases, regulatory substances

2a) Red Blood Cells (Erythrocytes)

Description of mature RBCs i) Function of RBCs ii) Hemoglobin iii) Formation of RBCs iv) Destruction of RBCs

5a) Mechanism of Blood Clotting

Goal of coagulation is to stop bleeding and prevent loss of vital body fluid in a swift and sure method; the classic theory is as follows: 1) Classic theory of coagulation advances in 1905; identified 4 components critical to coagulation: a) Prothrombin b) Thrombin c) Fibrinogen d) Fibrin 2) Current explanation of coagulation involves 3 stages: a) Stage 1 b) Stage 2 c) Stage 3

Physiological polycythemia

Healthy individuals who live & work in high altitudes often have elevated RBC numbers and hematocrit values

Differentiation of RBCs

Hemocytoblast --> 1) Proerythroblasts 2) Basophilic erythroblasts -- forms after mitotic divisions 3) Polychromatic erythroblasts -- produce hemoglobin. 4) Reticulocytes -- become this after losing their nuclei 5) Erythrocytes -- once reticulocytes lose their delicate reticulum once released into circulating blood. Takes 24-36 hours. Overall cell size decreases with each subsequent step.

Anemia

Inability of the blood to carry sufficient oxygen to the body cells. Can result from: 1) Inadequate # of RBCs. A decrease in # or volume of functional RBCs in a given unit of whole blood 2) Deficiency of oxygen-carrying hemoglobin. An adult with less than 10g/100mL hemoglobin content is diagnosed as having anemia.

i) Granulocytes

Include the 3 WBCs that have large granules in their cytoplasm. They're named according to their cytoplasmic staining properties: 1) Neutrophils 2) Eosinophils 3) Basophils

Where are a majority of plasma protein produced?

Liver For liver to make prothrombin, blood must contain adequate amount of VITAMIN K -- can be ingested or made by bacteria in gut. As pre-op safeguard, patients with jaundice are generally given vitamin K preparation.

Vitamin B12

Must be supplied to bone barrow, along with many other things, in order to function adequately in producing new RBCs. Called an... 1) Extrinsic factor -- derived from external sources in foods and is not synthesized by the body 2) Antianemic principle

% Value in Decreasing Order by Class of WBC

Never Let Monkeys Eat Bananas

Hyperchromic

RBCs with abnormally high hemoglobin content

Hypochromic

RBCs with abrnormally low hemoglobin content

Blood loss anemia

Reduction in RBC is result of blood loss, such as through hemorrhages associated with trauma, extensive surgeries, or other situations involving a sudden loss of blood.

Sickle cell anemia

Severe, sometimes fatal hereditary disease that is characterized by an abnormal type of hemoglobin. This hemoglobin is less solube than normal. It forms solid crystals when O2 is low, causing distortion & fragility of RBCs. The distorted RBC membranes can be damaged by drastic changes in shape... these damaged RBCs tend to stick to vessel walls and if a blood vessel in the brain is affected, a stroke may occur. Stroke is one of the most devastating problems associated with sickle cell anemia in children & will affect 10% of the youngsters who have this disease in the USA. Treatment: Frequent blood transfusions, bone marrow transplants in children, hemopoietic stem cell transplants in adults

Stage 1 of coagulation

Stage 1 can be divided into 2 separate mechanisms: 1) Production of thromboplastin activator by *either* of the following: i) Chemicals released from damaged tissues (Extrinsic Pathway)* ii) Chemicals present in the blood (Intrinsic Pathway)*

Leukemia

Term used to describe a # of blood cancers affecting the WBCs. In every form, marked leukocytosis occurs. Leukocytes counts above 100,000/mm3 in blood are common! Different types are classified as either CHRONIC or ACUTE or LYMPHOCYTIC or MYELOID. 4 most common types: 1) Chronic lymphocytic leukemia (CLL) 2) Acute lymphocytic leukemia (ALL) 3) Chronic myeloid leukemia (CML) 4) Acute myeloid leukemia (AML)

Chemotaxis

The process where neutrophils and other phagocytic WBCs are attracted to an infection site, triggered by the release of chemicals from damaged cells.

Hematocrit or Packed Cell Volume (PCV)

The volume % of RBCs in whole blood. Ex: Hematocrit/PCV of 45% means that in every 100 ml of whole blood there are 45 ml of RBCs and 55 ml of fluid plasma.

Buffy coat

Thin white layer of leukocytes & platelets that is present at the interface between the packed red cells & plasma.

Clotting Disorders

Thrombosis, Embolism, Hemophilia, Thrombocytopenia 1) Clots sometimes form in unbroken blood vessels of heart, brain, lungs, or other organs -- can be DEADLY because clot cans shut off blood supply to a vital organ 2) When a clot stays in place where it formed, it's called a "THROMBUS" and condition is called "THROMBOSIS". 3) When a clot dislodges & circulates, itt's called an "EMBOLUS", and the condition is called an "EMBOLISM". 4) Thrombosis & embolism cause most myocardial infarctions (MIs or heart attacks) and CVAs (or strokes), making them the leading cause of death in developed countries

Blood doping/Blood boosting

Transfusions of own blood to improve performance. It's intended to increase oxygen delivery to muscles. Few weeks before an athlete's competition, blood is drawn from the athlete and the RBCs are separated & frozen. Just before competition, the RBCs are thawed & injected. In practice, the advantage appears to have minimal effect. Is it even worth it? EPO abuse can produce dangerously high BP that may lead to a heart attack or stroke.

ii) Agranulocytes

WBCs without stained cytoplasmic granules: 1) Lymphocytes 2) Monocytes

Stage 3 of coagulation

conversion of fibrinogen --> fibrin (insoluble) and production of fibrin/blood clot (by thrombin & Ca++); RBCs are enmeshed in fibrin (like a net)

Stage 2 of coagulation

conversion of prothrombin --> thrombin (by prothrombin activator & Ca++)

Carbonic acid

dissociates and generates bicarbonate ions, which diffuse out of the RBC and serve to transport CO2 in the blood plasma

Carbonic anhydrase (CA)

enzyme in RBCs that catalyzes a reaction that joins CO2 and water to form carbonic acid

Plasmin

enzyme in the blood that catalyzes the hydrolysis of fibrin, causing it to dissolve; it is activated by chemicals released from damaged cells and acts slowly to dissolve the clot

Globulins

essential components of the immunity mechanism

Albumins

help maintain osmotic balance of the blood

2c) Platelets

i) Structure ii) Functions of Platelets iii) Platelet plug formation iv) Formation and life span of platelets (avg of 7 days)

Fibrinogen

key role in blood clotting; clotting proteins

Fibrinolysis

physiological mechanism that dissolves clots once it has formed 1) Plasminogen is converted into the active enzyme "plasmin" by thrombin & plasminogen activator, & lysosomal enzymes & factor XII. 2) Plasmin then hydrolyzes Fibrin strands & dissolves the clot

Hemostasis

refers to stoppage of blood FLOW; however, if injury is extensive, the blood-clotting mechanism is activated to assist

Cross-matching/Blood-typing

the act of testing a sample of donor and recipient's blood and observing for agglutination

Thrombus

when a clot stays in the place where it formed