6. Fill in the following as you describe the details of Erythrocytes:

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1 1 Key to Blood Power Quiz 1. The physical characteristics of blood include the following: Blood color depends on oxygen content, bright red is rich whereas dark red is poor. Blood is times more viscous than water and has a normal ph range of. Average blood volume in females is about and in males is about. Blood makes up about percent of total body weight. Oxygen; oxygen; 5; ; 4-5 liters (1.2 gal); 5-6 liters (1.5 gal); 8 2. Blood is composed of elements (cells and platelets) suspended in a fluid matrix called. Formed; plasma 3. The formed elements of blood include the that function in oxygen transport, the that function in immune defense, and that function in blood clotting. Erythrocytes; Leukocytes; Platelets (thrombocytes) 4. Plasma is a Straw-colored liquid that makes up about (2%; 7%; 55%, 91%) of blood volume. Plasma consists of about (2%; 7%; 55%, 91%) water, (2%; 7%; 55%, 91%) proteins, and (2%; 7%; 55%, 91%) other substances such as enzymes, hormones, metabolites, respiratory gases, nutrients, and electrolytes. 5. Fill in the following as you describe the details of plasma proteins: The plasma proteins are divided into 3 classes: Albumins; globulins and clotting proteins. The (albumins; globulins or clotting proteins) are produced by the (spleen, liver, or plasma cells) and function to clot the blood when there is blood vessel damage. The yellowish fluid remaining after blood has clotted (doesn t have the clotting proteins and factors) is called (plasma; fibrin; serum; or serous fluid). The (albumins; globulins or clotting proteins) are produced by the (spleen, liver, or thyroid gland) and function to maintain osmotic pressure of the vascular system. The (albumins; globulins or clotting proteins) consist of alpha, beta and gamma globulins. The (alpha, beta, gamma) globulins are produced by the (spleen, liver, or plasma cells) and function to transport lipids, steroids, fatsoluble vitamins, and metal ions such as iron. The (alpha, beta, gamma) globulins are produced by the (spleen, liver, or plasma cells) and function in immunity by the producing (interferon; renin; or antibodies). 6. Fill in the following as you describe the details of Erythrocytes: Erythrocytes function primarily to carry (O2, CO2, N2) and to a minor extend, (O2, CO2, N2). Erythrocytes are round cells shaped like (protruding or biconcave) discs. This shape (increases or decreases) surface area. Mature RBCs are (anucleated; atrunckated; or filled with lysosomes) and lack (protein, lipoprotein membrane, or mitochondria). RBCs generate ATP by (aerobic or anaerobic) respiration. RBCs are filled with Hemoglobin molecules that function to carry (O2, CO2, N2) and to a minor extend, (O2, CO2, N2). A hemoglobin molecule consists of (2, 4, 6, 21) polypeptide (protein) chains called (globins or kerritins) and (2, 4, 6, 21) iron containing pigment molecules called hemes. Of the 4 polypeptide chains, 2 are composed of identical alpha chains and two identical beta chains. A heme group consists of a

2 (heme; cyclic, beta, or porphyrin) ring that holds (1, 2, 4, 6, 21) atom(s) of iron. Thus one hemoglobin molecule holds 4 atoms of iron. An iron atom can reversibly bind to one oxygen molecule (O2). (Globin, Heme, Copper) gives blood its red color. 7. Normally Hemoglobin transports (10%, 20%, 30%, or 98.5%) of blood oxygen with the remaining oxygen transported in the plasma. Depending on what is bound to hemoglobin will determine its name. It is called (deoxyhemoglobin, carboxyhemoglobin, oxyhemoglobin) when it is binds to oxygen, (deoxyhemoglobin, carboxyhemoglobin, oxyhemoglobin) when the oxygen is released, and It is called (deoxyhemoglobin, carboxyhemoglobin, oxyhemoglobin) when iron binds to carbon monoxide Carbon dioxide is transported in the blood in three forms. Name the three forms and the approximate percentages of each form. 1) ~10% as dissolved CO2 in the plasma, 2) ~20% as carbaminohemoglobin (HbCO2). CO2 is attached to an amino acid in the globin portion. 3) ~70% as bicarbonate ion 9. Fill in the following as you review how carbon dioxide is transported in RBCs. With ~10% of CO2 dissolved in the plasma and ~20 % as carbaminohemoglobin you still have ~70 of the CO2 that needs to be transported but you can t get any more dissolved into the plasma or attached to hemoglobin so how do you transport it from the tissues to the lungs? Convert it to bicarbonate and H+. In the systemic capillaries, the H+ then binds to (iron, chlorine, hemoglobin) and the bicarbonate diffuses (out of or into) the RBC as (H+, Na+, K+, or Cl-) diffuses (out of or into) the RBC in what is known as the (H+, Na+, K+, or Cl-) shift. In the pulmonary capillaries this process is reversed. 10. Fill in the following as you explain the details of the chloride shift in RBCs. In systemic capillaries, the carbon dioxide concentrations are high driving the process called the (sodium, intermediate, reverse, or chloride) shift. High concentrations of carbon dioxide cause it to combine with water to form (acetyl, peptidyl or carbonic) acid, but at a slow rate. The high CO2 concentration in the RBCs cause the enzyme (acetyl, carbonic, or peptidyl) anhydrase to greatly speed this reaction to form (acetyl, peptidyl or carbonic) acid, (H2CO3). As (acetyl, peptidyl or carbonic) acid builds up it dissociates into hydrogen ions (H+) and the bicarbonate ions (HCO3-). Most of the (hydrogen or bicarbonate) ions remain in the RBC and attach to (chloride ions, sodium ions, or hemoglobin) while most of the (hydrogen or bicarbonate) ions diffuse (out of or into) the RBC and into the (plasma or lymph) by (active transport or facilitated diffusion) and can serve as a buffer. The result is that the inside of the RBC gains a net (negative or positive) charge. This attracts (Na+, Cl-, K+, Br-) ions, which move (out of or into) the RBCs as HCO3- moves (out of or into)

3 3 the RBC. This exchange of anions, diffusion of Cl- into RBCs as HCO3- diffuses out of the RBCs, is called the (chloride or bicarbonate) shift and occurs in the systemic capillaries. In the pulmonary capillaries (lungs), the carbon dioxide concentrations are low and the oxygen concentrations are high which cause the (forward, intermediate, or reverse) chloride shift to happen. In the lungs (carbon dioxide or oxygen) binds to deoxyhemoglobin and becomes (carboxyhemoglobin or oxyhemoglobin). (H+, CO2, Na+) doesn t bind well to oxyhemoglobin and (H+, CO2, Na+, Cl-) is released within the RBCs. The (H+, CO2, Na+, Cl-) attracts (chloride Cl-, anhydrase, or bicarbonate (HCO3-)) from the plasma, which combines with H+ to form carbonic acid and Cl- moves out of the RBC into the plasma. Under low (O2, CO2, N2) concentrations, as occurs in the lungs, carbonic anhydrase converts carbonic acid (H2CO3) to H2O and CO2. The CO2 is then (inhaled or exhaled). The process is called the (forward, intermediate, or reverse) chloride shift. 11. How do red blood cells know where to release more oxygen and where less? Or why do they unload more oxygen at all? Why is O2 released in tissues? The primary cause of oxygen unloading from RBCs has to do with a lower partial pressure of oxygen at the tissues. We will go over this in great detail when we cover the respiratory system. Another important factor is that under high levels of CO2 and thus H+ as occurs in actively metabolizing cells, causes a greater the release of (carbon dioxide, nitrogen, or oxygen) from hemoglobin in what is known as the (Starling, Frank, Stasis, or Bohr) effect. 12. In the (Starling, Frank, Stasis, or Bohr) effect, the (loading or unloading) of (carbon dioxide, nitrogen, or oxygen) from (deoxyhemoglobin or oxyhemoglobin) is (decreased or increased) by the bonding of (H+, CO2, Na+, Cl-) released from carbonic acid, which causes a(n) increase or decrease) in ph. This results in increased conversion of oxyhemoglobin to deoxyhemoglobin liberating more O2 in the tissues. Thus, increased carbon dioxide levels resulting in a decrease in ph promotes the release of (carbon dioxide, iron, or oxygen) from hemoglobin in what is known as the (Starling, Frank, Stasis, or Bohr) effect. 13. The generation of new blood cells that occurs in the red bone marrow is called: Hematopoiesis or hemopoiesis 14. Name of the stem cells that gives rise to all blood cells. Hemocytoblast 15. Hematopoiesis Includes which is the formation of white blood cells, which is the formation of red blood cells, and which is the formation of platelets. Of the cells listed above which is technically not a cell? Leukopoiesis; Erythropoiesis; Thrombopoiesis; Platelets (thrombocytes) not a cell.

4 4 16. Toward the end of the developmental sequence of erythropoiesis, the nucleus is ejected and the cell becomes a (hemocytoblast, normoblast, late erythroblast, or reticulocyte) which still contains some organelles such as mitochondria, ribosomes, and (endoplasmic reticulum or nucleus). The (hemocytoblasts, normoblasts, late erythroblasts, or reticulocytes) are released into circulation and lose their mitochondria, ribosomes, and endoplasmic reticulum and develop into erythrocytes within (1-2, 3-4, 5-6, or 7-10) days 17. Reticulocytes normally make up about (1-2, 3-4, 5-6, or 7-10) percent of the RBCs in the human body. A reticulocyte count or Retic Count measures the % of reticulocytes within a whole blood sample. A reticulocyte percentage that is higher or lower than "normal" can help in the determination of the type of anemia and/or health of the bone marrow because it represents recent production. A(n) (increased or decreased) reticulocyte count can occur when there is an (increased or decreased) production of red blood cells to overcome chronic or severe loss of red blood cells, such as in a hemolytic anemia or hemorrhage. A(n) (increased or decreased) reticulocyte count can be attributed to anemia due to poor RBC production as in aplastic anemia or pernicious anemia. Can occur do to chemotherapy, bone marrow malignancies, and various vitamin or mineral deficiencies (B9, B12, iron), 18. Fill out the information for the life cycle of a typical RBC RBCs have a lifespan of about (1, 30, 100, ) days. They are formed in the bone red bone marrow by (leukopoiesis, thrombopoiesis, erythropoiesis). Old and damaged RBCs are engulfed and broken down by (reticulocytes, macrophages, hemocytes) in the spleen, liver, and bone marrow. Hemoglobin is disassembled into heme and globin portions. The globin proteins are broken down into (carbon, fatty acids, glucose, amino acids) for reuse. The heme units are stripped of their (sodium, copper, iron) which is reused in (leukopoiesis, thrombopoiesis, erythropoiesis). The remainder of the heme is converted into a green colored pigment called (bilirubin, biliverdin, bilireano) and then to a yellow pigment called (bilirubin, biliverdin, bilireano). Most of the (bilirubin, biliverdin, bilireano) is excreted by the liver into the (blood, bile, sweat) and the remainder by the kidneys. Bilirubin and urobillins gives urine its characteristic yellow color. Inside the large intestine, bacterial convert the bilirubin into other forms that along with bilirubin give feces its characteristic brown color. 19. The percentage of RBC s in a whole blood sample is called the: Hematocrit (Hct) 20. When blood is centrifuged the WBCs and Platelets form a thin layer between the RBCs and plasma. What is this layer called? Buffy coat 21. Platelets are cell fragments produced by the in the bone marrow. Megakaryocytes 22. Process of platelet synthesis is called: Thrombopoiesis

5 5 23. Use the following terms to describe the mechanism of clot formation in a damaged blood vessel. Terms can be used more than once or not at all. collagen platelets circular platelet plug formation endothelial thrombin factor X or prothrombinase spiky fibrin thromboxane A2 fibrinogen vascular spasm fibrin web formation vasoconstrictor kidney Victor s factor liver von Willebrand s factor m shaped List the three step involved in stopping blood loss from a damaged vessel: 1) Vascular spasm 2) Platelet plug formation 3) Production of a fibrin web - clot formation. In step 1, known as, (vascular spasm) a cut or torn vessel immediately constricts and reduces blood flow through the vessel. In step 2 known as, (Platelet plug formation), the breakage of the (endothelial) lining of a blood vessel exposes (collagen) fibers from the basement membrane of the endothelium. The (collagen) fibers activate (platelets) to change shape forming (spiky) processes and become sticky which causes them to bind with the (collagen) fibers and other (platelets) to form a (platelet) plug. The endothelial cells in the injured area produce a protein called (von Willebrand s factor) which binds to both collagen and platelets holding them together. Activated platelets release several chemicals from their storage granules such as ADP and thromboxane A2 that activate other platelets. One of these substances called (Thromboxane A2), a prostaglandin, is a powerful (vasoconstrictor) which reinforces vascular spasms. Platelets also release chemicals to stimulate fibrin formation in the blood clot. In step 3 known as, (fibrin web formation) is the blood clotting step and involves the transformation of blood from a liquid into a solid structure that strengthens the platelet plug. During clot formation there is the conversion of the soluble protein (fibrinogen), which is produced by the (liver) and normally present in the blood to an insoluble threadlike protein called (fibrin). Actually many (fibrin) monomers attach to produce a (fibrin) polymer. (Fibrin) molecules adhere to the damaged blood vessels surface forming a netlike meshwork that traps blood cells the resulting mass of platelets, blood cells, and fibrin becomes the blood clot. (Thrombin) is the enzyme that converts fibrinogen to (fibrin) at the injury site. The thrombin enzyme is the active form and it comes from it inactive from called (Prothrombin) which is produced by the liver and normally present in the blood. Prothrombin is converted to (thrombin) by (factor X or prothrombinase), which was activated by a cascade of a number of clotting factors including thromboplastin and (Na+, Cl-, Ca 2+ )

6 6 The following answers are not from the word list 24. During the healing process the fibrin clot meshwork is dissolved by a fibrin splitting enzyme called: plasmin. 25. Plasminogen, the inactive form of plasmin, is activated by a number of plasminogen activators fond within the body including urokinase, kallikerin and Tissue plasminogen activator (TPA). 26. Clinically, TPA and urokinase, produced by genetically engineered bacteria, and streptokinase, a natural bacterial product, can be injected into the blood stream to dissolve blood clots such as in pulmonary embolism, myocardial infarction, stroke, and thrombus formation. TPA, urokinase and Streptokinase activate the conversion of to which dissolves the blood clot. plasminogen; plasmin 27. Aspirin can be used in blood clot prevention. Aspirin is a (COX-1, COX-2, COX-3) inhibitor and thus reduces platelet aggregation by inhibiting the production of (thromboxane A2, Plasmin, TPA). (thromboxane A2, Plasmin, TPA) is a prostaglandin required for platelet aggregation and is a potent (vasoconstrictor or vasodilator). The formation of thromboxane A2 is catalyzed by the (cyclooxygenase-1, cyclooxygenase-2) enzyme. 28. Since platelets are not compete cells, they cannot regenerate new enzymes and thus the (COX-1, COX-2, COX-3) enzyme is inhibited for the life of the platelet which is about (2, 5, 10, 20) days. Note: aspirin can significantly increase bleeding times. 29. Plavix inhibits platelet activation by blocking the receptors for (ADP, camp, TPA) on the platelet plasma membrane thus preventing platelet activation.

7 7 Basis of the ABO Blood Group 30. The ABO blood types are based on the presence or absence of two specific glycoprotein antigens known as (type A and type B or Type A and Type O), found on the RBC s external surface. 31. An is anything the body perceives as foreign and generates an immune response to. The term listed above is an abbreviation for Antigen; abbreviation for antibody generator. 32. Type A blood has the (A, B, A and B, or O) antigens on the RBCs 33. Type B blood has the (A, B, A and B, or O) antigens on the RBCs 34. Type AB blood has the (A, B, A and B, or O) antigens on the RBCs 35. Type O blood has neither (A, B, A and B, or O) antigens on the RBCs Antibodies of the ABO Blood Groups 36. Unique to the ABO blood groups is the presence of naturally occurring (antigens or antibodies) found in the plasma. Naturally occurring (antigens or antibodies) are those produced without known exposure to the (antigens or antibodies). These antibodies (agglutinins) act against RBCs carrying ABO antigens that are not present on a person s own RBCs. 37. A newborn lacks these (antigens or antibodies), however they begin to appear in the plasma within (2-6 months or 2-3 years) after birth. The naturally occurring antibodies are now known to be produced in response to the development of the normal (skin or gut) flora as there are A and B like antigens associated with common (skin or intestinal) bacteria. 38. Antibodies found in the plasma is a follows: 1) Type A blood contains (anti-a, anti-b, anti-a and anti-b, anti-o) antibodies 2) Type B blood contains (anti-a, anti-b, anti-a and anti-b, anti-o) antibodies 3) Type AB blood contains neither (anti-a, anti-b, anti-a and anti-b, anti-o) antibodies 4) Type O blood contains both (anti-a, anti-b, anti-a and anti-b, anti-o) antibodies 39. If the wrong blood type is transfused into a person the RBC surface glycoproteins will be recognized as foreign and antibodies will bind to and the cells together and destroy them. clump (agglutinate) 40. Since RBC antigens promote agglutination (clumping), they can also be called agglutinogens. 41. Although there are about 30 different groups of RBC antigens, the ABO and Rh blood groups are the most important because of the presence of naturally occurring antibodies and the chance of a reaction. Transfusion

8 8 Rh Blood Typing 42. Rh blood typing determines whether the Rh (antibody or antigen) is present (Rh+) or absent (Rh-) 43. Most people (85% of Caucasian population) are (Rh+ or Rh-) and lack the anti-rh (antigens or antibodies). 44. Rh factor is named for the, in which the antigens were first discovered. Rhesus monkeys 45. An individual is either positive or negative for the Rh factor; this is denoted by a '+' or ' ' after their ABO type. Blood that is Rh-negative (cannot or can) be transfused into a person who is Rh-positive, but an Rh-negative (should or should not) receive Rh-positive blood as the recipient can create (antibodies or antigens) for Rhpositive RBCs. 46. Anti-Rh (antibodies or antigens) are produced only in people who come into contact with the (Rh+ or Rh-) blood cells such as during a transfusion or pregnancy; an (Rh+ or Rh-) female who carries a (Rh+ or Rh-) fetus can become sensitized and threaten the health of the fetus. 47. Normally fetal and maternal blood are (in contract or kept separate) across the placenta and (do or do not) mix. At time of birth there may be tears in the placenta and exposure of Rh+ blood cells from the fetus can cause the Rh- mother s immune system to become sensitized and produce (antibodies or antigens) against the Rh-antigen. 48. Anti-Rh antibodies can move across the placenta and destroy RBCs, causing a condition known as: hemolytic anemia (erythroblastosis fetalis or hemolytic disease of the newborn). 49. It usually takes one pregnancy to become sensitized. The greatest chance of the blood mixing is during an abortion, miscarriage, or. delivery 50. Injecting the Rh- mother with an antibody preparation against the Rh factor can prevent erythroblastosis fetalis. It is administered before and soon after delivery, miscarriage, or abortion. Antibodies bind to and inactivate the (mother or fetal) Rh antigens before the mother s immune system can respond to the foreign antigens. The trade name for this antibody preparation is, and the GAM is short for RhoGAM; gamma globulin 51. Most people are (Rh+ or Rh-) and lack the anti-rh antibodies.

9 9 Transfusion Reactions 52. Transfusion reactions involve the clumping and of the donated (transfused) RBCs. hemolysis (rupture) 53. Clumped RBCs can plug up small (lymph vessels or blood vessels) preventing the delivery of oxygen and removal of waste products. Hemolysis cause the release of (hemoglobin or iron) which if high enough, will precipitate in the kidneys and block the urine-forming structures leading to acute kidney failure. 54. The most serious consequences arise from the effect of antibodies in the (donor s or recipient s) plasma on the incoming donor (RBCs, WBC, or platelets).the effect of the donor s antibodies on the recipient s RBCs is (minor or severe) unless (small or large) amounts of blood is transfused, because the donor s (antibodies or antigens) are diluted by the recipient s plasma. Note: Unless the person needs a large amount of blood, the transfused blood is in the form of packed red blood cells which is whole blood minus the (platelet, WBC, or plasma) portion. Blood Donors and Recipients 55. The universal donor is Type O- Since type O- individuals have no A B, or Rh antigens so no other blood type will reject it. 56. The universal recipient is Type AB+ Since type AB+ individuals lack both anti-a, anti-b and anti-rh antibodies and can receive they can accept donor blood of any other blood type. 57. Fill out the following table to indicate who can donate and receive various blood types.

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