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Blood Groups, RBC's Hemostasis
Wacker lecture 1/14/11 Guyton Ch 32, 35-36
122
Physiology
Undergraduate 4
01/17/2011

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Term
agglutinogen
Definition
another name for antigen, present on surface of RBC's
Term
A, B, neither, or both
Definition
types of antigens possible
Term
AA, Ao, BB, Bo, AB, OO
Definition
possible genotypes based on antigens
Term
41%
Definition
prevalence of blood type A in population
Term
9%
Definition
prevalence of B blood type in population
Term
3%
Definition
prevalence of AB blood type
Term
47%
Definition
prevalence of O blood type
Term
agglutinin
Definition
another name for antibodies against the agglutinogens
Term
agglutinin
Definition
antibodies produced against the antigens(agglutinogens) you do not have
Term
A antigens, produce B agglutinins
Definition
if you have blood type A, what type of antigen/agglutinogens and antibodies/agglutinins do you have?
Term
type AB +
Definition
universal reciever
Term
type O -
Definition
universal donor
Term
Rh
Definition
transmembrane proteins that transport CO2 and NH3 across the membrane
Term
C,D,E, c,d,e
Definition
Rh factors (list)
Term
3 (C or c + D or d + E or e)
Definition
each person has one of each of the ___(#) pairs of antigens
Term
D
Definition
most common and most antigenic, means Rh+,
85% whites, >95% blacks/asians
Term
Rh -
Definition
____ people develop anti-Rh agglutinins to Rh + factor
Term
erythroblstosis fetalis
Definition
Rh- mother and Rh+ child (from dad)
condition usually presents more on 2nd or 3rd Rh+ child
mom's agglutinins diffuse through placenta and cause agglutination
Term
bilirubin
Definition
breakdown product of Hemoglobin
Term
hemolysis, anemia, jaundice
Definition
clinical results of erythroblastosis fetalis
Term
erythroblastosis foetalis
Definition
due to mismatched blood (Rh compatibility or A and B mix)
causes agglutination
Term
agglutination
Definition
RBC clumping of donor blood (antigen/antibody response leads to immune response and possible circulatory shock b/c not enough blood flow)
Term
hemolysis
Definition
RBC destruction, causes Hb to be converted to bilirubin  (can lead to anemia b/c not enough O2 transporters)
Term
kidney failure
Definition
results from blocked tubules due to too much Hb breakdown product
Term
kidney failure
Definition
results from blocked tubules due to too much Hb breakdown product
Term
bilirubin
Definition
buildup of this can precipitate in neuronal cells if left long enough causing mental problems
Term
suspension
Definition
blood is a ______ of blood cells and platelets
Term
whole blood
Definition
plasma + blood cells
Term
plasma
Definition
55-60% of blood volume, whole blood - cells
Term
serum
Definition
plasma without clotting factors
Term
blood cells
Definition
Term
92%
Definition
percentage of plasma that is water
Term
7%
Definition
percentage of plasma that is proteins
Term
1%
Definition
percent of plasma that is electrolytes
Term
albumin, fibrinogen, globulins
Definition
3 plasma proteins
Term
albumin
Definition
60% of plasma proteins (most abundant)
binds to fats, steroids, bile salts to make soluble
maintains osmotic pressure
Term
hematocrit (H value)
Definition
percentage of whole blood occupied by cellular elements (women = 40%, men = 45% is normal H value)
Term
7.8 micrometers
Definition
mean diameter of RBC's
Term
carbonic anhydrase
Definition
converts CO2 + H2O to bicarb + H+
Term
yolk sac
Definition
where RBC's produced in first trimester
Term
liver, spleen, lymph node
Definition
where RBC's produced in 2nd trimester
Term
bone marrow of all bones
Definition
where RBC's produced in 3rd trimester - age 5
Term
long bones
Definition
where RBC's produced age 5-20
Term
ribs, sternum, vertebrae
Definition
where RBC's produced from age 20 onward
Term
Tibia, Femur, Rib, Sternum, Vertebra
Definition
order bones stop producing RBC's (vertebrae, Rib, Sternum, Tibia, Femur)
Term
hematopoeisis
Definition
generation of all blood cells
Term
cytokines, TPO (thrombopoeitin, IL(inter leukin), EPO (erythropoeitin
Definition
what tells blood cells to differentiate (chemical)
Term
eosinophils
Definition
release toxins, fight viruses and parasites
Term
eosinophils, basophils, neutrophils
Definition
list the granulocytes
Term
monocytes/macrophages
Definition
list the monocytes
Term
T-cells, and B-cells
Definition
list the lymphocytes
Term
Basophils
Definition
granulocyte important in allergic reactions, release histimine
Term
neutrophils
Definition
release lysosomal enzymes, H2O2(non-specific) digest foreign material or bacteria
Term
monocytes
Definition
phagocytosis-engulf foreign particles and present antigens on surface for other white blood cells
Term
T-cells
Definition
do cell mediated immunity, cytotoxic and killer varieties
Term
B-cells
Definition
make plasma cells which make antibodies
Term
platelets
Definition
fragments from megakaryocytes
Term
no nucleus, has ER and golgi*to synth protein), can have mito, actin and myosin
Definition
organelles platelets have
Term
platelets
Definition
release and attract clotting factors (lot of Ca stored in golgi), surface has glycoproteins
Term
platelets
Definition
release seratonin and thromboxin A-2
Term
nothing ->burst forming unit E, then EPO and IL-3 to make proerythroblasts
Definition
From MEP to make a RBC you need to add
Term
TPO -> colony forming unit-meg, then TPO + IL-3
Definition
From MEP to make a platelet you need to add ... to make a megakaryocyte
Term
CFU
Definition
CFU or BFU? proerythroblast
Term
reticulocyte
Definition
nucleus gone, remnants of organelles. Hb formed, pass into blood by diapedesis(squeeze through capillary pores)
Term
nuc and Hb form, then mito and ribosomes are lost
Definition
which is lost first nucleus or mito and ribosome? in a reticulocyte
Term
low PO2 (hypoxia from elevation or pneumothorax) and erythropoietin (low O2 triggers erythropoietin pdxn in kidneys)
Definition
things that raise RBC pdxn
Term
hemoglobin
Definition
4 subunits/chains, each with own heme group, each heme binds 1 O2 (4 total)favorable to load and unload oxygen
formation begins in proerythroblast stage and continues to reticulocyte stage
Term
men 15.5 g/dL, women 14g
Definition
conc. of Hb in men and women
Term
men 20 ml/dL blood, women 19 mL/dL blood
Definition
conc of O2 men and women
Term
b12 (cobalamin)
Definition
required for thymidine triphosphate production (TPP), and maturation of RBC's
Term
pernicious anemia/megaloblastic anemia
Definition
caused by a failure to absorb B12
Term
intrinsic factors
Definition
things in gut that help absorb B12, can lead to anemia if messed up
Term
iron
Definition
absorbed through intestines, helps with Hb binding, some excreted, some lost with blood lost/menstruation, needed to replace RBCs
Term
anemia
Definition
deficiency of hemoglobin in the blood
Term
blood loss anemia
Definition
type of anemia due to hemorrhage -> shortage of blood cells. even through fluid(plasma) is replaced, it can take weeks to replace RBC's
Term
aplastic anemia
Definition
occurs when bone marrow is destroyed due to radiation or lupus (immune response to bone marrow)
Term
megaloblastic anemia
Definition
due to b12 deficiency, or the inability to absorb b12. cannot make proper shaped RBC's (cells cannot divide fast enough and are too large)
Term
hemolytic anemia
Definition
type of anemia due to erythroblastosis fetalis (Rh factor immune response) or sickle cell
Term
polycisthemia
Definition
increase in RBC's
Term
secondary polycisthemia
Definition
increased production of RBC's due to decrease in pO2, aka physiologic polycysthemia, due to heart failure, high altitude
Term
polycysthemia vera
Definition
genetic cause for increased production of RBC's due to abnormal hemocytoblastic cells (don't stop producing RBC's) get bluish skin b/c Hb isn't saturated
Term
anemia: decreased viscosity, increased blood flow, increased cardiac output to a point (decreased venous return) opposite for polycisthemia
Definition
what happens to viscosity, blood flow, and cardiac output during anemia vs. polycisthemia
Term
hematocrit, fibrinogen, temperature
Definition
factors that affect whole blood viscosity
Term
F= change in pressure ((pi * r^4(/(8 *viscosity * l))
Definition
equation for predicting blood flow
Term
viscosity
Definition
flow depends on ____ of blood
Term
decrease
Definition
increase in viscosity causes a ____ in flow
Term
1) vasoconstriction/platelet aggregation/platelet plug -> blood clot -> fibrous tissue growth to seal hole -> clot retraction
Definition
steps in hemostasis after a cut
Term
platelet activation and aggregation
Definition
damage to vessel-damage endothelium and collagen exposed (what step of coagulation/clotting?)
Term
glycoproteins
Definition
what recognizes vascular damage and causes platelets to stick to damaged area?
Term
seratonin, thromboxane A-2, clotting factors (fibrinogen and factor V)
Definition
what platelets release
Term
vasoconstriction, platelet aggregation, initiate clotting
Definition
platelet products cause what 3 things?
Term
XII (12)
Definition
damage inside the vessel (intrinsic) causes this clotting factor to contact the abnormal surface
Term
blood trauma or contact with collagen
Definition
intrinsic pathway is initiated by this
Term
major damage to endothelial cells
Definition
initiates extrinsic pathway
Term
tissue factor (bound to fibroblasts and leukocytes) aka factor III
Definition
what is TF
Term
factors 10, 5, Ca++, phospholipids
Definition
what does the prothrombin activator complex consist of?
Term
thrombin
Definition
causes proteolysis of fibrinogen to fibrin
Term
thrombin
Definition
helps stabilize fibrin mesh via activation of factor XIII
Term
thrombin
Definition
catalyzes activation of cofactors V and VIII (positive feedback during clotting)
Term
thrombin
Definition
activates platelets via positive feedback
Term
factor X
Definition
Stuart-Prower factor: activates factor II, forms prothrombinase complex with factor V
Term
factor XI
Definition
plasma thromboplastin anticedent: activates factor IX
Term
factor XII
Definition
Hageman factor: activates factor XI and prekallikrein
Term
factor I
Definition
fibrinogen: forms clot(fibrin)
Term
actin/myosin
Definition
proteins responsible for clot retraction into plug
Term
lay down new CT
Definition
what fibroblasts do to clot
Term
scar tissue
Definition
what CT can form in a clot
Term
seals the membrane
Definition
what collagen does to a clot
Term
tissue plasminogen activator
Definition
to dissolve the clot, injured tissues slowly release what
Term
tissue plasminogen activator
Definition
converts plasminogen to plasmin
Term
plasmin
Definition
the reason (-) feedback isn't necessary for thrombin. this protease digests fibrin and other cofactors
Term
heparin, coumarin, Ca2+ chelators/deionizers
Definition
anticoagulents
Term
heparin
Definition
endogenously produced by mast cells and basophil cells -> prevents blood clot
Term
Coumarin
Definition
competes with vitamin K (used to make prothrombin), can't make clotting factors 7,9,10, K
used to prevent strokes
Term
Ca2+ chelators/deionizers
Definition
inhibit clotting cascade. prevent clotting by binding Ca+ and block intrinsic pathway
Term
Ca++ chelators/deionizers
Definition
silicon, sodium citrate, oxalate (examples of this)
Term
liver disease, vitamin K deficiency, hemophilia A and B
Definition
causes of excess bleeding
Term
VIII
Definition
hemophilia A, X chromosome mutation causing deficient factor _
Term
IX
Definition
hemophilia B,X chromosome mutation causing deficient factor _ , 1 in 10,000 males
Term
liver makes prothrombin, fibrinogen, and clotting factors
Definition
why liver disease causes clotting disorders
Term
need vit K to make stuff, K comes from bac. in gut, need fat to absorb K
Definition
why vit K deficiency causes clotting disorders
Term
thrombus
Definition
abnormal blood clot from high sugar scaring arteries, fatty deposits, or plaques
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