G. 33,36,37

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Questions and Answers

Which of the following is NOT a primary function of enzymes within red blood cells mentioned in the text?

  • Keeping iron in the ferrous state.
  • Facilitating membrane transport of ions.
  • Maintaining cell membrane pliability.
  • Synthesizing hemoglobin chains. (correct)

Why does the removal of the spleen typically result in an increased number of older, abnormal red blood cells in circulation?

  • The spleen is the primary site of red blood cell production.
  • The spleen regulates iron storage and release.
  • The spleen filters and removes old or damaged red blood cells. (correct)
  • The spleen produces enzymes necessary for red blood cell function.

How does chronic blood loss lead to microcytic hypochromic anemia?

  • It results in insufficient iron absorption over time. (correct)
  • It impairs the production of intrinsic factor in the stomach.
  • It directly damages the bone marrow, reducing red blood cell production.
  • It causes a deficiency in vitamin B12 absorption.

Which type of graft involves transplanting tissue between individuals of different species?

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

What is the primary role of intrinsic factor in the context of red blood cell production?

<p>It protects vitamin B12 from digestion and enhances its absorption. (A)</p> Signup and view all the answers

What is the primary purpose of tissue typing in the context of organ transplantation?

<p>To match human leukocyte antigens (HLA) for graft acceptance (C)</p> Signup and view all the answers

Which of the following is NOT a mechanism involved in hemostasis?

<p>Increased blood pressure (D)</p> Signup and view all the answers

Why do megaloblastic cells rupture easily, contributing to anemia?

<p>They are excessively large and structurally fragile due to impaired DNA synthesis. (B)</p> Signup and view all the answers

What is the role of thromboxane A2 in vascular constriction following trauma?

<p>It is released by platelets and contributes to the constriction of smaller vessels. (D)</p> Signup and view all the answers

A patient is diagnosed with hemolytic anemia. Which of the following is a characteristic feature of this condition?

<p>Premature rupture of red blood cells. (B)</p> Signup and view all the answers

How does the body typically compensate for rapid blood loss in the initial 1-3 days?

<p>Replacement of plasma volume to maintain blood pressure. (C)</p> Signup and view all the answers

Which of the following components is NOT typically found within platelets?

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

Which factor primarily determines the oxygen-carrying capacity of a hemoglobin chain?

<p>Variations in the amino acid composition of the chain. (B)</p> Signup and view all the answers

What prevents platelets from adhering to normal, uninjured endothelial cells?

<p>The presence of glycoproteins on the platelet membranes (D)</p> Signup and view all the answers

Why is vascular spasm an important initial step in hemostasis?

<p>It reduces blood flow, allowing time for platelet plugging and coagulation. (C)</p> Signup and view all the answers

Which of these therapeutic agents is used to supress the immune system to prevent graft rejection?

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

In sickle cell anemia, what is the primary mechanism that leads to red blood cell rupture?

<p>Faulty beta chains in hemoglobin forming crystals under low oxygen conditions (B)</p> Signup and view all the answers

Which of the following is the underlying cause of erythroblastosis fetalis?

<p>Incompatible blood types between mother and fetus leading to antibody attack (B)</p> Signup and view all the answers

How does anemia generally affect blood viscosity and, consequently, blood flow?

<p>Decreases viscosity, increasing blood flow (B)</p> Signup and view all the answers

What triggers secondary polycythemia, and how does it affect red blood cell production?

<p>Tissue hypoxia leading to increased red blood cell production (C)</p> Signup and view all the answers

What is the primary cause of the increased blood viscosity observed in polycythemia vera?

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

Why do individuals with polycythemia often exhibit a ruby complexion with a bluish tint (cyanosis)?

<p>Sluggish blood flow increases deoxygenation of hemoglobin (D)</p> Signup and view all the answers

In polycythemia, which of the following factors contribute to maintaining a nearly normal cardiac output?

<p>Increased venous return balanced by sluggish peripheral blood flow (D)</p> Signup and view all the answers

What is a critical consideration in blood transfusions to prevent agglutination and hemolysis?

<p>Ensuring compatibility of donor and recipient blood types (B)</p> Signup and view all the answers

A person with type A blood requires a blood transfusion. Which blood type(s) could safely be transfused, considering agglutinogens and agglutinins?

<p>Type A or Type O (D)</p> Signup and view all the answers

A patient's blood sample agglutinates with both anti-A and anti-B antibodies. What is the patient's ABO blood type?

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

A person with genotype 'OO' has which blood type and which agglutinins in their plasma?

<p>Blood type O, with anti-A and anti-B agglutinins (B)</p> Signup and view all the answers

A person with type B blood requires a blood transfusion, but only type A blood is available. What is the MOST likely immediate consequence if a transfusion of type A blood is administered?

<p>The recipient's anti-A agglutinins will react with the donor's A agglutinogens, causing agglutination. (A)</p> Signup and view all the answers

If a person has blood type AB, what is their genotype and what agglutinins are present in their plasma?

<p>Genotype AB; no agglutinins (B)</p> Signup and view all the answers

A woman with blood type A has a child with blood type O. What are the possible genotypes of the woman?

<p>AA or AO (B)</p> Signup and view all the answers

A doctor is explaining the importance of understanding blood types before a transfusion. Which statement accurately describes the primary risk associated with mismatched blood transfusions?

<p>Mismatched blood leads to agglutination and hemolysis due to antibody-antigen reactions. (D)</p> Signup and view all the answers

In an emergency, a patient's blood type is unknown, and a transfusion is needed immediately. Which blood type is generally considered the 'universal donor' due to the lack of A and B agglutinogens?

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

Which of the following mechanisms does NOT contribute to preventing unwanted blood clot formation in intact blood vessels?

<p>The activation of factor XII by a damaged endothelial wall. (C)</p> Signup and view all the answers

A patient with liver disease exhibits prolonged bleeding times. Which of the following is the MOST likely reason for this?

<p>Deficiency in vitamin K-dependent clotting factors. (D)</p> Signup and view all the answers

A patient is diagnosed with Hemophilia B. Which factor is deficient in this patient's blood?

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

Following a traumatic injury, a patient develops disseminated intravascular coagulation (DIC). What is the underlying mechanism initiating this condition?

<p>Widespread activation of clotting mechanisms. (B)</p> Signup and view all the answers

A patient with a deep vein thrombosis (DVT) in the leg is at risk of developing a pulmonary embolism. What physiological process is responsible for this risk?

<p>A portion of the thrombus detaching and traveling to the lungs. (C)</p> Signup and view all the answers

How does Heparin increase blood-clotting time?

<p>Enhances antithrombin III's activity. (B)</p> Signup and view all the answers

A patient is prescribed tissue plasminogen activator (t-PA) following a stroke caused by a blood clot. What is the mechanism of action of t-PA in this scenario?

<p>t-PA activates plasminogen to dissolve clots. (A)</p> Signup and view all the answers

A patient's lab results show a low platelet count (thrombocytopenia). Which of the following is LEAST likely to be a cause?

<p>Increased synthesis of thrombomodulin. (D)</p> Signup and view all the answers

What is the primary role of platelet thrombosthenin, actin, and myosin molecules during clot retraction?

<p>Contracting platelet spicules attached to fibrin, compressing the meshwork and pulling the broken vessel edges together. (A)</p> Signup and view all the answers

How does thrombin contribute to the positive feedback loop in clot formation?

<p>By promoting further clotting through its proteolytic action on other blood-clotting factors and prothrombin. (C)</p> Signup and view all the answers

In the extrinsic pathway of coagulation, what is the role of tissue factor?

<p>To complex with factor VII and calcium ions, leading to the activation of factor X. (A)</p> Signup and view all the answers

What is the key initial event in the intrinsic pathway of coagulation?

<p>Activation of factor XII and release of platelet phospholipids due to blood trauma or exposure to collagen. (A)</p> Signup and view all the answers

Which of the following factors is NOT directly activated by thrombin in the positive feedback loop of coagulation?

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

What is the critical role of calcium ions in the coagulation cascade?

<p>They are required for most blood-clotting reactions, excluding the first two steps in the intrinsic pathway. (B)</p> Signup and view all the answers

What is the primary difference between serum and plasma?

<p>Serum lacks fibrinogen and most clotting factors, while plasma contains them. (A)</p> Signup and view all the answers

Prothrombin activator is formed in both the intrinsic and extrinsic pathways. What components are required for its formation?

<p>Activated factor X, factor V, and platelet phospholipids (or tissue phospholipids in the extrinsic pathway). (C)</p> Signup and view all the answers

Flashcards

Cell Membrane Enzymes

Enzymes that help maintain cell membrane function and pliability.

Red Blood Cell Lifespan

The average lifespan of a red blood cell is 120 days.

Hemoglobin A

The most common type of hemoglobin in adults, made of four chains with iron heme groups.

Iron in Hemoglobin

Iron binds oxygen in hemoglobin, crucial for oxygen transport in the blood.

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Types of Anemia

Anemia is classified into four types: blood loss, aplastic, megaloblastic, and hemolytic.

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Aplastic Anemia

Anemia caused by bone marrow dysfunction, potentially from toxins or autoimmune disorders.

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Megaloblastic Anemia

Anemia where red blood cells become large and fragile due to vitamin B12 or folic acid deficiency.

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Hemolytic Anemia

Anemia where red blood cells are fragile, often rupturing easily, especially in the spleen.

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Autograft

Transplant from one body part to another in the same individual.

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Isograft

Transplant between identical twins.

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Allograft

Transplant between individuals of the same species.

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Xenograft

Transplant from one species to another.

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Tissue Typing

Matching human leukocyte antigens (HLA) for graft acceptance.

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Immunosuppression

Suppressing the immune system to prevent graft rejection.

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Platelet Plug Formation

Sealing small cuts in blood vessels using platelets.

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Vascular Constriction

Smooth muscle contraction that reduces blood flow after injury.

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Antigens on RBCs

Substances on red blood cells that trigger immune responses.

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O-A-B Blood Types

A blood classification system based on A and B antigens presence.

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Agglutinogens

Type A and B antigens that can cause agglutination of RBCs.

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ABO Blood Group Alleles

Three alleles (IA, IB, IO) that determine blood types.

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Genotype Combinations

There are six possible genotypes for blood types: OO, OA, OB, AA, BB, AB.

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Agglutination Process

Clumping of RBCs when agglutinins bind to agglutinogens.

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Origin of Agglutinins

Gamma globulins from bone marrow and lymph glands that cause agglutination.

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Rh Blood Types

Classification based on the presence of Rh antigen.

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Hereditary spherocytosis

A condition where red blood cells are small and spherical, making them fragile in the spleen.

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Sickle cell anemia

A genetic disorder where faulty hemoglobin causes red blood cells to form long crystals under low oxygen.

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Erythroblastosis fetalis

A condition in newborns where RH-positive fetal blood cells are attacked by antibodies from an RH-negative mother.

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Reduced blood viscosity

Condition where blood thickness decreases, leading to increased blood flow.

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Secondary polycythemia

Increased red blood cell production due to tissue hypoxia from factors like high altitude or heart failure.

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Polycythemia vera

A blood disorder caused by genetic changes leading to uncontrolled red blood cell production.

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Circulatory effects of polycythemia

Increased blood volume and sluggish flow leading to potential cyanosis and hypertension.

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Blood transfusion compatibility

The need for matching donor and recipient blood types to avoid agglutination and hemolysis.

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Blood Clot Composition

A blood clot consists of fibrin fibers, blood cells, platelets, and plasma.

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Clot Retraction

Clot retraction happens minutes after formation, expressing serum and pulling vessel edges together.

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Serum

Serum is the fluid that remains after clot retraction, lacking fibrinogen and clotting factors.

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Positive Feedback in Clotting

Thrombin promotes more clotting by activating factors VIII, IX, X, XI, and XII.

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Prothrombin Activator Formation

Prothrombin activator is formed by trauma to blood vessels or tissue, converting prothrombin to thrombin.

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Extrinsic Pathway of Coagulation

Triggered by tissue injury, it activates factor X through tissue factor and calcium ions.

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Intrinsic Pathway of Coagulation

Triggered by blood trauma or exposure to collagen, activating factors including XII and IX.

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Calcium in Clotting

Calcium ions are essential for most blood-clotting reactions except the first two intrinsic steps.

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Endothelial Surface Factors

Factors like smoothness and thrombomodulin that affect blood clotting.

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Thrombomodulin

A protein that binds thrombin and activates protein C, slowing clotting.

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Antithrombin III

A protein that inhibits thrombin, blocking its action on fibrinogen.

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Plasmin

The enzyme that digests fibrin in blood clots, promoting clot lysis.

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Vitamin K Deficiency

Leads to decreased production of critical clotting factors like prothrombin.

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Hemophilia

A genetic disorder causing deficiency in blood clotting factors, primarily affecting males.

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Thrombocytopenia

A condition marked by a low platelet count, leading to easy bruising and bleeding.

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Disseminated Intravascular Coagulation (DIC)

A condition characterized by widespread activation of the clotting process, often due to severe stress on the body.

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Study Notes

Red Blood Cells, Anemia, and Polycythemia

  • Red Blood Cells (Erythrocytes): Primary function is transporting oxygen via hemoglobin. Contain carbonic anhydrase for acid-base buffering. Normal concentrations are 5.2 million per microliter for men and 4.7 million per microliter for women. Hemoglobin concentration is up to 34g per 100ml of cells. Full hemoglobin saturation can bind 1.34ml of oxygen per gram.

  • Red Blood Cell Production: Early embryonic development occurs in the yolk sac. Later in the middle trimester, spleen and lymph nodes are involved. Before birth, bone marrow becomes primary producer. After birth, different bone marrows are responsible in different age groups, primarily the marrow of membranous bones for adults.

  • Red Blood Cell Genesis: Development begins with proerythroblasts and matures within 1-2 days, typically in reticular sites in bone marrow before entering blood capillaries as erythrocytes. Under normal conditions, reticular site concentration is below 1%. Erythropoietin, primarily produced in the kidneys (90%) and liver (10%), regulates red blood cell production in response to low oxygen levels.

  • Anemia: Categorized into types including blood loss, aplastic, megaloblastic, and hemolytic anemia. Blood loss anemia results from insufficient iron absorption in cases of chronic blood loss. Aplastic anemia is caused by bone marrow dysfunction, potentially due to high dose radiation, chemotherapy, or toxins. Megaloblastic anemia, is due to deficiencies of vitamin B12, folic acid, or intrinsic factor, which causes red blood cells to grow large and become fragile. Hemolytic Anemia results from fragile red blood cells that rupture easily, especially in the spleen.

  • Polycythemia: Can be secondary (due to tissue hypoxia) or primary (genetic). Secondary involves tissues becoming hypoxic leading to increased red blood cell production. Primary, called polycythemia vera, is caused by uncontrolled red blood cell production, leading to increased blood volume and viscosity.

Blood Types and Transfusions

  • Antigenicity and Immune Reactions: Blood transfusions can lead to serious complications if blood types are incompatible due to the presence of antigens and antibodies on red blood cells.

  • O-A-B Blood Groups: O-A-B system is one of the two major blood group systems. An individual's blood type is determined by the presence or absence of A and B antigens on the red blood cells. Different combinations of A and B antigens result in different blood types (O, A, B, and AB).

  • Agglutinogens and Agglutinins: Agglutinogens are antigens found on red blood cells, while agglutinins are antibodies found in the plasma. Type O blood contains both anti-A and anti-B agglutinins, A blood contains anti-B agglutinins, B blood contains anti-A agglutinins, and AB blood contains no agglutinins.

  • Rh Blood Types: Rh system involves the presence or absence of the D antigen determining Rh-positive or Rh-negative status. Rh-negative individuals do not have the D antigen on their red blood cells. Rh incompatibility can occur if an Rh-negative individual receives Rh-positive blood.

Hemostasis and Blood Coagulation

  • Vascular Constriction: Severed or ruptured vessels undergo contraction to reduce blood flow. This is initiated by local myogenic spasm, local factors from damaged tissues, vascular endothelium, blood platelets, and nervous reflexes from the area.

  • Platelet Plug Formation: Thrombocytes (Platelets) seal small cuts forming a plug. Activated platelets adhere to injured areas causing a release of granules and factors that lead to plug development and stability.

  • Blood Coagulation : the third step resulting from trauma, including factors from vessels, platelets, and blood proteins, activates a cascade of chemical reactions resulting in clot formation. Prothrombin activates into thrombin which converts fibrinogen into fibrin. Fibrin creates a mesh, forming the clot.

  • Fibrinogen to Fibrin: Thrombin converts fibrinogen to fibrin, creating a stable clot structure. Other clotting factors work with various pathways to complete the mechanism.

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