Nurs 3119 Exam 2 Guide With
Complete Solution
What is the lifespan of an RBC? - ANSWER 120 days
What is the structure of an RBC? - ANSWER - two alpha and two beta chains
- each protein chain holds one iron-containing heme group
- oxygen binds to the heme groups
- they are highly deformable (how they get through tight spaces)
What role does the kidneys place in RBC formation? - ANSWER Decreased
blood oxygen triggers erythropoiesis
the kindeys secrete erythropoietin--> produce immature RBCs, Reticulocytes,
and Mature RBCs
Where is iron absorbed? - ANSWER the small intestine--> Duodenum
What is transferrin? How is it composed? - ANSWER The iron that is absorbed
enters the circulation, where it immediately combines with a β -globulin,
apotransferrin, to form transferrin, which is then transported in the plasma
What is ferritin? - ANSWER iron is stored in the liver and other tissues as
ferritin
What percentage of iron is in the blood? - ANSWER floating iron consists of
60% of iron stores
What percentage of iron is stored in the liver? - ANSWER 15-30% of iron is
,stored in the liver as ferritin
What is the spleens role in the live cycle of RBCs? - ANSWER blood filters
through the spleen. As the RBC ages and cell walls weaken the RBC are
destroyed when filtering through.
What happens when the RBCs are destroyed? - ANSWER The bulk of the
heme unit is converted to bilirubin, the pigment of bile, which is insoluble in
plasma and attaches to plasma proteins for transport. Bilirubin is removed
from the blood by the liver and conjugated with glucuronide to render it
water soluble so that it can be excreted in the bile.
What causes jaundice? - ANSWER If the rate of red cell destruction and
consequent bilirubin production exceed the liver's ability to remove it from
the blood, unconjugated bilirubin accumulates in the blood. This results in
yellow discoloration of the skin, called jaundice.
Why is vitamin K important? - ANSWER Most of the coagulation factors are
proteins synthesized in the liver.
Vitamin K is necessary for the synthesis of factors VII, IX, and X; prothrombin
(factor II); and proteins C and S.
What is warfarin and how does it act? - ANSWER Warfarin acts by decreasing
prothrombin and other procoagulation factors. It alters vitamin K in a
manner that reduces its ability to participate in the synthesis of the vitamin
K-dependent coagulation factors in the liver. Warfarin is readily absorbed
after oral administration. Its maximum effect takes 36 to 72 hours because of
the varying half-lives of different clotting factors that remain in the
circulation.
it is an anticoagulant drug
,what type of anemia is sickle cell? - ANSWER hemolytic anemia
What subsection of anemia is sickle cell? - ANSWER hemogloinpathies
subjection of hemolytic anemia types
What are the two names classifying the size and color of sickle cell? -
ANSWER normocytic, and normochromic
What type of mutation is sickle cell? - ANSWER point mutation
what factors are associated with sickling? - ANSWER cold, stress, physical
exertion, infection, dehydration, illnesses that cause hypoxia/dehydration/or
acidosis
What happens when sickled cells block capillaries? - ANSWER acute pain
(blood vessels get blocked, and the tissue is not getting oxygen), infarctions
(cause chronic damage to liver, speen, heart, kidneys, eyes, bones),
pumonary infarction (acute chest syndrome where areas in the lungs get
damaged), cerebral infarction (stroke)
What are some characteristics of sickle cell anemia? - ANSWER - RBC start to
clump together
- sickled cells more likely to be destroyed and result in a increase in jaundice
and pigment gallstones
- HBS
- inherited
- spleen is susceptible to damage by HbS
Alpha Thalassemia - ANSWER - alpha chain is broken, end up producing a lot
of beta
, - Asian population
- 1-4 defective genes
- Affects both fetal and adult Hb
- in fetus, gamma Hb may form; in adult, beta Hb may form
- deletoins that remove one or both alpha genes from chromsome 16
Beta thalassemia - ANSWER - beta chain is broken, producing a lot of alpha
- defective gene for beta chain synthesis
- over 100 different mutations
- affects only adult Hb
- alpha hb may form
- point mutations in important regions of the beta globin gene on
chromosome 11
What are heinz bodies? - ANSWER excess α -globin chains form insoluble
aggregates (Heinz bodies) that precipitate within red cells and produce
severe membrane damage that causes extravascular hemolysis
-- accumulation of alpha globulin chains that are unstable, denature and
precipitate to form Heinz bodies
Complete Solution
What is the lifespan of an RBC? - ANSWER 120 days
What is the structure of an RBC? - ANSWER - two alpha and two beta chains
- each protein chain holds one iron-containing heme group
- oxygen binds to the heme groups
- they are highly deformable (how they get through tight spaces)
What role does the kidneys place in RBC formation? - ANSWER Decreased
blood oxygen triggers erythropoiesis
the kindeys secrete erythropoietin--> produce immature RBCs, Reticulocytes,
and Mature RBCs
Where is iron absorbed? - ANSWER the small intestine--> Duodenum
What is transferrin? How is it composed? - ANSWER The iron that is absorbed
enters the circulation, where it immediately combines with a β -globulin,
apotransferrin, to form transferrin, which is then transported in the plasma
What is ferritin? - ANSWER iron is stored in the liver and other tissues as
ferritin
What percentage of iron is in the blood? - ANSWER floating iron consists of
60% of iron stores
What percentage of iron is stored in the liver? - ANSWER 15-30% of iron is
,stored in the liver as ferritin
What is the spleens role in the live cycle of RBCs? - ANSWER blood filters
through the spleen. As the RBC ages and cell walls weaken the RBC are
destroyed when filtering through.
What happens when the RBCs are destroyed? - ANSWER The bulk of the
heme unit is converted to bilirubin, the pigment of bile, which is insoluble in
plasma and attaches to plasma proteins for transport. Bilirubin is removed
from the blood by the liver and conjugated with glucuronide to render it
water soluble so that it can be excreted in the bile.
What causes jaundice? - ANSWER If the rate of red cell destruction and
consequent bilirubin production exceed the liver's ability to remove it from
the blood, unconjugated bilirubin accumulates in the blood. This results in
yellow discoloration of the skin, called jaundice.
Why is vitamin K important? - ANSWER Most of the coagulation factors are
proteins synthesized in the liver.
Vitamin K is necessary for the synthesis of factors VII, IX, and X; prothrombin
(factor II); and proteins C and S.
What is warfarin and how does it act? - ANSWER Warfarin acts by decreasing
prothrombin and other procoagulation factors. It alters vitamin K in a
manner that reduces its ability to participate in the synthesis of the vitamin
K-dependent coagulation factors in the liver. Warfarin is readily absorbed
after oral administration. Its maximum effect takes 36 to 72 hours because of
the varying half-lives of different clotting factors that remain in the
circulation.
it is an anticoagulant drug
,what type of anemia is sickle cell? - ANSWER hemolytic anemia
What subsection of anemia is sickle cell? - ANSWER hemogloinpathies
subjection of hemolytic anemia types
What are the two names classifying the size and color of sickle cell? -
ANSWER normocytic, and normochromic
What type of mutation is sickle cell? - ANSWER point mutation
what factors are associated with sickling? - ANSWER cold, stress, physical
exertion, infection, dehydration, illnesses that cause hypoxia/dehydration/or
acidosis
What happens when sickled cells block capillaries? - ANSWER acute pain
(blood vessels get blocked, and the tissue is not getting oxygen), infarctions
(cause chronic damage to liver, speen, heart, kidneys, eyes, bones),
pumonary infarction (acute chest syndrome where areas in the lungs get
damaged), cerebral infarction (stroke)
What are some characteristics of sickle cell anemia? - ANSWER - RBC start to
clump together
- sickled cells more likely to be destroyed and result in a increase in jaundice
and pigment gallstones
- HBS
- inherited
- spleen is susceptible to damage by HbS
Alpha Thalassemia - ANSWER - alpha chain is broken, end up producing a lot
of beta
, - Asian population
- 1-4 defective genes
- Affects both fetal and adult Hb
- in fetus, gamma Hb may form; in adult, beta Hb may form
- deletoins that remove one or both alpha genes from chromsome 16
Beta thalassemia - ANSWER - beta chain is broken, producing a lot of alpha
- defective gene for beta chain synthesis
- over 100 different mutations
- affects only adult Hb
- alpha hb may form
- point mutations in important regions of the beta globin gene on
chromosome 11
What are heinz bodies? - ANSWER excess α -globin chains form insoluble
aggregates (Heinz bodies) that precipitate within red cells and produce
severe membrane damage that causes extravascular hemolysis
-- accumulation of alpha globulin chains that are unstable, denature and
precipitate to form Heinz bodies
