Chapter 17 BloodQ and A part 2

What is anemia? Give an example and describe it.

• Anemia is a condition that the blood’s ability to carry oxygen is too low to support cellular respiration (metabolism).• It is a symptom or sign of some disorder than a disorder itself.• Anemia sufferers are often pale, short of breath, fatigued, and chilled

• There are three categories of anemia• Blood loss or hemorrhagic anemia-due to injury or bleeding ulcer etc• Not enough RBCs produced• Too many RBCs destroyed

Continued on next slide

Closer look at Two Types of Anemia

Not enough RBCs produced• Iron-deficiency anemia

• Often secondary to blood loss• Also caused by inadequate iron diet

• Pernicious anemia• Autoimmune disease (often of the elderly)

where a substance is created that affects B12 absorption and hinders developing RBCs

• Renal anemia• Caused by a lack of EPO (controls RBC

production)• Usually accompanied by renal disease

• Aplastic anemia• Caused by destruction or inhibition of the red

bone marrow from drugs, cancer, radiation, or viruses—mostly unknown

Too many RBCs destroyed• Also called hemolytic anemias• Thalassemia• Typical in Mediterranean ancestry• RBCs are deficient in hemoglobin

• Sickle-cell anemia• On next slide

26. Describe sickle-cell anemia.• Hemoglobin is adnormal due to a single

change in the 146 amino acid chain• Under low oxygen conditions, the

causing RBCs to become sickle-shaped• Sickle-shaped RBCs rupture easily and

can dam up quickly• Reducing oxygen delivery

• Occurs chiefly in black people from the malaria belt of Africa and descendants• People with one copy of the sickle-cell

anemia gene have a much higher chance of surviving malaria!

27. What is blood doping and why is it an issue?

• Blood doping is artificial polycythemia• Athletes in aerobic activities typically

blood dope• RBCs are stored from an athlete and

body replaces them• RBCs are returned which temporarily

increase oxygen delivery

• Risk of stroke and heart attack, as blood becomes more viscous• Illegal in Olympic Games and deemed

unethical

• Polycythemia – adnormal excess of RBCs and caused blood to be sluggish and flow slowly

• Viscous or viscosity- ability to resist flow• Higher the viscosity, slower the

flow• Think of thick pancake syrup

versus water• The syrup has a higher viscosity

28. What are the only complete cells in the formed element portion of blood?

• Leukocytes, white blood cells, or WBCs are the only complete cells in the formed elements of blood• Complete cells meaning have a nucleus and other organelles to perform normal

cell function and maintenance

29. Describe diapedesis and amoeboid motion in relation to leukocytes.

• Diapedesis is the ability of WBCs to slip out of the capillary blood vessels and travel to areas of inflammatory or immune responses.• WBCs usually travel through loose connective tissues or lymphatic tissues)

• Amoeboid motion describes the way WBCs move through the tissues to the target area• Cells create cytoplasmic extensions or pseudopods (just like the protist called

an amoeba!) that move them along

30. List the classes of leukocytes and describe each.

• Granulocytes – spherically-shaped and short lived• Neutrophils

• Most numerous WBC and larger than RBCs• Have 3 to 6 lobed nuclei and contain visible granules• Destroy bacteria

• Eosinophils• Similar in size of neutrophils• Nuclei had two lobes• Lead attack against parasitic flatworms (tapeworms and flukes), roundworms (pinworms and hookworms)

• Basophils• Rarest WBC• Contain histamine (an inflammatory chemical that causes vasodilation [makes vessels get bigger in diameter] and

attracts other WBCs)

Continued to next slide

30. List the classes of leukocytes and describe each.• Agranulocytes- lack visible cytoplasmic granules

• Lymphocytes – 2nd most numerous and mostly located in the lymphatic tissues• major role in the body’s immunity and includes

• T lymphocytes • B lymphocytes

• Monocytes – largest WBCs• U or kidney-shaped nucleus• Act as macrophages (cells that engulf or “eat” foreign bodies) and are able to leave the blood stream• Major defender against viruses, intracellular bacterial parasites, and chronic infections (i.e. tuberculosis)

Continued next slide

30. List the classes of leukocytes and describe each.Be able to identify the WBCs!

31. What is the difference between T cells and B cells?

T lymphocytes• Function in the immune

response directly against virus-infected cells and tumor cells

B lymphocytes• Creates plasma cells• Plasma cells create antibodies

32. What class acts as a macrophage? When does this occur? What do macrophages do?

• Monocytes act as macrophages• Monocytes’ macrophagic activity begins when there is an infection

from viruses and parasitic bacteria or a chronic infection such as tuberculosis• Macrophages are cells that engulf or “eat” foreign bodies

33. What is the process of white blood cell creation called?• Leukopoiesis is the process of white blood cell (WBC or leukocyte)

production

34. What is leukemia? How does it affect the human body?

• Leukemia is a cancerous condition where the body creates too many abnormal WBCs.• The abnormal WBCs impair normal red bone marrow function• Leukemias are typically named after the WBC that is involved

35. What is “kissing disease” and what does it effect?

• Kissing disease, or infectious mononucleosis is a caused by the Epstein-Barr virus, typically occurring in young adults. It is very contagious.• Causes the body to manufacture an excess of agranulocytes• With no known cure, the infected suffer from being tired and achy,

chronic sore throat, and a low-grade fever

36. Platelets are described as megakaryocytes. What is that?

• Platelets are actually cytoplasmic fragments of much larger cells called megakaryocytes. • Platelets contain multiple chemicals that act in the clotting process

such as serotonin, Ca+ ions, ADP, platelet-derived growth factor (PDGF) and a variety of enzymes

37. What does thrombopoietin do?

• Thrombopoietin is a regulatory hormone that controls the formation of platelets

38. Describe the 3 steps of hemostasis.Hemostasis is the series of processes that stop bleeding when a blood vessel wall breaks• Step 1: Vascular spasm• Caused by

• Direct injury to vascular smooth muscle• Chemicals released by endothelial cells and platelets• Reflexes created by pain receptors

• A vascular spasm is the constriction of smooth muscle in blood vessels, especially arteries, arterioles, and capillaries• Greatly reduces the loss of blood

Continued on next slide

38. Describe the 3 steps of hemostasis.• Step 2: Platelet Plug Formation

• Platelets congregate at site of damage and form a “plug” to further reduce blood loss• Platelets adhere to collagen fibers that are exposed do to the damage

• Platelets do not stick to each other or epithelial linings under normal conditions• Epithelial cells release prostacyclin to keep platelets from sticking

• As platelets form the plug, chemical messengers are released• ADP (adenosine diphosphate) – a potent aggregating agent or causes more platelets to

stick to the platelet plug• Serotonin and thromboxane A2 – chemical messengers that improve vascular spasms and

platelet aggregation

Continued on next slide

38. Describe the 3 steps of hemostasis.• Step 3: Coagulation (blood clotting)• Fibrin threads (a structural protein) act as a “molecular glue” to help platelets

and RBCs adhere to each other and the damaged site to form a clot• Blood in the area of the damage also becomes gel-like due to various clotting

factors or procoagulants which helps RBCs to become part of the clot

39. Describe the intrinsic and extrinsic pathways to prothrombin activator.

• Prothrombin is a chemical vital to blood clot formation• Prothrombin must be activated to perform its job. If it was active all

the time, clots would be forming without need and increases the risk of stroke or heart attack

Continue to next slide to compare the two pathways

39. Describe the intrinsic and extrinsic pathways to prothrombin activator.Intrinsic Pathway• Must have PF3 (platelet factor 3) to

start• Factors for blood clotting are

contained within the blood• Triggered by negatively charged

membranes of platelets or collagen• Acts slowly due to several

intermediate steps

Extrinsic Pathway• Must have PF3 to start• Factors for blood clotting that

are outside of the blood• Exposed blood to tissues

underneath the epithelial tissue to tissue factor (TF)• Acts fast (up to 15 seconds!)

40. What is the key difference between fibrinogen and fibrin?

• Fibrinogen is a soluble (dissolves in water or blood)• Is apart of the blood

• Fibrin is an insoluble protein formed from fibrinogen to form a mesh and glue platelets together• Fibrinogen is transformed into fibrin by thrombin

What controls thrombin from causing fibrin production? Go to next slide!

41. What is the key difference between prothrombin and thrombin?

- Thrombin is created when the prothrombin activator is…well…activated.

- Prothrombin becomes thrombin which turns fibrinogen into fibrin.

What happens to the clots once the blood vessel is being repaired?• Clot retraction takes place• PDGF released by contracting platelets stimulates the vessel cells to

divide and rebuild the vessel wall • Platelet-derived growth factor (PDGF)

• Fibrinolysis is the process of clot removal by mostly the enzyme plasmin• Plasmin is created from plasminogen (notice a naming trend?)

What chemicals limit normal clot growth?• Antithrombin III inactivates thrombin not attached to clot• Heparin is an anticoagulant contained to basophils and surface of

epithelial cells

42. What bleeding disorder results from not having enough platelets?

• The disorder when not enough platelets are in the blood is called hrombocytopenia

43. What are the 2 human blood groups and describe them.

ABO Blood Groups• Based on the presence of two

agglutinogens A and B• Agglutinogen promotes

agglutination or clumping together

• A person could have A, B, AB, or neither of the agglutinogens

Rh Blood Groups• Rh agglutinogens or Rh factors• C, D, and E are most common of

the 52 named Rh factors

• 85% of Americans are Rh+

When reporting someone’s blood type, ABO Blood Group and Rh Blood group is reported together!

44. What is a universal donor and why are they important?

• When blood is removed from one person and given to another, it is called a blood transfusion

• Both blood groups of the both patients must be considered, because if mismatched, the blood receiver will reject the donated blood and the donated blood will clump and RBCs will burst (agglutinate and hemolysis)• A universal donor is blood type O (ABO blood group)

• Rh factors do not typically play an immediate role in mismatched blood• Antibodies are formed much later and typically only affect the patient if another

transfusion of mismatched blood occurs

45. What is blood typing and why is it important?

• This question relates to the information in the previous question. Blood typing is the determination of blood groups for both the donor and the recipient.

• Due to the threatening results of mismatched blood, cross matching tests are also performed before a transfusion• Blood serum from the donor and recipient is mixed together to see if agglutination

(clumping together) occurs

• Blood serum is blood plasma with the prothrombin and fibrinogen is removed (remember these are precursors to clotting!)

46. How does one restore blood volume?• If a patient’s blood volume is critically low and there may be not

enough time for a blood transfusion, doctors need to artificially increase the blood volume.• Typically a saline solution (which basically is what all the blood

elements are suspended in) is given intravenously • A saline solution that mimics the electrolyte composition of plasma is

preferred (known as Ringer’s solution)

47. Name and describe 3 blood tests.• Differential white blood cell count determines the relative proportions of individual

leukocyte types• Powerful tool that can help doctors pinpoint the cause of infections

• Example is a high eosinophil count could be due to a flatworm or roundworm infection

• Prothombin time test measures how long it takes blood to clot• Platelet count test is used when thrombocytopenia (deficient platelet numbers in the

blood) is suspended• SMAC determines the blood chemistry of the patients blood such as electrolytes, glucose,

and markers of kidney and liver disorders• Complete blood count (CBC) determines the counts of different types of formed elements,

the hematocrit, measurements of the hemoglobin content, and size or RBCs.

• SMAC and CBC tests are typically performed together to gain a comprehensive understanding of the patient’s overall health in relation to the blood

48. What condition is a normal homeostatic response to an infection in the body?• Leukocytosis, or a WBC count of over 11,000 cells per microliter, is a

normal homeostatic response to infection in the body

49. What are the most numerous WBCs?• Neutrophils are the most numerous WBC.

50. What is the rarest WBC?

• Basophils are the rarest of the WBCs.