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Questions and Answers
What is the study of adverse effects of chemicals on blood and blood-forming tissues called?
What is the study of adverse effects of chemicals on blood and blood-forming tissues called?
Why is the blood considered a unique target organ?
Why is the blood considered a unique target organ?
What is a consequence of direct or indirect damage to blood cells and their precursors?
What is a consequence of direct or indirect damage to blood cells and their precursors?
What is erythropoietin?
What is erythropoietin?
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What is the primary reason why hematotoxicity is considered a serious effect of xenobiotics?
What is the primary reason why hematotoxicity is considered a serious effect of xenobiotics?
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What is the term for hematotoxicity caused by damage to other tissues or systemic disturbances?
What is the term for hematotoxicity caused by damage to other tissues or systemic disturbances?
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What is a function of the blood mentioned in the text?
What is a function of the blood mentioned in the text?
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Why is the liver considered important in the risk assessment of individual patient populations exposed to toxicants?
Why is the liver considered important in the risk assessment of individual patient populations exposed to toxicants?
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What percentage of the circulating blood volume is composed of erythrocytes?
What percentage of the circulating blood volume is composed of erythrocytes?
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What is the primary function of erythrocytes?
What is the primary function of erythrocytes?
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What is a common effect of xenobiotics on erythrocytes?
What is a common effect of xenobiotics on erythrocytes?
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What is the name of the protein component of hemoglobin?
What is the name of the protein component of hemoglobin?
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What is the result of an imbalance between α- and β-chain production?
What is the result of an imbalance between α- and β-chain production?
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Which xenobiotic is known to interfere with erythroblast heme synthesis?
Which xenobiotic is known to interfere with erythroblast heme synthesis?
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What is the result of a deficiency in folate and/or vitamin B12?
What is the result of a deficiency in folate and/or vitamin B12?
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What is necessary for the synthesis of thymidine or its incorporation into DNA?
What is necessary for the synthesis of thymidine or its incorporation into DNA?
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What is the common effect of insults that increase oxidative injury, decrease metabolism, or alter the membrane?
What is the common effect of insults that increase oxidative injury, decrease metabolism, or alter the membrane?
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Which of the following diseases is associated with significant hemolysis?
Which of the following diseases is associated with significant hemolysis?
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What is the function of NADH-diaphorase in erythrocytes?
What is the function of NADH-diaphorase in erythrocytes?
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What is the most common enzyme defect associated with oxidative hemolysis?
What is the most common enzyme defect associated with oxidative hemolysis?
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What is the mechanism of immunologic destruction of erythrocytes in immune hemolytic anemia?
What is the mechanism of immunologic destruction of erythrocytes in immune hemolytic anemia?
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What is the effect of some drugs, such as penicillin, on erythrocytes?
What is the effect of some drugs, such as penicillin, on erythrocytes?
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What is the effect of cytotoxic drugs, such as methotrexate, on granulocytes?
What is the effect of cytotoxic drugs, such as methotrexate, on granulocytes?
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What is the effect of oxidative injury on erythrocytes?
What is the effect of oxidative injury on erythrocytes?
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What is the basis of platelet function?
What is the basis of platelet function?
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Which of the following drug groups does not affect platelet function?
Which of the following drug groups does not affect platelet function?
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What is the effect of impaired liver function on coagulation?
What is the effect of impaired liver function on coagulation?
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Which vitamin is essential for the synthesis of certain coagulation factors?
Which vitamin is essential for the synthesis of certain coagulation factors?
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What is the effect of warfarin on coagulation?
What is the effect of warfarin on coagulation?
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What is the mechanism of idiosyncratic reactions to xenobiotics?
What is the mechanism of idiosyncratic reactions to xenobiotics?
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What is the mechanism of action of oral anticoagulants like warfarin?
What is the mechanism of action of oral anticoagulants like warfarin?
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What is the use of heparin in hemostasis?
What is the use of heparin in hemostasis?
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What is the role of platelets in response to vascular injury?
What is the role of platelets in response to vascular injury?
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What is a common side effect of intensive chemotherapy on platelets?
What is a common side effect of intensive chemotherapy on platelets?
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What is the result of heparin-induced thrombocytopenia (HI)?
What is the result of heparin-induced thrombocytopenia (HI)?
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What is a characteristic of thrombotic thrombocytopenic purpura (P)?
What is a characteristic of thrombotic thrombocytopenic purpura (P)?
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What is the difference between hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (P)?
What is the difference between hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (P)?
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What is a common cause of thrombocytopenia?
What is a common cause of thrombocytopenia?
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What is a consequence of platelet activation and aggregation in heparin-induced thrombocytopenia (HI)?
What is a consequence of platelet activation and aggregation in heparin-induced thrombocytopenia (HI)?
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What is the result of xenobiotics interfering with platelet function?
What is the result of xenobiotics interfering with platelet function?
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Study Notes
Hematotoxicology
- The study of adverse effects of drugs and other chemicals on blood and blood-forming tissues
- Ranks with liver and kidney as among the most important considerations in risk assessment of individual patient populations exposed to potential toxicants
- Unique as a target organ due to:
- Vital functions (delivery of oxygen to tissues, maintenance of vascular integrity, and provision of immune functions)
- Exceptional proliferative tissue
- High regenerative capacity
- Highly susceptible to intoxication
- Supply of nutrients, clearance of toxins or metabolites, and production of vital growth factors
Consequences of Hematotoxicity
- Direct or indirect damage to blood cells and their precursors can lead to:
- Hypoxia
- Hemorrhage
- Infection
- Hematotoxicity can be primary (directly affecting one or more blood components) or secondary (resulting from other tissue injury or systemic disturbances)
Toxicology of the Erythron
- Erythrocytes (red blood cells) make up 40-45% of circulating blood volume
- Function as the principal vehicle for transportation of oxygen and carbon dioxide
- Can be affected by xenobiotics, leading to:
- Decreased red cell mass (anemia)
- Increased red cell mass (erythrocytosis)
- Shifts in plasma volume can alter the relative concentration of erythrocytes and be confused with true anemia or erythrocytosis
Mechanisms of Anemia
- Decreased production of erythrocytes due to:
- Abnormalities in hemoglobin synthesis (e.g., iron deficiency)
- Interference with heme synthesis (e.g., isoniazid, pyrazinamide, and chloramphenicol)
- Deficiency of folate and/or vitamin B12
- Increased destruction of erythrocytes due to:
- Infectious diseases (e.g., malaria)
- Oxidative hemolysis (e.g., phenol, dapsone, nalidixic acid, sulfanilamide, and nitrofurantoin)
- Immune hemolytic anemia (e.g., autoimmune hemolytic anemia, penicillin-induced hemolytic anemia)
Toxicology of the Leukon
- Toxic effects on granulocytes:
- Inhibitors of mitosis (e.g., cytotoxic drugs like methotrexate, cyclophosphamide, and nitrosoureas)
- Immune-mediated destruction of granulocytes
Toxicology of the Thrombocyte
- Toxic effects on platelets:
- Thrombocytopenia (low platelet levels) due to decreased production or increased destruction
- Interference with platelet function
- Heparin-induced thrombocytopenia (HI) and thrombotic thrombocytopenic purpura (TTP) are immune-mediated platelet destruction
- Hemolytic uremic syndrome (HUS) is a disorder with clinical features similar to those of TTP
Toxic Effects on Coagulation
- Decreased synthesis of coagulation proteins due to:
- Impaired liver function
- Vitamin K deficiency
- Increased clearance of coagulation factors due to:
- Antibodies reacting with coagulation proteins
- Toxicology of agents used to modulate hemostasis:
- Oral anticoagulants (e.g., warfarin) interfere with vitamin K metabolism
- Heparin is used for prophylaxis and therapy of acute venous thromboembolism
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Description
This quiz covers the toxic responses of the blood, a key topic in general toxicology. Learn about the effects of toxic substances on the blood system. Presented by Dr. Ban Majid Ali.
