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NURS 8022 EXAM 1 2024/2025 Detailed with complete Questions and Answers
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NURS 8022 EXAM 1 2024/2025 Detailed wHematopoiesis - CORRECT 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 - COR...

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  • 25 september 2024
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  • 2024/2025
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NURS 8022 EXAM 2 2024/2025
(Detailed with complete Questions and Answers)


VERIFIED
Hematopoiesis - CORRECT 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 - CORRECT ANSWER - Bone marrow
("myeloid tissue")
Difference between red and yellow bone marrow - CORRECT ANSWER - Red
marrow produces RBCs, yellow marrow does not produce RBCs
Active bone marrow sites - CORRECT ANSWER - pelvic bones
vertebrae
cranium
mandible
sternum
ribs
humerus
femur
Factors that increase hematopoiesis - CORRECT 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 - CORRECT ANSWER - production of RBCs

,Sequence of erythropoiesis - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER -
Hemoglobin and its structure - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER - Variation in RBC size

, Variation in RBC shape
Hereditary vs Acquired Hemolysis - CORRECT ANSWER - Hereditary
hemolysis: sickle cell disease


Acquired hemolysis: immune mechanisms (transfusion reaction), infection
(malaria), drugs (penicillin), liver or kidney disease, toxins (chemicals, venoms)
Normal Labs (RBCs, Hgb, Hct, MCV, MCH) - CORRECT ANSWER - RBCs 4.2-
6.1
Hgb 12-18
Hct 35-50%


MCV: 78-100 (related to size)
MCH: 27-34 (related to hgb content)


Reticulocytes: new RBC formation - low suggest issues in production
Microcytic-Hypochromic Anemias - CORRECT ANSWER - Characterized by
red cells that are abnormally small and contain reduced amounts of hemoglobin


Iron Deficiency Anemia (IDA)
Sideroblastic
Thalassemia
Iron Deficiency Anemia (IDA) - CORRECT ANSWER - Type of Microcytic-
Hypochromic Anemia


- Most common type of anemia
- Highest risk: older adults, women, infants, poverty


- Associated with cognitive impairment in children

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