Ch 17 blood

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Which of the following is a function of the blood?

-transport of nutrients and wastes – transport of body heat – transport of gases – defense against toxins and pathogens

Which of the following statements about blood is false?
A) contains buffers that control pH
B) normal pH is 6.8 to 7.0
C) is more viscous than water D) is about 55 percent plasma
E) None of the above is falseall are true.

B) normal pH is 6.8 to 7.0

Formed elements make up about what percentage of blood?

45 percent

The combination of plasma and formed elements is called

whole blood.

Whole blood for testing in a clinical laboratory is usually collected from

a superficial vein.

When checking the efficiency of gas exchange, it may be necessary to draw a blood sample from?

an artery.

Each of the following is a characteristic of whole blood, except a
A) temperature of approximately 38 degrees Celsius.
B) viscosity about the same as water.
C) pH of 7.4.
D) built-in system for clotting.
E) deep red color from hemoglobin.

B) viscosity about the same as water.

The total volume of blood in the body of a 76-kg man is approximately ________ liters.

5.3

A person who has a low blood volume is said to be

hypovolemic.

The chief differences between plasma and interstitial fluid involves the

concentration of proteins.

The most abundant proteins in blood plasma are

albumins.

Plasma proteins essential in body defense are the

immunoglobulins.

A plasma protein essential for blood coagulation is

fibrinogen.

The most abundant component of plasma is

water

All the circulating red blood cells originate in the

red bone marrow.

The process of lymphopoiesis goes on in all of the following organs, except
A) the spleen.
B) the kidney.
C) the lymph nodes.
D) the red bone marrow.
E) the thymus.

B) the kidney.

Granulocytes form in

red bone marrow.

Red blood cell production is regulated by the hormone

erythropoietin.

Which of the following statements concerning red blood cells is false?

A) Red cells are biconcave discs.
B) Red cells lack mitochondria.
C) Red cells are about 18 μm in diameter.
D) Red cells are specialized for carrying oxygen.
E) Red cells can form stacks called rouleaux.

Red cells are about 18 μm in diameter.

The average lifespan of a red blood cell is

4 months.

The function of red blood cells is to

-carry carbon dioxide from the cells to the lungs -carry oxygen from the lungs to the bodyʹs cells

More than 95 percent of the protein in a red blood cell is

hemoglobin.

The function of hemoglobin is to

-carry oxygen. -carry carbon dioxide.

________ is a condition in which the oxygen-carrying capacity of the blood is reduced.

Anemia

Pernicious anemia caused by a lack of intrinsic factor is specifically treated by

injections of vitamin B12

A red blood cell that contains normal amounts of hemoglobin would be called

normochromic.

The conversion of fibrinogen to fibrin is catalyzed by the enzyme

thrombin.

Aged and damaged erythrocytes are broken down by the

-spleen. -liver. -bone marrow.

The waste product bilirubin is produced from

heme molecules lacking iron.

Most of the iron that is removed from degraded hemoglobin is

recycled to the red bone marrow

In adults, erythropoiesis exclusively takes place in

red bone marrow

In adults, red bone marrow is located in the

-sternum and ribs -iliac crest, body of vertebrae

The process of red blood cell production is called

erythropoiesis

The developmental stage at which erythrocytes enter the circulation is as

reticulocytes

________ are immature erythrocytes that are present in the circulation.

Reticulocytes

Erythropoiesis is stimulated when

-oxygen levels in the blood decrease -blood flow to the kidney declines

The percent fraction of formed elements relative to whole blood is the

hematocrit.

A typical adult hematocrit is

45

Consider these results from a blood lab test. Which value is most likely abnormal?
A) RBCs5.2 million/μl
B) platelets280,000/μl
C) leukocytes8600/μl
D) hemoglobin10.7 g/100 ml
E) hematocrit44 percent

D) hemoglobin10.7 g/100 ml

A personʹs blood type is determined largely by the

presence of specific glycoproteins on the cell membrane.

People with type AB blood are considered the ʺuniversal recipientʺ for transfusions because

their blood lacks A or B agglutinins.

All of the following are true of neutrophils, except that they are
A) granular leukocytes.
B) phagocytic.
C) also known as polymorphonuclear leukocytes.
D) important in coagulation.
E) active in fighting bacterial infections.

D) important in coagulation

The most numerous white blood cells in peripheral circulation are the

neutrophils

White blood cells that release histamine at the site of an injury are

basophils

________ are large phagocytic white cells that spend most of their time outside the blood as fixed and free

Monocytes

Which of these descriptions best matches the term colony stimulating factor?

hormone that regulates blood cell formation

White blood cells that are increased in allergic individuals are the

eosinophils

A hormone that stimulates production of granulocytes and monocytes is

GM-CSF.

A hormone that stimulates the production of neutrophils is

G-CSF (Neupogen).

Platelets function in all of the following, except
A) dissolving a formed clot.
B) forming temporary clump in injured areas.
C) contraction after clot formation.
D) initiating the clotting process.
E) releasing chemicals that stimulate clotting.

A) dissolving a formed clot.

Platelets are pinched off from giant multinucleated cells in the bone marrow called

megakaryocytes

Platelets are

cytoplasmic fragments of large cells

Platelets are stored as a reserve in case of hemorrhage in

-the spleen. -other vascular organs.

________ involves a cascade of reactions leading to the conversion of fibrinogen to fibrin.

Coagulation

Most of the protein factors that are required for clotting are synthesized by

the liver

The extrinsic pathway of coagulation is initiated by the

release of tissue factor (Factor III) by damaged endothelium.

The intrinsic pathway of coagulation is activated by the

activation of Factor VII exposed to collagen.

The common pathway of coagulation begins with the

conversion of Factor X to prothrombinase

The process of fibrinolysis

dissolves clots

The enzyme that can digest fibrin and dissolve a clot is

plasmin

Tissue factor (Factor III) is a factor in the ________ pathway.

extrinsic

Plasma thromboplastin is a factor in the ________ pathway.

intrinsic

Which of the following vitamins is needed for the formation of clotting factors?

vitamin K

A person whose platelet count is 40,000/μl is suffering from

thrombocytopenia

A moving blood clot is called a(n)

embolus.

Areas in a vessel wall where large quantities of lipid accumulate are called

plaques.

Which of these descriptions best matches the term platelets?
A) adhere to collagen beneath endothelium
B) helper cells are one type
C) produce antibodies in response to antigens
D) kill bacteria using hydrogen peroxide
E) often elevated in allergic individuals

A) adhere to collagen beneath endothelium

Plasma is closest in composition to

interstitial fluid.

Which of the following drives exchange of fluids between the tissues and the blood?

-concentration gradients -osmosis -hydrostatic pressure

Which of the following is present in very low levels in plasma?

amino acids

Which of these is not one of the formed elements of blood?
A) RBCs
B) platelets
C) antibodies
D) lymphocytes
E) basophils

C) antibodies

Each hemoglobin molecule contains

four iron atoms.

Plasma composes about ________ percent of whole blood and water composes ________ percent of the plasma volume.

55, 92

Thyroid-binding globulin is an example of which kind of plasma protein?

hormone-binding

Transferrin is an example of which kind of plasma protein?

metalloprotein

Which plasma protein transports fatty acids and some hormones?

albumin

Which plasma protein transports testosterone?

testosterone-binding globulin

Which of these descriptions best matches the term B lymphocytes?

produce antibodies in response to antigens

Which of the following proteins is (are) found in plasma?

-prolactin -luteinizing hormone -insulin

Which organ secretes most of the plasma proteins?

liver

You are caring for an adult patient who weighs 48 kg. What would her approximate blood volume be?

3.8 L

The most abundant white blood cells are?

neutrophils

Which of the following blood count values would be a sign of anemia?
A) 10,000 WBC
B) 3.5 million RBC
C) 400,000 platelets
D) 5.5 million RBC
E) A and D taken together

B) 3.5 million RBC

Which of the following is NOT true of neutrophils?
A) less abundant than lymphocytes
B) can make hydrogen peroxide
C) can exit capillaries
D) can destroy bacteria
E) attracted to complement-coated bacteria

A) less abundant than lymphocytes

Which of the following is true of basophils?
A) constitute about 1 percent of WBCs
B) granules contain heparin
C) granules contain histamine
D) attract other defense cells
E) all of the above

E) all of the above

Which of these descriptions best matches the term T lymphocytes?
A) adhere to collagen beneath endothelium
B) helper cells are one type
C) produce antibodies in response to antigens
D) kill bacteria using hydrogen peroxide
E) often elevated in allergic individuals

B) helper cells are one type

The yellow color that is visible in the eyes and skin in jaundice results from

-excessive amounts of bilirubin in the plasma. -extensive breakdown of RBCs. -destruction of hemoglobin.

After donating 0.5 liter of blood, one would expect
A) an increased reticulocyte count.
B) an increased platelet count.
C) an increased erythrocyte count. D) an increased neutrophil count.
E) increased levels of clotting factors.

A) an increased reticulocyte count.

Eileen is a strict vegan and therefore eats no animal products. She develops an anemia that her doctor thinks is caused by a nutritional deficiency. Which of the following is the likeliest candidate?
A) iron deficiency
B) vitamin B12 deficiency
C) lack of intrinsic factor
D) vitamin K deficiency
E) vitamin B6 deficiency

B) vitamin B12 deficiency

A hematocrit provides information on

formed elements abundance.

In adults, the only site of red blood cell production, and the primary site of white blood cell formation, is the

red bone marrow.

The most numerous WBCs in a differential count of a healthy individual are

neutrophils.

A person with Type A blood has
A) antigen A on the RBCs.
B) anti-B agglutinins in the plasma.
C) anti-A agglutinins on the red blood cells.
D) A and B only
E) B and C only

D) A and B only

Hemolytic disease of the newborn may result if
A) the mother is Rh positive and the father is Rh negative.
B) both the father and the mother are Rh negative.
C) both the father and the mother are Rh positive.
D) an Rh-negative mother carries an Rh-positive fetus.
E) an Rh-positive mother carries an Rh-negative fetus.

D) an Rh-negative mother carries an Rh-positive fetus.

Each heme ring in hemoglobin encloses an atom of

iron

Excess iron is stored in the liver and spleen as

-hemosiderin -ferritin

Which of these descriptions best matches the term eosinophils?
A) adhere to collagen beneath endothelium
B) helper cells are one type
C) produce antibodies in response to antigens
D) kill bacteria using hydrogen peroxide
E) often elevated in allergic individuals

E) often elevated in allergic individuals

In which of the following situations would you expect the blood level of bilirubin to be elevated?
A) a person suffering from hemolysis
B) an alcoholic with a damaged liver C) iron-deficient diet
D) A, B, and C
E) A and B only

E) A and B only

If bile ducts are blocked,

-more bilirubin appears in the plasma. -bilirubin appears in the skin and eyes.

Which of these proteins functions to store or transport iron?
A) hemoglobin
B) ferritin
C) hemosiderin
D) transferrin
E) B, C, and D

B) ferritin C) hemosiderin D) transferrin

The disease sickle cell anemia is an example of what can happen if
A) the diet is deficient in iron.
B) there is insufficient heme in the hemoglobin.
C) a gene for adult hemoglobin is abnormal.
D) red blood cells bind too much oxygen.
E) hemolysis is prevented by a bad gene.

C) a gene for adult hemoglobin is abnormal.

During a bacterial infection you would expect to see increased numbers of

neutrophils.

The pus associated with infected wounds contains

-dead neutrophils -cellular debris -tissue fluids

Some rat poisons contain a toxin that blocks the liverʹs ability to utilize vitamin K. Animals that consume this poison would die of

hemorrhage

A substance that activates plasminogen might be useful to

cause clot dissolution to proceed faster.

How would removal of calcium ions from a blood sample affect coagulation?

-the coagulation pathway would be lacking a required cofactor at many steps -coagulation would be prevented

When a person who lives at sea level vacations in the Rocky Mountains, you would expect
A) a drop in oxygen levels.
B) the release of erythropoietin.
C) a rise in hematocrit.
D) both A and C
E) A, B, and C

E) A, B, and C

Surgical removal of the stomach could cause

pernicious anemia.

Mary is tested for the amount of hemoglobin in her blood. The test results indicate that her hemoglobin level is 16 g/dL of blood. This value indicates that

her hemoglobin level is normal.

An obstruction in blood flow to the kidneys would ultimately result in

increased erythropoiesis.

The level of erythropoietin in the blood would rise due to all of the following, except
A) during anemia.
B) at high altitudes.
C) as a consequence of hemorrhage.
D) during periods of fasting.
E) when blood flow to the kidneys is disrupted.

D) during periods of fasting.

Which of the following is NOT true of monocytes?
A) about same size as basophils
B) enter tissues and wander
C) become macrophages
D) are long lived
E) can phagocytize bacteria

A) about same size as basophils

Which of the following would you expect to see in increased numbers in a peripheral blood sample after donating a unit of blood?

reticulocytes

What are common sources of vitamin K?
A) green vegetables
B) organ meats
C) whole grains
D) intestinal bacteria
E) all of the above

E) all of the above

Bill wants to determine his blood type, so he takes a few drops of blood from a puncture wound in his finger and mixes it with various antisera. His blood cells agglutinate when mixed with the anti -A sera but not with the anti-B or anti-D sera. This means

Billʹs plasma contains B agglutinins.

People who suffer from hemophilia A fail to produce a functional Factor VIII; as a result

they lack a functional intrinsic pathway.

A digestive disorder that impairs a personʹs ability to absorb vitamin K will result in

-low levels of prothrombin -low levels of Factor X -low levels of thromboplastin -prolonged bleeding.

Tom suffers from severe liver disease secondary to alcoholism. Which of the following signs would you expect to see as a result?
A) decreased clotting ability
B) increased levels of bilirubin in the blood
C) reduced iron storage
D) all of the above
E) A and C only

D) all of the above

Which of the following is true of eosinophils?
A) granules stain with acid dyes
B) allergic patients have many
C) have bilobed nucleus
D) constitute about 2 to 4 percent of WBCs
E) all of the above

E) all of the above

Megan has an infected puncture wound to her foot. Which type of white blood cell would you expect to be elevated in a differential white cell count?

neutrophils

After blood is fractionated, its components are ________ for the purpose of analysis.

separated

Blood volume represents about ________ percent of a personʹs body weight.

7

Neutrophils usually make up from ________ to ________ percent of the circulating white blood cells.

50; 70

Blood is approximately ________ percent formed elements by volume.

45

Erythropoiesis is stimulated by a kidney-derived hormone called ________.

erythropoietin (EPO)

Hormones called ________ are involved in regulation of white blood cell populations.

colony-stimulating factors

The ________ is a procedure that is used to determine the number of each of the various types of white blood cells.

differential count

A fibrin network that contains trapped blood cells and platelets is called a(n) ________.

blood clot

Plasminogen is converted to its active form by an enzyme called ________.

tissue plasminogen activator

Reticulocytes complete their development into ________ in the circulation.

erythrocytes (or RBCs or red blood cells)

Match the term with its definition.
1. albumins
2. globulins
3. immunoglobulins
A) antibodies for defense
B) are the most abundant plasma protein
C) include many transport proteins

1-B; 2-C; 3-A

Endothelial cells release ________that stimulate smooth muscle contraction and accelerate the repair process.

endothelins

The normal pH of blood is ________.

slightly alkaline (7.4)

________ is responsible for the RBCʹs ability to transport oxygen and CO 2.

Hemoglobin

________ is the condition in which the oxygen-carrying capacity of blood is reduced, owing to a low blood hemoglobin concentration.

Anemia

How does Rhogam prevent erythroblastosis fetalis (HDN, hemolytic disease of the newborn)?

If a mother who is Rh negative carries a fetus who is Rh positive, she will make antibodies against its Rh RBCs after being exposed to the infantʹs blood during labor and delivery. By giving a dose of anti -Rh antibody (Rhogam) just before or after delivery, the fetal red cells will be agglutinated and removed from the motherʹs circulation before her immune system will have time to make anti-Rh antibodies that would endanger her next Rh-positive offspring.

Which of the formed elements would increase after the donation of a pint of blood?

Reticulocytes would increase in number as additional numbers of immature RBCs move into the bloodstream to compensate for the reduction in blood volume.

Why do people with advanced kidney disease commonly become anemic?

For three reasons: (1) Damaged kidneys produce less erythropoietin and so there is less stimulation of the marrow to produce RBCs. (2) Also, erythropoietin is more easily lost into the urine by leaky kidneys. (3) Finally, during dialysis treatment, the patientʹs erythropoietin is washed away. Treatment for kidney patients today includes injections of synthetic erythropoietin.

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