Physio 2 - Hemo 1

drraythe's version from 2015-06-09 01:27

Blood overview

Question Answer
what type of tissue is blood?fluid connective tissue
3 functions of blood? transportation, regulation, protection
what is hematocrit? PCV? average number for this? hematocrit = PCV, packed cell volume, %total vol of blood that is RBC's, **40%
Plasma protein average amount? main purpose of plasma proteins (4)? derived from? 7g/dl (deciliter) or 7g/100mL, to maintain oncotic pressure, transport, defense, and blood clotting. Made in liver.
what is an absolute increase in plasma proteins? when does this happen?it is when PCV is normal and PP are increased. This happens when globulins and fibrinogen (acute phase proteins) increase in inflammations...also if RBCs are lysed but in sample, Hb will be counted (it is a protein) and it will be high
what is a relative increase in plasma proteins? when does this happen? it is when PCV AND PP increase. This happens in dehydration/ haemo-concentration
when can plasma proteins decrease?end stage liver disease, or after blood loss, sighthounds are natrually low
where do all formed blood elements originate from? pluripotent stem cells, which then divide into lymphoid stem cells (for B+T lymphocytes) and myeloid stem cells (for RBC, platelet, monocytes, granulocytes)
where does hemopoiesis occur? what is it controlled by?it occurs in //red// bone marrow and //lymphoid tissue.// it is controlled by erythropoietin, thrombopoietin, cytokines, interleukins, and CSF's (colony stimulating factors)
where is the MAJOR site of erythropoiesis in adults? If challenged, who can contribute?FLAT bones (sternum, ribs, pelvis). If challenged, liver and spleen can contribute.
what is the TBV (total blood volume) of adults as a rule of thumb? 6-8% body weight
what animals have a lower than average TBV (total blood volume), which are higher?lower = cats (5%). higher = dogs (9%), warm-blooded horses (9%) birds (10%)
how much blood can be safely withdrawn from a patient? A healthy donor?patient = 1%, donor = 2% of body weight
rule of thumb for fluid replacement therapy for very dehydrated patients? for maintenance? can be given up to the equivalent of their total body volume (7%) in 1 hour (with crystalloids)....maintenance is their TBV over 24 hours
after 1 hour of fluid replacement therapy, what happens?75% of infused fluid moves from vascular system into tissues, so ECF and ICF are BOTH rehydrated

The Erythron

Question Answer
two main functions of RBCs (erythrocytes) exchange of gases and regulation of blood pH
what is an erythron?all erythroid cells = RBC's /and/ PRECURSORS
average size of RBC? average concentration?size = 4-8micrometers, concentration = 5-10 million/microliter
average hemoglobin content in a RBC?33%
metabolism of a RBC? makes them dependent on ___? anaerobic glycolysis, so glucose dependant
RBCs in reptiles/amphibians/birds?larger, HAVE nucleus (non-functional), oval
unique attribute of RBCs in fish? produced where in bony fish? cartilaginous fish?nucleated. bony fish = made in spleen and liver. cartilaginous fish = made in circulation
what is unique about the Antarctic icefishno RBCs, just circulating hemoglobin
what is a right-shift for oxygen binding hemoglobin?it means there is a decreased affinity of hemoglobin for oxygen, you would need a higher concentration to bind (this oxygen binding chart can go right down to hell)
what is a left-shift for oxygen binding hemoglobin?it means there is an increased affinity of hemoglobin for oxygen, you would need a smaller concentration for binding to occur
how does temperature/pH/carbon monoxide/met-Hb affect the oxygen binding curve?(1) temperature: increase= right shift= lower affinity. (2) pH: increase (more basic) = left shift = higher affinity. (3) CO: increase = right shift = lower affinity for O2. (4) methemoglobin: increase = left shift = higher affinity (wont let O2 go into tissue)
how much of CO2 (%) binds to globin portions?23%
CO2, bicarbonate, and buffering. what is the enzyme needed, what is the equation?carbonic anhydrase converts this equation faster: CO2 + H2O -> HCO3- + H+
CO2, bicarbonate, and buffering. how is it different in tissues vs. lungs?TISSUE = CO2 into RBC and HCO3- into plasma (H+ binds to globin). LUNG = HCO3- into RBC, CO2 expired
average survival time of a RBC? (cat/pig is what? bird is what?)average = 4-5months. cat/pig = 2 months. bird = 5 weeks.
how many RBCs die and are removed each day? what does the RBC production equal?1% removed and replaced. PRODUCTION = REMOVAL
how are aged RBCs removed from the body?rupture though narrow traberculae of spleen and absorbed by macrophages, or selectively removed by macrophages in spleen/liver/bone marrow (mononuclear-phagocytic system)
what parts of RBCs are recycled after it's removed? (3)(1) globin = amino acids released to blood and used elsewhere for protein synthesis. (2) protoporphyrin = (the heme after removal of Fe) converted to bilirubin to be put into circulation and bile. (3) Fe (iron) [see other flashcard]
how is Fe (iron) recycled after RBC is destroyed? Fe removed from heme, released into circulation. binds to plasma protein to form TRANSFERRIN [transport form]. Transferrin binds strongly with erythroblastic receptors and Fe is released into blast cells to make more Hb. //OR// transferrin releases Fe into any other tissue (intraperitoneal, esp. liver) and then Fe binds to intracellular protein to form FERRITIN (storage form) to be released from storage when needed. *If excess Fe? [see other flash card]
transport form of iron? storage form of iron? surplus form of iron?xport = transferrin. store = ferritin. surplus = hemosiderin
If Fe stores are full, what happens to free Fe?if ferritin stores are full, excess iron is stored in nearly insoluable HEMOSIDERIN (liver, pancreas, heart) and can lead to toxic damage (hemosiderosis/ iron-storage-disease)
What is erythropoiesis controlled by?**TISSUE OXYGENATION!
pathway to prompt erythropoiesis?withdrawl of RBC -> HYPOXIA -> renal tubular receptors ->erythropoietin (EPO) release -> bone marrow -> stim. erythropoiesis -> new RBCs
what happens after EPO (erythropoietin) stims. myeloid stem cells? (path of cell differentiation)myeloid -> CFU-ery (colony forming unit-erythrocyte) -> rubriblast -> reticulocytes -> erythrocyte
how long does it take to go from stem cell to reticulocyte? why ask for reticulocyte?4-5 days. reticulocytes are what are released into circulation and mature in 1-2 days to RBCs
differene between reticulocyte and RBC?retic. bigger, can still synth Hb and still has RNA material.
normal reticulocyte blood count? (%)**1-2%
erythropoiesis differentiation includes the cells properities changing how? when does division stop?getting smaller, Hb content increases, nucleus condenses. division stops when critical Hb levels are reached
exceptions to normal reticulocyte blood count are...? (under physiological conditions)HORSES and RUMNANTS only release MATURE RBCs. No circulating reticulocytes.
erythropoiesis requires adequate supplies of...?iron, folic acid, and vitamin B (2,6,12)
if EPO is strongly stimulated, what three things happen?(1) more CFU-E (colony forming unit-erythrocyte) are committed, mitotic rates increase, less mature cells are released
increase of reticulocytes in blood is called? (example of % in dogs to quality for this label?)reticulocytosis. 25% in dogs.
apprx. how long for full replacement of RBCs after single challange?14 days
in an extreme loss of blood, what can be released into blood? how does it change appearance of HCT? why is this done?metarubricytes, rubricytes, and rubriblasts released. this means you see nucleated RBCs and buffy coat turns pink. This is done b/c immature cells can still contribute to O2 carrying capacity
do horses or ruminants show reticulocytosis?horses = no. ruminants = mild response.
aggregate retis = ? punctate retis = ?ways to differentiate to count reticulocytes. AGGREGATE = nuclear material still in clump = counted. PUNCTATE = diffuse nuclear material = not counted.
2 types of rubricytes in reptilian blood?binucleate and mitotic **remember, reptilian RBCs have rubricytes have less defined looking nucleus.
3 measurements for PRIMARY RBC values are...?(1) hematocrit (Hct) (2) RBC count (3) hemoglobin content
hematocrit...unit? SI unit?in % of whole blood after centrifugation. SI= L RBC / L blood
RBC count? how performed, unit, SI unit?count in a counting chamber or automatic counter. unit = in millions RBCs / microliter blood performed. SI = trillion / L blood.
hemoglobin content. how performed? unit? (average?) SI unit?performed colorimetircally. unit = g/dl blood. average = (10-15gHb/dl----or 12-15?). SI unit = g/L blood
what happens if one of the primary RBC values changes?the others tend to change with it in the same way.
how does one evaluate RBC morphology and reticulocyte count?a blood smear evals morphology (shape, staining, size, presence of erythroblasts) and a blood smear allows % reticulocytes present after special staining process
what are the three RBC PARAMETERS (INDICES)? MCV (mean corpuscular volume), MCHC (mean corpuscular hemoglobin concentration), MCH (mean corpuscular hemoglobin)
how are the RBC parameters/indices calculated? why are they important? calculated from the 3 primary values (Hct + RBC count + Hb content). important for description and diagnosis of anemias.
MCV means? Unit? words for description of results?mean corpuscular volume (volume of one erythrocyte) in FEMTOLITER. descriptors: normocytic (normal). microcytic (smaller than normal.) macrocytic (larger than normal)
what would cause a microcytic RBC? a macrocytic RBC? MICROCYTIC= iron deficiency (cells divide more than normal because they don't reach their Hb saturation). MACROCYTIC= immature RBCs (cells haven't expelled all organelles yet)
MCHC means? Unit? words for description of results?mean corpuscular hemoglobin concentration (the Hb content in a deciliter of RBCs) in %. Results can be normochromic, hypochromic, and hyperchromic
what is normochromic? Hb%?(for MCHC measurement) normal conc. of Hb in RBCs....33%
what is hypochromic? examples of why?(for MCHC measurement) low conc. of Hb. ex: iron deficiency, immature RBCs
what is hyperchromic? why would this happen?(for MCHC measurement) beyond satruation point of Hb. artifact due to hemolytic sample (lysed RBCs)
MCH means? Unit? Note about MCH? words for description of results?mean corpuscular hemoglobin-- Hb content of 1 RBC. (picogram). NOT used often because inaccurate measurement. eval is normochromic, hypochromic, and hyperchromic
Definition of anemia?**deficiency in oxygen carrying capacity
3 types of classifications of anemia?1) according to cause. 2) according to marrow response. 3) according to RBC parameters
anemia classified according to causes (3)1) haemorrhagic 2) haemolytic 3) dyshemopoietic
anemia classified according to bone marrow response (2)1) regenerative 2) non-regenerative
anemia classified according to RBC parameters (2)1) RBC size 2) Hb content
hemorrhagic anemia. 3 words to describe it?hemorrhagic, macrocytic-hypochromic, regenerative anemia
what does dyshemopoeisis mean?malformation of blood
when is fluid replaced in anemia?1-3 days
when are plasma proteins replaced in anemia? within 1 week (7 days)
when does full RBC replacement happen after a challenge?apprx. 2 weeks (14 days)
how long before seeing signs of regeneration in anemia? what do you see? 3-5 days. Will see reticulocytes, nucleated RBCs, RBCs will be macrocytic and hypochromic
examples of what might cause hemolytic disorders? blood parasites, toxins, immune mediated (IMHA), inherent defects (eg sickle cell anemia)
4 types of dyshemopoietic anemias? (1) nutritional deficiencies (2)**anemia of chronic (INFLAMMATORY) disorders (ACD/AID) (3) chronic renal diseases (4) drug-related suppression
nutritional deficiency anemia: (e.g.)? typically described as? Starts as what and turns to what?(eg) lack of iron -> cells cant produce enough Hb -> keep dividing -> overall RBC production decreases. Typically microcytic/hypochromic. **starts regenerative, but quickly turns to non-regenerative
ACD/AID (anemia of chronic inflammatory disorders). described as? causes and results?**typically normocytic/normochromic. chronic diseases and infections (FeLV, ehrlichia, cancer, necrosis, sepsis) lead to release of TOXINS/CYTOKINES/TUMOR NECROSIS FACTOR. this suppresses EPO-> fewer but normal RBCs. this increases iron sequestration in macrophages (hepcidin)-> shortens RBC lifespan
anemia of chronic renal diseases: causes? described as? causes lack of EPO. normocytic/normochromic
anemia of drug/chemical-related suppression. possible cause? described as?estrogen can suppress EPO. normocytic normochromic.
what anemias can become non-regenerative when initially regenerative? hemorrhagic, hemolytic, and nutritional anemias can all be chronic, which leads to a exhaustion of iron stores after long stimulation, which cause them to eventually be non-regenerative.
what chemical don't platelets have?cytokines
unique about blood in ferrets?no blood typing
what animal has natural immunity?cats
thrombocyte lifespan/halflife8-12 days/10days
heparin works by..?promoting antithrombin III