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102 Cards in this Set
- Front
- Back
What is the average blood volume of females? males?
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Average total blood volume of females is 4.5-5.5L, for males 5.0-6.0L
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What is hematocrit? What is the "normal" hematocrit value?
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Hematocrit is the ratio of packed red blood cells to total blood volume in a centrifuged sample of blood, expressed as a percentage. A normal hematocrit value is ~45%.
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When blood is centrifuged, which layer contains WBCs? RBCs?
Platelets? albumin and fibrinogen? glucose? Ions? |
WBC's and platelets are both in the "buffy coat".
RBC's are at the bottom and are red in color. Albumin, fibrinogen, glucose and ions are all in the plasma at the top of the tube (generally yellowish in color). |
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What are the major proteins of plasma? Where are albumin and plasminogen synthesized? What are their functions?
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The major plasma proteins are albumin, globulins and fibrinogen. . They are synthesized in the liver. They provide the colloid osmotic pressure in the blood vessels (this helps to bring fluid back into the plasma from the interstitial fluid – we will discuss this later in the class)
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What are the scientific/medical names of red blood cells, white blood cells, and platelets?
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The scientific/medical names of red blood cells are erythrocytes, white blood cells are leucocytes, and platelets are thrombocytes
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From what type of cell do RBCs, WBCs, and platelets originate from? Where is this original type cell found?
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They all originate from pluripotent hematopoietic stem cells found in the bone marrow.
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What is the relative percentage of RBCs to WBCs in whole blood?
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Roughly 5,000,000 RBC to 5,000 WBC's, a ratio of 1000:1, because of differences in size, the percentages (of volume) found in the hematocrit are 45 (RBC): 1 (WBC)
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What is erythropoisis?
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Erythropoiesis refers to the formation of erythrocytes (RBC).
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What controls the rate at which it erythropoisis occurs?
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Erythropoiesis refers to the formation of erythrocytes (RBC). The amount of erythropoietin that
is in the blood stream. |
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What is anemia? How do the following contribute to anemia: B12, kidney disease, iron
deficiency, malaria? |
(These answers are from the lab).
Anemia is a condition in which insufficient oxygen is transported to the body's cells, it is usually associated with an abnormal reduction in the red blood cell count, hemoglobin concentration, or hematocrit, or any combination of these measurements. B12 is necessary for cell division, so without enough B12, new RBC's can't be formed. Kidney disease results in lower and lower concentrations of erythropoietin, until none is made, and so RBC production stops. Iron is an essential element in the heme group that allows the hemoglobin molecule to complex with ("carry") oxygen, so without it, the hemoglobin won't transport oxygen. And malaria is a parasite that infects RBC's , which causes the RBC's to rupture, this and sickle-cell anemia are both forms of hemolytic anemias. NOTE: Aplastic anemias are due to destruction of bone marrow by toxins or radiation or cancer. Hemolytic anemias refer to the rupture of RBC's as in sickle cell anemia or malaria. |
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What is the difference between plasma and serum?
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Plasma is the complete fluid portion of blood. If plasma is allowed to clot, and the clots
centrifuged so that the clot is separated from the remaining fluid, the remaining fluid is called serum. (So serum = plasma - fibrinogen and clotting factors |
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What are the three types of granular leucocytes?
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The three granular leucocytes are neutrophils, eosinophils, and basophils.
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What are the two major types of agranular leucocytes?
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The two types of
agranular leucocytes are monocytes/macrophages and lymphocytes. |
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What are the two types of lymphocytes?
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Lymphocytes are divided
into B-lymphocytes (B-cells), and T-lymphocytes (T-cells) |
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Which cell type is responsible for
producing antibodies? |
The only cells that make antibodies
are B-cells. |
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If, when analyzing a patents hematocrit, >1% of a "buffy coat" is observed - what might this indicate?
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This could indicate that the person has an infection, or leukemia.
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About how many hemoglobin molecules are in a single RBC?
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There are about 280 million hemoglobin molecules in a single RBC.
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What element is essential for transport of oxygen by hemoglobin?
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The element essential for
transport of oxygen is iron. |
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What hormone stimulates RBC maturation?
Where is it produced? |
Erythropoietin stimulates RBC maturation. It is produced in the kidneys
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What is responsible for the ABO blood types?
Why is it important to not transfuse the wrong blood type into a patient? |
The ABO blood type is produced by the presence or absence of specific antigens on the RBC's.
If you transfuse the wrong blood type into a patient, the RBC's will agglutinate (clump together). These cells that are agglutinated can act like a clot and block off blood flow to any areas of the body (including the heart and the brain.) Alternatively, the donors antibodies could attack and destroy any of the patients remaining RBC's |
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What is hemostasis?
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Hemostasis is the process which stops bleeding
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what are Platelets?
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Platelets are fragments of megakaryocytes
which when activated will quickly stick to and "plug" the damaged area of the blood vessel endothelium. |
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What causes platelets to stick to an injured vessel wall, to one another?
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Initially the exposed collagen attracts the platelets and causes them to stick, then the platelets
themselves start releasing ADP, serotonin and thromboxane A2 (TxA2). Serotonin and TxA2 aid in causing vasoconstriction of the local area, and ADP and TxA2 recruit more platelets to form a more contracted/tight plug. |
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What is Collagen?
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Collagen is a protein found in the extracellular matrix, under the endothelial cells
of the blood vessel, which binds the platelets to begin to form the "plug". |
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von Willebrand factor?
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von Willebrand factor
is another protein in the extracellular matrix that helps by binding to both collagen and platelets |
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What causes platelets to stick to an injured vessel wall, to one another
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Initially the exposed collagen attracts the platelets and causes them to stick, then the platelets themselves start releasing ADP, serotonin and thromboxane A2 (TxA2). Serotonin and TxA2 aid in causing vasoconstriction of the local area, and ADP and TxA2 recruit more platelets to
form a more contracted/tight plug. |
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What is fibrin?
What triggers its formation? |
Fibrin is created from conversion of fibrinogen to fibrin and will infiltrate into the platelet plug to create a very firm and stable clot.
Fibrinogen is converted to fibrin by a complex series of "clotting factors" which activate one another until fibrin is formed. |
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What is the advantage of having a multi-step
process (a series of enzymatic reactions) to trigger a response rather than a single-step process? |
Having a multi-step process
is important as it provides a series of check points to assure that the body doesn't just form fibrin in the blood that could clog up the vessels and cause hypoxia and even death |
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What role does Ca++ play in the clotting process, and how do we use this knowledge?
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Ca++ is required
as a cofactor for many of the clotting factors to become active. We can use this knowledge to prevent fibrin formation when it is occurring aberrantly. |
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How is a clot dissolved?
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A clot is dissolved by the formation of plasmin from plasminogen. This is important because when we no longer need the clot, we don't want to release it into the blood stream to clog our vessels
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What are anticoagulants?
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Anticoagulants are molecules that can prevent fibrin formation.
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Which anticoagulants are typically used in blood collection vials?
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Blood collection vials typically
use "sodium citrate" or "EDTA" which are chemicals that chelate or bind the free Ca++ in the plasma. Binding the Ca++ cofactor makes it impossible for the clotting factors to work. |
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Which anticoagulants can be injected into patients and why are they used?
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Two common molecules that are used in patients are heparin and coumarin type drugs (ie, coumadin or warfarin). Heparin inhibits thrombin from working and coumarin type drugs indirectly
reduces the interactions of Ca++ of the clotting factors, which slow down the clotting process. Heparin is often used in IV's to prevent a clot forming in the IV - called a "Hep block". And if a patient is too prone to forming fibrin naturally, they are often put on coumarin type drugs to prevent aberrant clots from forming in their blood. |
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Formed Elements
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Red blood cells, White blood cells, platelets
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Plasma
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Liquid portion of the blood, made up of three types of proteins: albumin, globulin, fibrinogen
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Albumin
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Plasma protein, smallest and most abundant: accounts for 60-80 % of plasma, creates colloid osmotic pressure that draws H2O from interstitial fluid into capillaries to maintain volume and pressure
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Globulin
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Plasma protein, carries lipids throughout the blood stream and to the body (water and lipids don’t mix so very important)
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Fibrinogen
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Plasma protein, serves as a clotting factor and is converted into fibrin that forms an insoluble threadlike molecule that forms a meshwork of a clot during blood coagulation, activated by thrombin
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Fibrin
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Formed from plasma protein fibrinogen (which is activated by thrombin), forms a threadlike molecule that createss a meshwork of a clot known as the “platelet plug”
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Serum
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The fluid left over when blood blots. (Serum=Plasma-fibrinogen)
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Chylomicron
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Transport cholesterol and lipids from intestines to liver and tissues via blood
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LDL
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Low Density Lipoprotein; transport cholesterol and lipids from liver to tissues (too much is bad, b/c if you build up cholesterol and lipids in tissues this leads to plaque build-up)
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Thrombocytes
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Platelets, smallest of formed elements, lack nucleus and mitochondria, fragments of megakaryocytes, constitutes most of mass of blood clots, survive 5-9 days, release serotonin to vasoconstrict and reduce blood flow to clot area
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HDL
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High Density Lipoprotein; transport excess cholesterol from tissues and delivers to liver (healthy, excess cholesterol from tissues is properly disposed of or stored in the liver for future use)
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Granular Leukocytes
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Help detoxify foreign substances and release heparin, include Eosinophils, basophils, neutrophils, have a graney appearance
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Hematopoiesis
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Formation of blood cells from stem cells in bone marrow, makes blood cells, contains two processes for RBC and WBC
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Erythrocytes
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RBCs, flattened biconcave discs that provide increased surface area for diffusion, lack nuclei and mitochondria, contains about 280 million hemoglobin molecules, lifespan ~120 days, old RBS are removed from blood by phagocytic cells in liver, spleen, and bone marrow, use glycolysis to make ATP, constantly being made
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Erythropoiesis
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Formation of RBCs, stimulated by erythropoietin (EPO) from the kidney
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Erythropoietin (EPO)
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Stimulates the production of RBC’s
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Bone Marrow
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Contains stem cells that are used in the formation of blood cells
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Heme Group
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Iron-containing groups bound to each polypeptide chain within a hemoglobin molecule which binds to the oxygen molecules, thus each hemoglobin can carry four oxygen molecules due to the four iron heme groups
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Folic Acid
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Required for adequate DNA replication
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B12
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Required for adequate DNA replication
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TPA (Tissue Plasminogen Activator)
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Given to patients with abnormal clots, dissolves an abnormal clot
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Hemoglobin (Hg)
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Found in red blood cells, consists of 4 globin folded polypeptide change and four iron heme groups used to attach to oxygen, a reddish pigment,
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Bilirubin
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Bile pigment, which is a waste product redrived from the degradation of hemoglobin during the breakdown of old RBCs, accumulation of this causes jaundice of the skin giving it an orangish color
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ABO System
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Major antigen group
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Antigen
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Found in cells, Any substance (as a toxin or enzyme or protein) that stimulates the production of antibodies, present on RBC surface that specifies blood type, triggers a specific immune response against itself when it gains entry into the body
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Antibody
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Found in plasma, An immunoglobulin produced by a specific activated B lymphocyte against a particular antigen, binds with the specific antigen against which it is produces and promotes the antigenic invaders destruction by augmenting nonspecific immune responses already initiated against the antigen,
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Agglutinate
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Clump together, if different blood types are mixed the antibodies will cause mixture and form clumping
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Universal Donor
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Type O, because it lacks A & B antigens, in blood shortage able to give this blood type with only the cells and not the plasma
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Universal Recipient
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Type AB because doesn’t make anti-A or anti-B antibodies so their blood won’t agglutinate
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Rho (D)/ Rh Factor
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Type of antigen found in RBC, Rh+ has Rho(D) antigens and Rh- does not, 85% of population is Rh+, can cause a problem when a Rh- mother has Rh+ babies b/c the mother may be exposed to Rh+ blood of fetus
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Erythroblastosis Fetalis
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Occurs when antibodies of Rh- mother and Rh+ fetus cross antibodies at the placenta causing hemolysis of fetal RBCs
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Diapedesis/Extravasation
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Able to squeeze through capillary walls, WBC’s are able to do this
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Leukopoiesis
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Formation of WBC’s
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Megakaryocyte
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Fragments of these form thrombocytes
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Intrinsic Pathway
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The conversion of fribinogen to fibrin, this pathway occurs when clots damaged vessels and blood left in test tube, it is initiated by exposure of blood to negatively charged surface of flass or blood vessel collagen, activated factor XII (Hageman factor) which then initiates a series of collagen factors, (most clotting factor require Ca to be activated), Ca then converts prothrombin to thrombin which then converts fibrinogen to fibrin
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Factor XII (Hageman Factor)
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Is activated by coming into contact with either exposed collagen in an injured vessel or a foreign surface such as a glass test tube, exposed collagen also initiates the formation of platelet plug and the chain reaction leading to clot formation
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Eosinophils
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WBC’s that are important in allergic responses and in combating internal parasite infestations
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Basophils
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WBC’s that synthesize, store, and release histamine, which is important in allergic responses, and heparin which hasten the removal of fat particles from blood
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Neutrophils
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WBC’s that are phagocytic specialists and important in inflammatory responses and defense against bacterial invasion, most prevalent (50%-75% of leukocytes), goes thru body and cleans up messes
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Agranular Leukocytes
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Are either destructive/phagocytic (lymphocytes) or produce antibodies (monocytes)
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Monocytes Macrophages
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WBC’s that emigrate from the blood, enlarge, and become marchophages, large-tissue phagocytes
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Phagocytes/Phagocytosis
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A type of monocytes and WBCs
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Lymphocytes
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Become either T- or B- Cells, 20-40% of these cells expand during infection, provides immune defense against targets for which they are specifically programmed
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Cell-Mediated Immunity
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A specific immune response accomplished by activated T lymphocytes, which directly attack unwanted cells, T-CELLS, attack infected host cells, cancer cells, and foreign cells
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T-Cells
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Develop from lymphocytes that seed thymus, can only be replenished up until late childhood, can be depleted by AIDS or Chemo, do not secrete antibodies, provide cell-mediated immunity which attacks infected cells
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Thymus
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Grows during childhood, gradually regresses after puperty, contains T cells that cannot be replenished
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B-Cells
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Mature in the bone marrow, fight infections by secreting antibodies into blood and lymph, provide humoral immunity, only job is to make antibodies which mark cells for destruction
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Humoral Immunity
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Occurs in B-cells that helps mark cells for destruction and secrete antibodies
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Hematocrit
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Percentage of blood volume occupied by erythrocytes as they are packed down in a centrifuged blood sample, 45% is normal
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Polycythemia
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Excess circulating erythrocytes, accompanied by an elevated hematocrit, not always a bad thing can occur from high levels of elevation
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Buffy Coat
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The middle layer of a centrifuge spin that contain less then 1% of material, a mixture of platelets and WBC’s
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Hemostasis
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The stopping of bleeding from an injured vessel, cessation of bleeding, promoted by reactions initiated by vessel injury which vasoconstricts blood flow to area where a platelet plug forms which the plug and surroundings are infiltrated by web of fibrin forming a clot
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NO (Nitric Oxide)
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A chemical mediator released from endothelial cells and other tisses, exerts a wide array of effects ranging from caushing local arteriolar vasodilation to acting as a toxic agent against foreign invaders to serving as a unique type, production is activated by ATP, Ach, bradykinin, L-arginine, and histamine
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Collagen
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Found underneath endothelial cells and are used when damaged endothelium allows forming of platelet plug by combining with platelets and allow them to stick
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Von Willaband Factor
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Found underneath endothelial cells and are used in forming platelet plug, increased bond by binding to both collagen and platelets
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Platelet Plug
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When platelets stick to collagen, they release ADP, serotonin, and Thromboxane A2 which stimulated vasoconstriction, reducing blood flow to wound, as platelets continue to be sticky and attach, this continues to form platelet plug which becomes infiltrated by meshwork of fibrin (comes from plasma protein)
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Plug Contraction
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Platelet plug undergoes plug contraction to form more compact plug that initiates clotting factors
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Extrinsic Pathway
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The conversion of fibrinogen to firbin that allows for clotting shortcut, damage to outside blood vessels releases tissue thromboplastin that triggers a clorring shortcut
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Tissue Thromboplastin
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Occurs in extrinsic patheway that triggers a clotting shortcut, found in damage to outside blood vessels
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Prothrombin
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Activated by factor x which then activated thrombin, which activates fibrinogen and then activated fibrin and forms the fibrin meshwork to form the clot
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Thrombin
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Activated by prothrombin which then activated fibrinogen which then activated fibrin and forms the firbrin meshwork to form the clot, activated plasminogen
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Kallikrein
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Activated by factor XII (Hageman Factor) which converts plasminogen into plasmin which digest fibrin dissolving the clot
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Plasmin/Plasminogen
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Plasminogen is converted into Plasmin by the activated XII Factor (Hageman factor) plasmin then digest fibrin dissolving the clot, also activated by thrombin
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Ca Chelator
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A type of anticoagulant that prevents clotting (e.g. sodium citrate or EDTA
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Sodium Citrate
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A type of anticoagulant, is a Ca Chelator that prevents clotting
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EDTA
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A type of anticoagulant, is a Ca Chelator that prevents clotting
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Heparin
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A type of anticoagulant, activated antithrombin III (block thrombin) stops clots from forming and therefore cannot dissolve clots
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Coumarin/Warfarin
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A type of anticoagulant, blocks clotting indirectly reducing the effect of Ca which results in slower clotting times
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Anemia
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A reduction below normal in O2 carrying capacity of the blood , insufficient oxygen transported to the body cells, associated with abnormal reduction of RBC’s. can be contributed by B12 (needed for cell division), kidney disease(lowered/no EPO production), iron deficiency(no attachment of oxygen to hemoglobin), and malaria(infections of RBC’s causing them to rupture)
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