Chapter 17 Study Guide PDF

**Chapter 17 Study guide** 1. List some functions of blood. a. What is transported in/by blood? O2, CO2, nutrients, waste products, hormones b. What variables does blood help maintain homeostasis for? pH, blood volume, temperature c. How is blood protective? WBC a...

**Chapter 17 Study guide** 1. List some functions of blood. a. What is transported in/by blood? O2, CO2, nutrients, waste products, hormones b. What variables does blood help maintain homeostasis for? pH, blood volume, temperature c. How is blood protective? WBC are cells of immune system, defend against pathogens also blood clotting (platelets) protect against blood loss. 2. Describe the composition of blood. d. What type of tissue is blood? connective e. What percentage is plasma? 55% f. What percentage is formed elements? 45% g. What % of blood would be RBC? 45% h. What % of a blood sample would be WBC and platelets? Less than 1% 3. Define formed elements and hematocrit. i. What are formed elements? The cells that are in the blood, RBC, WBC, platelets j. Where are all formed elements made? Red bone marrow k. What hematocrit a measure of? The % of red blood cells in a sample l. What are normal values for hematocrit in males and females? M: 47%, F: 42% m. Why is male hematocrit higher? Testosterone stimulates RBC production, Estrogen suppresses RBC production n. Would hematocrit increase or decrease in polycythemia? Increase, poly means many, many extra RBC o. Would hematocrit increase or decrease in anemia? Decrease, "an" means lack of 4. Discuss the composition of plasma. p. Plasma is mostly made of: water q. Name some substances dissolved in plasma proteins, nutrients, gases, ions, hormones 5. List some plasma proteins and their functions. r. Where are all plasma proteins made? liver s. Which plasma protein is the most common? albumin t. Which plasma protein is responsible for generating osmotic pressure? albumin u. Which plasma protein transports ions and vitamins? globulins v. Which plasma proteins are antibodies? Gamma globulins w. Which plasma proteins are involved with blood clotting? fibrinogen 6. Name the formed elements and be able to recognize each in a picture of a blood smear. x. What is the correct term for a RBC? erythrocyte y. What is the correct term for a WBC? leukocyte z. What is the mnemonic to remember the names and frequency of the WBC? Never let monkeys eat bananas a. Do RBC have a nucleus? no b. Are platelets whole cells or fragments of cells? fragments c. Be able to recognize RBC and WBC under the microscope. See handout 7. Describe the general process of hematopoiesis and know where it takes place and the name of the key stem cell involved. d. What is the meaning of the term hematopoiesis? Making new blood cells e. Where does hematopoiesis take place? Red bone marrow f. The major stem cell in red bone marrow that gives rise to all blood cells is: hemocytoblast g. When a hemocytoblast differentiates it can follow one of two pathways. Name the two progenitor cells for the pathways? Myeloid and lymphoid h. Which cells come from the lymphoid progenitor? The B and T lymphocytes and natural killer cells i. Which cells come from the myeloid progenitor? Erythrocytes, neutrophils, basophils, eosinophils, monocyes, platelets j. What is the differentiated stem cell that gives rise to basophils, eosinophils, neutrophils and macrophages? myeloblast k. Name the differentiated stem cell that gives rise to platelets? megakaryocyte l. Why does a bone marrow transplant help people with blood cell cancers? The new stem cells will start copying and making new blood for them. 8. Describe the structure and function of erythrocytes. m. Describe what a RBC looks like? Biconcave disc, it has dents on either side n. What is the term for the shape of the RBC? Biconcave disc o. Do RBC have a nucleus? NO p. Do RBC have a mitochondria? NO q. Can a RBC repair itself if damaged? NO r. Do RBC do aerobic or anaerobic respiration? anaerobic s. Could you recognize them in a picture? Yes, red and no nucleus t. What protein are red blood cells full of? hemoglobin u. What is the function of RBC? To carry O2 and CO2 9. Describe the structure of hemoglobin, how and where it binds oxygen and the different variants of hemoglobin that exist. v. The hemoglobin consists of 4 polypeptide chains called: \_\_globins\_\_\_\_\_\_\_\_\_\_\_ w. There are usually \_\_\_2\_\_ alpha chains and \_\_2\_\_\_\_ beta chains x. Each globin chain has a \_\_\_heme\_\_\_\_\_\_\_ attached which holds the metal ion \_\_\_Fe2+ iron\_\_\_\_\_\_\_\_. y. The only place oxygen can bind to on the hemoglobin is the \_\_\_iron\_\_\_\_\_\_\_\_. z. How many oxygen can 1 hemoglobin bind? 4, as it has 4 iron a. Approx. how many hemoglobins are in a RBC? 250 million b. What color does hemoglobin turn when it is oxygenated? red c. If oxygen is bound it is referred to as: oxyhemoglobin d. What color does hemoglobin turn when it is deoxygenated? Bluish/dark red e. If no oxygen is bound, it is referred to as: deoxyhemoglobin f. If there are 3 oxygens bound, how saturated is hemoglobin? 75% g. If there is 1 oxygen bound, how saturated is hemoglobin? 25% h. What would be the expected saturation of hemoglobin in the lungs? 100%, every one should be full i. If the PO~2~ is 40 mmHg, what is the saturation of hemoglobin? (Use graph in slides) 70% saturated j. Where does CO~2~ bind on hemoglobin? On the globin chain k. What is the term for hemoglobin which has CO~2~ bound? Carbaminohemoglobin l. m. If hemoglobin is carrying oxygen, will it bind CO~2~? No, hemoglobin main job is carry O2, it will only pick up CO2 if it is empty on the way back to the lungs. n. What is the most common variant of hemoglobin? HbA1 o. What globin chains are present in HbA~1~? Two alpha, two beta p. What globin chains are present in HbA~2~? Two alpha, two delta q. What globin chains are present in HbF? Two alpha, two gamma r. Why does the fetus need a different type of hemoglobin? The mom's Hb wants to hold onto O2 for the mom. The fetal hemoglobin has to be more attractive to the oxygen to suck it to the baby. s. How can hemoglobin be used as an index of blood sugar levels? Glucose sticks to the outside of the red blood cell, the higher the blood glucose level, the more gets stuck, we can measure this as hemoglobin A1C 10. Describe the process of erythropoiesis: the stem cells involved, the nutrients required and how erythropoiesis is regulated by erythropoietin. t. The differentiated (committed) stem cell that gives rise to erythrocytes is called: proerythroblast u. What happens to cell size during erythropoiesis? gets smaller v. What happens to cell color during erythropoiesis? Turns purple to red w. What happens to nucleus and organelles during erythropoiesis? They get pushed out of cell x. What nutrients do you need for erythropoiesis? Iron, amino acids y. Why do you need iron in your diet? Iron is required to make functional hemoglobin z. Which ion carrier carries iron in blood? transferrin a. Which ion carrier binds and holds iron inside cells? ferretin b. Why do you need intrinsic factor? You need B12 to make RBC. You can only absorb B12 if you have intrinsic factor c. Where is intrinsic factor produced? Know specific cell and location. Parietal cells in stomach wall d. What is the function of Vitamin B~12~? Needed for mitosis. Needed to make new RBC e. What is the condition that results from B~12~ deficiency? Pernicious anemia f. Why do red blood cells have such a short life span? They cannot repair damage as there is no nucleus or organelles g. What hormone causes formation of new RBC in bone marrow? erythropoietin h. Where is erythropoietin produced? kidney i. What is the stimulus for erythropoietin release? Low oxygen levels j. Where does erythropoietin work? At the bone marrow k. Would you expect a person on Mount Everest for 3 weeks to have more or less RBC than a person in Baltimore? Many many more at high altitude l. Would you expect a male to have more or less RBC than a female? More, testosterone stim RBC production m. Who would have more RBC, a normal individual or an anemic? Normal n. Who would have more RBC, Lance Armstrong or any other competitor in the Tour de France? (Just kidding ) if Lance was epo doping his levels would be high 11. Describe the process for erythrocyte breakdown. o. Where are damaged red blood cells broken down? Where is the RBC graveyard? Spleen p. Name the large phagocyte in the spleen which removes damaged red blood cells from circulation? Macrophage q. What happens to the iron and the protein when a RBC is broken down? Recycled r. What happens to the heme? Trash, needs to be removed s. What is the yellow colored breakdown product of heme? billirubin t. Bilirubin is turned into Bile at the liver. What happens to the bile then? Goes into digestive system u. Name the two pathways for bilirubin excretion. Pee and poop. It is the reason pee is yellow and poop is brown. 12. Give examples of disorders caused by abnormalities of erythrocytes. Explain what goes wrong in each disorder. v. What is the name for the conditions where there are too many RBC? Polycythemia-note this is a normal reaction to going to high altitude. w. What is the name for the condition where there is not enough RBC? anemia x. Name some common causes of anemia? Lack of iron, lack of protein, hemorrhage y. Know the correct terminology for RBC that are: i. Too small microcytic ii. Normal size normocytic iii. Too large macrocytic iv. Too pale hypochromic v. Normal color normochromic vi. Too dark hyperchromic z. Name two genetic disorders of hemoglobin? vii. What has changed in thalassemia? One of the globin chains is absent or faulty viii. What has changed in sickle cell anemia? There is an error on the B globin chain, misfolds ix. How does hydroxyurea help treat people with sickle cell disease? It tells their bone marrow to stop making adult hemoglobin and start making fetal hemoglobin again. Since fetal hemoglobin has no B chains, the RBC will have normal shape 13. List the classes, structural characteristics, and functions of leukocytes. a. The WBC are protective as they are a huge part of the \_\_immune\_\_\_\_\_\_\_\_\_\_ system. b. True or False: The body makes more RBC than WBC? False, it makes the same amount or sometimes even more WBC. But WBC do not stay in blood vessels. They go out and live in body tissues and lymph tissues to search for pathogens. c. What is diapedesis? When white blood cells squeeze through wall of blood vessel to go out to tissues. d. What factors stimulate WBC formation in bone marrow? Colony stimulating factors e. Can WBC copy when in other tissues by cell cycle and mitosis? Yes, they have a nucleus so can copy wherever. f. What does it mean if a cell is a phagocyte? It will eat and destroy pathogens. g. Which WBC have phagocytic functions? Neutrophils, monocyes, these two are awesome. Basophils and eosinophils are weak phagocytes but they can do it!. h. Which one type of WBC has no phagocytic function? Lymphocyte i. What is the most common WBC in a blood sample? Neutrophil j. What is the least common WBC in a blood sample? Basophil k. List the granulocytes. Neutrophils, basophil, eosinophil l. List the agranulocytes. Lymphocyte, monocyte. m. Be able to identify all WBC in pictures. x. What will you look for to recognize a neutrophil? Many lobed nucleus xi. How do the granules stain in neutrophils? Neutral, you can't see them xii. How do defensins help kill bacteria? Punch holes in cell membrane of the pathogens xiii. What will you look for to recognize an eosinophil? Pink granules xiv. How do the granules stain in eosinophils? pink xv. When do eosinophil numbers increase? When infected with: parasites and worms xvi. What will you look for to recognize a basophil? Blue granules xvii. How do the granules stain in basophils? blue xviii. What chemical is inside the basophil granules? Histamine and heparin xix. What are the functions of histamine? Stimulate inflammation xx. How will you recognize a lymphocyte? Nucleus takes up whole cell xxi. What are the two types of lymphocytes? B and T xxii. Which lymphocyte attacks pathogens directly? T think Mr. T in A team! xxiii. Which lymphocytes make antibodies? B xxiv. How will you recognize a monocyte? Biggest cell with kidney shaped nucleus xxv. What are monocytes called when they leave blood vessels and move into tissues? macrophages xxvi. What is the main function of macrophages? phagocyte n. What is the name cancer which results in overproduction of malfunctioning WBC? Leukemia o. What is the name of the infectious disease caused by the Epstein Barr virus? Mononucleosis p. Are granulocytes or agranulocytes affected by mono? Agranulocytes 14. Describe the structure and function of platelets. q. What is another name for platelets? Thrombocytes r. Are platelets whole cells or cell fragments? Fragments s. What is the function of platelets? Blood clotting 15. Describe the process of platelet formation. t. Where are platelets made? Red bone marrow u. Which committed stem cell breaks apart to form platelets? Megakaryocyte v. Which hormone regulates platelet formation? Thrombopoietin 16. Describe the process of hemostasis. w. The lining tissue in a blood vessel is called the: endothelium x. Will a clot form if the endothelium is not damaged? NO y. What do platelets look like when they are inactive? Round z. What do platelets look like when they are activated? Star a. List the 3 steps of hemostasis in order. Vascular spasm, platelet plug, coagulation b. Why does it make sense for the blood vessel to constrict if it is punctured? This helps prevent blood loss c. List the steps of platelet plug formation in order. xxvii. If the blood vessel is damaged the connective tissue protein \_\_\_collagen \_\_\_\_\_\_\_\_\_ is exposed. xxviii. The first platelet sticks to the collagen and is held in place by \_\_\_\_von willabrand\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ factor. (VWF) xxix. Once the platelet sticks, it releases the granules inside it. The granules contain the chemical \_ADP, thromboxane, serotonin\_\_\_\_\_\_\_\_\_\_\_ which can activate other platelets. xxx. The platelets activate each other using \_\_\_positive\_\_\_\_\_\_\_\_\_\_\_ feedback. xxxi. The platelets are held together by the protein \_\_\_fibrin \_\_\_\_\_\_\_\_\_ and form a platelet plug. d. Where are all clotting factors made? Liver e. Which vitamin is required to make 4 of the clotting factors? K f. Inactivated clotting factors and the protein fibrinogen are all floating in the \_\_plasma\_\_\_\_\_\_\_\_\_\_\_\_\_ of normal blood. g. Know the sequence of clotting events. See diagram in handout h. What starts the extrinsic clotting pathway? Damage to non vascular tissue i. What starts the intrinsic clotting pathway? Factors in the blood itself j. Which is faster extrinsic or intrinsic? Extrinsic k. Chemicals released from damaged tissues which stimulate extrinsic coagulation are called \_\_\_tissue\_\_\_\_\_\_\_\_\_\_ factors. l. What ion is necessary for clotting? calcium m. What enzyme turns pro-thrombin into thrombin? Prothrombin activator n. What enzyme turns fibrinogen into fibrin? Thrombin o. What is clot retraction? When a clot contracts and makes a tight plug p. What two contractile proteins are present in platelets? Why are they needed? Actin and myosin, pull clot together tightly. 17. Name some factors that limit clot formation and prevent undesirable clotting and know how each works. q. Name 2 naturally occurring anti-coagulants in blood vessels? Nitric oxide, prostacyclin r. How does aspirin inhibit clot formation? Blocks thromboxane A2 one of the positive feedback signals for platelets. s. How does heparin inhibit clot formation? Blocks platelet plug formation t. How do warfarin and Coumadin inhibit clot formation? Vitamin K inhibitors 18. Describe the process of fibrinolysis. u. What happens during fibrinolysis? Clot is broken down v. What enzyme digests fibrin to break up the clot? Plasmin w. The inactive form of plasmin floating in plasma is called: plasminogen x. What converts plasminogen to plasmin? Tissue plasminogen activator 19. What is PDGF and what is its function? Platelet derived growth factor. A very strong chemical that heals tissues fast. 20. Give examples of hemostatic disorders. Indicate the cause of each condition. y. Differentiate between a thrombus and an embolus? A thrombus stays in one place, an embolus is moving. z. Differentiate between an embolus and an embolism? An embolus is floating around , an embolism is stuck and completely blocking a blood vessel. a. List the causes of some common bleeding disorders liver problems like cancer or cirrhosis. Vit K deficiency, genetic disorders of clotting. b. What is wrong in thrombocytopenia? Not enough platelets c. Why does liver damage lead to bleeding disorders? All the clotting factors are made in the liver. d. Name the group of genetic bleeding disorders. Hemophilia 21. Know how to blood type and how to read the results of a blood typing test. See handout 22. Describe the ABO and Rh blood groups. List agglutinogens and agglutinins present in each type. e. What is an agglutinogen? Antigen or antibody? Antigen f. What are agglutinins? Antigen or antibody? antibody g. What agglutinogens are on the blood cells of each blood type? See chart we did in class h. What agglutinins are in the plasma of each blood type? See chart we did in class 23. Explain the basis of transfusion reactions and if given a blood type, know what blood they could receive in a transfusion situation. i. If given a blood type, know which blood types they can safely receive? See chart j. What blood can you give to everyone (Universal donor)? O- k. Which blood type can get all 4 kinds of blood? (Universal acceptor) AB+ l. Which blood type can only **[get]** blood of 1 type? O- m. Can you give Rh --ve blood to an RH + person. Example: Could you give A- to an A+ blood type and vice versa? Yes, you CAN give --ve to +ve. You CANNOT give +ve to --ve. 24. Describe the condition known as hemolytic disease of the newborn. Explain why it happens and how it can be prevented. n. Is there a problem if a Rh --ve mom is pregnant with a Rh --ve baby? no o. Is there a problem if a Rh +ve mom is pregnant with a Rh +ve baby? no p. Is there a problem if a Rh --ve mom is pregnant with a Rh +ve baby? YES q. If a Rh --ve mother gets pregnant with an Rh +ve baby, is there a problem if it is the first pregnancy? no r. How about if the woman gets pregnant a second time with another Rh +ve baby? yes [Note:] - Usually short answer questions look like the course objectives. - You always get more points if you include a diagram or drawing in your short answer response. - Write as much as you can on the topic and include all the details. You will lose points if your answer lacks detail. - You should write your answer as if you were teaching that topic to a class of students who are new to the concept. What would you tell them? What diagrams would you draw to illustrate the processes? - Different versions of the test will have different SAQ. 1. 2. 3. 4. 5. 6.