Guyton 33 book. Red Blood Cells and Anemia Quiz

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Questions and Answers

What is the term for the cell type that is committed to becoming a specific type of blood cell?

  • Multipotential stem cell
  • Intermediate-stage cell
  • Colony-forming unit
  • Committed stem cell (correct)

What does the abbreviation CFU-E stand for?

  • Colony-forming unit - erythrocyte (correct)
  • Colony-forming unit - granulocyte
  • Colony-forming unit - lymphocyte
  • Colony-forming unit - macrophage

Which of the following is NOT a characteristic of committed stem cells?

  • They are capable of self-renewal.
  • They are committed to a specific cell lineage.
  • They can produce colonies of specific cell types in culture.
  • They are multipotent. (correct)

What is the difference between intermediate-stage cells and multipotential stem cells?

<p>Intermediate-stage cells are committed to a specific cell lineage, while multipotential stem cells are not. (A)</p> Signup and view all the answers

Which of the following abbreviations represents a colony-forming unit that produces granulocytes and monocytes?

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

What is the name given to the process by which committed stem cells produce colonies of specific cell types in culture?

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

What is the primary site of red blood cell production during the last month of gestation and after birth?

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

Which of the following statements about committed stem cells is TRUE?

<p>They are only found in the bone marrow. (D)</p> Signup and view all the answers

Which of the following bones contribute to red blood cell production throughout a person's life?

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

What happens to the bone marrow of long bones (excluding the proximal humeri and tibiae) as an individual ages?

<p>It becomes fatty and ceases RBC production. (C)</p> Signup and view all the answers

A committed stem cell that produces lymphocytes would be designated as which of the following?

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

What is the primary role of the multipotential hematopoietic stem cells in the bone marrow?

<p>Generating all circulating blood cells. (D)</p> Signup and view all the answers

What is the significance of the multipotential hematopoietic stem cells remaining in the bone marrow as new cells are produced?

<p>To ensure continued production of new blood cells. (D)</p> Signup and view all the answers

As an individual ages, what happens to the number of multipotential hematopoietic stem cells in the bone marrow?

<p>They decrease gradually. (D)</p> Signup and view all the answers

Which of the following statements accurately reflects the shape of a red blood cell?

<p>Flexible and disc-shaped, with a slight indentation. (C)</p> Signup and view all the answers

Compared to the liver, the spleen and lymph nodes play what role in red blood cell production?

<p>They contribute to a small amount of red blood cell production. (B)</p> Signup and view all the answers

Which of the following is a direct precursor to the formation of erythrocytes?

<p>CFU-E (A)</p> Signup and view all the answers

Which of the following cell types is NOT a direct descendant of CFU-GM?

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

Based on the diagram, which of the following is a direct descendant of CFU-S?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following cell types is involved in the formation of both red blood cells and white blood cells?

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

According to the diagram, which of these is not directly derived from the MHSC?

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

Which cell type is directly responsible for the production of platelets?

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

What is the correct order of cell development from MHSC to erythrocyte?

<p>MHSC -&gt; CFU-S -&gt; CFU-B -&gt; CFU-E -&gt; Erythrocyte (A)</p> Signup and view all the answers

What is the name of the cells responsible for controlling the growth and reproduction of the stem cells?

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

What happens to blood volume in polycythemia?

<p>Blood volume is greatly increased. (C)</p> Signup and view all the answers

How does polycythemia affect cardiac output during exercise?

<p>Cardiac output remains close to normal. (B)</p> Signup and view all the answers

What mechanism helps to regulate arterial pressure in polycythemia?

<p>Blood pressure-regulating mechanisms. (B)</p> Signup and view all the answers

What is the consequence of tissue hypoxia in individuals with polycythemia during exercise?

<p>Extreme tissue hypoxia and possible cardiac failure. (A)</p> Signup and view all the answers

In individuals with elevated arterial pressure due to polycythemia, what is true for most people?

<p>Arterial pressure is generally normal. (C)</p> Signup and view all the answers

What causes secondary polycythemia?

<p>Hypoxia from too little oxygen in the air. (B)</p> Signup and view all the answers

How does polycythemia vera affect the skin’s color?

<p>Increases blood quantity in the subpapillary venous plexus. (D)</p> Signup and view all the answers

What occurs beyond certain limits of regulation in polycythemia?

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

What happens to RBC concentration after rapid hemorrhage if a second hemorrhage does not occur?

<p>RBC concentration returns to normal within 3 to 6 weeks (D)</p> Signup and view all the answers

What type of hemoglobin is produced in sickle cell anemia?

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

In hereditary spherocytosis, how do the RBCs differ from normal RBCs?

<p>They are smaller and spherical instead of biconcave (B)</p> Signup and view all the answers

What physiological effect occurs in patients with chronic blood loss anemia?

<p>Insufficient absorption of iron from the intestines (A)</p> Signup and view all the answers

What is a characteristic feature of microcytic hypochromic anemia?

<p>RBCs are much smaller and contain too little hemoglobin (C)</p> Signup and view all the answers

What can lead to bone marrow aplasia?

<p>Exposure to high-dose radiation or certain chemicals (D)</p> Signup and view all the answers

What causes the RBCs in sickle cell anemia to take on a sickle shape?

<p>Exposure to low concentrations of oxygen (A)</p> Signup and view all the answers

What happens to RBCs in hereditary spherocytosis when they pass through the splenic pulp?

<p>They are ruptured by slight compression (A)</p> Signup and view all the answers

What is the role of macrophages in the destruction of hemoglobin?

<p>Macrophages absorb iron from hemoglobin and release it back into the blood. (B)</p> Signup and view all the answers

Which of the following is NOT a source of iron absorbed by the small intestine, as described in the text?

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

What is the primary function of transferrin in iron absorption?

<p>Transferrin interacts with receptors on intestinal epithelial cells to facilitate iron absorption. (D)</p> Signup and view all the answers

How is bilirubin formed during the breakdown of hemoglobin?

<p>Macrophages convert the porphyrin portion of hemoglobin into bilirubin through a series of stages. (D)</p> Signup and view all the answers

What is the relationship between transferrin and ferritin?

<p>Ferritin is a storage form of iron, whereas transferrin transports iron in the blood. (A)</p> Signup and view all the answers

Which of the following is NOT a characteristic of anemia?

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

What is the primary role of apotransferrin in iron absorption?

<p>Apotransferrin combines with iron to form transferrin. (B)</p> Signup and view all the answers

How does the breakdown of hemoglobin contribute to the production of new red blood cells?

<p>The iron released from hemoglobin is used in the synthesis of new red blood cells. (A)</p> Signup and view all the answers

Flashcards

Apotransferrin

A protein secreted by the liver that binds iron in the bile.

Transferrin

A combination of apotransferrin and iron, responsible for iron transport in the blood.

Kupffer cells

Macrophages in the liver that help destroy hemoglobin.

Hemoglobin destruction

The process of hemoglobin breakdown by macrophages after RBCs burst.

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Iron absorption

The uptake of iron from the small intestine into the bloodstream.

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Bilirubin

A bile pigment derived from the breakdown of hemoglobin by macrophages.

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Ferritin

A protein that stores iron in the liver and other tissues.

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Anemia

A condition marked by a deficiency of hemoglobin in the blood.

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Intermediate-stage cells

Cells similar to multipotential stem cells but committed to a specific lineage.

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Committed stem cells

Stem cells that are destined to become a specific type of cell.

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Colony-forming units (CFUs)

Cells that can proliferate into specific types of mature blood cells when cultured.

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CFU-E

A committed stem cell that specifically produces erythrocytes (red blood cells).

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CFU-GM

Colony-forming unit for granulocytes and monocytes in blood cell culture.

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Erythrocytes

Red blood cells responsible for carrying oxygen.

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Granulocytes

A type of white blood cell involved in immune response.

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Monocytes

Large white blood cells that differentiate into macrophages.

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Red Blood Cell Production

The process by which erythrocytes are formed in the bone marrow, varying with age and influenced by growth inducers.

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Growth Inducers

Proteins that regulate the growth and reproduction of stem cells.

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MHSC

Multipotent hematopoietic stem cell, a type of stem cell capable of differentiating into various blood cells.

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Megakaryocytes

Large bone marrow cells that produce platelets necessary for blood clotting.

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Blood Loss Anemia

A type of anemia caused by rapid loss of blood, leading to low RBC concentration.

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Spherocytosis

A hereditary condition where RBCs are small and spherical instead of biconcave discs.

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Microcytic Hypochromic Anemia

Anemia characterized by smaller than normal RBCs with insufficient hemoglobin due to chronic blood loss.

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Sickle Cell Anemia

A genetic form of anemia where RBCs form abnormal sickle shapes due to hemoglobin S.

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Hemoglobin S

An abnormal type of hemoglobin found in sickle cell anemia, leading to cell deformation under low oxygen.

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Bone Marrow Aplasia

A condition characterized by the lack of functional bone marrow often leading to anemia.

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Effects of High-Dose Radiation

Exposure that can lead to bone marrow dysfunction and subsequent aplastic anemia.

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Chronic Blood Loss

Persistent loss of blood that causes the body to struggle in replacing iron and hemoglobin quickly.

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Polycythemia

A condition characterized by increased red blood cell volume, often leading to increased blood viscosity.

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Effects of Polycythemia

In polycythemia, blood flow may increase but cardiac output remains near normal due to blood viscosity effects.

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Cardiac Output in Polycythemia

In polycythemia, cardiac output does not significantly increase despite increased blood flow demands.

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Tissue Hypoxia

A condition where tissues lack sufficient oxygen, often a risk during severe exercise in anemic patients.

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Arterial Pressure in Polycythemia

Many individuals with polycythemia have normal arterial pressure; however, some may experience elevated pressure.

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Secondary Polycythemia

Occurs when tissues are hypoxic due to low oxygen environments or inadequate oxygen delivery, stimulating red blood cell production.

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Subpapillary Venous Plexus

A network of veins just under the skin which contributes to skin color; its blood volume increases in polycythemia vera.

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RBC Production

Red blood cells (RBCs) are primarily produced in the liver during early gestation and later in bone marrow.

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Multipotential Hematopoietic Stem Cells

These are stem cells in the bone marrow that can differentiate into various blood cells.

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Bone Marrow Age Limit

Bone marrow production of RBCs decreases significantly after age 20.

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Long Bones

These bones primarily produce RBCs in childhood but become fatty and less productive with age.

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Fatty Marrow

Beyond a certain age, the marrow in long bones turns fatty and is less effective in producing RBCs.

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Membranous Bones

Bones such as the vertebrae and sternum continue producing RBCs even as other marrow becomes less productive.

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RBC Lifecycle

RBCs are produced from stem cells and eventually differentiate into various blood cell types.

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Age and RBC Production

With increasing age, the overall production of RBCs diminishes.

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Study Notes

Red Blood Cells, Anemia, and Polycythemia

  • Red blood cells (RBCs), also known as erythrocytes, transport oxygen from lungs to tissues using hemoglobin.
  • Hemoglobin is enclosed within RBCs in humans, unlike some animals.
  • RBCs contain carbonic anhydrase, an enzyme speeding up CO2 and water reaction to carbonic acid, facilitating CO2 transport.
  • RBCs act as buffers for maintaining blood's acid-base balance.
  • Normal RBCs are biconcave discs, about 7.8 micrometers in diameter and 2.5 micrometers thick.
  • The average RBC volume is 90-95 cubic micrometers.
  • RBCs can change shape to fit through capillaries.
  • Healthy men have ~5.2 million RBCs/cubic millimeter, women ~4.7 million.
  • Persons at high altitudes have higher RBC counts.
  • RBCs can concentrate hemoglobin up to 34 g/100 ml of cells.
  • Healthy men have ~15 g hemoglobin/100 ml of blood, women ~14 g.
  • 1 g of hemoglobin can carry ~1.34 ml oxygen.
  • During gestation, primitive RBCs are first created in the yolk sac, then the liver, then the bone marrow exclusively.
  • Bone marrow produces RBCs until about 5 years old.
  • The production rate of RBCs decreases in older adults.

Genesis of Blood Cells

  • Multipotential hematopoietic stem cells (MHSC) in bone marrow are the progenitor cells for all blood cells.
  • MHSC differentiate into committed stem cells (CFU).
  • Erythropoietin (a glycoprotein) is mainly produced by the kidneys, with some from the liver, and regulated by tissue oxygenation.
  • Hypoxia (low oxygen) increases erythropoietin production.
  • Erythropoietin stimulates the production of proerythroblasts.
  • Proerythroblasts mature into erythrocytes through various stages(e.g. basophil, polychromatophils, reticulocytes)
  • Normal RBC lifespan is approximately 120 days
  • Reticulocytes are immature RBCs, make up ~1% of total RBCs, disappear after 1-2 day.
  • Aged/defective RBCs are destroyed by macrophages (e.g., Kupffer cells in the liver).

Anemia

  • Anemia is a condition characterized by low hemoglobin levels or a reduced number of RBCs.
  • Blood loss anemia is caused by rapid or chronic blood loss.
  • Hemolytic anemia results from premature destruction of red blood cells.
  • Aplastic anemia occurs with reduced bone marrow function.
  • Megaloblastic anemia is linked to insufficient B12 or folate, inhibiting proper DNA synthesis, creating large, immature RBCs.

Polycythemia

  • Secondary polycythemia develops as a result of tissue hypoxia.
  • Polycythemia vera is a disease where the bone marrow overproduces RBCs, platelets, and granulocytes.
  • Blood viscosity increases in polycythemia, impacting blood flow.

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