Erythropoiesis- RBCs Part 1

HbF has an oxygen affinity that is __1st__ that of HbA. In the absence of any globin chains, heme's affinity for oxygen would be excessively__2nd__.

1st) HIGHER THAN

2nd) HIGH

The cellular role of vitamins is to _____

act as coenzymes

Which one of the following statements about the reticulocyte is FALSE?

It is never found in circulation

The hematocrit is expressed as the ratio of

volume of packed red blood cells / volume of whole blood

The hemocytoblast is considered the stem cell to all future blood cells. Substances, known as _____, are responsible for directing populations of cells down the various cell lines.

Differentiation inducers

Erythropoiesis in the older, normal adult (over 40 yrs) occurs mainly in _____.

the axial skeleton

The site of erythropoiesis changes during development. Embryonic synthesis occurs predominantly in the __1st__ and gradually shifts to the __2nd___ in the fetus.

1st) yolk sac

2nd) spleen and liver

Which one of the following IS NOT a role of the macrophage?

Conjugate bilirubin.

The liver plays several vital roles. Which of the following is not a function of hepatocytes?

Manufacture antibodies

The form of intracellular iron that is less soluble and prone to form visible crystals in iron overload.

Hemosiderin

Is the plasma protein carrier for iron

Transferrin

A hepatocyte intracellular protein that is bound to iron and is part of the normal "blood iron buffer"

Ferritin

Iron in the +3 state

Ferric

Hgb with iron in the +3 state

Methemoglobin

Iron in the +2 state

Ferrous

An increase in hemolytic rate will eventually result in

Increased plasma EPO levels

Liver disease, such as hepatitis, may result in elevated levels of circulating _________ bilirubin.

Unconjugated

Gallstones and blocked biliary secretion may result in elevated levels of circulating ______ bilirubin.

Conjugated

Blood viscosity, or "thickness" of blood, is mainly a function of

RBC count

An erythrocyte's biconcave shape is an advantage over a spherical shape because this gives the cell a(n) __1st_ surface to volume ratio, __2nd___ gas exchange.

1st) INCREASED

2nd) ENHANCING

More than one selection may be correct. Select all correct choices. Even though a mature erythrocyte does not have a nucleus, its cytoplasmic enzymes keep that cell viable for its limited lifespan. These enzymes are responsible for

- maintaining the flexibility of the membrane

- allowing the cell to carry out membrane transport

- keeping the iron in hemoglobin in the correct redox state

In the embryo, Hb formed is composed of the following chains:

𝛼

2

𝜀

2

The hemocytoblast is considered the stem cell to all future blood cells. Substances, known as ____1st____, are responsible for directing populations of cells down the various cell lines. The hemocytoblast is considered to be _____2nd_____.

1st) Differentiation inducer

2nd) determined

The site of erythropoiesis changes during development. Fetal synthesis occurs predominantly in the __1st__ and gradually shifts to the __2nd___ in the newborn.

1st) Spleen and liver

2nd) bone marrow

You have just given a blood donation. We would expect to see an _____1st_____ in erythropoietin and an increase in red blood cells in the blood within _____2nd______days.

1st) INCREASE

2nd) 5-7 days

A patient comes to her physician because she notices her stool has lost its brown appearance and now looks white. Her skin and sclera have a yellow color. Her blood is drawn and sent to the lab for analysis.

1) What predictions could we make about her blood values (1st response)?

2nd) and what could be the problem (second response)?

1st) The patient's conjugated bilirubin will be high

2nd) bile duct obstruction

Cooley's Anemia

Thalassemia

Megaloblastosis

Pernicious/megalobastic anemia

Gastric atrophy

Pernicious/megalobastic anemia

Erythropoietic failure

Aplastic anemia

Hereditary, genetic defect, valine

Sickle cell anemia

Hereditary, genetic defect, failure to make one type of globin chain

Thalassemia

Which of the following statements is true?

Persons with sickle cell trait are resistant to malaria.

The event that triggers erythrocyte sickling in HbS is

Low oxygen pressure at the erythrocyte

Thymidine is important for synthesis of __1st___. In the case of developing cells, a lack of this can limit the rate of __2nd__.

1st) DNA

2nd) cell division

"Anisocytotic, hypochromic, microcytic" are words that might characterize erythrocytes in this disease:

Iron deficiency anemia

A person climbs to high altitude. There, the concentration of gases in the air is _1st__ than normal. This means that after several weeks, this person will have __2nd__.

1st) Lower

2nd) polycythemia

Methemoglobin is a form of Hb that lacks iron, and is due to an iron deficiency.

False

True or false. Sickle cell disease is a hereditary disease and its effects can be observed in the fetus carrying these genes. This disease may even affect fetal development and the viability of the pregnancy (ie. failure of the fetus to come to full term.)

FALSE

Sickle cell "disease" is indicative of a patient who is __1st___ for the defect. This patient __2nd____.

1st) homozygous

2nd) will most likely suffer from a sickling "crisis" during his lifetime

A 62-year-old female arrives for her annual physical. She complains of itching in her hands along with headaches and vertigo. A routine complete blood count reveals a RBC of 8.2 million cells/

𝜇

l. Her erythropoietin levels are lower than normal. The primary diagnosis would be:

polycythemia vera (Primary polycythemia)

__1st__ cells make a product required in the absorption of Vitamin B12. The vitamin is absorbed into the bloodstream across the lining of the __2nd__.

1st) Parietal

2nd) IIeum

A patient, vacationing in the mountains (at a high elevation), is being seen by a physician. Among his blood lab results is the finding that his HCT and EPO are markedly elevated. The physician should:

see this as secondary polycythemia and do nothing to treat his condition.

A patient presents with all the symptoms of polycythemia. One way to determine if the cause is primary or secondary is to check for:

The patient's EPO levels

polcythemia vera

Hematocrit: 60+

EPO: 1-5

Answer: B

aplastic anemia

Hematocrit: 40+

EPO: 500

Answer: D

end-stage renal disease

Hematocrit: 40

EPO: 1-5

Answer: A

If there is NOT any erythropoietin present, a patient would ultimately become ________.

Anemic

The form of intracellular iron that is less soluble and prone to form visible crystals in iron overload

Hemosiderin

The preferred way to store intracellular iron

Ferritin

The kind of bilirubin that would increase in premature babies due to an immature liver.

Unconjugated bilirubin

A blockage in the common bile duct would lead to increased amounts of this bilirubin.

Conjugated bilirubin

If you have a reduced oxygen carrying capacity, you would be _________.

Anemic

This disorder can result from a slow-growing cancer of the bone marrow producing ↑HCT, ↑# RBCs, ↑# WBCs, ↑# platelets.

Polycythemia vera

A hereditary disorder that generates microcytic, hypochromic red blood cells.

Thalassemia

This disorder can arise from bone marrow destruction and is characterized by ↓HCT, ↓# RBCs, ↓# WBCs, ↓# platelets.

Aplastic anemia

This type of anemia can result from chronic blood loss.

Iron-deficiency anemia

The red blood cells shrink over time due to loss of the red blood cell membrane.

Hereditary spherocytosis

This type of anemia can occur due to a blood transfusion of mismatched blood.

Acquired hemolytic anemia

Kidney disease leads to ↓EPO, producing ↓# RBCs but normal # WBCs and normal # platelets.

Aplastic anemia

A person with this would have a hard time maintaining iron in a reduced state and should avoid fava beans.

G6PD deficiency

A form of this anemia results in nonviable pregnancies because all four of the Hb α-subunit gene copies are nonfunctional.

Thalassemia

↑HCT due to dehydration.

Thalassemia

A mutation resulting in a valine amino acid substituted for glutamic acid.

Sickle Cell Anemia

Ascending to high altitudes produces an adaptive ↑EPO and ↑HCT.

2° polycythemia

Venom from the Southern Pacific Rattlesnake can produce this type of anemia.

Acquired hemolytic anemia

Gastric atrophy resulting in less intrinsic factor (IF) would produce this type of anemia.

Megaloblastic Anemia

A form of anemia that results in normochromic cells with ↓MCV and ↑ MCHC.

Hereditary spherocytosis

This type of anemia produces microcytic, hypochromic RBCs and is associated with symptoms like sore throat and pica.

Iron-deficiency anemia

This type of anemia is associated with crises that cause ischemia, pain, and potentially tissue necrosis due to hypoxic conditions that may arise while sleeping, exercising, or experiencing an infection.

Sickle Cell Anemia

Alcoholism and liver cirrhosis can produce this type of anemia.

Megaloblastic Anemia

Use of antimalarial medications is contraindicated in patients with this type of anemia.

G6PD deficiency

Respiratory or cardiac disorders lead to ↑EPO and ↑HCT.

2° polycythemia