What is the structure of an RBC? - answer✔- two alpha and two beta chains
- each protein chain holds one iron-containing heme group
- oxygen binds to the heme groups
- they are highly deformable (how they get through tight spaces)
What role does the kidneys place in RBC formation? - answer✔Decreased blood oxygen triggers
erythropoiesis
the kindeys secrete erythropoietin--> produce immature RBCs, Reticulocytes, and Mature RBCs
Where is iron absorbed? - answer✔the small intestine--> Duodenum
What is transferrin? How is it composed? - answer✔The iron that is absorbed enters the
circulation, where it immediately combines with a β-globulin, apotransferrin, to form
transferrin, which is then transported in the plasma
What is ferritin? - answer✔iron is stored in the liver and other tissues as ferritin
What percentage of iron is in the blood? - answer✔floating iron consists of 60% of iron stores
What percentage of iron is stored in the liver? - answer✔15-30% of iron is stored in the liver as
ferritin
What is the spleens role in the live cycle of RBCs? - answer✔blood filters through the spleen. As
the RBC ages and cell walls weaken the RBC are destroyed when filtering through.
What happens when the RBCs are destroyed? - answer✔The bulk of the heme unit is converted
to bilirubin, the pigment of bile, which is insoluble in plasma and attaches to plasma proteins
for transport. Bilirubin is removed from the blood by the liver and conjugated with glucuronide
to render it water soluble so that it can be excreted in the bile.
What causes jaundice? - answer✔If the rate of red cell destruction and consequent bilirubin
production exceed the liver's ability to remove it from the blood, unconjugated bilirubin
accumulates in the blood. This results in yellow discoloration of the skin, called jaundice.
Why is vitamin K important? - answer✔Most of the coagulation factors are proteins synthesized
in the liver.
Vitamin K is necessary for the synthesis of factors VII, IX, and X; prothrombin (factor II); and
proteins C and S.
What is warfarin and how does it act? - answer✔Warfarin acts by decreasing prothrombin and
other procoagulation factors. It alters vitamin K in a manner that reduces its ability to
participate in the synthesis of the vitamin K-dependent coagulation factors in the liver.
Warfarin is readily absorbed after oral administration. Its maximum effect takes 36 to 72 hours
because of the varying half-lives of different clotting factors that remain in the circulation.
it is an anticoagulant drug
what type of anemia is sickle cell? - answer✔hemolytic anemia
What subsection of anemia is sickle cell? - answer✔hemogloinpathies subjection of hemolytic
anemia types
What are the two names classifying the size and color of sickle cell? - answer✔normocytic, and
normochromic
What type of mutation is sickle cell? - answer✔point mutation
what factors are associated with sickling? - answer✔cold, stress, physical exertion, infection,
dehydration, illnesses that cause hypoxia/dehydration/or acidosis
What happens when sickled cells block capillaries? - answer✔acute pain (blood vessels get
blocked, and the tissue is not getting oxygen), infarctions (cause chronic damage to liver, speen,
heart, kidneys, eyes, bones), pumonary infarction (acute chest syndrome where areas in the
lungs get damaged), cerebral infarction (stroke)
What are some characteristics of sickle cell anemia? - answer✔- RBC start to clump together
- sickled cells more likely to be destroyed and result in a increase in jaundice and pigment
gallstones
- HBS
- inherited
- spleen is susceptible to damage by HbS
Alpha Thalassemia - answer✔- alpha chain is broken, end up producing a lot of beta
- Asian population
- 1-4 defective genes
- Affects both fetal and adult Hb
- in fetus, gamma Hb may form; in adult, beta Hb may form
- deletoins that remove one or both alpha genes from chromsome 16
Beta thalassemia - answer✔- beta chain is broken, producing a lot of alpha
- defective gene for beta chain synthesis
- over 100 different mutations
- affects only adult Hb
- alpha hb may form
- point mutations in important regions of the beta globin gene on chromosome 11
What are heinz bodies? - answer✔excess α-globin chains form insoluble aggregates (Heinz
bodies) that precipitate within red cells and produce severe membrane damage that causes
extravascular hemolysis
-- accumulation of alpha globulin chains that are unstable, denature and precipitate to form
Heinz bodies
MCV? - answer✔Mean Corpuscular Volume: describes the volume of an average RBC in a
specimen. This is essential in evaluating the cause of a particular anemia
MCV in normal adults is between 80-96 fL
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