,10/30/24, 7:05 PM NURS 8022 EXAM 2 LATEST 2024 ACTUAL 161 EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONAL…
(1) conversion of yellow bone marrow, which does not
produce blood cells, to hematopoietic red marrow by
the actions of erythropoietin (a hormone that
Factors that increase
stimulates erythrocyte production)
hematopoiesis
(2) faster differentiation of progenitor cells
(3) faster proliferation of stem cells into progenitor
cells
Erythropoiesis production of RBCs
Pluripotent hematopoietic stem cell --> committed
Proerythroblast/Pronormoblast -->
Erythroblast/Normoblast (Hgb synthesis begins) -->
Reticulocyte (nucleus is lost; 3 days spent in bone
Sequence of marrow, about 1 day in blood) --> Erythrocyte
erythropoiesis
* aprox. 1% of RBCs are reticulocytes *
In each step the quantity of hemoglobin increases
and the nucleus decreases in size
A hormone produced and released by the kidney that
stimulates the production of red blood cells by the
bone marrow
Always present in plasma
Erythropoietin
Released in response to low renal oxygenation
- NOT the # of RBCs but rather oxygen delivery
- e RBC production increases within 24 hours; life
span 4-12 hours; increased RBC # in 5 days
- Given to dialysis and chemo patients
,10/30/24, 7:05 PM NURS 8022 EXAM 2 LATEST 2024 ACTUAL 161 EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONAL…
▪ Last immature form of erythroblast
▪ Contains polyribosomes (globin synthesis) and
mitochondria (heme synthesis)
▪ 24-48 hours after leaving bone marrow for
circulation, matures into erythrocyte
- Loses polyribosomes and mitochondria
Reticulocytes
-Make up 1-2% of RBCs
- Last about 2 days in bone marrow and 1 day in blood
continuing to mature
- During time of low HCT time in marrow decreased to
as little as 1 day
▪ Reticulocyte count -- Indicates whether new RBCs
are being produced; good indicator of erythropoiesis
Renal oxygenation
negative feedback loop
Oxygen-carrying protein of the erythrocyte --> may
carry up to 300 hgb molecules
Reversible deformity to be abvle to squeeze through
the tiniest of capillaries
Hemoglobin and its
structure Each Hgb molecule has 2 pairs of different globin
chains and 4 complexes of iron + heme
▪ Heme: large, flat, iron-protoporphyrin disk that is
synthesized in the mitochondria and can carry one
molecule of oxygen
▪ Each Hgb can carry 4 molecules of oxygen
, 10/30/24, 7:05 PM NURS 8022 EXAM 2 LATEST 2024 ACTUAL 161 EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONAL…
Heme: Synthesized in mitochondria of reticulocyte
- Carries Oxygen
Globin: Polyribosomes in reticulocytes
Heme vs Globin
- 2 pairs of globin chains on each Hgb molecule
- Combo of pair determines type of globin chain
▪ Most common hgb A: 2 alpha chains and 2 beta
chains - hgb F (fetal): 2 alpha, 2 gamma
Sac of Hgb, no nucleus or mitochondria, only
hemoglobin & enzymes surrounded by membrane
-Lack mitochondria, rely on glycolysis for energy -->
"aerobic metabolism"
Red blood cell structure
▪ Deficiencies of 2 enzymes result in anemia
• Pyruvate kinase - necessary for glycolysis - no
glycolysis results in RBC damage and death
• G6PD - involved in protecting the RBC against
oxidative stress
Anisocytosis Variation in RBC size
Poikilocytosis Variation in RBC shape
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