nbde biochemistry-physiology bld
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NBDE Biochemistry/Physiology Bld
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Normal range for hemoglobin is different between the sexes and is approx. _____ for men and _____ for women.
13-18 g/deciliter12-16 g/deciliter
What is a quaternary protein consisting of four tertiary (folded) polypeptide chains, each containing an associated iro-containing heme group?
Hemoglobin
What are the four polypeptide chains in a hemogolbin?
2 Alpha chains2 Beta chains
Where does oxygen bind on a hemoglobin?
The heme group
Where does carbon dioxide bind on a hemoglobin?
Amine groups of amino acids in polypeptide chain
How many hemoglobins reside within a Erythrocyte?
300 million
What is the maximum binding capacity for oxygen on a single hemoglobin molecule?
8 oxygen (4 hemeglobins each with the ability to bind one diatomic oxygen)
What is the normal blood value of a new born?
14-20 g/deciliter
What does the Hgb value depend on?
# of RBC's and theAmount of Hgb in each RBC
Where is a low Hgb value found?
AnemiaHyperthyroidismCirrhosis of the liver
What does a high Hgb value indicate?
WTR: HIGH CPolyCethemia, Copd, Congestive heart failure
Blood leaving the lungs is _____ saturated with oxygen. However, the hemoglobin of normal venous blood returning to the lungs is only _____ saturated.
98%75%
What is hemoglobin that is carrying carbon dioxide from the tissues to the lungs?
Carbaminohemoglobin
What is the percentage of carbon dioxide carried by hemoglobin?How is the rest transported?
30%Bicarbonate or Carbon Dioxide
_____ is a major type of protein present in human blood plasma. It represents an important _____ reserve for the body and, more importantly, plays a crucial role in maintaining the blood's _____ pressure, which tends to draw water _____ the capillaries.
AlbuminAmino AcidColloid osmoticOut of
**(Oncotic pressure, or colloid osmotic pressure, is a form of osmotic pressure exerted by proteins in blood plasma that usually tends to pull water into the circulatory system.)
Albumin
What is the most abundant plasma protein in humans and other mammals?
Albumin is one of the most ____ plasma proteins
Hydrophilic
How does Albumin act as a transport protein?
Carriers Hemin and Fatty acids
What is the normal blood level of Albumin?
3.5-5.0 g/100ml
When is albumin decreased?
MalnutritionLiver failurePregnancy
Without
Viscosity
0.8
Albumin is a single tightly packed polypeptide with 585 aa ______ any covalently bound carbohydrate
Albumin's shapes minimizes its effect on plasma ____?
Although albumin accounts for only 60% of the total plasma protein, it provides ___% of the colloid osmotic presure of the plasma
What is another name for Colloid osmotic pressure in the plasma?
Oncotic pressure (necessary to prevent edema)
Kidney
Besides Oncotic pressure what are the other forces that regulate the movement of fluid across capillary membranes?
Hydrostatic pressure inside the capillaryFluid pressure in interstitial fluid
What is the organ chiefly responsible for the regulation of the osmotic pressure in the body fluids by regulating the reabsorption of water in response to ADH or vasopressin?
Albumin
0.08
0.45
With the exception of _____, almost all plasma proteins are glycoproteins.
What is Albumin transporter for?
TriiodothyronineThyroxineFatty AcidsBilirubinBile AcidsSteroid hormonespharmaceuticalsInorganic Ions
Human blood constitutes about _____ of the body's weight
What does blood consist of?
Cells and Cell fragments in an aqueous medium
What percentage of blood is made up of hematocrit?
Plasma
Blood maintains _____ and plays a decisive role in defending the body against _____.
HomeostasisPathogens
The clear, thin, and sticky fluid portion of the blood obtained after removal of the fibrin clot and blood cells. It differ from the plasma in that serum it lacks fibrin.
WTR = serUM ...um no fibrin in my plasma pleaseSerum
What is the fluid portion of blood and contains no cells (minus the formed elements)?
0.55
Platelets
What percentage does plasma make up in the blood?
What is the breakdown of plasma?
Proteins - 7%Water - 91%Other solutes - 2%
What are the proteins found in plasma?
AlbuminsGlobulinsFibrinogen
What constitutes the other solutes found in plasma?
Metabolic end productsFood materialsRespiratory gasesHormonesIons
The function of these is to agglutinate and plug small ruptured vessels.
What is the principle hormone for calcium-level regulation?
Parathyroid hormone
How much calcium does the human body contain?Where is this primarily located?
1-1.5 KgBone
What is the variation of normal plasma concentration of calcium?
8.5 mg% - 10.5 mg%
What increases bone resorption and reabsorption of calcium in the kidney tubules?What does this do?
Parathyroid HormoneIncreases plasma calcium levels
VitaminD3
What vitamin regulates the uptake of calcium in the GI tract?
What does low serum calcium levels result in?
Hyperirritability of nerves and muscles
What will patients with hyperparathyroidism be subject too?
Decreased renal calcium excretionIncreased likelihood of bone fracture
What increases calcium blood levels?
Hypervitaminosis DHyperparathyroidismBone cancerBone diseases
4 mg%
100 mg%
Calcium blood levels are _____ in severe diarrhea, in hypoparathyroidism, and in avitaminosis D (rickets and osteomalacia)
Decreased
Besides calcium what does the parathyroid hormone regulate?
Plasma phosphorus concentration
What is plasma glucose concentration regulated by?
Insulin (lowers)Glucagon (raises)
What is the normal phosphorus concentration?
What is the normal plasma glucose concentration?
0 mg/min.
What is the normal glucose clearance in the kidney?
The general term for reactions that prevent or minimize loss of blood from the vessels if they are injured or ruptured is...
Hemostasis
What are the three processes that the circulatory system undergoes to guard against blood loss?What do these lead to?
1.Vasoconstriction2. Platelet aggregation3. CoagulationLeads to clotting
The production of thrombin from prothrombin during the clotting process requires a prothrombin activator (factor Xa-Factor V complex), which is formed either by way of an extrinsic pathway or by way of an intrinsic pathway. Remember: The only protease of the extrinisic pathway is factor VIIa,
WTR Coagulation common pathway: factors in order
10 5 - 2 = 13Coagulation common pathway:Factor X to Factor V to Factor II to Factor XIII
http://o.quizlet.com/cJH1cri0G5yxwakUybKkow.jpg
What acts enzymatically to catalyze the formation of thrombin (Factor IIa) from prothrombin (Factor II)?
Prothrombin activator (Factor Xa - Factor V complex)
http://o.quizlet.com/cJH1cri0G5yxwakUybKkow.jpg
Blood Clot
What acts as an enzyme to convert fibrinogen (Factor I) into fibrin (Factor Ia) threads that enmesh red blood cells and platelets to form the clot itself?
Thrombin (Factor IIa)
http://o.quizlet.com/cJH1cri0G5yxwakUybKkow.jpg
Both extrinsic and intrinsic pathways
What is the reason for a lack of clotting formation when a patient has cirrhosis of the liver? What factors are synthesized in the liver?
Deficient prothrombin and fibrinogen levelsII, VII, IX, X
http://o.quizlet.com/cJH1cri0G5yxwakUybKkow.jpg
Synersis
Tendency towards equilibrium between different but interdependent elements of an organism.
Homeostasis
The process of producing red blood cells.
Erythropoiesis
What is the liquid separating from a gel due to further solidification or coagulation?
Iron, the most important mineral in the formation of hemoglobin, is resorbed mainly in the _____ and is only resorbed as _____.
Upper small intestine (Duodenum)Fe2 (Ferrous, Bivalent)
Iron
What is the most quantitatively important trace element in the body?
How much iron does the body contain?
4-5 g (mostly bound form)75% Heme15-25% Stored in liver, spleen, marrow
Where are heme proteins found?
HemoglobinMyoglobin
What form is iron found while stored in the liver, spleen and marrow?
FerritinHemosiderin
In the duodenum Iron immediately combines in the blood plasma with a _____ globulin _____, to form _____, which is then transported in the plasma.
Betaapotransferrintransferrin
Where is excess iron stored?
Liver (60% of excess)
Since Iron can only be taken up in its Bivalent form (Fe2 ), what is required to promote iron uptake?
Reducing agentsAscorbate (vitamin C)
Bilirubin
What is the dominant factor controlling absorption of iron in the GI tract?
Saturation of mucosal cells with iron
An iron storage disease that results in the deposition of iron-containing pigments in the peripheral tissues with characteristic bronzing of the skin, diabetes, and weakness.
Hemochromatosis
What is the product of Heme degradation?
What is type O blood referred to as?Why?
Universal DonorDo not produce ABO antigens so no rejection
What is type AB blood referred to as?Why?
Universal receiversDo not produce ABO antibodies so accept everything
What are primarily responsible for the ABO types?
2 Antigens 2 Antibodies
What is the permutation of type A Blood?
Antigen A, Anti-B antibody
What is the permutation of type B Blood?
Antigen B, Anti-A antibody
What is the permutation of type O Blood?
Anti-A and Anti-B antibodies
What is the permutation of type AB Blood?
Antigen A and B
0.33
No Direct
What is the weight percentage of hemoglobin in RBC's?
The combination of hemoglobin and oxygen is reversible. What depends on the binding or releasing of oxygen?
Oxygen Partial Pressure (Po2)High, > AffinityLow, < Affinity
The partial pressure of O2 (ppO2) is a factor in determining the amount of O2 bound to Hb; however there is _____ _____ proportionality to the ppO2.
What influences supercedes the ppO2's influence on determining the amount of O2 bound to Hb?
ppCo2 - increasepH - decreasetemp. - increasesDPG levels - increase
What does DPG stand for?
Diphosphoglycerate
The normal fetal globin portion of Hb consists what chains?
2 Alpha2 Gamma
What is a nitrogen containing organic pigment molecule that has a single atome of iron in a reduced statein its center, which can combine with one molecule of oxygen?
Heme molecule
Hemoglobin combines reversibly with _____ _____ at the protein portion of the hemoglobin molecule.
Carbon Dioxide
How does carbon monoxide decrease the amount of oxygen that can be transported by hemoglobin?
Competing with oxygen at the hemoglobin binding siteCO (> affinity) O2
How much higher is the affinity of Carbon monoxide over oxygen?
240x greater
What contains iron in the ferric state (Fe3 ) and cannot function as an oxygen carrier?
Methemoglobin
Which form of hemoglobin is considered to be normal?
Hemoglobin A
Abnormal hemoglobin in which lysine has replaced glutamic acid, causing reduced plasticity of the red blood cells.
WTR: C it lyses (lysine)Hemoglobin C
An abnormal hemoglobin composed of four beta chains; it is usually associated with a defect in three of the four alpha chain genes resulting in alpha-thalassemia.
WTR: H has 4 points so all 4 are alphaHemoglobin H
S
An abnormal hemoglobin in which valine has replaced glutamic acid in the beta chain.
WTR: S is Sickle cellHemoglobin S
What does the presence of an S hemoglobin cause the red blood cells to do?
Form a sickle shape in decreased amounts of O2
What deficiencies are caused by S hemoglobin?
Circulation blockageDecreased oxygen carrying capacityDecreased cell life span
What is the predominate form of hemoglobin in Sickle cell anemia?
A group of abnormal hemoglobins in which a single amino acid substitution favors the formation of methemoglobin and is thus associated with methemoglobinemia
Hemoglobin M
Erythropoietin is produced by _____, and has its primary action on the _____.
KidneyBone Marrow
A glycoprotein hormone produced in the kidneys that stimulates the production of red blood cells by bone marrow.
Erythropoietin
What is the production of erythropoietin and thus erythrocytes regulated by?
Negative feedback associated with oxygen delivery to tissues (esp. kidneys)
What is the site of action of action involved with the hormone associated with erythropoiesis?
Hemocytoblast (pluripotent stem cell)
What leads to anemia, increased cardiac output, and hypoxia?
Inadequate erythropoiesis
What can lead to polycythemia, an increase in blood viscosity, and sluggish blood flow?
Excessive Erythropoiesis
Anemic individuals have _____ oxygen tension but _____ oxygen content in their systemic arterial blood.
NormalReduced
Erythrocytes are _____ disks, _____ in diameter, lack _____ and _____ and contain _____.
Biconcave7.5 micronsNucleiiMitochondriaHemoglobin
What are located on the membranes of Erythrocytes?
LipoproteinsSpecific blood groups (A,B,O)
What is the proportion of erythrocytes in a sample of blood?
Hematocrit
What is the life span of erythrocytes?
105-120 days
What is a good indication of the amount of erythrocyte destruction per day?
Amount of bile pigments excreted by the liver
What happens when the muscle is actively contracting (in terms of pH, Pco2, and blood temp)?
Lactic acid is being produced (lower pH), CO2 is being produced (increasing PCO2 --thus decreasing pH by formation of carbonic acid), and heat is being produced (increase temp of blood). By-products of exercise are the exact factors that stimulate O2 release from oxyhemoblin
Active tissues have what characteristics and why
WTR-Right shift-C-BEAT:C02BPG (2 ,3-BPG)ExerciseAcid/ AltitudeTemperature
1. lower PH (acidic conditions decease affinity of Hb for O2. The higher the H ion concentration the less O2 is bound to Hb)2. Increased arterial PCO2 (The partial pressure of carbon dioxide
More info
Fetal hemoglobin (2a and 2y subunits) has loweraffinity for 2 ,3-BPG than adult hemoglobin(HbA) and thus has higher affinity for 02.When you're Relaxed, you do your job better(carry 02) .
Hemoglobin is composed of 4 polypeptidesubunits (2a and 2beta) and exists in 2 forms :
Fetal erthropoiesis occurs where (4)
WTR: Young Liver Synthesizes Blood.Fetal erythropoiesis occurs in:l. Yolk sac (3-8 wk)2. Liver (6-30 wk)3. Spleen (9-28 wk)4. Bone marrow (28 wk onward)
Fetal hemoglobin = a2y2 .Adult hemoglobin = a2b2