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Questions and Answers

What percentage of body weight does Total Body Water approximate?

  • 50%
  • 60% (correct)
  • 40%
  • 70%
  • Which of the following components are part of the Extracellular Fluid compartment?

  • Intracellular Fluid only
  • Interstitial Fluid only
  • Plasma only
  • Both Interstitial Fluid and Plasma (correct)
  • What is the primary role of Erythropoietin in blood physiology?

  • Increasing plasma volume
  • Stimulating red blood cell production (correct)
  • Facilitating oxygen transport
  • Inhibiting red blood cell production
  • At what stage does red blood cell production predominantly occur in the bone marrow?

    <p>Between 6-7 months postnatally</p> Signup and view all the answers

    Which vitamins are essential for the proper production of red blood cells?

    <p>Vitamin B12 and folic acid</p> Signup and view all the answers

    What shape does a mature erythrocyte primarily exhibit?

    <p>Biconcave</p> Signup and view all the answers

    What condition is indicated by a reduced amount of red blood cells or hemoglobin?

    <p>Anemia</p> Signup and view all the answers

    Which of the following is a consequence of high altitude on red blood cell production?

    <p>Physiological increase in red blood cell production</p> Signup and view all the answers

    Where is the primary site of red blood cell production in adults?

    <p>Vertebrae and pelvis</p> Signup and view all the answers

    Synthetic Erythropoietin is used primarily for which medical condition?

    <p>Chronic renal failure</p> Signup and view all the answers

    What is the primary function of hemoglobin in red blood cells?

    <p>Transport oxygen and carbon dioxide</p> Signup and view all the answers

    Which of the following statements about hemoglobin structure is accurate?

    <p>Hemoglobin contains two alpha and two beta chains.</p> Signup and view all the answers

    What is a primary cause of anemia in patients with Sickle Cell Disease?

    <p>Fragility of sickled cells</p> Signup and view all the answers

    During the breakdown of red blood cells, which of the following sequences correctly describes the breakdown of heme?

    <p>Heme &gt; Iron &gt; Biliverdin &gt; Bilirubin</p> Signup and view all the answers

    Which blood group is considered a 'Universal Donor'?

    <p>Blood group O Rh negative</p> Signup and view all the answers

    What happens to bilirubin in the body?

    <p>It is secreted in bile after being processed in the liver.</p> Signup and view all the answers

    Which of the following is NOT a function of red blood cells?

    <p>Transporting nutrients</p> Signup and view all the answers

    How does foetal hemoglobin differ from adult hemoglobin?

    <p>Foetal hemoglobin assists in oxygen transfer from mother to fetus.</p> Signup and view all the answers

    What condition is primarily caused by a high level of bilirubin in the blood?

    <p>Jaundice</p> Signup and view all the answers

    Which of the following statements about RBC lifespan is correct?

    <p>RBCs typically have a lifespan of around 120 days.</p> Signup and view all the answers

    Study Notes

    Total Body Water

    • Approximately 60% of body weight is water
    • In a 70kg male, this equates to 40-45 litres of water
    • Water is divided between intracellular fluid (ICF) and extracellular fluid (ECF)
    • ECF consists of plasma and interstitial fluid (ISF)

    Composition of Blood

    • Plasma is a component of the ECF compartment
    • Blood is composed of 55% plasma and 45% cellular components

    Cellular Content of Blood

    • Red blood cells (erythrocytes)
    • White blood cells (leukocytes)
    • Platelets (thrombocytes)

    Red Blood Cells (Erythrocytes)

    • Mature red blood cells are non-nucleated
    • Cells are biconcave in shape
    • Shape allows for increased surface area to volume ratio for efficient gas exchange

    RBC/Erythrocyte Production

    • Production begins in utero
    • Bone marrow takes over production at 6-7 months
    • All bone marrow involved in children
    • In adults, production is mainly in the sternum, vertebrae, ribs, and pelvis
    • Production requires adequate intake of:
      • Protein
      • Vitamins like B12 and folic acid
    • Erythropoietin, a hormone released by the kidneys, plays a crucial role
    • Anaemia is a condition where there is a lack of red blood cells or haemoglobin, leading to a reduced oxygen carrying capacity
    • Erythropoietin production is stimulated by low oxygen levels in the blood.

    Sequence of Events in RBC Production

    • Committed stem cell differentiates into proerythroblast
    • Proerythroblast undergoes several divisions and maturation stages
    • Nucleus shrinks and is eventually expelled
    • Reticulocyte is released into bloodstream and matures into erythrocyte

    Role of Erythropoietin in RBC Production

    • Erythropoietin stimulates erythropoiesis in the bone marrow
    • Increased production can be triggered by altitude changes or chronic renal failure
    • Synthetic erythropoietin is available for treatment of chronic renal failure
    • Use of erythropoietin in athletes for blood doping is dangerous and can lead to:
      • Polycythaemia
      • Increased blood viscosity
      • Heart failure or stroke

    Functions of RBCs

    • Contain haemoglobin
    • Oxygen transport
    • Carbon dioxide transport
    • Blood buffering to maintain a normal blood pH of 7.4

    Structure of Haemoglobin

    • Consists of four polypeptide chains:
      • Two alpha (α) and two beta (β) chains in adult HbA
      • Two alpha (α) and two gamma (γ) chains in fetal HbF
    • Each polypeptide chain is linked to a haem molecule
    • Each haem molecule contains one iron atom for oxygen binding
    • Haemoglobinopathies are caused by abnormal haemoglobin structure, such as sickle cell disease and thalassaemias

    Anaemia

    • Sickle cell disease is a genetic disorder
    • Symptoms appear in childhood
    • Sickled cells are fragile and become trapped in microcirculation
    • Obstruction of blood flow leads to ischemia, pain, and potentially stroke, jaundice, and respiratory symptoms

    Red Blood Cell Breakdown

    • Lifespan of red blood cells is about 120 days
    • Old cells become fragile
    • They are trapped and destroyed in the spleen
    • Haemoglobin breaks down into heme and globin
    • Globin is recycled as amino acids
    • Iron from heme is recycled
    • Heme breakdown products yield biliverdin, which converts to bilirubin
    • Bilirubin is a yellow pigment transported to the liver and excreted in bile
    • Jaundice occurs when bilirubin levels in the blood are high, potentially due to liver disease

    Blood Groups

    • Determined by the antigen present on the red blood cell membrane
    • Each blood group is either Rh positive or Rh negative
    • Blood group O-negative is a "universal donor" as it lacks antigens that would react with antibodies in the recipient's plasma.

    Blood Transfusions

    • Patients' blood is typed and crossmatched with donor cells to determine compatibility
    • If donor cells react with antibodies in the recipient's plasma, a transfusion reaction can occur.

    Role of Platelets in Haemostasis

    • Platelets (thrombocytes) are essential for haemostasis, the process of stopping bleeding.
    • They adhere to the site of injury and form a platelet plug, which helps seal the damaged blood vessel.

    Sequence of Events in Clotting

    • The clotting cascade is a complex series of enzymatic reactions that lead to the formation of fibrin.
    • Fibrin is a protein that forms a mesh-like structure over the platelet plug, trapping red blood cells and forming a clot.
      • The cascade involves:
        • Intrinsic pathway (activated by factors within the blood)
        • Extrinsic pathway (activated by factors outside the blood)
      • Both pathways converge to activate a common pathway, culminating in the formation of thrombin.
        • Thrombin converts fibrinogen to fibrin, forming the clot.

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