BLOOD PHYSIOLOGY

Learning Objectives
1st Semester, SY 2014-2015
RED BLOOD CELL (RBC) PHYSIOLOGY
RBC Production
A. To enumerate the characteristics and function of the red blood cell (RBC).
1. How can you describe the cell membrane of the RBC?
2. What is the major function of the rbc?
3. What is the importance of rbc in acid-base balance?
B. To discuss the role of erythropoietin (EPO) in RBC production.
1. What is the most important regulator of RBC production ?
2. What conditions can lead to increased production of EPO ? (Give 5)
3. Where is EPO produced?
4. What is the mechanism of action of EPO?
C. To discuss the steps in haemoglobin (hgb) synthesis.
1. What are the components of hemoglobin ?
2. How is each component synthesized?
3. How many oxygen atoms can 1 hemoglobin molecule bind? How many mL of oxygen can
bind to 1 gram of hgb?
D. To discuss the mechanisms of iron uptake, utilization and storage.
1. Where is iron absorbed ?
2. What transporter allows the absorption of iron from the apical membrane to the lumen?
3. What transporter allows the absorption of iron from the basolateral membrane to plasma?
4. What is the main transport form of iron?
5. Where is iron utilized and stored?
6. What is the major storage form of iron?
II. RBC Maturation: To describe the absorption, transport and utilization of vitamin B12.
1. What factor is secreted by the parietal cells to prevent digestion of vitamin B12 in the stomach?
2. How is vitamin B12 absorbed through the terminal ileum?
3. How is vitamin B12 transported from plasma to the liver?
III. RBC Death: To describe the fate of the rbc components after it is engulfed in the splenic pulp.
1. What is the lifespan of the RBC?
2. When the RBC dies, what happens to heme? To globin chains? To iron?
IV. Clinical Correlate: Anemia
A. To define Anemia.
B. To describe the pathology and enumerate changes in rbc size, shape and color in the
following types of anemia:
1. RBC production: Iron deficiency anemia
2. RBC maturation: Vitamin B12 and Folic acid deficiency
3. RBC death: Hereditary spherocytosis
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V.

HEMOSTASIS
Definition of terms: To define the following
A. Hemostasis
B. Thrombosis
Endothelium:
A. To enumerate the factors responsible for the Anti-thrombotic and Pro-thrombotic
properties of the endothelium.
1. What part of the endothelium is anti-thrombotic? Why
2. What part of the endothelium is pro-thrombotic?
3. What are the antiplatelet (Give 2), anticoagulant (Give 2) and fibrinolytic (Give 1) factors that
are released by the endothelium? Enumerate only. Be prepared to discuss their importance
when you talk about the platelets and coagulation factors.
B. To describe the 1st step in Hemostasis (Vasoconstriction).
III. Platelet
A. To describe the function of the structural components of platelets (e.g. cell membrane
component and cytoplasmic organelles).
1. What are the important components of the platelet cell membrane (Give 2) that is
responsible for both its pro-thrombotic and anti-thrombotic properties?
2. What are the contractile proteins present in the platelet cytoplasm?
3. What are the contents of the electron dense granules? Alpha granules?
B. To discuss the different steps in Primary Hemostasis (Platelet Plug Formation):
1. Adhesion: What endothelial component and platelet component are responsible for the
adhesion of platelets to the endothelium?
2. Secretion:
3. Aggregation: What receptors are responsible for platelet aggregation?

For a., b. and c., what are the events that occur in each step?
Coagulation Proteins
A. To differentiate the extrinsic pathway from the intrinsic pathway in terms of
1. Stimulus for activation
2. Time required for activation: Which one is activated first?
3. Coagulation factors that are activated: What are the coagulation factors that are
activated? What is the importance of Ca2+ and phospholipids in the coagulation cascade?
B. To discuss the sequential activation of coagulation factors in the common pathway
(Activation of Factors X to Formation of firbin polymer): What is the rate limiting step in the
coagulation cascade?
C. To enumerate the clotting factors that are formed in the liver.
D. To describe the role of vitamin K in the activation of clotting factors that are formed in the
liver.
E. To describe the role of the following naturally occurring anticoagulants in the restriction
of the hemostatic plug to the site of injury.
1. Antithrombin III
2. Protein C
3. Plasmin
Clinical Correlate: Primary Hemostatic Disorder and Secondary Hemostatic Disorder
A. To differentiate a primary from a secondary hemostatic by using the following parameters:
1. Clinical Example
2. Onset of bleeding
3. Site of bleeding
4. Physical Findings
5. Laboratory Tests

IMMUNE SYSTEM
I. To state the function of the immune system
II. Definition of Terms: To define the following
A. Antigen
B. Antibody
III. To differentiate the Innate immune response from the Adaptive Immune Response based on
A. Function
B. Characteristics
1. Specificity: What is specificity? What is responsible for the specificity of the adaptive immune
response
2. Diversity: What is diversity? How is diversity encoded in the innate immune response? In the
adaptive immune response?
3. Memory: What is memory? What is a primary immune response? Secondary immune
response?
4. Tolerance: What is tolerance?
C. Cell/Tissue Components: What are the different cells involved in the innate and adaptive immune
response? What are their characteristics? What are their functions?
IV. To differentiate Humoral Immunity from Cell-Mediated Immunity according to events that occur
in the different phases of the adaptive immune response
A. Antigen recognition
B. Leukocyte activation
C. Antigen elimination
D. Contraction
E. Memory
V. Clinical Correlate:
A. Immunization: To differentiate Passive immunity from Active Immunity
B. Organ transplantation
1. To define the following: isograft, allograft, autograft and xenograft
2. To differentiate the different types of graft rejection according to time elapsed after
transplantation and reason behind rejection