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 Answered questions on blood physiology by Dr Khaled A Abulfadle

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مُساهمةموضوع: Answered questions on blood physiology by Dr Khaled A Abulfadle   Answered questions on blood physiology by Dr Khaled A Abulfadle Emptyالثلاثاء يناير 24, 2012 8:49 am

SEQs


Normal PH of the blood is ……………………

General blood functions include ………………………….

Homeostatic functions of blood include…………………..

Functions of RBCs include…………………

Blood group O (+ve) means …………………

Blood group AB is a universal recipient due to…………………

Functions of ABO system include ………………….

Importance of Rh system include …………………

Erythroblastosis fetalis is ………………

Steps of phagocytosis …………….

Eosinophilia occurs in ………………

Monocyte-macrophage system ……………………

Functions of lymphocytes include ……………

Types of T-lymphocytes include ………………….

Define plasma, serum, homeostasis, hemostasis and thrombosis?

Local vascular spasm after vascular injury is caused by…………………… and it is of value in ……………………….

Platelet contents include ……………………….

Platelet functions include ………………………………..

Interactions between intrinsic and extrinsic cascades of blood clotting ……………….

Clot retraction …………………………….

Fibrinolytic system ………………………..

Role of calcium in hemostasis ……………………………

Factors prevent intravascular clotting normally include ………………….



===============================================
MCQs


1- Erythrocyte is another name for …………….
a-white blood cells.
b-platelets.
c-monocytes.
d-red blood corpuscles.
e-macrophages.


2- Which of the following blood components provide the major defense for our bodies against invading bacteria and viruses?
a-white blood cells.
b-platelets.
c-target cells.
d-red blood corpuscles.
e-reticulocytes.


3- Most of the volume of normal human blood is composed of…………..
a-white blood cells.
b-platelets.
c-plasma.
d-red blood corpuscles.
e-reticulocytes.


4- Stoppage of bleeding is called……………
a- clumping.
b- vascular spasm.
c- thrombosis.
d- coagulation.
e- hemostasis.


5-Which statement concerning blood viscosity is incorrect?
a. The viscosity of blood is 4.5 to 5.5 higher than the viscosity of water.
b. Blood viscosity is due to the presence of the plasma proteins and erythrocytes.
c. The higher the blood viscosity the harder the heart has to work to move blood through the vessels.
d. Anemia increases blood viscosity.
e. Increase erythrocyte count increases blood viscosity.


6-Differences between plasma and serum include …………
a. plasma contains hemoglobin; serum does not.
b. serum is yellow; plasma has no color.
c. serum contains antibodies; plasma does not.
d. plasma contains clotting factor IV; serum does not.
e. plasma contains clotting proteins; serum does not


7- The benefit of the biconcave shape of red blood cells is that it……………
a. decreases the distance between the cell membrane and hemoglobin molecules, facilitating oxygen uptake.
b. allows the cells to hold less hemoglobin.
c. gives more room for the nucleus and organelles.
d. decreases surface area of cell membrane.
e. keeps Hb concentrated in center of RBCs.


8- Blood test results for an adult male are returned and the total red blood cell count is 2,500,000 cells per mm3. This person………………
a. has a normal total red blood cell count.
b. has an abnormally low total red blood cell count.
c. has an abnormally high total red blood cell count
d. shows that he has been exercising more than usual or has spent some time at high altitudes.
e. has polycythemia.


9- As red blood cells get older, they……………………..
a. are less likely to become damaged.
b. become more fragile.
c. are less likely to rupture.
d. are less likely to be phagocytized in the liver.
e. are less likely to be destroyed in the spleen.


10- Blood group…………..is considered as a universal donor for blood transfusion.
a-A.
b-B.
c-AB.
d-O.
e-None of the above.


11-ABO antibodies are…………
a-IgA.
b-IgG.
c-IgM.
d-IgE.
e-IgD.


12-An acute infection would show up in a blood count as…………………………
a-leukopenia.
b-too few helper T cells.
c-polycythemia.
d-leukocytosis.
e-thrombocytopenia.


13-Which one of the following indicates a normal white blood cell count?
a- 1 million per mm3.
b- 15,000 per cm3.
c- 10,000 per mm3.
d- 20,000 per mm3.
e- 3,000 per mm3.


14- Which cell is not phagocytic?
a- neutrophil.
b- monocyte.
c- macrophage.
d- eosinophil.
e- basophil.


15- Antibodies are defense substances produced by the ………………… cells.
a- neutrophil.
b- monocyte.
c- B-lymphocyte.
d- eosinophil.
e- basophil.


16- Which of the following initiates the coagulation cascade in vivo?
a- Factor XII.
b- Thrombin.
c- Tissue factor.
d- Factor X.
e- Prekallikrein.


17- What does von Willebrand factor do?
a- Binds platelets to each other.
b- Binds platelets to the subendothelium.
c- Binds platelets to the phospholipid surface.
d- Carries factor VII.
e- Cleaves factor V.


18- Which of the following anti-clotting substances acts on factors V and VIII?
a- Anti-thrombin III.
b- Protein C.
c- Anti-heparin.
d- Plasmin.
e- t-PA.


19- Which of the following is a cofactor?
a- XII.
b- X.
c- VIII.
d- VII.
e- II.


================================================


Answers

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Q: Why in iron deficiency anemia there are heavy mensturation and tachycaria




Answer




Iron deficiency anemia causes hypoxia which may cause heavy menstruation (due to vasodilatation increasing blood loss in menses) and tachycardia due to stimulation of cardiac acceleratory center increasing HR






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Q: In liver cell failure, what is your comment on A/G ratio



Answer




When we are asked about our comment on A/G ratio in any condition, we should comment on:

1-Albumin

2-Globulins

Then, on the ratio as a whole


In such case of liver cell failure:

1-Albumin synthesis is markedly decreased as it is excusively synthesized by the liver

2-Globulins' synthesis is slightly decreased as they are synthesized also by RES , in addition to the liver


Thus, albumin/globulins ratio is decreased (below 1.2) in that condtion of liver failure ; Normal A/G ratio= 1.2-1.7








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Q: Male O married Female B what are the impossible blood groups that their expected children could have?



Answer




Their expected children may be of blood group O or B, but, NEVER to be A or AB


Explanation


Father phenotype is O, thus his blood group genotype is OO ONLY

Mother blood group phenotype is B, thus, his blood group genotype may be BB or BO.


THUS, if OO married BO the possible chilren will be O or B only
Thus, blood groups A or AB are never to be their expected children





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Q: What are the expected genotypes of blood group A+?



Answer:


A person with phenotype A+, his expected genotypes may be AADD, AADd, AODD or AODd


Explanation:


Blood group A+ means phenotype of both ABO and Rh systems of blood grouping.

Thus,

Genotype of A may be AA or AO but, that of + may be DD or Dd

THUS, a person with phenotype A+, his expected genotypes may be AADD, AADd, AODD or AODd




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Q: Why there is microcytic hypochromic anemia in chronic inflammations?
=====


A: In chronic inflammations, there is increased production of hepcidin by the liver. it is an iron regulatory peptide hormone that binds to ferroportin (Fpn) inhibiting release of iron into plasma with subsequent decrease in plasma iron (hypoferremia) which results in iron deficiency anemia (microcytic hypochromic anemia).


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Question:

A 71-year-old man presents with fatigue, diffuse joint pain, decreased appetite, and a weight loss of 5.44 kg over the last 4 months. Laboratory studies reveal the following:
Leukocyte count 29,000/mm3
Hemoglobin 6 gm/dL
Mean corpuscular volume 84 fL
RBCs count 3 million/mm3
Platelets 122,000/mm3

1-Calculate:
a. PCV
b. MCH
2-What is your comment?

===================

Answer


1-
a-MCV=PCV/RBCs count x 10 i.e. 84=PCV/3 x 10
So, PCV=84x 3/10= 25.2% (decreased)
b-MCH=Hb content/RBCs count x 10
=6/3 x 10 = 20 picogram/cell (decreased)

2-Comment:
A case of microcytic hypochromic anemia (e.g. iron deficiency anemia) with decreased RBCs count, Hb content, PCV, MCV and MCH.




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Question
What is the role of platelet in hemostasis?

=============

Answer

Platelets share in all steps of hemostasis i.e.

1-They play a role in local vascular spasm through release of its contents including serotonin, ADP and thromboxane A2

2-Platelet plug formation through adhesion, activation, aggregation and release reaction

3-They share in clot formation through its content of clotting factors and PF3

4-They share in clot retraction

5-They share in healing of vessel wall through its contents of PDGF

6-They share in dissolution of the clot as they share in the fibrinolytic system by its content of profibrinolysin.


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Question

Why Leukemia is accompanied by bleeding tendency and anemia
=========
Answer

Leukemia causes damage to the bone marrow, by the way of displacing the normal bone marrow cells with higher numbers of immature white blood cells, results in a lack of
a-Blood platelets, which are important in the blood clotting process, resulting in bleeding disorders
b-RBCs resulting in anemia


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Q: Discuss briefly clonal selection
==================
A: Clonal selection theory is a scientific theory in immunology that explains the functions of cells (lymphocytes) of the immune system in response to specific antigens invading the body.
The theory states that in a pre-existing group of lymphocytes (specifically B cells), a specific antigen only activates (i.e. selection) its counter-specific cell so that particular cell is induced to multiply (producing its clones) for antibody production. This activation occurs in secondary lymphoid organs such as the Spleen and the Lymph Nodes.









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Question

Mention the Clinical uses of Prothrombin time and partial thromboplastin time

=======
Answer

The prothrombin time (PT)is an assay evaluating the extrinsic pathway of coagulation. it is used to determine the
clotting tendency of blood, in the measure of warfarin dosage, liver damage, and vitamin K status. PT measures factors I (fibrinogen), II (prothrombin), V, VII, and X.
============================
**The activated partial thromboplastin time (aPTT) which measures the intrinsic pathway and common pathway. It is used to monitor the treatment effects with heparin, a widely prescribed drug that reduces blood's tendency to clot
=======================


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Q: Mention factors falsely decrease ESR and mention its mechanism
=====
Answer:

ESR is falsely decreased in some conditions which interfere with rouleaux formation as:
==================
1-Severe Leukocytosis.
2-Polycythemia.
3-Red Blood Cell abnormalities:
=Acanthocytosis
=Poikilocytosis
=Anisocytosis
=Spheocytosis
=Sickle Cell Disease
=Microcytosis (e.g. Iron Deficiency Anemia)
4-Protein abnormalities:
=Hypofibrinogenemia
=Hypogammaglobulinemia
=Macroglobulinemia (e.g. Hyperviscosity Syndrome)



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Question: Why total iron binding capacity is increased in iron deficiency anemia
==========
Answer: Total iron-binding capacity (TIBC) or transferrin iron-binding capacity is a medical laboratory test that measures the blood's capacity to bind iron with transferrin. It is increased with Iron deficiency as the liver produces more transferrin, presumably attempting to maximize use of the little iron that is available.

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Q: Explain why serum hepcidin & ferretin are increased in Inflammation

A: Hepcidin inhibits iron release from macrophages as well as intestinal iron absorption. In inflammatory states, hepcidin production is no longer regulated by iron burden (i.e., if the iron level is low, hepcidin synthesis should be downregulated) but is rather increased through IL-6 stimulation
As inflammation causes hepcidin production to increase, a lot of iron is put into storage and converted to ferritin. Ferritin is usually a good measure of overall iron status, but in the presence of inflammation, it functions as an immune response, not as a marker of iron status


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