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NURS 8022 EXAM 2 LATEST EXAM
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NURS 8022 EXAM 2 LATEST 2024-2025 EXAMHematopoiesis - 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
Renal oxygenation negative feedback loop - answer-
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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