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Questions and Answers
What is the stimulus that triggers the body's response to low blood oxygen levels?
What is the stimulus that triggers the body's response to low blood oxygen levels?
Which organ is primarily responsible for secreting erythropoietin in response to low blood oxygen levels?
Which organ is primarily responsible for secreting erythropoietin in response to low blood oxygen levels?
What is the direct effect of erythropoietin on red blood cell production?
What is the direct effect of erythropoietin on red blood cell production?
What is one potential cause of hypoxia, leading to the release of erythropoietin?
What is one potential cause of hypoxia, leading to the release of erythropoietin?
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What is the primary function of red blood cells in the body?
What is the primary function of red blood cells in the body?
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In what type of blood vessel do oxygen and nutrients diffuse across capillary walls and into organs?
In what type of blood vessel do oxygen and nutrients diffuse across capillary walls and into organs?
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What is the non-living fluid matrix of blood called?
What is the non-living fluid matrix of blood called?
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What is the main function of erythrocytes?
What is the main function of erythrocytes?
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What is the Buffy coat composed of?
What is the Buffy coat composed of?
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What is hematocrit?
What is hematocrit?
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What is the approximate hematocrit range for males?
What is the approximate hematocrit range for males?
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Which of the following is NOT a formed element of blood?
Which of the following is NOT a formed element of blood?
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What is the function of platelets in blood?
What is the function of platelets in blood?
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What is the direct stimulus for erythropoiesis?
What is the direct stimulus for erythropoiesis?
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What is the main role of the Buffy coat layer in blood?
What is the main role of the Buffy coat layer in blood?
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What is the key difference between plasma and the Buffy coat?
What is the key difference between plasma and the Buffy coat?
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Which of the following factors can lead to an increase in erythropoietin production?
Which of the following factors can lead to an increase in erythropoietin production?
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What is the direct consequence of increased erythropoietin levels in the blood?
What is the direct consequence of increased erythropoietin levels in the blood?
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Which of the following is a potential danger associated with abusing artificial EPO?
Which of the following is a potential danger associated with abusing artificial EPO?
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Which of the following conditions can lead to decreased red blood cell production?
Which of the following conditions can lead to decreased red blood cell production?
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How does testosterone influence red blood cell production?
How does testosterone influence red blood cell production?
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Which of the following is NOT a typical symptom of anemia?
Which of the following is NOT a typical symptom of anemia?
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Which type of anemia is caused by a lack of intrinsic factor, leading to a deficiency of vitamin B12?
Which type of anemia is caused by a lack of intrinsic factor, leading to a deficiency of vitamin B12?
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What is the primary treatment for iron-deficiency anemia?
What is the primary treatment for iron-deficiency anemia?
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Which of the following is NOT a cause of hemolytic anemia?
Which of the following is NOT a cause of hemolytic anemia?
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What causes sickle-cell anemia?
What causes sickle-cell anemia?
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Which of the following is a characteristic of sickle-cell anemia?
Which of the following is a characteristic of sickle-cell anemia?
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What is the function of transferrin?
What is the function of transferrin?
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What is the primary pigment that results from the breakdown of heme?
What is the primary pigment that results from the breakdown of heme?
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Which type of anemia is often associated with renal disease?
Which type of anemia is often associated with renal disease?
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What are thalassemias?
What are thalassemias?
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Which of the following is NOT a reason why a person might experience a low blood oxygen level (hypoxia) leading to an increase in erythropoietin production?
Which of the following is NOT a reason why a person might experience a low blood oxygen level (hypoxia) leading to an increase in erythropoietin production?
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What is the primary effect of erythropoietin on red blood cell production?
What is the primary effect of erythropoietin on red blood cell production?
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Which organ is primarily responsible for secreting erythropoietin?
Which organ is primarily responsible for secreting erythropoietin?
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What is a potential danger associated with the abuse of artificial erythropoietin (EPO)?
What is a potential danger associated with the abuse of artificial erythropoietin (EPO)?
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Which of the following is a possible cause for decreased red blood cell production?
Which of the following is a possible cause for decreased red blood cell production?
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Which of the following situations would NOT lead to an increased production of erythropoietin?
Which of the following situations would NOT lead to an increased production of erythropoietin?
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What is the primary role of "intrinsic factor" in the absorption of vitamin B12?
What is the primary role of "intrinsic factor" in the absorption of vitamin B12?
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Which of the following is a key difference between plasma and the Buffy coat?
Which of the following is a key difference between plasma and the Buffy coat?
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Which of the following conditions is NOT a cause of low red blood cell production (low RBC production)?
Which of the following conditions is NOT a cause of low red blood cell production (low RBC production)?
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In what scenario would an increase in reticulocytes likely be observed?
In what scenario would an increase in reticulocytes likely be observed?
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Which of the following best describes the characteristics of red blood cells in iron-deficiency anemia?
Which of the following best describes the characteristics of red blood cells in iron-deficiency anemia?
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What is the main function of transferrin in the body?
What is the main function of transferrin in the body?
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What is the primary consequence of a lack of erythropoietin (EPO) production in the body?
What is the primary consequence of a lack of erythropoietin (EPO) production in the body?
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Which of the following is a potential cause of aplastic anemia?
Which of the following is a potential cause of aplastic anemia?
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What is the primary physiological mechanism responsible for the sickle shape of red blood cells in individuals with sickle-cell anemia?
What is the primary physiological mechanism responsible for the sickle shape of red blood cells in individuals with sickle-cell anemia?
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Which of the following types of anemia is often associated with renal disease?
Which of the following types of anemia is often associated with renal disease?
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What is the primary treatment strategy for pernicious anemia?
What is the primary treatment strategy for pernicious anemia?
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What is the approximate percentage of blood volume that is erythrocytes?
What is the approximate percentage of blood volume that is erythrocytes?
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What happens to oxygen and nutrients in the capillaries?
What happens to oxygen and nutrients in the capillaries?
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Which of the following is TRUE about the Buffy coat?
Which of the following is TRUE about the Buffy coat?
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Which of the following describes the flow of blood through the circulatory system?
Which of the following describes the flow of blood through the circulatory system?
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What is the primary function of blood plasma?
What is the primary function of blood plasma?
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Which of the following is NOT a component of blood?
Which of the following is NOT a component of blood?
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What is the role of capillaries in the circulation system?
What is the role of capillaries in the circulation system?
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What is the primary physiological consequence of the imbalance in the blood oxygen levels, as depicted in the diagram?
What is the primary physiological consequence of the imbalance in the blood oxygen levels, as depicted in the diagram?
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How does the body compensate for the imbalance in oxygen delivery, as shown in the diagram?
How does the body compensate for the imbalance in oxygen delivery, as shown in the diagram?
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What is the primary role of the kidney in the body's response to low blood oxygen levels, as shown in the diagram?
What is the primary role of the kidney in the body's response to low blood oxygen levels, as shown in the diagram?
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What is the physiological consequence of enhanced erythropoiesis in response to the imbalance in oxygen levels, shown in the diagram?
What is the physiological consequence of enhanced erythropoiesis in response to the imbalance in oxygen levels, shown in the diagram?
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Which of the following scenarios could potentially trigger the cascade of events depicted in the diagram, resulting in enhanced erythropoiesis?
Which of the following scenarios could potentially trigger the cascade of events depicted in the diagram, resulting in enhanced erythropoiesis?
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What is the primary function of the red bone marrow as depicted in the diagram, in response to the imbalance in blood oxygen levels?
What is the primary function of the red bone marrow as depicted in the diagram, in response to the imbalance in blood oxygen levels?
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Which of the following would NOT directly contribute to the imbalance in blood oxygen levels, as depicted in the diagram?
Which of the following would NOT directly contribute to the imbalance in blood oxygen levels, as depicted in the diagram?
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What is the reason for the rise in the O2-carrying ability of blood, as depicted in the diagram, in response to the imbalance in oxygen delivery?
What is the reason for the rise in the O2-carrying ability of blood, as depicted in the diagram, in response to the imbalance in oxygen delivery?
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What is the primary mechanism by which erythropoietin stimulates red blood cell production, as depicted in the diagram?
What is the primary mechanism by which erythropoietin stimulates red blood cell production, as depicted in the diagram?
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How does the imbalance in blood oxygen levels depicted in the diagram, lead to a change in the oxygen-carrying ability of blood?
How does the imbalance in blood oxygen levels depicted in the diagram, lead to a change in the oxygen-carrying ability of blood?
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Flashcards
Homeostasis
Homeostasis
The state of stable internal conditions in the body, like normal blood oxygen levels.
Hypoxia
Hypoxia
A condition where there is inadequate oxygen delivery to tissues.
Erythropoiesis
Erythropoiesis
The process of producing red blood cells (RBCs) in the body.
Erythropoietin
Erythropoietin
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RBC Count
RBC Count
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Erythropoiesis Nutrients
Erythropoiesis Nutrients
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Iron in Erythropoiesis
Iron in Erythropoiesis
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Erythrocyte Life Span
Erythrocyte Life Span
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Anemia Definition
Anemia Definition
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Causes of Anemia
Causes of Anemia
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Iron-deficiency Anemia
Iron-deficiency Anemia
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Pernicious Anemia
Pernicious Anemia
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Hemolytic Anemia
Hemolytic Anemia
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Sickle-cell Anemia
Sickle-cell Anemia
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Thalassemias
Thalassemias
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Circulation
Circulation
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Capillaries
Capillaries
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Blood Plasma
Blood Plasma
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Erythrocytes
Erythrocytes
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Leukocytes
Leukocytes
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Hematocrit
Hematocrit
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Veins
Veins
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Buffy Coat
Buffy Coat
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Plasma
Plasma
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Erythropoietin (EPO)
Erythropoietin (EPO)
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Effects of EPO
Effects of EPO
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Testosterone's effect on EPO
Testosterone's effect on EPO
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Causes of hypoxia
Causes of hypoxia
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Arteries
Arteries
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Blood Composition
Blood Composition
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Platelets
Platelets
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Plasma Composition
Plasma Composition
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RBC Production Rate
RBC Production Rate
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EPO Basal Level
EPO Basal Level
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EPO Response to Hypoxia
EPO Response to Hypoxia
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EPO Effects
EPO Effects
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Dialysis and RBC Counts
Dialysis and RBC Counts
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Testosterone's Role
Testosterone's Role
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Rapid Reticulocyte Count Increase
Rapid Reticulocyte Count Increase
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Imbalance in Homeostasis
Imbalance in Homeostasis
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Hypoxia Causes
Hypoxia Causes
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Enhanced Erythropoiesis
Enhanced Erythropoiesis
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Stimulus for Erythropoiesis
Stimulus for Erythropoiesis
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Kidney Response to Hypoxia
Kidney Response to Hypoxia
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Erythropoietin Function
Erythropoietin Function
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Role of Liver in EPO
Role of Liver in EPO
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Consequences of Low RBC Count
Consequences of Low RBC Count
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Normal Blood Oxygen Levels
Normal Blood Oxygen Levels
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Enhanced RBC Production Trigger
Enhanced RBC Production Trigger
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Ferritin
Ferritin
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Hemosiderin
Hemosiderin
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Bilirubin
Bilirubin
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Urobilinogen
Urobilinogen
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Hemorrhagic Anemia
Hemorrhagic Anemia
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Renal Anemia
Renal Anemia
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Aplastic Anemia
Aplastic Anemia
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Sickle-Cell Trait
Sickle-Cell Trait
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Anemia Symptoms
Anemia Symptoms
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Study Notes
Blood Composition and Functions
- Blood is a fluid connective tissue.
- Plasma is the non-living fluid matrix.
- Formed elements are living cells suspended in plasma.
- Erythrocytes (red blood cells, or RBCs): transport oxygen and carbon dioxide.
- Leukocytes (white blood cells, or WBCs): function in defense against disease.
- Platelets (cell fragments): involved in blood clotting.
Blood Circulation
- Blood exits the heart via arteries, moving away from the heart.
- Arteries branch into capillaries, where oxygen and nutrients diffuse across capillary walls and into organs.
- Carbon dioxide and waste from organs enter the bloodstream.
- Oxygen-deficient blood leaves the capillaries and flows into veins.
- Veins return blood to the heart.
Blood Plasma
- Blood plasma is mostly water (approximately 90%).
- Over 100 dissolved solutes, including nutrients, gases, hormones, wastes, proteins, and inorganic ions.
- Plasma proteins are the most abundant solutes.
- They remain in the blood and aren't absorbed by cells.
- Plasma proteins are largely produced within the liver.
- Albumin (60%), globulins (36%), and fibrinogen (4%) are important plasma proteins.
Formed Elements: Erythrocytes (RBCs)
- Primarily biconcave discs, anucleate (no nucleus), and have few organelles.
- Contain hemoglobin (Hb): crucial for oxygen transport.
- Diameters of RBCs are larger than some capillaries.
- Contain spectrin and other proteins, enabling flexibility to change shape to pass through narrow capillaries.
- The biconcave shape maximizes surface area for efficient gas exchange.
- RBCs are primarily responsible for transporting oxygen.
Formed Elements: Erythrocytes - Structure and Function
- Structural characteristics contribute to gas transport.
- Biconcave shape—huge surface area relative to volume.
- Contain >97% hemoglobin.
- No mitochondria; anaerobic ATP production; lack of oxygen consumption which allows Hb to transport more oxygen and avoid using the oxygen itself.
- Superb example of complementarity of structure and function.
Formed Elements: Erythrocytes - Function
- RBCs are primarily responsible for respiratory gas transport.
- Hemoglobin binds reversibly with oxygen.
- Normal values: males (13-18 g/100 mL), females (12-16 g/100 mL).
Formed Elements: Hemoglobin Structure (Hb)
- Composed of 4 polypeptide chains (2 alpha and 2 beta chains) and heme pigment.
- Each hemoglobin molecule binds up to 4 oxygen molecules.
- Iron in heme gives blood its red color.
Formed Elements: Hemoglobin (Hb)
- O2 loading in lungs: produces oxyhemoglobin (ruby red).
- O2 unloading in tissues: produces deoxyhemoglobin (dark red).
- CO2 loading in tissues: 20% of CO2 in blood binds to Hb, forming carbaminohemoglobin.
Formed Elements: Hematopoiesis
- Blood cell formation occurs in red bone marrow.
- Composed of reticular connective tissue and blood sinusoids.
- In adults, found in the axial skeleton, girdles, and proximal epiphyses of humerus and femur.
- Hematopoietic stem cells (hemocytoblasts) give rise to all formed elements.
- Hormones and growth factors direct cell development.
Formed Elements: Erythropoiesis (RBC Production)
- Myeloid stem cell transforms into a proerythroblast.
- In 15 days, proerythroblasts develop into basophilic, polychromatic, orthochromatic erythroblasts, and then into reticulocytes.
- Reticulocytes enter the bloodstream and mature into RBCs.
- Hemoglobin is synthesized, and iron accumulates.
- The nucleus is ejected.
- Reticulocyte ribosomes degrade; mature erythrocytes are produced.
Formed Elements: Erythropoiesis Regulation
- Too few RBCs: tissue hypoxia.
- Too many RBCs: increased blood viscosity.
- Balance between RBC production and destruction depends on hormonal controls and adequate supplies of iron, amino acids, and B vitamins.
Formed Elements: Erythropoiesis Regulation: Hormones
- Erythropoietin (EPO): a direct stimulus for erythropoiesis, released by kidneys (some by the liver) in response to hypoxia.
- High RBC or O2 levels depress EPO production.
- Causes of hypoxia: decreased RBC numbers, insufficient hemoglobin, reduced availability of O2.
Formed Elements: Erythrocyte Fate and Destruction
- Life span: 100-120 days.
- No protein synthesis, growth, or division.
- Old RBCs become fragile, with Hb beginning to degenerate.
- Trapped in smaller circulatory channels, especially in the spleen.
- Macrophages engulf dying RBCs.
Formed Elements: Erythrocyte Fate and Destruction (cont.)
- Heme and globin are separated.
- Iron is salvaged for reuse.
- Heme degrades into bilirubin (yellow pigment).
- Bilirubin is secreted into intestines.
- Degradation products become urobilinogen.
- Pigment leaves the body in feces as stercobilin.
- Globin metabolized into amino acids, released into circulation.
Formed Elements: Leukocytes (WBCs)
- Make up <1% of total blood volume.
- Normal values: 4,800–10,800 WBCs/µL blood.
- Function in defense against disease.
- Can leave capillaries via diapedesis.
Formed Elements: Leukocytes (WBCs) - Types and Categories
- Two categories: granulocytes and agranulocytes.
- Granulocytes: visible cytoplasmic granules; include neutrophils, eosinophils, and basophils.
- Agranulocytes: no visible cytoplasmic granules; include lymphocytes and monocytes.
- Function: defense
Formed Elements: Leukocytes: Granulocytes
- Larger and shorter-lived than RBCs.
- Have lobed nuclei.
- Cytoplasmic granules stain specifically with Wright's stain.
- All are phagocytic to some degree.
Formed Elements: Leukocytes: Neutrophils
- Most numerous WBCs.
- Also called polymorphonuclear leukocytes (PMNs or polys).
- Granules stain lilac, containing hydrolytic enzymes (like lysozymes) or defensins.
- 3–6 lobes in nucleus; twice the size of RBCs.
- Very phagocytic ("bacteria slayers").
Formed Elements: Leukocytes: Eosinophils
- Red-staining granules.
- Bilobed nucleus.
- Granules are lysosome-like; release enzymes to digest parasitic worms.
- Play a role in allergies and asthma, and defense against parasites and allergens
Formed Elements: Leukocytes: Basophils
- Rarest WBCs.
- Nucleus deep purple, with 1-2 constrictions.
- Large, purplish-black (basophilic) granules contain histamine.
- Histamine acts as a vasodilator and attracts WBCs to inflamed sites.
- Functionally similar to mast cells
Formed Elements: Leukocytes: Agranulocytes
- Lack visible cytoplasmic granules.
- Spherical or kidney-shaped nuclei.
Formed Elements: Leukocytes: Lymphocytes
- Second most numerous WBCs.
- Large, dark-purple circular nuclei with a thin rim of blue cytoplasm.
- Mostly in lymphoid tissue (e.g., lymph nodes, spleen).
- Crucial for immunity; part of the adaptive immune system.
Formed Elements: Leukocytes: Lymphocytes (Types)
- T lymphocytes (T cells): target virus-infected cells and tumor cells via cell-mediated immunity.
- B lymphocytes (B cells): give rise to plasma cells, producing antibodies via humoral immunity.
Formed Elements: Leukocytes: Monocytes
- Largest leukocytes.
- Abundant pale-blue cytoplasm.
- Dark-purple-staining U- or kidney-shaped nuclei.
- Leave circulation, entering tissues, and differentiate into macrophages.
- Phagocytic cells crucial against viruses, intracellular bacterial parasites, and chronic infections; part of the innate immune system.
Formed Elements: Leukocytes: Leukopoiesis
- Production of WBCs is stimulated by chemical messengers from red bone marrow and mature WBCs.
- Includes two types of chemical messengers: interleukins (e.g., IL-3, IL-5) and colony-stimulating factors (CSFs).
- All leukocytes originate from hemocytoblasts.
Formed Elements: Platelets
- Cytoplasmic fragments of megakaryocytes.
- Blue-staining outer region; purple granules contain serotonin, Ca2+, enzymes, ADP, and platelet-derived growth factor (PDGF).
- Act in clotting processes.
- Normal values: 150,000–400,000 platelets/mL blood.
Formed Elements: Platelets (cont.)
- Form temporary platelet plugs to seal breaks in blood vessels.
- Kept inactive and mobile by nitric oxide (NO) and prostacyclin from endothelial cells.
- Age quickly, degenerating within about 10 days.
- Formation is regulated by thrombopoietin.
Hemostasis and Blood Replacement
- Fast series of reactions for stopping bleeding (vasoconstriction, platelet plug formation, coagulation).
- Requires clotting factors and substances released by platelets and injured tissues.
- Includes three overlapping steps: vascular spasm, platelet plug formation, and coagulation.
Hemostasis: Coagulation Overview
- Reinforces the platelet plug with fibrin threads.
- Converts blood from liquid to a gel.
- Uses a series of reactions using clotting factors (procoagulants).
- Most plasma proteins are needed.
- Vitamin K is necessary for the synthesis of particular clotting factors.
Hemostasis: Coagulation: Phase 1 - Prothrombin Activator
- Two pathways (intrinsic and extrinsic) initiate coagulation, forming prothrombin activator.
- Intrinsic: involved within blood, triggered by negatively charged surfaces (activated platelets, collagen, glass).
- Extrinsic: triggered by tissue factor (TF or factor III), bypassing several intrinsic steps.
Hemostasis: Coagulation: Phase 2 - Pathway to Thrombin
- Prothrombin activator triggers the transformation of prothrombin to active enzyme thrombin.
- Clot formation occurs within 10-15 seconds.
Hemostasis: Coagulation: Phase 3 - Common Pathway to Fibrin Mesh
- Thrombin converts soluble fibrinogen to insoluble fibrin.
- Fibrin forms the structural basis of the clot; entraps formed elements.
- Thrombin, with calcium, activates factor XIII, which cross-links fibrin, making the clot stronger and more stable.
Hemostasis: Clot Retraction
- Stabilizes the clot.
- Actin and myosin in platelets contract within 30-60 minutes.
- Contraction pulls on fibrin strands, squeezing serum from the clot.
- Draws ruptured blood vessel edges together.
Hemostasis: Vessel Repair
- Vessel healing takes place during clot retraction.
- Platelet-derived growth factor (PDGF) stimulates division of smooth muscle cells and fibroblasts to rebuild the blood vessel wall.
- Vascular endothelial growth factor (VEGF) stimulates endothelial cells to multiply and restore the endothelial lining.
Fibrinolysis
- Removes unneeded clots after healing.
- Begins within two days and continues for several days.
- Plasminogen in the clot is converted to plasmin (a fibrin-digesting enzyme) via tissue plasminogen activator (tPA), factor XII, and thrombin.
Factors Limiting Clot Growth or Formation
- Swift removal and dilution of clotting factors.
- Inhibition of activated clotting factors (e.g., thrombin bound onto fibrin threads, Antithrombin III inactivates unbound thrombin).
- Heparin, in basophils and mast cells, inhibits thrombin by enhancing antithrombin III.
Factors Preventing Undesirable Clotting
- Platelet adhesion is prevented by the smooth endothelium preventing platelets from clinging.
- Antithrombic substances (nitric oxide and prostacyclin) are secreted.
- Vitamin E quinone acts as a potent anticoagulant.
Disorders of Hemostasis
- Thromboembolic disorders: undesirable clot formation.
- Bleeding disorders: abnormalities preventing normal clot formation.
- Disseminated intravascular coagulation (DIC): involves both types of disorders.
Thromboembolic Conditions
- Thrombus: a clot that forms and persists in unbroken blood vessels.
- Embolus: a thrombus that freely floats in the bloodstream.
- Embolism: an embolus obstructing a vessel.
- Risk factors: atherosclerosis, inflammation, slowly flowing blood (stasis), immobility.
Anticoagulant Drugs
- Aspirin: inhibits thromboxane A2.
- Heparin: anticoagulant used clinically for pre- and postoperative cardiac care.
- Warfarin (Coumadin): used for those prone to atrial fibrillation; interferes with vitamin K action.
- Dabigatran: directly inhibits thrombin.
Bleeding Disorders: Thrombocytopenia
- Deficient number of circulating platelets.
- Petechiae appear due to spontaneous, widespread hemorrhage.
- Due to suppression or destruction of red bone marrow (e.g., malignancy, radiation, drugs).
- Platelet count < 50,000/µL is diagnostic.
- Treated with a transfusion of concentrated platelets.
Bleeding Disorders: Liver Function Impairment
- Impaired liver function: inability to synthesize procoagulants (e.g., vitamin K deficiency, hepatitis, cirrhosis).
- Impaired fat absorption can prevent liver from producing bile.
- This impairs absorption of fat and vitamin K, thus also affecting clotting factors.
Bleeding Disorders: Hemophilia
- Includes several similar hereditary bleeding disorders.
- Hemophilia A: most common; factor VIII deficiency.
- Hemophilia B: factor IX deficiency.
- Hemophilia C: mild type; factor XI deficiency.
- Symptoms: prolonged bleeding, especially into joint cavities.
- Treated with plasma transfusions and injection of missing factors.
Bleeding Disorders: Disseminated Intravascular Coagulation (DIC)
- Clotting causes bleeding.
- Widespread clotting blocks intact blood vessels.
- Severe bleeding occurs because residual blood is unable to clot due to the over-consumption of clotting factors.
Additional Notes
- Never let monkeys eat bananas: a useful mnemonic for remembering the decreasing abundance of granulocytes in blood (Neutrophils, Eosinophils, Basophils).
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Description
This quiz focuses on the essential components of human blood, including erythropoietin and the roles of red blood cells. It explores how low oxygen levels trigger responses in the body and the functions of various blood elements. Test your knowledge on hematocrit, platelets, and the structural components of blood!