bio18.txt

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itzlinds
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130601
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bio18.txt
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2012-02-03 12:41:34
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circulatory system blood
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circulatory system: blood
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  1. list the fxn of the circulatory system:
    • transport: O2, CO2, nutrients (glucose), wastes, hormones, stem cells
    • protection: immune system, infection (WBC), clotting
    • regulation: body fluid distribution, buffer (pH), body temperature
  2. List the components of of blood and state the normal percentage of each components:
    • Plasma
    • formed elements: erythrocytes (RBC), Leukocytes (WBC), Thrombocytes ( platelets)
  3. describe the general composition of blood plasma:
    • water: >90%
    • proteins: albumin, globulins, fibrinogen
    • nutirents: glucose, amino acids, fats
    • wastes: urea, creatinine, ammonia
    • electrolytes: Na+, K+, Cl-, 90% Na+
    • hormones
    • vitamins
    • gases: O2, CO2
  4. describe serum:
    plasma without clotting factors
  5. describe albumin:
    a soluble, transport protein, contributes to visocisty and osmolarity, and serves as a buffer
  6. describe the role of pluripotent stem cells in hemopoiesis:
    • develop into multiple mature cell types
    • maintain a small but persistent population in the bone marrow
    • some go on to become specialized cells, colony-forming units (CFU)
  7. Name the hemopoietic tissues of the body:
    • myeloid: blood formation in the bone marrow
    • lymphoid: lymphocytes produced in the thymus, tonsils, lymph nodes, spleen
  8. describe the viscosity of blood:
    • the measure of resistance against flow
    • properties: thickness, adherence
    • whole blood~= 5x as thick as water (RBC mostly contribute)
  9. describe the osmolarity of blood:
    • the measure of dissolved substances (proteins/electrolytes)
    • ~300 mOsm millosmoles (relationship with specific gravity)
    • determins if fluids flow out (filatration) or into (reabsorbtion) the capillaries
  10. describe the structure and fxn of erythrocytes:
    • structure
    • 4 to 6 million/microliter
    • discoid, bioconcave shape
    • few organelles, no nucleus, no protein synthesis/miotsis, no mitochondria
    • anaerobic fermentation only, durable- squeeze thru capillaries
    • 33% hemoglobin (Hgb)
    • HCT rule of thumb: HCT/3= 15g/100ml

    Fxn: transport O2 and CO2
  11. describe the structure and fxn of hemoglobin:
    • Structure
    • 4 protein complexes
    • 4 protein chains ( globins)
    • 4 heme molecules ( 1/globins)
    • 4 iron groups, Fe++ (1/heme group)
    • 4 O2 molecules (1/Fe++) (when saturated)

    Fxn: gives blood its color
  12. state the normal hematocrit values and be able to calculate them:
    • hematocrit (packed cell volume): the % of whole blood volume composed of RBC
    • normal values men: 42% - 52%
    • normal values women: 37% - 48%
    • PCV/TV x 100
    • HCT rule of thumb: HCT/3=15g/100ml Hgb
  13. state the normal hemoglobin values and be able to calculate them:
    • normal values men: 13 - 18 g/dL
    • normal values women: 12 - 16 g/dL
  14. Explain the process for erythropoiesis:
    • formation in the bone marrow, 3-5 day process
    • 1. pluripotent stem cell becomes a erythrocyte colony-forming unit
    • 2. ECFU has receptors for erythropoienin (EPO), which stimulates ECFU to transform into a erythroblast
    • 3. erythroblasts makes hemoglobin, loses nucleus
    • 4. the lost nucleus makes the cell a reticulocyte ( a temp. network of ribosome clusters), then lose ribsomes
    • 5. mature erythrocyte
  15. list the requirements for erythropoiesis:
    • EPO: erythropoetin, hormone from kidney's to stimulate the process
    • Fe++: to make Hgb
    • vitamins: B12/folate for cell divsion
    • amnio acids
    • lipids
  16. describe the the role of erythrocytes in maintaining homeostasis:
    • Hypoxemia: inadequate O2 transport
    • 1. sensed by the liver/kidneys
    • 2. kidneys secrete erythropoient
    • 3. EPO stimulates red bone marrow
    • 4. accelerated erythropoiesis
    • 5. increase RBC count
    • 6. increase O2 transport

    effectors: altitude, excerise, blood loss
  17. describe what happens to erythrocytes and their components when they die:
    • Expired erythrocytes break up in the liver/spleen
    • cell fragments are phagocytized
    • hemoglobin degraded: hemolysis
    • hemolysis breakdown for iron: stored, reused, lost during mensies or injury
    • hemolysis breakdown into bleliverdin: further in to bilirubin, then secreted into bile, then into feces
  18. describe the common erythrocyte disorder polycythemia:
    excess # of RBC, and increase blood viscosity
  19. describe the common erythrocyte disorder anemia:
    • RBC deficiency
    • nutritional (Fe++, B12, folate) decreased
    • decreased erthropoiesis
    • decreased blood volume
    • decreased oxygen
  20. describe the common erythrocyte disorder sickle cell disease:
    • recessive allele of Hgb
    • Hgb doesnt bind O2 well, RBC is sickle shaped, and blocks the vessels
  21. define antigen:
    a molecule that triggers an immune response
  22. define antibodies:
    a globulin that binds to a foregin antigen and cases an immune response
  23. describe the ABO blood group:
    blood grouping based on the presences or absence of A or B antigens
  24. describe the Rh blood group:
    numerous RBC antigens of which are C, D and E. antigen D is the far most reactive so a person is concered Rh+ if they have the D antigen, if they are lacking the D antigen they are considered Rh-
  25. define agglutination:
    antibodies bind to antigens and cause RBCs to clump
  26. describe how aggultination casues a transfusion rxn and the consequence:
    transfusion rxn aggultination is caused by mismatched blood, the RBCs blocks the vessels, the RBC is destroyed, releasing Hgb, and leads to renal failure
  27. state the universal donor based on transfusion of packed red blood cells:
    Type O
  28. state the universal recipient based on transfusion of packed red blood cells:
    Type AB
  29. Define hemolytic disease of the newborn (HDN) as it relates to Rh differences between mother and child:
    1st pregancy exposes mother to Rh+ fetal blood, she produces anti D antibodies. If she becomes pregnant with an Rh+ fetus a 2nd time, her anti D antibodies may pass thru the palcenta and agglutinate the fetal erythrocytes, the agglutinated RBCs hemolyze and the babe is born with server anemia called HDN
  30. Discuss how HDN can be prevented:
    give Rh immune globulin, RhoGAM, the immune globulin binds fetal RBC antigens so they cannot stimulate her immune system to produce anti D
  31. discuss how transfusion rxns can be prevented:
    If not an exact match for whole blood, must give packed cells to eliminate antibodes

    give packed RBCs with a minimum of plasma
  32. describe the structure, fxn, and classification of leukocytes:
    • structure: has nucleus, lysosomes, and organelles
    • fxn: protection against infection and other diseases
    • classification: white blood cells, 5000-10,000 WBC/microliter, plus more in connective tissue
  33. describe the microscopic appearance, abundance, classification, and fxn of neutrophils:
    • microscopic appearance:visible nucleus,3-5 lobes when mature, cytoplasm - fine reddish to violet (lilac) specific granules
    • abundance: 60-70% of the WBCs, 4000 cells/microliter
    • classification: granuloctye
    • fxn: destroy bacteria
  34. describe the microscopic appearance, abundance, classification, and fxn of eosinophils:
    • microscopic appearance: nucleus- 2 large lobes, cytoplasm - large orange (red)/pink granules
    • abundance: 2-4% of WBCs, 170 cells/microliter
    • classification: granuloctyes
    • fxn: phagocytize antigen-antibody complexes, allergens and inflammatory chemicals, releases enzymes that weaken, destroy parasites
  35. describe the microscopic appearance, abundance, classification, and fxn of basophils:
    • microscopic appearance: nucleus- large, pale (obscured from view), cytoplasm - abundant dark violet granules
    • abundance: 0.5 - 1 % of WBCs, 40 cells/microliters
    • classification: granulocytes
    • fxn: sectretes histamine- vasodilator and heparin - anticoagulant, aka- mast cells
  36. describe the microscopic appearance, abundance, classification, and fxn of lymphoctyes:
    • microscopic appearance: nucleus- large w/ dimple, mottled dark violet color, cytoplasm - scanty rim of clear, light blue
    • abundance: 25-33 % of WBCs, 2,200 cells/microliter
    • classification: agranuloctyes
    • fxn: recognize, destroy infected cells, secrete antibodies, coordinates immune response

    * t (thymus) and b (bone marrow) cells
  37. describe the microscopic appearance, abundance, classification, and fxn of monocytes:
    • microscopic appearance: nucleus- large horse shoe shaped, violet in color, cytoplasm - light blue stain
    • abundance: 3-8% of WBCs, 450 cells/microliter
    • classification: agranulocyes
    • fxn: macrophages when in tissue, destroy cells, break up foreign matter, can become antigen presenting cells
  38. Explain the process of leukopoiesis:
    • 1. pluripotent, hemopoietic, stem cells
    • 2. two different branches the stem cells can take - a. colony-forming unit (CFUs) produce myeloid stem cells b. lymphoid stem cells
    • 3.Blast level - a. myeloblasts, or monoblasts (produce monocytes) b. lympoblasts (produce lymphocytes)
    • 4. precursor level -
    • 5. mature cells -

    • * precursor of platelets is megakaryocyte
    • * mature cells secrete stimulating factors, ex- bacterial infection, more neurtophils
  39. Describe the lifespan of granulocytes, monocytes, and lymphocytes:
    • granulocytes: 4-5 days
    • monocytes: a few years
    • lymphocytes: weeks to decades
  40. describe the common leukocyte disorder of leukopenia:
    WBC deficiency, < 5000 WBC/microliter, disease conditions - AIDS, influenza, poisoning, drugs
  41. describe the common leukocyte disorder of leukocytosis:
    >10,000 WBC/microliter, disease condidtions, infections, allergies
  42. describe the common leukocyte disorder of leukemia:
    much greater >>10,000 WBC/microliter, disease condidtions - cancer of hemopoietic tissues, increased immature WBC, replace normal RBC, WBC, platelets - patients immune is compromised, anemic and hemorrhagic ( impaired clotting ability)
  43. describe the structure and fxn of thrombocytes (platelets):
    • structure: nucleus- none, cytoplasm - has organelles
    • fxn: hemostasis (cessation of bleeding)

    • *not a cell per se, but cell fragments
    • * # RBC > # platelets > # WBC
    • * ~ 130,000-400,000/microliter
  44. Explain the process of thrombopoiesis:
    • hemopoietic (pluirpotent, stem cells) produce receptors for the hormone throbopoietin, and become megakaryoblasts
    • then become meagkaryocyte, it then sprouts long tendrils called proplatelets that protrude into the blood.
    • the blood flow shears off the proplatelets, which break up into platelets in the bloodstream

    • *20-40% stored in spleen
    • *lifespan - 10 days
  45. Explain the mechanisms that regulate vascular spasm:
    • promopt constriciton of the broken vessel
    • triggered by: injury, pain
    • vasoconstriction: platelets release serotonin, so vascular spasm is maintained long enought for other two hemostatic mechanisms to come into play
  46. Explain the mehcanisms that regulate platelet plug formation:
    • a broken vessel exposes its collagen fibers of its wall to the blood
    • platelets adhere to the vessel, contract, and draw the walls of the vessel together
    • degranulation: excotyosis of their cytoplasm, realease factors that promote hemostasis
  47. Distinguish between aggultination and coagulation:
    • aggultination: clumping of cells or molecules to anitbodies, each antibody molecule binds to two or more antigen molecules and sticks them together
    • coagulation: the clotting of blood, to convert the plasma protein fribrinogen into fibrin, a sticky protein that adheres to the vessel wall
  48. Name the goal (end product) of coagulation:
    to convert the plasma protein fibrinogne into fibrin, a sticky protein that adheres to the walls of a vessel
  49. in general terms distinguish between extrinsic, intrinsic, and common pathways of clot formation:
    • extrinsic: indicicated by damaged tissue (not the blood itself)
    • intrinsic: uses only clotting factors from blood itself
    • common pathway: both extrinsic and instrinsic verge into common pathway

    * both mechansims active when bleeding - positive feedback
  50. list the clotting factors:
    • procoagulatns: "inactive", most produced by the liver, always exist in plasma usually in an inactive state
    • vitamin K
    • Ca2+

    • * each factor amplifies or produces more factors in sucessive steps
    • *procoagulants are proteins
  51. describe the mechanisms and importance of clot rxn:
    • platelets pull on the fibrin threads and draws the edges of the broken vessels together
    • clot becomes more compact within about 30 minutes
  52. describe the mechanisms and importance of vessel repair:
    • platelets and endothelial cells secrete a stimulatn named platelet-derived growth factor (PDGF)
    • PDGF stimulates fibroblasts to multiply, repair damaged blood vessel
  53. describe the mechanisms and importance of fibrinloysis:
    • fibrinlyosis: the dissolution of a clot
    • plasminogen, a fibrin-dissolving enzyme that breaks up the clot is activated
  54. define thrombus:
    a stationary blood clot
  55. define embolus:
    • traveling blood clot
    • may lodge in heart, brain, kidneys
  56. define anticoagulants:
    prevents blood clots
  57. describe the cause and effect of hemophilia:
    • cause: sex linked recessive, hereditary
    • effect: clotting factor deficiency, (A - VIII, B- IX, C - XI)
    • excertion causes internal bleeding
  58. summarize factors that prevent coagulation:
    • cuomadin (warferrin) inhibits vitamin K
    • aspirin, prvents platelet aggergation
  59. The percentage of blood volume made up of erythrocytes is the:

    plasma
    colloid osmotic pressure
    buffy coat
    hemoglobin concentration
    hematocrit
    hematocrit
  60. Serum is equivalent to blood plasma except serum does not have:

    clotting proteins
    antibodies
    nutrients
    nitrogenous wastes
    any plasma proteins
    clotting proteins
  61. Which of the following is TRUE?

    Leukocytes have organelles but platelets do not.
    Leukocytes have a nucleus but erythrocytes do not. Erythrocytes have organelles but leukocytes do not.
    Erythrocytes have a nucleus but platelets do not.
    Leukocytes have a nucleus but erythrocytes do not.
  62. ___________ is a molecule secreted by the kidneys that stimulates erythrocyte production.

    ferritin
    erythropoietin
    folic acid
    albumin
    hemoglobin
    erythropoietin
  63. A disease that produces an unusually high number of leukocytes in the blood is called:

    sickle-cell disease
    polycythemia
    leukopenia
    pernicious anemia
    leukemia
    leukemia
  64. ___________occurs when blood cells and platelets get trapped together by a sticky protein called fibrin, whereas __________ occurs when antibodies bind to
    multiple antigens at once thus clumping many cells together.

    sickle-cell disease; coagulation
    vascular spasm; transfusion reaction
    fibrinolysis; agglutination
    coagulation; platelet plug formation
    coagulation; agglutination
    coagulation; agglutination
  65. A transfusion reaction will occur if a person with blood type _______ receives blood from a person with blood type ______.

    B; AB
    AB; O
    AB; A
    A; A
    B; O
    B; AB
  66. Which type of leukocyte transforms into a macrophage once in the tissues and functions to consume dead and foreign cells?

    neutrophil
    basophil
    eosinophil
    monocyte
    lymphocyte
    monocyte
  67. Put the three hemostatic mechanisms in the order in which they occur

    formation of platelet plug
    coagulation
    vascular spasm
    • vascular spasm
    • formation of platelet plug
    • coagulation
  68. Platelets are formed from cells called ___________.

    myeloblasts
    megakaryocytes
    reticulocytes
    lymphoblasts
    agranulocytes
    megakaryocytes
  69. The ultimate goal of coagulation is to convert _____________ into _____________.

    prostacyclin; thromboxane A2
    prothrombin; factor X
    thrombin; prothrombin
    fibrinogen; fibrin
    plasminogen; plasmin
    fibrinogen; fibrin
  70. Which of the following is NOT required for coagulation?

    vitamin K
    calcium
    factor X
    vitamin B12
    fibrinogen
    vitamin B12
  71. the outermost layer of the myocardium is the:

    A. epicardium
    B. endocardium
    C. pericardial sac
    D. mycardium
    A. epicardium
    (this multiple choice question has been scrambled)
  72. which of the following is NOT a function or characteristic of erythrocytes?

    A. transport O2 and CO2
    B. have no mitochondria
    C. have a nucleus
    D. durable so that they can squeeze throught capillaries
    C. have a nucleus
    (this multiple choice question has been scrambled)
  73. a patient's hemaocrit (Hct) is 30%. what is the hemoglobin (Hb) concentration?

    A. 90g/100ml
    B. 10g/100ml
    C. 30g/100ml
    D. 15g/100 ml
    B. 10g/100ml
    (this multiple choice question has been scrambled)
  74. which of the following is NOT required for erythropoiesis?

    A. red bone marrow
    B. erythropoietin
    C. iron
    D. vitamin B12
    E. vitamin K
    E. vitamin K
    (this multiple choice question has been scrambled)
  75. after hemoglobin is broken down into heme and globin, what happens to the heme?

    a. it is recombined with amino acids in the liver to make more hemoglobin
    b. it is recombined with lipids in the spleen to make more hemoglobin
    c. it si ultimately broken down into iron and bilirubin. the iron is the excreted by the kidneys and the bilirubin is reused to make more RBCs.
    d. it is ultimately broken down into iron and bilirubin. the iron is then reused to make more RBC and teh bilirubin is excreted in the feces as a componet of bile.
    • d. it is ultimately broken down into iron and bilirubin. the iron is
    • then reused to make more RBC and teh bilirubin is excreted in the feces
    • as a componet of bile.
  76. which of the following is TRUE?

    A. a person with blood type A+ can safely dontate blood cells to someone who is O+
    B. a person with blood type AB+ can safely recieve blood cells from someone who is A+
    C. a person with blood type AB+ can safely dontate blood cells to someone who is B+
    D. a person with type O+ can safely receive blood cells from someone is AB+
    E. a person with blood type B- can safely recevie blood cells from someone who is AB-
    B. a person with blood type AB+ can safely recieve blood cells from someone who is A+
    (this multiple choice question has been scrambled)
  77. Hemolytic disease of the newborn (HDN) is most likely to occur:

    A. Rh- mothers as the first Rh+ fetus develops
    B. Rh+ mothers as the first Rh- fetus develops
    C. Rh- mothers as teh second Rh+ fetus develops
    D. Rh+ mothers as the seconde Rh- fetus develops
    C. Rh- mothers as the second Rh+ fetus develops
    (this multiple choice question has been scrambled)
  78. which type of leukocyte releases histamine and heparin?

    A. esoinophil
    B. basophil
    C. neutrophil
    D. moncyte
    E. lymphocyte
    B. basophil
    (this multiple choice question has been scrambled)
  79. platelets are produced in red bone marrow from which cell type?

    A. magkaryocyte
    B. myeloblast
    C. lymphocyte
    D. reticulocyte
    A. megakaryoctye
    (this multiple choice question has been scrambled)
  80. which of the following is NOT needed for coagulation?

    A. albumin
    B. fibrinogen
    C. calcium
    D. thrombin
    A. albumin
    (this multiple choice question has been scrambled)
  81. blood clotting proteins are produced by which organ?

    A. red bone marrow
    B. spleen
    C. kidney
    D. liver
    E. thymus
    D. liver
    (this multiple choice question has been scrambled)

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