Blood Week 1.txt

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Blood Week 1.txt
2013-10-25 16:43:20

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  1. Constituents of blood
    Cellular components and Plasma components
  2. Three main cell types of blood:
    RBCs, WBCs, and Platelets
  3. What is serum?
    Plasma w/o clotting factors
  4. Reduced RBC?
    Anemia --> fatigue
  5. Reduced WBC?
    Leukopenia --> infection
  6. Reduced thrombocytes/clotting factors?
    Thrombocytopenia/hemophilia --> bleeding
  7. What can increased amount of cellular component indicate? (eg, leukocytosis)
    Physiological response or malignant proliferation
  8. Increased RBC?
    Erythrocytosis = Hypoxia or Polycythemia Rubra Vera
  9. Increased WBC?
    Leukocytosis = Infection or Leukemia
  10. Increased thrombocytes?
    Thrombocytosis = Response to inflammation or Essential thrombocytosis
  11. Increased clotting factors?
    Hypercoaguable states
  12. List the three locations for blood production
    Yolk Sac --> Liver/Spleen (5/6 weeks) --> Bone Marrow (5-6 months on)
  13. What are cytokines?
    Growth factors
  14. What does hypoxia lead to? (growth wise)
    Hypoxia --> EPO --> RBC
  15. What does infection lead to? (growth wise)
    Infection --> GCSF/GMCSF --> Neutrophils/Monocytes
  16. What does hemorrhage lead to? (growth wise)
    Hemorrhage --> Thromobopoeitin --> Platelets
  17. Two defining characteristics of hematopoietic stem cells (HSC) ?
    Pluripotent and Capacity for self renewal
  18. What does pluripotent mean?
    Capacity to generate all cell lineages (but can't fully regenerate organism)
  19. What does totipotent mean?
    Ability to differentiate and form all cells of a complete organism
  20. What does quiescent mean?
    Dormant (not cycling); only 5% of HSC cycle at once
  21. Diff between symmetric and asymmetric division?
    Symmetric: parent stem cell to two identical daughters; Asymmetric: parent generates a daughter and another parent (regenerates itself)
  22. Put these in order: Committed CFU, Stem Cell, Colony Forming Unit
    Stem Cell (pluripotent, quiescent) --> CFU (high proliferative rate, high potential, limited self renewal) --> Committed CFU (high proliferative rate, lineage specific)
  23. What is aplastic anemia?
    Damaged bone marrow/stem cells (often result from radiation)
  24. What are hematologic cancers?
    Clonal expansion of hematopoetic cells induced by (epi)genetic changes; Leukemia, lymphoma, myeloma.
  25. How do monoclonal tumours differ from polyclonal tumours?
    Monoclonal tumours originate from only one crazy cell
  26. Describe RBC shape and why it is that way
    Biconcave disc for flexibility, maximum surface area for gas exch, laminar flow
  27. What are the RBC roles?
    Primary carrier of gases for cellular resp.; oxygen, CO2, NO; also possibly oxygen sensor
  28. What is the lifespan of a RBC?
    120 days
  29. What is a reticulocyte?
    A young RBC with no nucleus; 1% of red cells in peripheral blood
  30. If RBC count/tissue oxygenationv is low, EPO level will be....
  31. Where does EPO act and what does it do?
    BFU-E and CFU-E; stimulate growth and maintain survival
  32. Where is EPO made?
    Peritubular cells of kidney
  33. Describe primary Hemoglobin structure?
    4 Globin chains (2 alpha and 2 beta); Each chain linked to heme protein; Each heme has an iron molecule
  34. What are the three types of Hemoglobin and what globin chains are they composed of?
    Fetal--> 2 alphas/2 gammas; Adult 1 --> 2 alphas/2 betas; Adult 2 --> 2 alphas/2 deltas
  35. Where are beta/gamma globin genes?
    Chromosome 11
  36. Where are alpha globin genes?
    Chromosome 16
  37. What is low hemoglobin called?
  38. What occurs when we have lack of globin chain due to mutation on chromosome 16 or 11?
  39. What occurs when a point mutation lead to a val-->glu?
    Sickle cell disease
  40. What is Hb-O dissociation curve shape and why?
    Sigmoid; cooperativity between globin chains
  41. What modifies the Hb-O curve?
    Ph, 2,3 DPG,
  42. List types of WBC
    Neutrophil, Lymphocytes, Monocytes, Eosinophils, Basophils
  43. What do platelets do?
    Thrombocytes form a plug when they come into contact with damaged blood vessel wall; initiate coagulation cascade
  44. Are platelets the smallest cell of blood?
  45. Do platelets circulate in active form?
  46. How long do they live and what stimulates their growth?
    7-10 days; Thrombopoietin
  47. How much does plasma volume increase in pregnancy?
  48. How much does RBC mass increase by and what is the issue with this?
    20-50%; Hb concentration falls 10-20 g/L
  49. What is EPO stimulated by during pregnancy?
  50. Which of the following does not increase during pregnancy: WBC, Platelets and/or clotting factors?
    Platelet count stays the same
  51. What are the components of plasma (BONUS: what is the biggest consituent)?
    Water (95%), Proteins (albumin, gamma globulins, clotting factors), Electrolytes, Glucose, fats and minerals
  52. What results from a deficiency of clotting factors and what is a possible cause?
    Hemophilia due to liver disease (produces all except VIII)
  53. What is the clinical relevance of immunoglobulin deficiency?
    Increased susceptibility to infection (congenital or acquired immunodeficiency)
  54. What are possible causes of albumin loss?
    Nephrotic syndrome (peeing it out), liver disease, protein losing enteropathies
  55. What is a CBC? Describe briefly how it is done
    Complete Blood Count; Blood collected in EDTA, Ca++ chelator to stop clotting, place lyse/unlysed sample in automated cell counter
  56. What does the lysed sample tell us?
    Hb concentration, WBC stuff
  57. What does the unlysed sample tell us?
    RBC #, size (MCV), and distribution (RDW); Platelet count
  58. What are the most important measurements of the CBC?
    WBC count, Hb conc g/L, RBC count, MCV, RDW, Platelet count
  59. What are some calculated (less relevant) components on the CBC?
    Hematocrit (RBC x MCV), Mean cell Hb/MCH (Hb/RBC), Mean cell Hb conc/MCHC (Hb/Hct)