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Questions and Answers
What is the primary function of albumins in blood plasma?
Which component of blood plasma is primarily composed of water?
Which type of blood cells are produced continuously due to their short lifespan?
What role do globulins play in the blood?
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What is a compensatory response in the progression of heart disease?
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Which genetic factor is linked to heart diseases according to the content?
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What is the primary method used to obtain plasma for analysis?
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What is the clinical definition of elevated pulmonary artery pressures?
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Which plasma protein is crucial for blood clotting?
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What physiological change occurs in the mother during pregnancy related to heart function?
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What is the primary composition of blood?
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What type of hypertrophy is characterized by abnormal structural changes in cardiac cells?
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What is a major characteristic of white blood cells compared to red blood cells in circulation?
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What is a common consequence of interstitial fibrosis in the heart?
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In the context of energy metabolism shifts, which substrate is prioritized first according to the progression?
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Which of the following is a common cause of pulmonary hypertension mentioned?
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What are intercalated discs primarily responsible for in cardiac muscle?
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Which pressure represents the maximum contraction of the heart?
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Why does the left ventricular wall need to be thicker than the right?
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What are the two main types of circulatory systems in the body?
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What primarily causes visible striations in cardiac muscle?
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What role does the right heart (RH) play in the circulatory system?
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What happens when the AV valves close during the cardiac cycle?
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Which factor influences the direction of blood flow in the circulatory system?
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What percentage of total blood volume does plasma comprise in a normal adult male?
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Where are plasma proteins primarily produced?
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What signifies the beginning of hematopoiesis?
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What is the lifespan of red blood cells?
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What is the term for the formation of red blood cells?
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What indicates anemia in terms of packed red blood cell percentage?
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Which vitamin is essential for red blood cell formation?
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What is the role of erythropoietin produced in the kidney?
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How long do platelets typically remain in circulation?
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What is a key characteristic of hemolytic anemia?
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Which component plays an essential role in the clotting factor synthesis?
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What process is described as the cessation of bleeding?
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What do endothelial cells produce to prevent clotting?
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Which of the following describes the role of anticoagulants in hemostasis?
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What happens during the coagulation cascade in hemostasis?
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What is not a characteristic of iron-deficient anemia?
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Study Notes
Cardiovascular System
- Consists of striated muscle with intercalated discs connecting cardiomyocytes
- Blood flows from a high to a low pressure
Blood Pressure
- Blood pressure (mm Hg) is the pressure that the blood exerts on the myocardium
- Systolic Pressure (Maximum contraction pressure)
- Diastolic Pressure (Lowest relaxation pressure)
The Heart
-
2 PUMPS:
- Left Heart (LH)
- left atrium (LA)
- left ventricle (LV)
- Right Heart (RH)
- right atrium (RA)
- right ventricle (RV)
- Left Heart (LH)
-
2 CIRCULATORY SYSTEMS:
- Pulmonary Circulation
- Systemic Circulation
- NB: RH supplies pulmonary circulation.
Left Ventricular Wall Thickness
- Why is the left ventricular wall thicker?
- It needs to pump at higher pressure, known as a high-pressure system (Systemic system)
- Why is the pressure lower in the atria compared to the ventricles?
- When the AV valves close, the ventricles build up enough pressure to empty via the aortic and pulmonary valves.
Intercalated Discs
-
Functions of intercalated discs:
- Acts as a connector between cardiomyocytes to keep them from separating during contraction.
Pathophysiology
- Due to various factors: autoimmune responses, stress-activated cytokines, oxidative stress, and genetic factors in prolactin cleavage.
- Increased LV wall thickness without abnormal loading conditions
- Interstitial fibrosis
- Arrhythmias
- Cardiomyocyte hypertrophy and disarray
Disease Progression
-
Compensatory response:
- Hypertrophy
- Initiation of fetal gene program
- Metabolic shifts (phosphocreatine → fatty acids→ glucose)
- Fibrosis (interstitial and perivascular)
- End-stage heart failure: energy and functional imbalance
Genetics
- Approximately 50% of patients have mutations in one or more of >20 sarcomeric genes
Mitral Valve Stenosis in Pregnant Women
- Mitral stenosis is occasionally encountered in pregnant women, especially in developing countries, where rheumatic fever is endemic.
- Patients with mild mitral stenosis usually tolerate pregnancy and delivery well.
Pulmonary Hypertension
- Clinical definition: elevated pulmonary artery pressures, ≥ 20 mmHg at rest (echocardiography or right heart catheterization).
- Common causes: COPD, parenchymal lung disease, chronic thrombo-embolic disease, congenital heart disease, and TB.
Hematology
- The study of blood, blood organs, and blood diseases.
- Hema means blood, and ology is the study of blood.
Blood
-
Plasma composition:
- Mostly water, with organic molecules including proteins (plasma proteins: albumin, globulins, fibrinogens), glucose, nutrients, ions, hormones, and respiratory gases.
-
Composition of Blood:
- Obtained through venipuncture, separating plasma and blood cells via centrifugation.
- Plasma comprises 50-60% of total blood volume, while the cellular compartment consists of red blood cells, white blood cells, and platelets.
- In a normal adult male (70 kg), total blood volume is about 5 liters.
- Plasma: 3 liters (50-60%)
- Packed red blood cells: 2 liters (40-50%)
Colloid Osmotic Pressure
- Ensures water is drawn into the vasculature from tissues.
- Liver failure leads to reduced plasma protein production, decreasing colloid osmotic pressure.
Hematopoiesis
- "HEMA" signifies blood, and "poiesis" means formation.
- In adults, blood cells are produced in the bone marrow.
- Packed red blood cells are also called hematocrit and indicate anemia if less than 40-50%
Hematopoietic Process
- Hematopoiesis begins with hematopoietic stem cells that can differentiate into any of the three cell lines.
- Precursor cells are immature blood cells found in the bone marrow.
Red Blood Cell Formation (Erythropoiesis)
- Erythropoiesis is the formation of red blood cells (erythrocytes).
- Erythropoietin, produced in the kidney, stimulates red blood cell production.
Red Blood Cell Lifespan and Recycling
- Red blood cells live for 120 days.
- Components of hemoglobin are recycled:
- Heme groups contain iron atoms for reversible oxygen binding.
Vitamin B12 and Folic Acid Deficiency Anemias
-
Hematocrit testing:
- Hemolytic anemia: Decreased hematocrit, increased bilirubin, smaller but normal-sized red blood cells.
- Iron-deficient anemia: Lower hematocrit, paler appearance, smaller red blood cells.
Platelets
- Platelets remain in circulation for approximately 10 days and play a crucial role in blood clotting.
Haemostasis
-
Introduction:
- Coagulation is part of the hemostasis process, which is the cessation of bleeding.
- Hemostasis keeps blood within vessels while repairing breaks without affecting blood flow.
-
Homeostasis vs. Haemostasis:
- Haemostasis is different from homeostasis, which maintains internal stability.
A. Vascular Constriction (Spasm)
- Injured blood vessels constrict immediately to limit blood loss.
B. Healing and Sealing (Clot Formation - Thrombus):
- Plasma clotting factors are involved in the coagulation cascade.
- The endothelium is a barrier between blood circulation and body tissues.
- Hemostasis involves a positive feedback system.
- Liver produces clotting factors, and vitamin K and calcium are crucial for their synthesis.
C. Removal of Clot (Thrombolysis):
- A stable clot (thrombus) is formed.
- Endothelial cells produce anticoagulants like nitric oxide and prostacyclin.
- These anticoagulants prevent platelet aggregation and clotting.
Anticoagulation Mechanism:
- In vitro, anticoagulants like EDTA are used to prevent blood clotting during laboratory procedures.
Bone Marrow
- Most developing cells in the bone marrow are white blood cells, which have a short lifespan in circulation.
- In circulation, there are more red blood cells than white blood cells.
- New white blood cells are continually produced due to their short lifespan.
Cells
- White blood cells: have nuclei
- Red blood cells: lack nuclei
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Description
Test your knowledge on the structure and function of the cardiovascular system, including the heart, blood pressure, and circulation. This quiz covers key concepts about the heart's anatomy and its dual pumping action, along with the significance of ventricular wall thickness.
