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List the three main functions of blood:
- 1. Transport of nutrients/oxygen to tissues
- 2. Transport of waste products/CO2 away from tissues
- 3. Aid in fight against infection
List the three layers found in a blood tube that have been spun down.
- 1. Liquid portion
- 2. Buffy coat
- 3. Erythrocyte layer
The liquid portion is referred to as:
Serum or plasma
The �buffy coat� contains
Leukocytes and platelets
The erythrocyte layer contains?
Red blood cells
Define: �formed elements� �
The cellular portion of the blood: red blood cells, white blood cells and platelets.
List the types of formed elements found in the blood:
What differentiates serum from plasma?
- Plasma contain clotted factors � it is spun down before it clotted
- Serum does not contain clotted factors � it is the liquid portion pulled off after the clot formation
Why can you not always draw blood samples for multiple lab tests in one single tube?
Some tubes contain anticoagulants
List the major components of whole blood:
RBC, WBC, platelets, plasma/serum
The fluid component of blood which formed elements and various solutes are suspended and circulated.
Serum is blood plasma without the clotting factors.
- Define: Erythrocyte �
- Red blood cell
Describe the shape and unique characteristics of an erythrocyte:
The average life span of an erythrocyte is ________days.
List the two main functions of an erythrocyte:
- 1. Carry O2 to tissues
- 2. Carries CO2 away
Deine: Hemolysis �
Hemolysis is when the red blood cells burst, spilling their contents into the plasma.
If an erythrocyte were to hemolyze, what cytoplasmic contents would be spilled into the plasma, thus increasing the amount found in the plasma?
Hemoglobin, potassium, and glucose
Define: Erythropoiesis �
The production of erythrocytes
Where does erythropoiesis occur?
Erythrocyte production begins when a hemocytoblast descendant called a myeloid stem cell is transformed into a proerythroblast. Proerthroblast, in turn, give rise early (basophilic) erythroblasts that produce huge numbers ribosomes. During the first two phases, the cells divide many times. Hemoglobin is synthesized and iron accumulates as the early erythroblast is transformed into a late erythroblast then a normoblast. Then when a normoblast has accumulated almost all of its hemoglobin it ejects most of its organelles. Additionally, its nuclear functions end and its nucleus degenerates and inches off, allowing the cell to collapse inward and eventually assume the biconcave shape resulting in the reticulocyte ( a young erythrocyte)
What hormone stimulates erythropoiesis?
Erythropoietin is secreted by what organ?
When will erythropoietin be produced?
When there are low levels of oxygen, low levels of hemoglobin or low RBC count.
Discuss the general process of destruction of RBCs in the reticuloendothelial system (spleen).
When the RBCs become old their cell walls cannot flex as easily, when they have to go thought small vessels they lyse and release their contents.
Hemoglobin molecules consists of?
4 globulin units.
Each globulin unit contains what?
A heme unit
What is a heme unit?
An iron molecule that is present to carry an oxygen molecule.
Therefore, each hemoglobin molecule can carry up to ___ molecules of oxygen.
Hemoglobin is broken down into two components which are?
Heme and globin
Heme is broken down into
Biliverdin and Iron
Globin is broken down into
Amino acids and proteins
The iron, amino acids, and proteins are all ____.
The Biliverdin is broken down into ____ in the blood stream.
The bilirubin is transferred to the liver via bile and then into the
Once the bilirubin enters the small intestine, bacteria converts the bilirubin into
Most of the urobilinogen is transferred to the
Once the urobilinogen is in the large intestine it is converted to what?
Stercobolin is secreted in the
Small amounts of he urobilinogen goes into the
Once in the bloodstream, the urobilinogen goes into the
Once the urobilinogen is in the kidneys it is secreted in the
Define: Jaundice -
Yellow appearance to skin and eyes caused by an increase in blood bilirubin levels
List the 2 common causes of increased blood bilirubin levels:
- Liver disorders - hepatitis
List 3 conditions that may cause hemolysis
- 1. Hemolytic disease of newborn �bili babies�
- 2. Other hemolytic disorders
- 3. Transfusion reactions
Anemia is when the blood has a low oxygen carrying capacity, resulting from too few erythrocytes or abnormal hemoglobin.
Is an abnormally high number of erythrocytes.
List the three general causes of anemia
- 1. Low RBC count
- 2. Low hemoglobin content w/in the cell
- 3. Abnormal hemoglobin
List three reasons one might encounter a low RBC count?
- 1. Hemorrhagic anemia (excessive bleeding)
- 2. Hemolytic anemia (cells break open)
- 3. Aplastic anemia (body not making enough)
List two disorders in which hemoglobin content within each cell is abnormally low
- 1. Iron deficiency anemia
- 2. Pernicious anemia � not enough vitamin B 12
Give two examples of disorders involving presence of abnormal hemoglobin
- 1. Thalassemias
- 2. Sickle cell anemia
Define: Hemolytic anemia
Is a condition of low oxygen carrying capacity due to the lysis of red blood cells.
Define: Hemorrhagic anemia
Is a condition of low oxygen carrying capacity due to excessive bleeding
Define: aplastic anemia
Is a condition of low oxygen carrying capacity due to an insufficient amount of red blood cells.
Define: iron deficiency anemia
Is a condition of low oxygen carrying capacity due to the lack of iron in the hemoglobin.
Define: pernicious anemia
Is a condition of low oxygen carrying capacity due to the lack of vitamin B12
Define: sickle cell anemia
Is a condition of low oxygen carrying capacity due to abnormal sickle shaped erythrocytes
Is a condition of low oxygen carrying capacity due to erythrocytes being thin, delicate, and deficient in hemoglobin.
Is an abnormal excess of erythrocytes that increases the blood viscosity, causing it to slow down, or sludge.
Why would excess RBC�s not necessarily be a good thing?
The increased viscosity of the blood makes it hard for the heart to pump it.
Normal values of hemoglobin for males
Normal values of hemoglobin for females
Hematocrit levels for males
47% +- 5%
Hematocrit levels for females
42% +- 5%
Briefly describe the characteristics of a white blood cell (also known as leukocyte)
Colorless, nucleated, can be stained
Why are leukocytes referred to as �white blood cells� when we see them as pinks and purples on the slides?
They are found in the Buffy coat layer, not the red blood cell layer and are stained pink and purple.
List the three functions performed by leukocytes
- 1. Phagocytes
- 2. Release histamines
- 3. Produce antibodies and/or other substances that help fight disease
What is the normal range for leukocyte count?
List 4 possible reasons the total leukocyte count might be elevated
- 1. Leukemia
- 2. Infection
- 3. Inflammatory response
- 4. Trauma
List 3 reasons one might encounter a low leukocyte count
- 1. Leukemia (under treatment)
- 2. Impaired bone marrow
- 3. Other immune system disorders
Describe how a differential count is preformed
- Count the relative number of the various types of WBCs
- Determine how many of each type per 100 WBCs are present
If one counts 100 cells, approximately how many of each of he following cells would one find in a normal healthy individual � Neutrophils
If one counts 100 cells, approximately how many of each of he following cells would one find in a normal healthy individual � Eosinophils
If one counts 100 cells, approximately how many of each of he following cells would one find in a normal healthy individual � Basophils
If one counts 100 cells, approximately how many of each of he following cells would one find in a normal healthy individual � Lymphocytes
If one counts 100 cells, approximately how many of each of he following cells would one find in a normal healthy individual � Monocytes
Cellular components of blood =
Erythrocytes, leukocytes, platelets
Cells with Granulated cytoplasm =
Cells with agranulated cytoplasm =
Name the three types of granulocytes
- 1. Eosinophils � parasitic
- 2. Neutrophils � bacterial
- 3. Basophils - immune response � allergic rxns
- What are the characteristics of neutrophils
- � Multilobed nucleus
- � Pink or lavender fine granules in cytoplasm
- � Involved in fighting bacterial infections
- What are the characteristics of eosinophils
- � multilobed nucleus
- � Bright orange or red large granules in cytoplasm
- � Involved in fighting parasites and allergic reactions
What are the characteristics of basophils
- � Multilobed nucleus
- � Dark blue or black granules in cytoplasm
- � Involved in immune response - release of heparin and histamine
Name the two types of agranulocytes
- 1. Monocytes
- 2. Lymphocytes
What are the characteristics of monocytes?
- � Non-segmented nucleus
- � Smooth cytoplasm
- � Blue cytoplasm
- � Abundant cytoplasm
- � Involved in fighting long term infections
What are the characteristics of lymphocytes?
- � Non-segmented nucleus
- � Smooth cytoplasm
- � Light blue or grey cytoplasm
- � Very little cytoplasm
- � Involved in fighting viral infections
t-lymphocytes (t-cells) do what?
Function in the immune response by acting directly against virus-infected cells and tumor cells
B-lymphocytes (b-cells) do what?
Give rise to plasma cells which produce antibodies that are released into the blood
Define: Leukopenia �
Abnormally low white blood cell count commonly induced by drugs, particularly glucocorticoids and anticancer agents
Define: Leukemia �
- Overproduction of white blood cells. A group of cancerous conditions involving the WBCs. The WBCs are all of a single clone, and impair normal red bone marrow function
- What is an alternate name for platelets?
Describe the histology of a platelet
What is found within platelets?
Granules that contain clotting factors
What is the main function of a platelet?
To aid in the clotting process
List and describe the stages of the clotting process
- 1. Platelet plug formation
- 2. Intrinsic pathway of the complement cascade
- 3. Extrinsic pathway of the complement cascade
- 4. Fibrin mesh formation
- 5. Clot retraction � 30-60 min clot pulls close in
Describe in detail the process of platelet plug formation
- � Platelets attach to damaged vessel wall tissue
- � Chemicals released by damaged cells cause platelets to become sticky
- � Complement cascade initiated causes soluble fibrinogen to make insoluble fibrin
Describe the complement cascade
- � 30 substances
- � Series of chemical reaction which depends on products of the previous step being present
- � Clotting factors are chemicals that aid in the chemical reactions, come of which are products of the previous step.
- � Note: Vitamin K is needed to synthesize some of these factors
- � It could break down at any point
What will occur if only one item is missing from the complement cascade?
Lose ability to make fibrin needed for clots
List and briefly describe 2 reasons one factor might be missing from the complement cascade
- � Genetics � code missing
- � Vitamin K deficiency � needed to continue cascade
Bleeding disorders are not always a problem with the complement cascade. List and give the causative property of three categories of bleeding disorders.
- 1. Thrombocytopenia � low platelet count
- 2. Impaired liver function � low vitamin K and low clotting factors
- 3. Hemophilia � hereditary lack of ability to produce one or more clotting factors
Once tissue has healed, the clot needs to be dissolved. Name the process for dissolving clots?
List two factors that naturally aid in fibrinolysis. Which is used therapeutically?
- 1. Tissue Plasminogen Acivator (tPA) - used therapeutically
- 2. Streptokinase
Define: �Thrombolytic Disorder.�
Unwanted clots forming in the bloodstream
Clot formed in unbroken blood vessels which can block circulation, especially cardiac circulation
Thrombus that has broken away from the wall of at BV and is traveling through the circulatory system
Fibrinolytic drugs � mode of action:
Breaks down formed clots
Fibrinolytic drugs � examples:
Anticoagulants � mode of action:
Prevent clot formation
Anticoagulants � examples
- � Heraprin
- � Asprin
- � Warfarin
Why would you need to closely monitor patients that are taking fibrinolysins or anticoagulants?
To be sure that the patient would clot when they needed to.
Identify a thrombocyte in a blood smear.
Describe the basic formation of a thrombocyte from a megakaryocyte
They are pieces of cytoplasm off a stem cell from the bone marrow
What are the first and final steps in the complement cascade?
- 1st � intrinsic or extrinsic pathways
- Final � cross linked fibrin polymer
What is an intrinsic pathway?
When the vessel endothelium ruptures, exposing underlying tissues
What is an extrinsic pathway?
Tissue cell trauma
Hereditary lack of ability to produce one or more clotting factors
Define: Antibody �
A protein molecule that is released by plasma cells and that binds specifically to an antigen.
Define: antigen �
A substance or part of a substance that is recognized as foreign by the by he immune system and reacts with immune cells and their products
List the antigens on the blood type: A-
A antigens present
List the antigens on the blood type: A+
A-antigens and D-antigens
List the antigens on the blood type: B-
B antigens present
List the antigens on the blood type: B+
B-antigens and D-antigens
List the antigens on the blood type: AB-
A-antigens and B-antigens
List the antigens on the blood type: AB+
A-antigens, B-antigens and D-antigens
List the antigens on the blood type: O-
List the antigens on the blood type: O+
List the antibodies present in the plasma for blood type: A-
List the antibodies present in the plasma for blood type: A+
List the antibodies present in the plasma for blood type: B-
Anti-A and Anti-D
List the antibodies present in the plasma for blood type: B+
List the antibodies present in the plasma for blood type: AB-
List the antibodies present in the plasma for blood type: AB+
List the antibodies present in the plasma for blood type: O-
Anti-A, anti-B, Anti-D
List the antibodies present in the plasma for blood type: O+
Anti-A and Anti-B
What blood type can you give a person who is: A-
- A-, O-
- What blood type can you give a person who is: A+
- A+, O+, A-, O-
- What blood type can you give a person who is: B-
- B-, O-
- What blood type can you give a person who is: B+
- B+, O+, B-, O-
- What blood type can you give a person who is: AB-
- A-, B-, AB- O-
What blood type can you give a person who is: AB+
A+, B+, AB+, O+, A-, B-, AB-, O- = All
What blood type can you give a person who is: O-
What blood type can you give a person who is: O+
Define: Antibody-antigen reaction:
An antibody can only bind to the specific antigen which causes its� production. Upon binding it can cause clumping can trigger an immune system to initiate immune response against the antigen
Define: Transfusion Reaction
A transfusion reaction is an adverse reaction to a blood transfusion. It is most often caused by an antibody-antigen reaction between the antigens on red blood cells infuses into a patient and on antibody in the patients plasma
A laboratory test used prior to infusion of RBCs to minimize chance of transfusion reaction. This test will screen the patient�s plasma for antibodies that will react with antigens on the incoming RBCs.
Hemolytic Disease of the Newborn is one of the most common causes of anemia in newborns. It I when hemolysis is occurring in the newborn due to the RH incompatibility between the mother and the child.
What babies would be at risk for HDN?
Rh neg mom, Rh pos baby who is not the first child born unless the mother has had previous blood transfusions with blood that was Rh pos.
What is a preventive measure to protect against HDN?