Red Blood Cells and Anemia Quiz

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Questions and Answers

What is the primary function of hemoglobin concerning oxygen?

  • To transport carbon dioxide exclusively
  • To facilitate the excretion of iron
  • To store iron in a soluble form
  • To combine loosely and reversibly with oxygen (correct)

Which protein combines with iron to form ferritin in the cell cytoplasm?

  • Hemoglobin
  • Transferrin
  • Globulin
  • Apoferritin (correct)

What happens to iron absorption when the body has excess iron?

  • Iron absorption rates increase significantly
  • Iron absorption rates remain unchanged
  • Iron absorption ceases completely
  • Iron absorption rates decrease significantly (correct)

How does hemosiderin differ from ferritin regarding iron storage?

<p>Hemosiderin contains more iron than ferritin (D)</p> Signup and view all the answers

What characterizes the absorption rate of iron from the intestines?

<p>It is slow, limited to a few milligrams per day (B)</p> Signup and view all the answers

What happens to the pluripotential cells as they reproduce?

<p>A small portion remains as pluripotential cells to maintain the supply in bone marrow. (A)</p> Signup and view all the answers

Which statement is true regarding the differentiation of pluripotential cells?

<p>Differentiation results in the formation of various circulating blood cells. (B)</p> Signup and view all the answers

What happens to the number of retained pluripotential cells as age increases?

<p>Their numbers diminish with age. (D)</p> Signup and view all the answers

Where are pluripotential cells primarily retained to maintain their supply?

<p>In the bone marrow. (D)</p> Signup and view all the answers

Which of the following locations does NOT show the retention of pluripotential cells?

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

What characteristic is retained in a portion of the reproduced pluripotential cells?

<p>Pluripotential properties. (A)</p> Signup and view all the answers

What occurs with the reproduced cells of pluripotential cells?

<p>Most differentiate into other cell types. (C)</p> Signup and view all the answers

What differentiates intermediate-stage cells from pluripotent stem cells?

<p>Intermediate-stage cells are already committed to a particular line of cells. (D)</p> Signup and view all the answers

Which type of colony-forming unit is responsible for the generation of platelets?

<p>CFU-M (D)</p> Signup and view all the answers

In the context of blood cell formation, what does PHSC stand for?

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

Which of the following stem cells is specifically linked to the generation of T lymphocytes?

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

What type of blood cell does CFU-E specifically produce?

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

Which lineage do CFU-GM stem cells give rise to?

<p>Granulocytes and monocytes (B)</p> Signup and view all the answers

What is a characteristic of fully committed stem cells?

<p>They are restricted to producing specific lineages. (A)</p> Signup and view all the answers

Which of the following stem cells is not involved in the production of red blood cells?

<p>CFU-GM (B)</p> Signup and view all the answers

Which blood cell type is derived from CFU-B?

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

What is the principal stimulus for red blood cell production in low oxygen states?

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

Where is the majority of erythropoietin produced in the body?

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

What happens to red blood cell production when tissue oxygenation decreases?

<p>Red blood cell production increases (C)</p> Signup and view all the answers

What is the molecular weight of erythropoietin?

<p>34,000 (C)</p> Signup and view all the answers

In the absence of erythropoietin, what effect does hypoxia have on red blood cell production?

<p>It has no effect (A)</p> Signup and view all the answers

What role does the liver play in erythropoietin production?

<p>Produces a small amount of erythropoietin (C)</p> Signup and view all the answers

What occurs when the erythropoietin system is functional during hypoxia?

<p>Erythropoietin production markedly increases (D)</p> Signup and view all the answers

What is the main consequence of an extremely anemic state due to hemorrhage?

<p>Bone marrow produces large amounts of red blood cells (C)</p> Signup and view all the answers

What issue arises if red blood cells become too numerous?

<p>Impediment of blood flow (A)</p> Signup and view all the answers

What is the result of hypoxia on the erythropoietin system in terms of red blood cell production?

<p>It stimulates erythropoietin production and increases red blood cell production (B)</p> Signup and view all the answers

What is the main factor triggering the growth and differentiation of erythrocytes?

<p>Exposure to low oxygen levels over time (A)</p> Signup and view all the answers

What happens to the basophilic material during the transition from reticulocyte to mature erythrocyte?

<p>It normally disappears within 1 to 2 days (B)</p> Signup and view all the answers

Which of the following correctly describes reticulocytes in the blood?

<p>Their concentration is slightly less than 1% of red cells (C)</p> Signup and view all the answers

What role does erythropoietin play in red blood cell production?

<p>It stimulates the production of red blood cells in response to low oxygen (C)</p> Signup and view all the answers

Which type of anemia is characterized by microcytic and hypochromic red blood cells?

<p>Iron deficiency anemia (C)</p> Signup and view all the answers

During what process do reticulocytes enter the bloodstream from the bone marrow?

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

What is the primary consequence of hypoxia on erythropoietin levels?

<p>Increased formation of erythropoietin (B)</p> Signup and view all the answers

What is the ultimate function of growth inducers during the reticulocyte stage?

<p>To facilitate the differentiation of erythrocytes (B)</p> Signup and view all the answers

Which statement about erythropoiesis is false?

<p>It occurs solely in the liver (B)</p> Signup and view all the answers

What is the expected hematocrit change as a result of increased erythropoiesis?

<p>Increase in hematocrit levels (A)</p> Signup and view all the answers

What role does transferrin play in the iron transport process?

<p>Transferrin binds to iron in the plasma and delivers it to erythroblasts. (B)</p> Signup and view all the answers

What physiological change occurs to red blood cells as they approach the end of their life span?

<p>They become increasingly fragile and less active metabolically. (D)</p> Signup and view all the answers

What happens to hemoglobin after red blood cells are destroyed?

<p>It is ingested by monocyte-macrophage cells, releasing iron. (D)</p> Signup and view all the answers

Why might a deficiency in transferrin lead to hypochromic anemia?

<p>Failure to transport iron to developing erythroblasts. (C)</p> Signup and view all the answers

How does the spleen contribute to the lifecycle of red blood cells?

<p>It filters old red blood cells and aids in their destruction. (A)</p> Signup and view all the answers

What is the primary function of differentiation inducers in stem cell maturation?

<p>To cause specific differentiation of committed stem cells (D)</p> Signup and view all the answers

Which type of stem cell is specifically responsible for forming red blood cells?

<p>Colony-forming unit-erythrocyte (CFU-E) (C)</p> Signup and view all the answers

At what stage do proerythroblasts begin to significantly accumulate hemoglobin?

<p>After becoming basophilic erythroblasts (B)</p> Signup and view all the answers

What happens to the endoplasmic reticulum during the transition from a reticulocyte to a mature erythrocyte?

<p>It is partially reabsorbed by the cell (C)</p> Signup and view all the answers

Which protein primarily promotes growth and reproduction of various stem cells?

<p>Interleukin-3 (D)</p> Signup and view all the answers

What is the primary characteristic of basophilic erythroblasts?

<p>They show minimal accumulation of hemoglobin (B)</p> Signup and view all the answers

During hematopoiesis, what triggers the production of large numbers of red blood cells from CFU-E?

<p>Appropriate stimulation by growth inducers (A)</p> Signup and view all the answers

What percentage of total body iron is represented by hemoglobin?

<p>65 percent (A)</p> Signup and view all the answers

Which of the following correctly describes the composition of hemoglobin A?

<p>Two alpha chains and two beta chains (B)</p> Signup and view all the answers

What is the average total quantity of iron in the human body?

<p>4 to 5 grams (B)</p> Signup and view all the answers

Which type of chains are NOT a component of hemoglobin?

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

Where is the majority of stored iron found in the body?

<p>Reticuloendothelial system and liver (B)</p> Signup and view all the answers

Which heme compound is responsible for promoting intracellular oxidation?

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

What is the molecular weight of hemoglobin A?

<p>64,458 (B)</p> Signup and view all the answers

Which statement about iron storage is false?

<p>Transferrin is the primary iron storage protein. (A)</p> Signup and view all the answers

Which of the following options indicates a lesser-known form of hemoglobin chains?

<p>Gamma and delta chains (D)</p> Signup and view all the answers

Which component contributes to about 1 percent of total body iron?

<p>Various heme compounds (B)</p> Signup and view all the answers

What is the primary factor that influences red cell production under low oxygen conditions?

<p>Tissue demand for oxygen (B)</p> Signup and view all the answers

Which cells primarily secrete erythropoietin in the kidney?

<p>Fibroblast-like interstitial cells (A)</p> Signup and view all the answers

What role does hypoxia-inducible factor-1 (HIF-1) play in the synthesis of erythropoietin?

<p>It serves as a transcription factor for the erythropoietin gene (A)</p> Signup and view all the answers

What physiological condition can lead to increased erythropoietin synthesis aside from altitude-related hypoxia?

<p>Decreased tissue blood flow due to disease (D)</p> Signup and view all the answers

Which of the following is NOT associated with the response to hypoxia in the body?

<p>Increased absorption of oxygen in the lungs (D)</p> Signup and view all the answers

Which sequence accurately describes the process triggered by renal tissue hypoxia?

<p>Increased HIF-1 levels → Increased erythropoietin mRNA transcription (A)</p> Signup and view all the answers

What is the ultimate effect of insufficient oxygen transported to tissues on red blood cell production?

<p>Increased red blood cell production (D)</p> Signup and view all the answers

Which factor directly induces the transcription of erythropoietin mRNA during hypoxic conditions?

<p>Presence of hypoxia response elements (D)</p> Signup and view all the answers

What primarily regulates the total body iron level?

<p>Altering the rate of iron absorption (A)</p> Signup and view all the answers

What component of the hemoglobin molecule is vital for its function?

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

What is a key characteristic of hemosiderin compared to ferritin?

<p>Hemosiderin can accumulate in larger clusters in cells (B)</p> Signup and view all the answers

What limits the rate of iron absorption when the body has sufficient iron stores?

<p>Saturation of apoferritin storage pools (A)</p> Signup and view all the answers

What is the maximum iron absorption rate from the intestines for a healthy person?

<p>Only small proportions can be absorbed, even with high intake (B)</p> Signup and view all the answers

What is one consequence of having a high total quantity of iron in the body?

<p>Formation of hemosiderin in cells (A)</p> Signup and view all the answers

Which factor increases the rate of iron absorption when stores are depleted?

<p>Enhanced absorption rate up to five times normal (C)</p> Signup and view all the answers

What role does apoferritin play in iron metabolism?

<p>It serves as an iron storage protein (A)</p> Signup and view all the answers

What characteristic is notable about ferritin compared to hemosiderin?

<p>Ferritin particles are smaller and more dispersed (A)</p> Signup and view all the answers

How does iron absorption from the intestines change with varying body iron levels?

<p>It decreases significantly with high iron stores (D)</p> Signup and view all the answers

Flashcards

Pluripotential cell

A type of cell in bone marrow that can develop into any type of blood cell.

Hematopoiesis

The process by which pluripotential cells divide and specialize into different types of blood cells.

Stem cells

A small portion of pluripotential cells that remain undifferentiated, ensuring a continuous supply of new blood cells.

Diminishing pluripotential cells with age

The decrease in the number of pluripotential cells over time.

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Cell differentiation

The majority of pluripotential cells differentiate to form various blood cell types.

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Maturation of blood cells

A type of blood cell formation where immature cells develop into more specialized forms.

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Maintenance of blood cell population

The process by which pluripotential cells are constantly being replaced and renewed.

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Pluripotent Hematopoietic Stem Cell (PHSC)

A stem cell that has the potential to develop into any type of blood cell.

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Committed Stem Cell

A type of stem cell that is committed to a specific blood cell lineage, but still has the potential to create several types of cells.

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Colony-forming Unit - Erythrocytes (CFU-E)

A specific cell type that is part of the red blood cell lineage.

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Colony-forming Unit - Granulocytes, Monocytes (CFU-GM)

A specialized stem cell that will differentiate to become a specific kind of white blood cell.

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Colony-forming Unit - Megakaryocytes (CFU-M)

Specialized stem cell responsible for producing platelets, which aid in blood clotting.

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Blood Cell Maturation

The process by which immature blood cells develop into more specialized forms.

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Blood Cell Maintenance

Cells that create a continuous supply of new blood cells, ensuring a consistent population.

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Diminishing Pluripotent Stem Cells with Age

The number of pluripotent stem cells decreases as we age.

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Basophilic erythroblast

An immature red blood cell that has a lot of ribosomes and RNA, making it appear blue under the microscope.

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Erythropoietin

An important hormone that stimulates the bone marrow to increase red blood cell production.

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Diapedesis

The process by which cells move through the tiny pores of blood vessels.

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Anemia

A condition where there is a shortage of red blood cells or low hemoglobin levels.

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Microcytic anemia

A type of anemia in which red blood cells are smaller than normal.

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Sickle cell anemia

A type of anemia in which red blood cells are abnormally shaped and less flexible.

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Megaloblastic anemia

A type of anemia in which red blood cells are larger than normal.

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Erythroblastosis fetalis

A condition where the baby's red blood cells are destroyed by the mother's immune system.

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Reticulocyte

An immature red blood cell that still contains some ribosomes and RNA, giving it a bluish tint.

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What is hemoglobin?

The molecule that binds to and carries the oxygen.

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What is reversible oxygen binding?

The ability of hemoglobin to bind to and release oxygen as needed.

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What is ferritin?

The main form of iron storage in the body, found primarily in the liver, spleen, and bone marrow.

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What is hemosiderin?

An extremely insoluble form of iron storage, often appearing in large clusters in cells.

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How does the body regulate iron levels?

The body's primary mechanism for controlling total iron levels.

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Red blood cell production

The process of creating new red blood cells.

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Oxygenation as the regulator

The primary factor influencing red blood cell production is the amount of oxygen available in the tissues.

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Hypoxia

Low levels of oxygen in the blood or tissues.

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Red blood cell regulation

The body tightly regulates the number of red blood cells, ensuring enough are available to carry oxygen without clogging blood flow.

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Hypoxia's effect on red blood cell production

The production of red blood cells increases when there's a shortage of oxygen in the tissues.

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Kidneys and erythropoietin

The kidneys are the primary site of erythropoietin production.

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Erythropoietin and hypoxia feedback loop

Erythropoietin production increases in response to hypoxia, leading to an increase in red blood cell production until oxygen levels return to normal.

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Bone marrow and red blood cell production

The bone marrow is responsible for producing red blood cells.

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CFU-E

A stem cell committed to becoming a red blood cell.

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Growth Inducers

Proteins that stimulate cell growth but don't cause differentiation.

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Differentiation Inducers

Proteins that initiate the transformation of a committed stem cell into a specific blood cell type.

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Proerythroblast

The first recognizable cell in the red blood cell formation process, characterized by a large nucleus and a lack of hemoglobin.

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Red Blood Cell Formation

The process of forming red blood cells, beginning with a committed stem cell and ending with a fully functional, oxygen-carrying red blood cell.

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Hemoglobin's Function

The primary function of hemoglobin is to bind and release oxygen, enabling the transport of oxygen throughout the body.

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Iron Storage Forms

Iron is stored in the body primarily in two forms: ferritin and hemosiderin. Ferritin is the main storage form, while hemosiderin is a less soluble form that accumulates when iron levels are high.

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Iron Absorption Regulation

The body tightly regulates iron levels by controlling the rate of iron absorption from the intestines. When iron stores are low, absorption increases, and when stores are high, absorption decreases.

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Hypoxia and Red Blood Cell Production

A low oxygen level in the blood or tissues, known as hypoxia, triggers the body to produce more red blood cells.

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Erythropoietin and Red Blood Cell Production

The kidneys produce a hormone called erythropoietin, which stimulates the bone marrow to produce more red blood cells in response to low oxygen levels.

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Erythropoietin Feedback Loop

This is a feedback loop where low oxygen levels trigger erythropoietin production, leading to increased red blood cell production, which eventually restores normal oxygen levels.

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Reversible Oxygen Binding

The ability of hemoglobin to bind and release oxygen is crucial for oxygen transport. When oxygen is abundant, hemoglobin binds to it, and when oxygen is scarce, hemoglobin releases it.

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Ferritin Function

Ferritin is a protein that stores iron in the body. It is found mainly in the liver, spleen, and bone marrow.

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Hemosiderin Function

Hemosiderin is another form of iron storage. It is less soluble than ferritin and accumulates when iron levels are high.

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What is diapedesis?

The process by which cells, such as white blood cells, squeeze through tiny pores in blood vessels to reach areas of infection or inflammation.

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How are old red blood cells destroyed?

When red blood cells reach the end of their lifespan (around 120 days), they are broken down by monocyte-macrophage cells, releasing their hemoglobin for iron recycling.

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How is iron transported to erythroblasts?

A unique characteristic of the transferrin molecule is that it binds strongly with receptors in the membranes of erythroblasts (immature red blood cells) in the bone marrow. This allows transferrin to deliver iron directly to the mitochondria, where heme is synthesized.

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What is red blood cell production?

The formation of new red blood cells is called erythropoiesis. It's vital for replenishing aging red blood cells and ensuring an adequate supply of oxygen carriers in the blood.

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How is red blood cell production regulated?

Oxygenation levels in the tissues greatly influence red blood cell production. When oxygen levels are low (hypoxia), the body increases red blood cell production to compensate for the oxygen shortage.

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What is hypoxia?

Hypoxia is a state of low oxygen levels in the blood or tissues. It can be caused by various factors, including altitude sickness, anemia, or lung disease.

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What is red blood cell regulation?

The body maintains an adequate supply of red blood cells while preventing excessive number of red blood cells. This balance ensures efficient oxygen transport without increasing blood viscosity.

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How does hypoxia affect red blood cell production?

Hypoxia triggers the kidneys to release erythropoietin, a hormone that stimulates the bone marrow to produce more red blood cells. This process increases the number of oxygen carriers, restoring normal oxygen levels.

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Study Notes

Red Blood Cells, Anemia, and Polycythemia

  • Red blood cells (erythrocytes) are the most abundant blood cells, crucial for oxygen delivery to tissues. They contain hemoglobin, which transports oxygen from lungs to tissues. Hemoglobin also acts as a buffer in maintaining acid-base balance in the blood.
  • Erythrocytes are biconcave discs, about 7.8 micrometers in diameter and 2.5 micrometers thick at the centre. Their shape allows for flexibility to squeeze through capillaries. This flexibility prevents rupturing during deformation.
  • Healthy adult male erythrocyte count: 5,200,000/mm³ (plus/minus 300,000). Female count: 4,700,000/mm³ (plus/minus 300,000). Higher at high altitude.
  • Hemoglobin concentration in erythrocytes: roughly 34 grams per 100 milliliters of cells. This maximum concentration prevents damage to the cell.
  • Normal hematocrit (percentage of blood volume occupied by red blood cells): 40-45% (men) & 37-47% (women)
  • Each gram of hemoglobin can carry 1.34 ml of oxygen .
  • Factors affecting erythrocyte production include tissue oxygenation (critical), hemorrhage, high altitude, cardiac failure, and lung diseases.
  • Erythropoietin, a hormone, regulates red blood cell production, primarily produced in the kidneys and (less so) liver. Hypoxia (low oxygen availability) triggers erythropoietin production. Erythropoietin stimulates the production of proerythroblasts from hematopoietic stem cells in the bone marrow and speeds up the erythroblastic stages.
  • Red blood cell maturation requires specific precursor cells in bone marrow, and involves folic acid and vitamin B12. Deficiency in these leads to abnormal cell development and maturation failure, resulting in larger cells (macrocytes) and/or premature destruction of cells. The vitamin deficiencies can result from poor absorption due to conditions like pernicious anemia or sprue. Pernicious anemia is caused by an atrophic gastric mucosa that doesn't produce adequate intrinsic factor, which is required for vitamin B12 absorption.
  • Anemia: reduced hemoglobin content or red cell count. Several causes of anemia include blood loss, aplastic anemia (bone marrow failure), megaloblastic anemia (vitamin deficiencies), and hemolytic anemia (destruction of red blood cells). Hemolytic anemia can result from genetic defects (like spherocytosis or sickle cell anemia) or acquired conditions. Sickle cell anemia is characterized by an abnormal type of hemoglobin (hemoglobin S) causing the cell to become rigid and fragile.
  • Polycythemia: excessive red blood cells. Secondary polycythemia arises from tissue hypoxia and triggers increased red blood cell production to compensate. Polycythemia vera is a pathological condition in which red blood cell production isn't regulated, resulting in an elevated hematocrit.
  • Red blood cells have a lifespan of approximately 120 days. At the end of lifespan, they are destroyed in the spleen, and iron is released and recycled.
  • Iron obtained from hemoglobin breakdown is essential for red blood cell formation. Iron is stored and transported effectively within the body using transferrin. Storage iron is found as ferritin, while storage iron in excess is stored as hemosiderin. Iron is absorbed from the small intestine effectively when there are adequate quantities of apotransferrin.

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