Essentials of Human Anatomy and Physiology, 11e (Marieb) Chapter 10 Blood 10.1 Multiple Choice Part I Questions Using Figure 10.1, identify the following: 1) The neutrophil is indicated by. A) Label A B) Label B C) Label C D) Label D Page Ref: 339, 340 1
2) The eosinophil is indicated by. A) Label A B) Label B C) Label C D) Label D Page Ref: 339 3) The monocyte is indicated by. A) Label A B) Label B C) Label C D) Label D Page Ref: 339 4) The lymphocyte is indicated by. A) Label A B) Label B C) Label C D) Label D Page Ref: 339 5) The granulocytes are indicated by and. A) Label A; Label C B) Label B; Label A C) Label C; Label D D) Label D; Label B Page Ref: 339 6) The most common type of leukocyte is indicated by. A) Label A B) Label B C) Label C D) Label D Page Ref: 339, 343 2
7) The type of leukocyte that fights allergies and parasitic worms is indicated by. A) Label A B) Label B C) Label C D) Label D Page Ref: 339, 343 8) Normal blood ph falls in a range between to. A) 7.1; 7.2 B) 7.35; 7.45 C) 7.6; 7.75 D) 7.85; 8.05 Page Ref: 338 9) An important plasma protein that contributes to the osmotic pressure of blood is. A) thyroglobulin B) fibrin C) albumin D) glucose Page Ref: 338 10) The percentage of erythrocytes in blood is known as the. A) hematocrit B) buffy coat C) hemoglobin D) plasma Page Ref: 338 11) Each hemoglobin molecule is able to transport molecules of oxygen. A) 1 (one) B) 2 ( two) C) 3 (three) D) 4 (four) Page Ref: 341 3
12) A decrease in the oxygen-carrying ability of the blood, for any reason, is a condition known as. A) polycythemia B) leukemia C) anemia D) leukocytosis Page Ref: 341 13) Life at a high altitude can lead to a red blood cell disorder known as. A) anemia B) polycythemia C) leukocytosis D) leukemia Page Ref: 341-342 14) A total white blood cell count above 11,000 cells/mm3 is a condition known as. A) leukopenia B) leukocytosis C) polycythemia D) anemia Page Ref: 342 15) The process by which white blood cells travel through the wall of blood vessels is termed. A) diffusion B) diapedesis C) filtration D) chemotaxis Page Ref: 342 16) Abnormally low levels of white blood cells causes a condition known as. A) leukocytosis B) anemia C) thrombocytopenia D) leukopenia Page Ref: 343 4
17) White blood cells containing granules and lobed nuclei are classified as. A) agranulocytes B) granulocytes C) thrombocytes D) neutrophils Page Ref: 343 18) Platelets are fragments of a multinucleate cell known as a. A) megakaryocyte B) erythrocyte C) reticulocyte D) monocyte Page Ref: 343 19) The process by which bleeding is stopped is called. A) hematopoiesis B) erythropoiesis C) homeostasis D) hemostasis Page Ref: 347 20) The rate of erythrocyte production is controlled by a hormone known as. A) erythropoietin B) insulin C) growth hormone D) aldosterone Page Ref: 345 21) During coagulation, long, hairlike molecules known as form the basis for a clot. A) thrombin B) prothrombin C) fibrin D) fibrinogen Page Ref: 347-348 5
22) Hereditary bleeding disorders that result from lack of clotting factors are referred to as. A) petechiae B) hemophilia C) aplastic anemia D) thrombocytopneia Page Ref: 348 23) Substances that the body recognizes as foreign are called. A) antigens B) antibodies C) formed elements D) megakaryocytes Page Ref: 349 24) When antibodies bind to antigens on foreign blood types, clumping or occurs. A) coagulation B) hematopoiesis C) agglutination D) alkalosis Page Ref: 349 25) The ABO blood groups are based on two antigens: antigen and antigen. A) A; B B) A; O C) AB; O D) B; O 26) The blood type that contains both antigens A and B is. A) AB B) A C) B D) O -352 6
27) A person with type B blood can receive blood from blood type(s). A) AB, B B) B, O C) A, B, AB, O D) B, O, AB -352 28) If you carry the Rh antigen, you are referred to as Rh. A) positive B) sensitive C) negative D) compatible 29) The condition in which maternal antibodies cross the placenta and destroy the baby's RBCs is called. A) hemophilia B) thrombus C) hemolytic disease of the newborn D) physiologic jaundice Page Ref: 352 30) The condition in which fetal RBCs are destroyed faster than the infant liver can rid the body of the breakdown products of hemoglobin is called. A) hemolytic disease of the newborn B) pernicious anemia C) sickle cell trait D) physiologic jaundice Page Ref: 353 7
10.2 Multiple Choice Part II Questions 1) The matrix of blood is called. A) buffy coat B) plasma C) erythrocytes D) lymphocytes E) formed elements Page Ref: 338 2) In a centrifuged blood sample, the buffy coat situated between the formed elements and the plasma contains. A) leukocytes and erythrocytes B) platelets and erythrocytes C) leukocytes and platelets D) eythrocytes only E) leukocytes only Page Ref: 338 3) Blood is. A) acidic B) cooler than body temperature C) sweet tasting D) composed mostly of white blood cells and platelets E) slightly alkaline Answer: E Page Ref: 338 4) The hematocrit is the percentage of. A) plasma in blood B) erythrocytes in blood C) leukocytes in blood D) formed elements in blood E) platelets in blood Page Ref: 338 8
5) Which formed element is the most abundant in blood? A) erythrocyte B) eosinophil C) platelet D) basophil E) lymphocyte Page Ref: 339, 340 6) Erythrocytes. A) possess lobed nuclei and cytoplasmic granules B) lack a nucleus and most organelles C) are the least common of all formed elements D) travel by diapedesis through the walls of vessels E) clot blood Page Ref: 340 7) Normal whole blood contains g of hemoglobin per 100 ml. A) 4-8 B) 12-18 C) 15-20 D) 30-35 E) 42-48 Page Ref: 341 8) Which of the following red blood cell disorders may result from life at a higher altitude? A) aplastic anemia B) sickle cell anemia C) pernicious anemia D) polycythemia E) hemolytic anemia Page Ref: 341-342 9
9) White blood cells differ from red blood cells because only they contain. A) a biconcave shape B) a nucleus and most organelles C) the ability to transport both oxygen and carbon dioxide D) the iron-containing molecule called hemoglobin E) cytoplasm Page Ref: 342 Bloom's: 4) Analysis 10) Jordan works in a hematology lab and received a blood report showing 22,000 white blood cells per cubic millimeter of blood for a patient. He determines this patient has. A) a normal blood count B) polycythemia C) anemia D) leukocytosis E) leukopenia Page Ref: 342 Bloom's: 4) Analysis 11) The two major groups of white blood cells are. A) leukocytes and erythrocytes B) platelets and megakaryocytes C) neutrophils and basophils D) granulocytes and agranulocytes E) granulocytes and leukocytes Page Ref: 343 12) Which of the following cells are classified as granulocytes? A) neutrophils, eosinophils, and basophils B) lymphocytes and monocytes C) eosinophils and monocytes D) basophils and lymphocytes E) neutrophils, lymphocytes, and eosinophils Page Ref: 343 10
13) Which type of granulocyte produces antibodies? A) eosinophils B) basophils C) neutrophils D) lymphocytes E) monocytes Page Ref: 344 14) The most numerous of the white blood cells are the. A) lymphocytes B) neutrophils C) eosinophils D) monocytes E) basophils Page Ref: 343 15) Which type of leukocyte contains heparin, an anticoagulant? A) neutrophil B) monocyte C) lymphocyte D) basophil E) eosinophil Page Ref: 344 16) Place these leukocytes in order from the most common to the least common: 1) basophil 2) eosinophil 3) lymphocyte 4) monocyte 5) neutrophil A) 1, 2, 3, 4, 5 B) 3, 4, 5, 1, 2 C) 5, 3, 2, 4, 1 D) 5, 2, 3, 1, 4 E) 5, 3, 4, 2, 1 Answer: E Page Ref: 343 Bloom's: 4) Analysis 11
17) Platelets are fragments of multinucleate cells called. A) erythrocytes B) eosinophils C) basophils D) megakaryocytes E) macrophages Page Ref: 343 18) Where does hematopoiesis produce new red blood cells? A) yellow bone marrow B) articular cartilage C) red bone marrow D) epiphyseal line E) synovial membrane Page Ref: 345 19) Low levels of oxygen in the blood stimulate the release of erythropoietin by the. A) stomach B) pancreas C) kidneys D) hypothalamus E) spleen Page Ref: 346 20) The average functional lifespan of an RBC is. A) 20-30 days B) 50-75 days C) 100-120 days D) one year E) the body's lifetime Page Ref: 345 12
21) An immature RBC which contains some endoplasmic reticulum is called a(n). A) megakaryocyte B) hemocytoblast C) reticulocyte D) agranulocyte E) granulocyte Page Ref: 345 22) What enzyme joins soluble fibrinogen proteins into long molecules of fibrin during coagulation? A) PF3 B) thrombin C) tissue factor D) prothrombin E) calcium Page Ref: 347 23) The application of a sterile gauze to a cut aids with. A) platelet plug formation B) the release of tissue factor C) the formation of fibrin D) coagulation E) vascular spasms Page Ref: 348 Bloom's: 4) Analysis 24) The series of reactions that stop blood flow following a cut is called. A) homeostasis B) coagulation C) hemostasis D) erythropoiesis E) agglutination Page Ref: 347 13
25) Which one of the following represents the proper sequence of hemostasis? A) platelet plug formation, coagulation, vascular spasm B) vascular spasm, coagulation, platelet plug formation C) coagulation, vascular spasm, platelet plug formation D) vascular spasm, platelet plug formation, coagulation E) coagulation, platelet plug formation, vascular spasm Page Ref: 347 Bloom's: 3) Application 26) Why do you think Mrs. Gonzalez was prescribed heparin, an anticoagulant? A) to enhance hematopoiesis B) to inhibit release of erythopoietin C) to enhance the formation of clots D) to increase vascular spasms E) to inhibit the formation of clots Answer: E Page Ref: 348 Bloom's: 4) Analysis 27) Blood normally clots in approximately. A) 1 minute B) 3 to 6 minutes C) 5 to 10 minutes D) 15 minutes E) 30 minutes Page Ref: 348 28) The formation of an insoluble clot during hemostasis is termed. A) agglutination B) coagulation C) hematopoiesis D) positive chemotaxis E) diapedesis Page Ref: 347 14
29) Which of the following insoluble fibers forms a mesh network and the basis for the formation of a clot during coagulation? A) albumin B) fibrin C) thrombin D) fibrinogen E) hemoglobin Page Ref: 347 30) A persistent clot in an unbroken blood vessel is known as. A) an embolus B) polycythemia C) hemophilia D) a thrombus E) leukopenia Page Ref: 348 31) Which of the following is a blood clotting disorder? A) polycythemia B) hemophilia C) leukocytosis D) leukopenia E) anemia Page Ref: 348 32) Bleeding disorders often result from a lack of which one of the following vitamins. A) vitamin B12 B) vitamin A C) vitamin C D) vitamin D E) vitamin K Answer: E Page Ref: 348 15
33) The ion essential for blood clotting is. A) sodium B) calcium C) iodine D) potassium E) hydrogen Page Ref: 347 34) The organ largely responsible for the synthesis of clotting factors is the. A) pancreas B) thyroid C) liver D) spleen E) kidneys Page Ref: 348 35) Treatment of hemophilia often involves. A) transfusion of plasma and vitamin K supplements B) injections of missing clotting factors and vitamin B12 injections C) vitamin K supplements only D) transfusion of plasma or injections of missing clotting factor E) vitamin K supplements and vitamin B12 injections Page Ref: 348 36) Severe shock that can be fatal occurs with blood loss exceeding. A) 5 percent B) 10 percent C) 20 percent D) 30 percent E) 50 percent Page Ref: 349 16
37) A substance that stimulates the immune system to release antibodies is the. A) antigen B) antibody C) interleukin D) fibrinogen E) prothrombin activator Page Ref: 349 38) The process whereby the binding of antibodies to antigens causes RBCs to clump is called. A) hemostasis B) coagulation C) agglutination D) clotting cascade E) hemolysis Page Ref: 349 39) Which blood type contains the A antigen only? A) blood type A B) blood type B C) blood type AB D) blood types A and AB E) blood type O 40) The most common type of blood in the U.S. population is. A) A B) B C) AB D) O E) AO 17
41) Molly has blood type A and her daughter has blood type B. Why can't Molly donate blood to her daughter? A) Blood types A and B will coagulate during a transfusion. B) Mothers cannot donate blood to their daughters. C) Blood type B contains anti-a antibodies, which will agglutinate with type A blood. D) Blood transfusions cannot be performed among relatives. E) Only fathers can donate blood to their daughters. Page Ref: 349, 351 Bloom's: 4) Analysis 42) Hemolysis most likely will occur when. A) an Rh negative person receives the first transfusion of blood that is Rh positive B) any person receives blood type O during a transfusion C) an Rh positive person receives the first transfusion of blood that is Rh negative D) an Rh negative person receives the second transfusion of blood that is Rh positive E) platelets cling to the ruptured endothelium of a blood vessel Bloom's: 2) Comprehension 43) Which blood type(s) can a person with blood type O receive? A) blood type A B) blood type B C) blood type AB D) blood type O E) blood types A, B, AB, or O 44) The immune serum used to prevent maternal sensitization to Rh antigens is. A) serotonin B) interleukin C) agglutinin D) RhoGAM E) fibrinogen 18
45) Which of these blood types carries no antigens? A) blood type A B) blood type B C) blood type AB D) blood types A, B, and AB E) blood type O Answer: E Page Ref: 349, 351 46) Compatibility testing for agglutination of donor RBCs by the recipients' serum is called. A) blood typing B) transfusion reaction C) cross matching D) hemolysis E) hemodialysis Page Ref: 352 47) Physiologic jaundice occurring in newborns results from. A) bone marrow disorders B) accumulation of destroyed fetal red blood cells C) a diseased gallbladder that needs to be removed D) erythrocyte mutations E) vitamin deficiencies Page Ref: 353 10.3 True/False Questions 1) Normal blood ph is between 7.35 and 7.45. Answer: TRUE Page Ref: 338 2) Erythrocytes make up the majority of the formed elements. Answer: TRUE Page Ref: 338, 339 3) The primary job of erythrocytes is to transport oxygen. Answer: TRUE Page Ref: 340 19
4) Polycythemia arises from an excess or abnormal increase in the number of white blood cells. Answer: FALSE Page Ref: 341 5) The amount of hemoglobin contained within a RBC determines its capability to transport oxygen. Answer: TRUE Page Ref: 340 6) Megakaryocytes are classified as agranulocytes since they lack visible granules in the cytoplasm. Answer: FALSE Page Ref: 343 7) Basophils are the most numerous type of leukocyte. Answer: FALSE Page Ref: 343 8) All formed elements arise from a common type of stem cell called a hemocytoblast. Answer: TRUE Page Ref: 345 9) The life span of a red blood cell is 100 to 120 days. Answer: TRUE Page Ref: 345 10) Erythropoeitin is released to stimulate platelet production in response to inadequate amounts of oxygen in the blood. Answer: FALSE Page Ref: 345 11) Vascular spasms, a part of process of hemostasis, limit blood loss during blood vessel injury. Answer: TRUE Page Ref: 347 20
12) Calcium is necessary for coagulation to properly occur during hemostasis. Answer: TRUE Page Ref: 347 13) Blood type A can receive blood from blood types A and AB during a transfusion. Answer: FALSE 14) Rh-related problems occur in pregnant Rh- women carrying an Rh+ baby. Answer: TRUE 15) Cross matching prevents transfusion reactions by testing for agglutination between donor and recipient blood prior to the transfusion. Answer: TRUE Page Ref: 352 21
10.4 Matching Questions Match the following function with its blood cell: A) platelet B) leukocyte C) erythrocyte 1) Excess numbers of these cells cause leukocytosis Page Ref: 342 2) Alternate name for white blood cell Page Ref: 342 3) Granulocytes and agranulocytes are classified as types of these cells Page Ref: 343 4) Excess of these cells cause polycythemia Page Ref: 341 5) Type of cell produced in response to erythropoietin Page Ref: 345 6) Cell fragments that form from the rupture of a megakaryocyte Page Ref: 343 7) Immature form of this cell is called a reticulocyte Page Ref: 345 8) Type of cell that contains hemoglobin for gas transport Page Ref: 340 9) Most common type of blood cell Page Ref: 340 10) Type of cell fragment involved in hemostasis Page Ref: 347 22
Answers: 1) B 2) B 3) B 4) C 5) C 6) A 7) C 8) C 9) C 10) A Match the following blood types: A) Blood type A B) Blood type O C) Blood type AB 11) The blood type that has no antigens 12) The blood type that possesses the A antigen only 13) The blood type that can receive blood types B and AB 14) The blood type that forms both anti-a and anti-b antibodies 15) The most common blood type 16) The blood type that does not form anti-a or anti-b antibodies Answers: 11) B 12) A 13) C 14) B 15) B 16) C 23
10.5 Essay Questions 1) Scott's blood test shows that he has excess red blood cells. Identify and describe two causes of this disorder. Answer: Scott's disorder is polycythemia, which results from excess numbers of erythrocytes in the blood. This disorder may result from: 1. Bone marrow cancer (called polycythemia vera) 2. Life at a high altitude where the air is thinner and less oxygen is available (called secondary polycythemia) Increased sluggishness of the blood results from polycythemia. Page Ref: 341-342 Bloom's: 3) Application 2) Discuss why Martina, who has blood type A, cannot receive blood type B during a transfusion. Answer: Martina has the antigen for A on her red blood cells. During infancy, her body built anti-b antibodies since she lacked that antigen in her blood. If she receives a transfusion of blood type B, her body will already have the anti-b antibodies in place. Agglutination will occur as the anti-b antibodies bind and clump to the foreign B antigen. The red blood cells will be lysed, hemoglobin will be released into the blood stream, and these events would lead to a transfusion reaction. Page Ref: 349, 351 Bloom's: 2) Comprehension 3) While looking through a microscope in your anatomy lab, you see a cell whose cytoplasm has a pale pink color with fine granules and a tri-lobed deep purple nucleus. Determine what type of cell you see (be specific). Explain why you made this selection. Answer: You have likely seen a neutrophil, a type of leukocyte, while looking through the microscope. Neutrophils are granulocytes with a pale pink cytoplasm and fine granules that are difficult to see. Neutrophils have nuclei with three to seven lobes connected by thin strands of nucleoplasm. Page Ref: 343, 344 Bloom's: 3) Application 4) Describe the three phases of the normal blood-clotting process. Answer: Hemostasis involves three major phases. The first phase is the vascular spasm phase, in which serotonin released by the platelets causes the blood vessels to spasm and constrict, thus decreasing blood loss. The second phase is the platelet plug formation, in which platelets become "sticky" and cling to the site of injury. The third phase is coagulation wherein thromboplastin interacts with PF3 and calcium, as well as other blood proteins, to form prothrombin activator. Prothrombin activator converts prothrombin to thrombin, which then joins with fibrinogen to form fibrin, the basis of the clot. Page Ref: 347 Bloom's: 2) Comprehension 24
5) Which situation do you predict to prompt the release of more erythropoietin into the blood: anemia or polycythemia? Explain. ny decline in the level of oxygen in the blood prompts the kidneys to release more erythropoietin into the blood. Erythropoietin targets the bone marrow to produce more red blood cells. Anemia is a decrease in the blood's ability to transport oxygen for any reason while polycythemia is an excessive or abnormal increase in the number of red blood cells. Therefore, anemia would prompt the release of more erythropoietin so that the blood could transport more oxygen. In fact, polycythemia would inhibit erythropoietin production by the kidneys. Page Ref: 341, 345-346 Bloom's: 3) Application 6) Describe ABO and Rh blood groups. Answer: The blood groups are based on the presence or absence of specific surface antigens. Blood group A has type A antigens on their RBCs, blood group B has type B antigens on their RBCs, blood group AB has both type A and type B antigens on their RBCs, and blood group O lacks either type A or type B antigens. The Rh+ blood group indicates the presence of the Rh antigens on their RBCs. Individuals belong to blood groups A, B, AB, or O, and they are also classified as either Rh+ or Rh-. Page Ref: 349, 351 Bloom's: 2) Comprehension 7) Explain agglutination as it relates to blood groups. ntigens are surface proteins found on all cells including blood cells. In the case of blood groups, an individual's blood type reflects the presence or absence of specific antigens. An antigen-antibody response is initiated if the individual receives a transfusion of blood containing antigens that it identifies as being "foreign." Antibodies found in a person's blood bind to the foreign antigen, causing agglutination, or clumping. The antigen-antibody complexes clog the small blood vessels, and the foreign RBCs are lysed, releasing hemoglobin into the bloodstream. The most serious complication of a transfusion reaction is kidney failure due to blockage of the kidney tubules by the hemoglobin molecules. Page Ref: 349-352 Bloom's: 2) Comprehension 8) Mrs. Litaker was concerned because her baby was born with yellow skin. Name and explain this condition to her. Answer: This condition is known as physiologic jaundice and it arises because fetal red blood cells are destroyed at a rate faster than the newborn's liver can rid the body of the hemoglobin breakdown products in bile. This form of jaundice typically causes no major problems. Page Ref: 352-353 Bloom's: 3) Application 25