Blood Lifecycle Overview
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Questions and Answers

What form of iron must Fe3+ be converted to for absorption in the small intestine?

  • Fe2+ (correct)
  • Heme iron
  • Ferritin
  • Fe4+

Which protein primarily stores iron in the liver?

  • Transferrin
  • Ferritin (correct)
  • Hemoglobin
  • Albumin

Which condition causes jaundice due to destruction of red blood cells?

  • Post-hepatic jaundice
  • Pre-hepatic jaundice (correct)
  • Hepatic jaundice
  • Obstructive jaundice

What hormone regulates the release of iron from ferritin when needed?

<p>Hepcidin (C)</p> Signup and view all the answers

What is one common cause of aplastic anemia?

<p>Bone marrow dysfunction (A)</p> Signup and view all the answers

What type of anemia results from insufficient iron replacement leading to small and pale erythrocytes?

<p>Microcytic hypochromic anemia (C)</p> Signup and view all the answers

What blockage causes post-hepatic jaundice?

<p>Gallstones (C)</p> Signup and view all the answers

What is the characteristic pigmentation of skin and eyes seen in jaundice?

<p>Yellowish/orangish pigmentation (D)</p> Signup and view all the answers

At what stage in development is the primary site of blood cell production located in the liver?

<p>Fetal (D)</p> Signup and view all the answers

Which bones are primarily responsible for blood cell production by the mid-20s?

<p>Ribs, vertebrae, sternum (A)</p> Signup and view all the answers

What is the first stage of erythrocyte production?

<p>Pluripotent stem cell (A)</p> Signup and view all the answers

How long do erythrocytes typically live before being destroyed?

<p>120 days (B)</p> Signup and view all the answers

What role does erythropoietin (EPO) play in erythrocyte production?

<p>Increases proerythroblast production (A)</p> Signup and view all the answers

What is measured by the hematocrit?

<p>Percentage of red blood cells in the blood (A)</p> Signup and view all the answers

Which condition is likely to raise the hematocrit level?

<p>Dehydration (D)</p> Signup and view all the answers

What is one effect of exercise training on hematocrit?

<p>Can improve blood oxygen capacity (D)</p> Signup and view all the answers

What is the primary function of hemoglobin?

<p>To bind oxygen molecules (C)</p> Signup and view all the answers

What happens to heme groups as red blood cells are broken down?

<p>They are converted into bilirubin (D)</p> Signup and view all the answers

What is the outcome of increasing plasma volume in relation to hematocrit?

<p>It reduces hematocrit levels (B)</p> Signup and view all the answers

What color is unconjugated bilirubin?

<p>Yellow (A)</p> Signup and view all the answers

Which component of hemoglobin is responsible for oxygen binding?

<p>Heme groups (C)</p> Signup and view all the answers

What happens to conjugated bilirubin after being metabolized by the liver?

<p>It is secreted into bile (D)</p> Signup and view all the answers

How is bilirubin ultimately eliminated from the body?

<p>As part of urine or feces (C)</p> Signup and view all the answers

What happens to the iron from the heme group during the breakdown of hemoglobin?

<p>It is recycled or stored (D)</p> Signup and view all the answers

Which clinical sign may indicate a more severe condition related to internal bleeding?

<p>Hypovolemic shock (C)</p> Signup and view all the answers

What is a common clinical sign of Deep Vein Thrombosis in the affected limb?

<p>Asymmetrical appearance (D)</p> Signup and view all the answers

Which factor is NOT considered a risk factor for developing Deep Vein Thrombosis?

<p>Regular physical activity (B)</p> Signup and view all the answers

What symptom might a patient with Deep Vein Thrombosis report that could indicate migration of a clot?

<p>Shortness of breath (A)</p> Signup and view all the answers

When managing a patient suspected of having a Deep Vein Thrombosis, what is the correct action?

<p>Refer to a specialist immediately (B)</p> Signup and view all the answers

What is the role of thrombin in the coagulation cascade?

<p>It converts fibrinogen into fibrin. (B)</p> Signup and view all the answers

Which factor is involved in the process of fibrinolysis?

<p>Plasminogen (C)</p> Signup and view all the answers

What condition can result from excessive thrombosis or insufficient fibrinolysis?

<p>Myocardial infarction (D)</p> Signup and view all the answers

Which of the following is NOT a potential cause of endothelial injury leading to thrombosis?

<p>Atrial fibrillation (C)</p> Signup and view all the answers

What is the primary function of tissue plasminogen activator (tPA) during fibrinolysis?

<p>To convert plasminogen to plasmin. (B)</p> Signup and view all the answers

Which of the following best describes the relationship between thrombosis and fibrinolysis?

<p>They are in constant balance affecting each other's rates. (C)</p> Signup and view all the answers

Which condition illustrates the consequence of excessive fibrinolysis?

<p>Abnormal bleeding. (C)</p> Signup and view all the answers

Which mechanism can contribute to hypercoagulability?

<p>Inherited forms of clotting disorders. (B)</p> Signup and view all the answers

Which of these is a result of insufficient B12 and folic acid in erythroblast maturation?

<p>Failure of nuclear maturation and division (B)</p> Signup and view all the answers

What characterizes hemolytic anemia?

<p>Destruction of erythrocytes faster than they are produced (B)</p> Signup and view all the answers

Which condition can lead to dilutional anemia?

<p>Increased plasma volume during pregnancy (B)</p> Signup and view all the answers

What is the primary effect of anemia on cardiovascular function?

<p>Increased cardiac output to maintain blood pressure (B)</p> Signup and view all the answers

What initiates the process of thrombosis?

<p>Endothelial cell injury (A)</p> Signup and view all the answers

What is the role of cytokines released by platelets during primary hemostasis?

<p>To attract other platelets to the site (D)</p> Signup and view all the answers

How does tissue factor contribute to coagulation during thrombosis?

<p>Activates a cascade of coagulation factors (B)</p> Signup and view all the answers

Which statement is true regarding hemophilia related to coagulation factors?

<p>It causes abnormal function in specific coagulation factors (B)</p> Signup and view all the answers

Flashcards

Hemoglobin function

Hemoglobin binds oxygen molecules, primarily found in red blood cells.

Hemoglobin structure

Hemoglobin consists of 4 heme groups (each with an iron-ion) and globin molecules.

Hemoglobin breakdown

Macrophages break down old red blood cells and separate hemoglobin into globin, heme, and iron.

Globin recycling

Recycled globin proteins are used to create new hemoglobin.

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Bilirubin formation

Heme is converted into bilirubin, a yellow pigment, after breakdown and elimination.

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Bilirubin metabolism

Unconjugated bilirubin in the liver is converted to water-soluble conjugated bilirubin.

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Bilirubin elimination

Conjugated bilirubin is secreted in bile, converted to stercobilin for feces and urobilin for urine color.

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Iron recycling/storage

Iron from the heme group is recycled or stored in the body.

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Erythrocyte Production Sites (Fetal/Adult)

Blood cells are produced in different locations depending on age. Fetal blood cell production is primarily in the liver, while infants produce blood cells in all bones. Adult production shifts mostly to ribs, vertebrae, and sternum, with some in the tibia and humerus, influenced by bone marrow fat deposits.

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Erythropoiesis Stages

Erythrocytes (red blood cells) develop in a series of stages starting with pluripotent stem cells. These differentiate and mature step-by-step through proerythroblasts into reticulocytes (with no nucleus) then erythrocytes.

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Erythrocyte Lifecycle

Red blood cells live about 120 days. They are actively involved in maintaining cellular integrity, hemoglobin, and ion transport during their life. They are destroyed by macrophages.

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Erythropoietin (EPO) Role

EPO is a hormone released by the kidneys in response to low oxygen levels in the blood. It triggers increased red blood cell production.

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Normal Hematocrit Range

Hematocrit is the percentage of red blood cells in the blood. Normal ranges are around 35-45% for females and 40-50% for males.

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Hematocrit Measurement

Hematocrit measures the proportion of red blood cells in a blood sample.

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Factors Affecting Hematocrit

Hematocrit is influenced by both red blood cell production/destruction and the amount of plasma in the blood. Increased RBC means increased hematocrit and vice versa. Dehydration increases hematocrit while overhydration lowers it.

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Exercise and Hematocrit

Exercise training can influence hematocrit. Factors like increased red blood cell production can lead to a higher hematocrit.

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Iron absorption

The process of taking iron from food into the bloodstream.

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Ferrous iron

Iron in its Fe²⁺ form; easily absorbed from animal products.

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Ferric iron

Iron in its Fe³⁺ form; found primarily in plant products, needs conversion for absorption.

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Transferrin

A protein that carries iron in the blood.

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Jaundice

Yellowing of skin and eyes due to high bilirubin levels in the blood.

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Pre-hepatic jaundice

Jaundice caused by excess bilirubin production due to red blood cell destruction.

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Blood loss anemia (hemorrhagic)

Anemia caused by blood loss.

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Aplastic anemia

Anemia due to bone marrow dysfunction.

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Easy bruising

A clinical sign indicating a problem with blood clotting where the skin easily bruises with minor trauma.

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Petechiae

Small, pinpoint-sized red or purple spots on the skin, caused by bleeding under the skin.

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DVT Risk Factor

Prolonged immobilization, especially in a gravity-dependent position, can increase the risk of deep vein thrombosis.

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DVT Clinical Sign

Swelling and redness (erythema) in the affected limb, usually unilateral, are common clinical signs of DVT.

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DVT Management

Patients presenting with suspected DVT need immediate medical attention, including a referral to the emergency room.

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Immature erythroblasts

Erythroblasts that have not fully matured, often due to nutrient deficiencies like folate or B12.

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Hemolytic anemia

A condition where red blood cells are destroyed faster than they can be produced.

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Dilutional anemia

Anemia caused by an increase in blood plasma volume, diluting the red blood cell concentration.

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Anemia's impact on heart

Anemia increases the heart's workload to maintain oxygen delivery. Cardiac output must increase to meet the body's oxygen needs.

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Primary Hemostasis

The initial, platelet-based stage of blood clotting.

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Thrombosis

Formation of a blood clot (thrombus) inside a blood vessel.

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Endothelial cell injury

Damage to the lining of blood vessels, initiating the formation of a thrombus.

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Coagulation factors

Proteins crucial for the blood clotting cascade.

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What is the role of thrombin in blood clotting?

Thrombin is an enzyme that converts fibrinogen into fibrin, a sticky protein that forms the meshwork of the blood clot.

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What is fibrinolysis?

Fibrinolysis is the breakdown of a blood clot (thrombus) after it has formed.

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Tissue Plasminogen Activator (tPA)

tPA is an enzyme released from the endothelium, it activates plasminogen to break down fibrin.

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How does plasmin break down blood clots?

Plasmin is an enzyme that dissolves fibrin, the protein that forms the meshwork of a blood clot.

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What are the three key factors that contribute to thrombosis?

Abnormal blood flow (stasis or turbulent flow), endothelial injury, and hypercoagulability.

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Stasis in blood flow

Stasis is a condition where blood flow is slow or stagnant, increasing the risk of thrombosis.

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Turbulent blood flow

Turbulent blood flow is irregular, swirling blood flow that can damage the endothelium and promote clotting.

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What is the clinical implication of an imbalance in thrombosis and fibrinolysis?

An imbalance can lead to either excessive clotting (leading to ischemic disease) or excessive bleeding (due to insufficient clotting).

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Study Notes

Blood Lifecycle

  • Blood cell production sites change with age:
    • Fetus: Primarily liver
    • Infant: All bones
    • Adults (mid 20s+): Ribs, vertebrae, sternum, tibia, and humerus. Production depends on bone marrow fat content.
  • Erythrocyte (red blood cell) development:
    • Pluripotent stem cell (nucleated)
    • Proerythroblast
    • Erythroblasts (various stages, progressively less basophilic)
    • Reticulocyte (first without a nucleus, short-lived, with remnants); its release increases in acute anemia.
    • Erythrocyte (mature red blood cell, ~120 days lifespan).
  • Erythrocyte fate:
    • Live ~120 days
    • Metabolically active; enzymes maintain cell membrane and hemoglobin integrity, transport of ions
    • Destroyed by macrophages; hemoglobin is broken down into bilirubin, and iron is recycled to bone marrow by transferrin
    • Self-destruction in the spleen.
  • Erythropoietin (EPO):
    • Released by the kidneys (and possibly other tissues) in response to low oxygen levels
    • Stimulates erythroblast (red blood cell precursor) production
    • Progression through developmental stages is accelerated.

Hematocrit

  • Normal range:
    • Females: 35-45
    • Males: 40-50
  • Measures the percentage of red blood cells in the blood. Factors influencing it:
    • Red blood cell formation / destruction
    • Plasma volume (hydration)

Hemoglobin

  • Function: Binds oxygen molecules
  • Structure: 4 heme groups (each with an iron ion) and 4 globin molecules.
  • Metabolism: Hemoglobin is broken down by macrophages. Globins are recycled, and heme is broken down into biliverdin (green), then bilirubin (yellow) which is either eliminated in feces (as stercobilin, leading to brown feces) or urine (as urobilin, leading to yellow/amber color). Iron is recycled.

Iron Metabolism

  • Iron intake: Absorbed in the small intestine as ferrous (Fe2+) iron (from animal products) or ferric (Fe3+) iron (from plant products).
  • Metabolism: Ferric iron is converted to ferrous iron before absorption.
  • Transport: Bound to transferrin protein in the blood.
  • Storage: Stored in ferritin and hemosiderin, with bone marrow as a primary uptake location for hemoglobin production.
  • Release: Iron is released during need for hemoglobin production.

Jaundice

  • Yellowish discoloration of the skin and sclera due to excess bilirubin. This is caused by several underlying mechanisms.

Anemia

  • Various types of anemia exist, including blood loss anemia (hemorrhagic- acute or chronic), aplastic anemia (bone marrow dysfunction), megaloblastic anemia (defective red blood cell maturation due to lack of B12 or folic acid), hemolytic anemia (red blood cell destruction), dilutional anemia, and more.

Blood Clotting

  • Thrombosis:
    • Endothelial cell injury
    • Vasoconstriction
    • Primary hemostasis (platelet activation and aggregation)
    • Secondary hemostasis (coagulation cascade activation). The formation of a fibrin mesh.
  • Fibrinolysis: Breakdown of clots. Tissue Plasminogen Activator (tPA) is crucial in this process.
  • Factors influencing blood clots:
    • Abnormal blood flow (stasis or turbulence)
    • Endothelial injury

Risk Factors for Thrombosis

(Note: Information is organized by risk factor rather than separate categories as requested.)

  • Prothrombotic environment (family history, chronic inflammation, infectious disease, or certain medical conditions).
  • Long periods of immobilization (prolonged sitting or travel/driving).
  • Dehydration. Certain medications or high risk medical states can also contribute.

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Blood (Week 8) Study Guide PDF

Description

Explore the intricate lifecycle of blood cells, including the production sites that change from fetus to adult and the stages of erythrocyte development. Understand the roles of erythropoietin and the fate of mature red blood cells. This quiz delves into hematology and the physiological processes involved in blood cell formation and maintenance.

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