Red Blood Cells (Erythrocytes) Overview
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Questions and Answers

What controls the relative rates of red blood cell production in the bone marrow?

  • Growth inducers (correct)
  • Oxygen levels
  • Stem cells
  • Colony-forming units
  • Which type of stem cell is categorized as multipotent in hematopoiesis?

  • MHSC (correct)
  • CFU-GM
  • CFU-M
  • CFU-E
  • Which colony-forming unit is specific for megakaryocytes?

  • CFU-S
  • CFU-GM
  • CFU-E
  • CFU-M (correct)
  • Which of the following is not a type of granulocyte?

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

    What role do erythrocytes play in the body?

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

    Which colony-forming unit is responsible for producing both granulocytes and monocytes?

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

    At what stage do stem cells begin differentiating into specific blood cell types?

    <p>Upon receiving growth inducers (B)</p> Signup and view all the answers

    What type of stem cells give rise to B lymphocytes?

    <p>Lymphoid stem cells (B)</p> Signup and view all the answers

    Which of the following statements about megakaryocytes is true?

    <p>They give rise to platelets. (C)</p> Signup and view all the answers

    Which stage marks the first appearance of hemoglobin in erythrocyte development?

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

    Which of the following statements regarding growth inducers is true?

    <p>They promote growth but not differentiation of committed stem cells. (D)</p> Signup and view all the answers

    What occurs to the nucleus of erythrocytes during maturation?

    <p>It condenses and is eventually extruded from the cell. (C)</p> Signup and view all the answers

    Which condition is characterized by the presence of smaller, pale red blood cells?

    <p>Microcytic, hypochromic anemia (A)</p> Signup and view all the answers

    What is the role of differentiation inducers in blood cell formation?

    <p>They assist in the differentiation of specific cell types. (A)</p> Signup and view all the answers

    What type of anemia is indicated by the abnormal production of erythrocytes?

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

    Which erythrocyte precursor is the most mature stage before becoming an erythrocyte?

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

    What role does erythropoietin play in red blood cell production?

    <p>It stimulates the synthesis of red blood cells when tissue oxygenation declines. (A)</p> Signup and view all the answers

    How does hypoxia influence erythropoietin secretion?

    <p>It may stimulate erythropoietin secretion from tissues other than the kidneys. (D)</p> Signup and view all the answers

    What happens to red blood cell production when the kidneys are removed?

    <p>The individual invariably becomes very anemic due to lack of erythropoietin. (C)</p> Signup and view all the answers

    What is the primary regulator of red blood cell production according to the given information?

    <p>The amount of oxygen transported to tissues in relation to demand. (D)</p> Signup and view all the answers

    Which statement about erythropoietin production during high altitude exposure is accurate?

    <p>Only 10% of normal erythropoietin is formed, leading to decreased RBC production. (D)</p> Signup and view all the answers

    Which substance is mentioned as stimulating erythropoietin production?

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

    What is the effect of x-ray therapy on the bone marrow in relation to erythropoiesis?

    <p>It results in hyperplasia of the remaining bone marrow. (D)</p> Signup and view all the answers

    What is indicated by the maximum production time frame of erythropoietin?

    <p>Production begins slowly and peaks at 24 hours after exposure to low oxygen. (C)</p> Signup and view all the answers

    What is the primary site of RBC production during the last month of gestation and after birth?

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

    Which type of cell serves as the origin for all circulating blood cells?

    <p>Multipotential Hematopoietic Stem Cell (D)</p> Signup and view all the answers

    At what age does the production of RBCs start to decline significantly in long bones?

    <p>20 years (A)</p> Signup and view all the answers

    Which organs produce reasonable numbers of RBCs during the first trimester of gestation?

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

    Which bones continue to produce RBCs into adulthood?

    <p>Only membranous bones (C)</p> Signup and view all the answers

    What happens to the marrow of long bones as a person ages?

    <p>It becomes fatty and less productive (D)</p> Signup and view all the answers

    What keeps the supply of multipotential cells available in the bone marrow?

    <p>Retention of some cells in original form (C)</p> Signup and view all the answers

    What is a characteristic of the marrow in long bones after about the age of 20 years?

    <p>It produces no RBCs (A)</p> Signup and view all the answers

    What is the main protein that iron combines with in the cytoplasm to form ferritin?

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

    How does the body regulate total body iron when it becomes saturated?

    <p>By decreasing iron absorption from the intestines (D)</p> Signup and view all the answers

    What form does iron take in the storage pool when it is present in extremely insoluble clusters?

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

    What happens to the absorption rate of iron when stores become depleted?

    <p>It increases significantly (B)</p> Signup and view all the answers

    How long do red blood cells typically circulate before being destroyed?

    <p>120 days (D)</p> Signup and view all the answers

    What is transferrin's unique characteristic in iron transport?

    <p>It binds strongly with cell membrane receptors (C)</p> Signup and view all the answers

    Ferritin can store what type of iron in varying amounts?

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

    What happens to the rate of iron absorption when there is a low quantity of iron in plasma?

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

    What happens to the cardiac output in a person with anemia during exercise?

    <p>It is insufficient to meet tissue demand. (D)</p> Signup and view all the answers

    What is a common outcome when a person with polycythemia exercises?

    <p>Extreme tissue hypoxia. (D)</p> Signup and view all the answers

    What factor can influence blood viscosity in individuals with polycythemia?

    <p>Increased RBC production. (A)</p> Signup and view all the answers

    Which of the following is a key characteristic of secondary polycythemia?

    <p>It occurs due to hypoxia from low oxygen in the air. (C)</p> Signup and view all the answers

    How does polycythemia typically affect arterial pressure?

    <p>Most individuals have normal arterial pressure. (B)</p> Signup and view all the answers

    What physiological change occurs to blood when an individual experiences tissue hypoxia?

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

    What is a result of the body's pressure-regulating mechanisms during polycythemia?

    <p>They can sometimes fail leading to hypertension. (B)</p> Signup and view all the answers

    Which statement about the skin's color in polycythemia vera is correct?

    <p>It appears flushed due to increased blood in venous plexus. (C)</p> Signup and view all the answers

    Flashcards

    RBC Production Locations (Early vs. Late)

    Early in gestation, the liver, spleen, and lymph nodes produce red blood cells (RBCs). Later, after about the 4th month in utero, bone marrow is the primary site for RBC production.

    Bone Marrow RBC Production

    All bones produce RBCs until about 5 years old. Longer bones stop producing RBCs around age 20. Membranous bones continue production but decrease with age.

    Multipotential Hematopoietic Stem Cell

    The single type of cell from which all blood cells arise. It is like a blueprint for all types of blood cells

    Hematopoietic Stem Cell Function

    A small portion of the cells remain as stem cells and are stored in the bone marrow to maintain the blood cell supply

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    Differentiation of Blood Cells

    Most of the reproduced cells from stem cells become different types of blood cells.

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    RBC Shape

    Red blood cells (RBCs) are flexible and easily deformable, like a bag that can change shape.

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    Long Bone Marrow Aging

    After age 20 the marrow of the long bones become less active in producing RBC's, often fatty.

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    Membranous Bone Marrow Aging

    Membranous bones, like vertebrae, ribs and ilia, continue RBC production later in life but their production ability decreases with age.

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    Erythrocytes

    Red blood cells

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    CFU-B

    Colony-forming unit-blast

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    CFU-E

    Colony-forming unit-erythrocytes

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    CFU-S

    Colony-forming unit-spleen

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    CFU-GM

    Colony-forming unit–granulocytes, monocytes

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    CFU-M

    Colony-forming unit–megakaryocytes

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    MHSC

    Multipotent hematopoietic stem cell

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    Growth Inducers

    Proteins that control red blood cell production

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    What is hematopoiesis?

    The process of forming blood cells from a common ancestor in the bone marrow. It results in the creation of all blood cells, including red blood cells, white blood cells, and platelets.

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    What is a multipotent hematopoietic stem cell?

    A single cell type that can differentiate into all types of blood cells. It's like a master blueprint for all blood cell types.

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    What are growth inducers?

    Substances that promote the growth and reproduction of blood cells. They help increase the overall number of cells.

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    What are differentiation inducers?

    Substances that control the development of blood cells into specific types, like red blood cells or platelets. They influence the 'job' of the cell.

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    What is a proerythroblast?

    The earliest stage of a red blood cell development, characterized by a large nucleus and a relatively small amount of cytoplasm.

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    What is a reticulocyte?

    An immature red blood cell that still contains some of its original cellular machinery. It is released into the bloodstream and matures into a mature red blood cell.

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    What is erythropoietin (EPO)?

    A hormone produced by the kidneys that stimulates the production of red blood cells in response to low oxygen levels.

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    What is a mature red blood cell?

    A fully developed red blood cell that lacks a nucleus and is filled with hemoglobin. It carries oxygen to the body's tissues.

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    Hypoxia's Effect on RBC Production

    When tissue oxygen levels decrease, the body increases red blood cell (RBC) production to deliver more oxygen.

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    Erythropoietin: The RBC Production Regulator

    Erythropoietin is a hormone primarily produced by the kidneys that stimulates the production of red blood cells in response to low oxygen levels.

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    Where does erythropoietin come from?

    The kidneys are the primary source of erythropoietin, but the liver can also contribute to a lesser extent.

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    How does erythropoietin work?

    Erythropoietin binds to receptors on red blood cell precursors (proerythroblasts) in the bone marrow, triggering a cascade of events that ultimately leads to the production of mature RBCs.

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    Erythropoietin: A Fast Response

    When oxygen levels drop, erythropoietin production increases quickly, peaking within 24 hours.

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    Kidney Failure and Anemia

    Without functioning kidneys, erythropoietin production is severely limited, leading to significant anemia due to insufficient RBC production.

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    Other Factors Influencing Erythropoietin

    Factors like norepinephrine, epinephrine, and certain prostaglandins can also stimulate erythropoietin production, suggesting non-kidney sensors might play a role.

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    Tissue Oxygen Demand: The Driver

    The amount of oxygen transported to the tissues in relation to tissue demand, rather than just RBC count, drives RBC production.

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    Iron Storage: Ferritin

    Ferritin is a protein in the cytoplasm of cells that stores iron. It can bind varying amounts of iron, acting like a large iron container.

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    Iron Overload: Hemosiderin

    Hemosiderin is an insoluble form of stored iron that forms when there's too much iron for ferritin to hold. It's like iron overflowing from the storage unit.

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    Iron Absorption Rate

    The body only absorbs a small amount of iron from food each day, even if you eat a lot of iron-rich foods. This rate changes depending on iron stores.

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    Iron Absorption Regulation

    When the body is full of iron, iron absorption slows down. When iron stores are low, absorption speeds up to replenish them.

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    Transferrin: Iron Carrier

    Transferrin is a protein in the blood that carries iron to where it's needed. It's like a taxi for iron.

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    Transferrin and Erythroblasts

    Transferrin binds to receptors on erythroblasts, young red blood cells, to deliver iron for hemoglobin production.

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    RBC Lifespan

    Red Blood Cells (RBCs) live for about 120 days in the bloodstream before being broken down and recycled.

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    RBCs Lack Organelles?

    Mature red blood cells lack a nucleus, mitochondria, and endoplasmic reticulum. They are essentially bags of hemoglobin.

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    Secondary Polycythemia

    An increase in red blood cell production due to reduced oxygen availability in the tissues, often triggered by conditions like high altitude or heart failure.

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    Tissue Hypoxia

    A state where tissues are deprived of adequate oxygen.

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    Polycythemia Vera

    A rare blood disorder characterized by an overproduction of red blood cells, leading to an increase in blood volume and viscosity.

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    What happens in secondary polycythemia?

    The body produces more red blood cells in response to tissue hypoxia, which occurs when tissues are deprived of sufficient oxygen. This can be due to factors such as high altitude or heart failure.

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    Blood Viscosity

    The thickness or stickiness of blood, affected by the number of red blood cells and other factors.

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    Peripheral Resistance

    The resistance to blood flow in the blood vessels, primarily due to friction between blood and vessel walls.

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    What can happen to blood pressure in polycythemia?

    In polycythemia, the increased blood volume and viscosity can raise peripheral resistance, which normally increases blood pressure. However, the body's blood pressure regulating mechanisms can usually offset this increase, unless it becomes too severe, leading to hypertension.

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    What does the skin color reveal about blood volume?

    The color of the skin is influenced by the amount of blood in the subpapillary venous plexus. In polycythemia vera, this plexus contains an increased amount of blood, leading to a ruddy complexion.

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    Study Notes

    Red Blood Cells (Erythrocytes)

    • Major function: Transport hemoglobin, which carries oxygen from lungs to tissues.
    • Hemoglobin remains inside RBCs in humans for effective transport.
    • RBCs contain carbonic anhydrase, speeding up CO2 and water reaction to carbonic acid, facilitating CO2 transport.
    • Hemoglobin is a good acid-base buffer, playing a role in blood pH balance.
    • Shape: Biconcave disc, about 7.8 micrometers in diameter and 2.5 micrometers thick at thickest point, 1 micrometer or less in the center.
    • Size: Average volume is 90-95 cubic micrometers.
    • Shape flexibility: RBCs can change shape to squeeze through capillaries, preventing rupture.
    • Concentration in blood: Healthy men: 5,200,000 (±300,000) RBCs/cubic millimeter; Healthy women: 4,700,000 (±300,000) RBCs/cubic millimeter. Higher at high altitudes.
    • Hemoglobin concentration: Up to 34 g/100 ml of cells; maintaining this level prevents exceeding metabolic capacity.
    • Normal hematocrit (percentage of blood comprised of cells): 40-45%
    • Hemoglobin content: Normal men: 15 g/100 ml blood; Normal women: 14 g/100 ml blood.
    • Oxygen-carrying capacity: Each gram of hemoglobin can combine with 1.34 ml of oxygen (when saturated).
    • Production of RBCs:
      • Embryonic weeks: Yolk sac, liver.
      • Mid-gestation: Liver primary production area.
      • Later gestation/after birth: Exclusively in bone marrow.
      • Bone marrow production: All bones until age 5; long bones stop around age 20; other bones gradually decrease in production over time.

    Genesis of Blood Cells

    • Multipotential hematopoietic stem cells (MHSCs): Origin of all blood cells.
    • Committed stem cells (CFU): Differentiated cells, committed to a specific type of blood cell.
      • CFU-E (Colony forming unit-erythrocyte): forms erythrocytes.
      • CFU-GM (Colony forming unit-granulocytes, monocytes).
      • CFU-M (Colony forming unit-megakaryocytes): forms megakaryocytes.

    Production of Red Blood Cells

    • Erythropoietin: A glycoprotein hormone, primarily produced by the kidneys (90%).
    • Function: Stimulates production of proerythroblasts from hematopoietic stem cells.
    • Stimulation: Regulation of total mass of RBCs. Maintains appropriate levels to carry sufficient oxygen without hindering blood flow.
    • Hypoxia: Low oxygen levels in tissue stimulate erythropoietin production.
    • Kidney function: Renal tissue hypoxia increases HIF-1 levels, leading to erythropoietin gene transcription.

    Maturation of Red Blood Cells

    • Proerythroblast: Early cell in RBC line.
    • Basophil erythroblast: Earliest generation, stains with basic dyes.
    • Polychromatophil erythroblast: Contains hemoglobin.
    • Orthochromatic erythroblast: Contains significant amount of hemoglobin, nucleus condenses, and then gets extruded.
    • Reticulocyte: Still has some residual cytoplasmic organelles and is transitional form from bone marrow to blood.
    • Erythrocyte (Mature RBC): No nucleus, final stage.

    Tissue Oxygenation

    • Condition: Low tissue oxygen level increases RBC production.
    • Causes: Hemorrhage, x-ray therapy to bone marrow, high altitudes, decreased tissue blood flow, and certain lung and heart diseases.

    Maturation Failure Anemia / Pernicious Anemia

    • Deficiency: Lack of absorption of Vitamin B12.
    • Causes: Atrophic gastric mucosa (i.e., decreased intrinsic factor)
    • Effects: Leads to abnormal and reduced DNA synthesis, resulting in abnormally large RBCs.

    Folic Acid Deficiency Anemia

    • Deficiency: Lack of folic acid absorption.
    • Causes: Small intestinal disease or sprue; insufficient folic acid ingestion; cooking methods.
    • Effect: Insufficient DNA synthesis, resulting in abnormally large RBCs.

    Hemoglobin Formation

    • Chemical steps: Formation involves succinyl CoA, glycine, pyrrole, protoporphyrin IX, iron, and polypeptide chains (a and b).
    • Structure: Four polypeptide chains bind loosely to form the hemoglobin molecule, enabling oxygen binding.

    Iron Metabolism

    • Function: Hemoglobin, myoglobin, cytochromes, and other compounds require iron (4-5 grams in body).
    • Storage: Primarily ferritin, deposited in hepatocytes and reticuloendothelial cells (liver, spleen, bone marrow).
    • Transport: Iron combines with apotransferrin to form transferrin, carried in plasma for delivery to cells.

    Life Span of Red Blood Cells

    • Lifespan: ~120 days in circulation.
    • Destruction: When damaged cells rupture and release hemoglobin, it's engulfed by macrophages.
    • Macrophages process hemoglobin, release iron, and recycle components.

    Anemias

    • Blood Loss Anemia:
      • Acute: Plasma and RBCs restored in 1-3 days with fluid balance.
      • Chronic: Iron absorption inadequate to make up for blood loss = microcytic, hypochromic anemia.
    • Aplastic Anemia: Bone marrow failure secondary to various causes.
    • Megaloblastic Anemia: Impairment in RBC maturation due to Vitamin B12 / Folic acid deficiency.
    • Hemolytic Anemia: RBC fragility causes premature destruction (e.g., hereditary spherocytosis, sickle cell anemia, erythroblastosis fetalis).

    Polycythemia

    • Secondary Polycythemia: Excess RBC production due to chronic hypoxia.
      • Can be caused by altitude differences or lung/heart/circulatory issues.
    • Polycythemia Vera (Erythremia): Pathological condition.
      • Abnormal RBC production.

    Effects of Anemia and Polycythemia on Circulation

    • Anemia: Low blood viscosity due to reduced RBC count = increase in cardiac output.
    • Polycythemia: Increased blood viscosity due to greater RBC concentration = reduced venous return. Regulation maintains normal cardiac output.

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    Description

    This quiz explores the structure and function of red blood cells (RBCs), highlighting their role in oxygen transport and carbon dioxide management. It covers aspects such as hemoglobin content, shape flexibility, and concentration in the blood. Test your knowledge about these vital components of the circulatory system.

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