NURS 8022 EXAM 2 NEWEST ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT VERIFIED ANSWERS
(DETAILED ANSWERS) ALREADY GRADED A+ 100%
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Hematopoiesis - ANSWER-Process of blood cell production in adult bone
marrow or the liver and/or spleen of the fetus
Two stages
▪ Mitosis (proliferation)
▪ Maturation (differentiation)
Primary site of hematopoietic stem cells - ANSWER-Bone marrow ("myeloid
tissue")
Difference between red and yellow bone marrow - ANSWER-Red marrow
produces RBCs, yellow marrow does not produce RBCs
Active bone marrow sites - ANSWER-pelvic bones
vertebrae
cranium
mandible
sternum
,ribs
humerus
femur
Factors that increase hematopoiesis - ANSWER-(1) conversion of yellow bone
marrow, which does not produce blood cells, to hematopoietic red marrow by
the actions of erythropoietin (a hormone that stimulates erythrocyte
production)
(2) faster differentiation of progenitor cells
(3) faster proliferation of stem cells into progenitor cells
Erythropoiesis - ANSWER-production of RBCs
Sequence of erythropoiesis - ANSWER-Pluripotent hematopoietic stem cell -->
committed Proerythroblast/Pronormoblast --> Erythroblast/Normoblast (Hgb
synthesis begins) --> Reticulocyte (nucleus is lost; 3 days spent in bone marrow,
about 1 day in blood) --> Erythrocyte
** aprox. 1% of RBCs are reticulocytes **
In each step the quantity of hemoglobin increases and the nucleus decreases in
size
Erythropoietin - ANSWER-A hormone produced and released by the kidney that
stimulates the production of red blood cells by the bone marrow
Always present in plasma
Released in response to low renal oxygenation
,- NOT the # of RBCs but rather oxygen delivery
- e RBC production increases within 24 hours; life span 4-12 hours; increased
RBC # in 5 days
- Given to dialysis and chemo patients
Reticulocytes - ANSWER-▪ Last immature form of erythroblast
▪ Contains polyribosomes (globin synthesis) and mitochondria (heme synthesis)
▪ 24-48 hours after leaving bone marrow for circulation, matures into
erythrocyte
- Loses polyribosomes and mitochondria
-Make up 1-2% of RBCs
- Last about 2 days in bone marrow and 1 day in blood continuing to mature
- During time of low HCT time in marrow decreased to as little as 1 day
▪ Reticulocyte count -- Indicates whether new RBCs are being produced; good
indicator of erythropoiesis
Hemoglobin and its structure - ANSWER-Oxygen-carrying protein of the
erythrocyte --> may carry up to 300 hgb molecules
Reversible deformity to be abvle to squeeze through the tiniest of capillaries
Each Hgb molecule has 2 pairs of different globin chains and 4 complexes of
iron + heme
▪ Heme: large, flat, iron-protoporphyrin disk that is synthesized in the
mitochondria and can carry one molecule of oxygen
▪ Each Hgb can carry 4 molecules of oxygen
, Heme vs Globin - ANSWER-Heme: Synthesized in mitochondria of reticulocyte
- Carries Oxygen
Globin: Polyribosomes in reticulocytes
- 2 pairs of globin chains on each Hgb molecule
- Combo of pair determines type of globin chain
▪ Most common hgb A: 2 alpha chains and 2 beta chains - hgb F (fetal): 2 alpha,
2 gamma
Red blood cell structure - ANSWER-Sac of Hgb, no nucleus or mitochondria,
only hemoglobin & enzymes surrounded by membrane
-Lack mitochondria, rely on glycolysis for energy --> "aerobic metabolism"
▪ Deficiencies of 2 enzymes result in anemia
• Pyruvate kinase - necessary for glycolysis - no glycolysis results in RBC
damage and death
• G6PD - involved in protecting the RBC against oxidative stress
Anisocytosis
Poikilocytosis - ANSWER-Variation in RBC size
Variation in RBC shape
Hereditary vs Acquired Hemolysis - ANSWER-Hereditary hemolysis: sickle cell
disease
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