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Where are plasma proteins synthesized?
In the liver
Proteins are limited to compartments and exert _______ pressure
What are the major functions of plasma proteins?? (3)
- 1- transportation
- 2- drug binding
- 3- regulating temperature
True or false, mature RBCs do not have a nucleus, mitochondria, or ER.
Iron ions in the Hb are in the ________ state
reduced ferrous (Fe2+)
RBCs are produced in:
- 1- yolk sac
- 2- liver,spleen, lymph nodes
- 3- bone marrow
- 4- tibia, humerus
- 5- sternum, vertebrae, ribs
RBC growth/reproduction are controlled by?
Growth inducers (IL-3)
What stimulates RBC production? (2)
- 1- any decrease in O2 (hypoxia)
- 2- erythropoietin
Where is erythropoietin formed?
Mainly the kidneys and some in the liver
True or false, adult Hb has a higher affinity for oxygen than fetal Hb.
False, fetal Hb requires a higher affinity for oxygen than adult Hb
What 2 vitamins are required for DNA synthesis in Hb?
- 1- Folic acid
- 2- Vitamin B12
Fe2+ in each heme group binds to how many O2?
only 1, BUT 1 Hb binds to 4O2 (heteroTETRAmeric)
Oxygen binds to Hb in ____levels in the lungs and releases in ____levels in the tissues
____% of total body iron is bound to Hb
____% of total body iron is stored in the liver bound to ferritin
Iron enters the ______ in the RBC where it is synthesized into ______ and released as free iron
What is the role of transferrin?
It TRANSFERS iron from the GI tract to erythrocyte membranes in the bone marrow where it is endocytosed
RBCs ____ in the spleen then they squeeze through the ________
recticular mesh (aka red pulp)
What phagocytizes Hb?
macrophages in the spleen & bone marrow
kupffer cells in the liver
Anemia is the deficiency of Hb to carry O2 by? (2 things)
decreased RBC production
decreased Hb in RBCs
What causes sickle-cell anemia?
An amino acid change in the Hb causing the Hb to crystalize
What 2 types of anemia are caused by vitamin deficiencies?
Pernicious anemia (B-12 not absorbed right)
Sprue (lack of B-12 and folic acid)
What is clot retraction?
Shrinking of a blood clot over a number of days that depends on the release of coagulation factors
What is the role of PGI2 in platelet aggregation?
It inhibits platelet aggregation
It is released by UNDAMAGED tissue
What is the role of TXA2 in platelet aggregation?
It is released by DAMAGED tissue to induce aggregation
Calcium is required at which steps in the clotting cascade?
- Factor 9 --> 9a
- Factor 10 --> 10a
- Prothrombin (2) ---> Thrombin (2a)
- Fibrinogen monomer --> Fibrin (1a)
What are the 3 essential steps in the clotting cascade?
- 2- conversion of prothrombin to thrombin
- 3- conversion of thrombin to fibrinogen to insoluble fibrin
Which pathway in the clotting cascade is the fasest?
Extrinsic, it goes from factor 7 --> 10
Which pathway in the clotting cascade has positive feedback?
Calcium removal can ______ clotting, especially calcium citrate and calcium oxalate.
What does activated protein C inhibit?
Factor 8a and 5a
What inactivates heparin?
What cells secrete heparin?
Mast cells and basophils
What is the role of plasmin in clot removal?
Plasmin breaks down fibrin into soluble fibrin fragments
Plasmin is activated via tissue plasminogen activators (t-PA)
A vitamin k deficiency affects the synthesis of what?
- Prothrombin (2)
- Factors 7, 9, and 10
Hemophilia is caused by a deficiency in what factor(s)?
- 85% is factor 8
- 15% is factor 9
What are the 2 main causes for inappropriate clotting?
- 1- AP (athrostatic plaque)
- 2- slow moving blood
How does Coumadin (warfarin) prevent clotting?
It decreases levels of Factors 7, 9, 10 and compete with vitamin K
How does cerumen (ear wax) function in pathogen defense?
It traps dust and repels insects
What do sebaceous glands contain?
lactic acid and fatty acid
How do nose hairs function in pathogen defense?
They filter and warm the air
True or false, vaginal secretions after menstruation become more basic.
false, they become more ACIDIC
Blood draining through the GI tract filters through the ______.
Liver (full of immune cells)
What enzyme in mother's milk transfers antibodies from mother to child?
What 2 mechanisims prevent pathogen invasion?
Monocytes turn into ______ in the tissues.
________ and _______ move via chemotaxis and phagocytize.
Which granulocytes have multi-lobed nuclei?
Eosinophils & basophils have bi-lobed nuclei
Lymphocytes enter the blood through the lymph via _______.
Which WBC is able to phagocytize more bacteria a neutrophil or a macrophage?
A macrophage ~100 bacteria and is larger
A neutrophil ~3-20 bacteria
What is margination?
Is when the adhesion molecules tether the neutrophils to the surface near the infection allowing for diapedesis.
What is the role of integrin in margination?
It is the adhesion molecule that stabilizes neutrophil binding allowin diapedesis
What are the 5 substances responsible for inflammation?
TNF, IL-1, GM-CSF (granulocytes/monocytes), G-SCF (granulocytes), M-CSF (monocytes)
What are interferons?
They are cytokines that inhibit viral replication in host cells
Eosinophils are made in response to ______ infections and are attracted through chemotaxis via _____________
eosinophil chemotactic factor
Basophils bind to _____ antibodies triggering release of _______, _________, __________, and _________ enzymes
What is leukopenia?
Cancerous mutations of WBC precursors that result in uncontrolled WBC production
How do eosinophils kill?
Via hydrolytic enzymes and ROS's
Aquired immunity is mediated via which 2 lymphocytes?
How to t-lymphocytes work?
they attack antigenic material directly (cell-mediated immunity)
Where do t-lymphocytes migrate to for maturation?
Where are b-lymphocytes made?
Before birth- in the liver
After birth- bone marrow
B-lymphocytes bind to what?
T-lymphocytes bind to what?
surface receptor proteins
What is the role of macrophages in lymphocyte activation?
They present antigenic material directly via cell-to-cell contact (APC complex)
secrete IL-1 that promotes production of lymphocyte clones
Helper cells secrete _______ after activation via _____ which enhances activation of ___-lymphocytes
What happens to the b-lymphocytes that do not become plasma cells?
They remain dormant until activated via a specific antigen (memory cells)
Immunization prepares the immune system for ______ response
Antibodies are ____ ______ called immunoglobulin
Which portion of the antibody determines antigenic specificiy?
The heavy chain variable portion
Which 2 types of antibodies are the most important against bacteria & viruses?
IgG and IgM
Which antibody is involved in allergic reactions?
What are the 5 classes of antibodies?
What is agglutination in antibody action?
When large invaders become bound via antibodies into a clump
What is antibody lysis?
When the antibody ruptures the cell membrane
What is antibody neutralization?
When the antibody covers and inactivates toxic sites on the invader
Which factors in the complement system form the MAC attack complex (lytic complex)?
C5b, 6, 7, 8, and 9
What triggers the complement system cascade?
The stem portion of the antibody binds to C1 and triggers the cascade
Which complement factor causes chemotaxis of neutrophils and macrophages?
Which complement factors activate mast cells and basophils?
C3a, C4a, and C5a
What is the only function of dendritic cells?
antigen presentation via adhesion molecules
Where is MHC-1 found and how does it function?
On all nucleated cells
Presents antigens to cytoxic t-lymphocytes
Where is MHC-2 found and how does it function?
only found on APCs
presents to helper-t cells
What are the 4 type sof t-lymphocytes?
- NK (Natural Killer)
Which type of lymphocytes does AIDS affect?
Which type of lymphocytes attack transplanted tissues? (kideny transplant)
True or false, MHCs are involed in presenting antigens to NK cells.
False, NK cells are NOT antigen specific
What is the function of Helper T-cells? (3)
- 1- activation of suppressor and cytotoxic cells
- 2- stimulation of b-lymphocyte growth
- 3- differentiation into plasma cells
What is passive immunity?
Injection of antibodies produced from another source or specifically activated t-lymphocytes or both
Which cells function in anaphylaxis?
Eosinophils and mast cells
What is a xenograft?
transplantation between different species
What is the most common type of transplantation?
Allograft (between same species)
How do cortisollglucocorticoids function?
They supress growth of lymphoid tissues and decrease formation of lymphocytes
What is the only combination that is Rh+?
D, all other are Rh- (C, E, c, d, e)
What is erythroblastis fetalis?
When the mother Rh+ has and Rh- baby
What causes jaundice?
hemolyzed RBCs result in Hb recycling and bilirubin production which causes the skin discoloration
What is opsonization?
When the bactrium is "marked" for phagocytosis
The AB blood group possesses:
NO antibodies**THIS EXPLAINS UNIVERSAL RECIPIENTS
The O blood group possesses:
NO antigens **THIS EXPLAINS UNIVERSAL DONOR
BOTH antibodies (Anti-A & Anti-B)
The A blood group possesses:
The B blood group possesses:
What do the platelets adhere to during plug formation?
Collagen and von willbrand factor
What are platelets formed from?
They are fragments of megakaryocytes
How are platelets removed?
Via macrophages in the spleen (phagocytosis)
Explain the positive feedback loop during platelet plug formation.
The platelets secrete ADP and TXA2 which activate other platelets to come to site of injury
What is blocked by Plavix?
How do LMW heparins work?
Increase the action of AT3 ON 10a but NOT on THROMBIN(2a)
How does heparin work? (2)
It increases the INACTIVATION of thrombin(2A)
It acts with AT3 to affect 10a
What is the alternate complement pathway?
Activated without antibodies and is non-specific
C3b connects bacteria for opsonization
What is significant about Factor 5?
It is inactive and thrombin feeds back in the positive feedback loop to speed clotting