BB Lec - RBC Biology and Preservation

Question 1

two important RBC characteristics:

Answer 1

deformability and permeability

Question 2

is the network of proteins that contributes shape, strength, and function to a cell membrane.

Answer 2

cytoskeleton

Question 3

gives RBC their characteristic biconcave shape

Answer 3

cytoskeleton

Question 4

purpose of biconcave shape of RBCs

Answer 4

to allow gas exchange while carrying great quantities of oxygen

Question 5

gives a red cell flexibility
strengthens the cell membrane,
facilitates its efficient travel through capillaries

Answer 5

Cytoskeleton

Question 6

CAUSES OF SPHEROCYTOSIS (4)

Answer 6

defects in:
spectrin
spectrin and ankyrin
anion exchanger
palidin

Question 7

defect in proteins that provides vertical support

Answer 7

HEREDITARY SPHEROCYTOSIS

Question 8

defect in proteins that provide horizontal support

Answer 8

HEREDITARY ELLIPTOCYTOSIS:

Question 9

causes of loss of deformability (2)

Answer 9

The loss of adenosine triphosphate (ATP) (energy) levels [leads to a decrease in the phosphorylation of spectrin and, in turn, a loss of membrane deformability]

An accumulation or increase in deposition of membrane calcium also results, [causing an increase in membrane rigidity and loss of pliability ]

Question 10

loss of ATP leads to ___

Answer 10

decrease in the phosphorylation of spectrin

Question 11

decrease in the phosphorylation of spectrin leads to

Answer 11

loss of membrane deformability

Question 12

manifestations of loss of membrane deformability [3]

Answer 12

spherocytes
bite cells
shortened lifespan

Question 13

cells with a reduced surface-to-volume ratio and in which the

Answer 13

“spherocytes”

Question 14

what cells

removal of a portion of membrane has left a permanent indentation in the remaining cell membrane

Answer 14

“bite cells”

Question 15

The RBC membrane is freely permeable to

Answer 15

water and anions

Question 16

importance of permeability of rbc membrane (2)

Answer 16

prevent colloid hemolysis

control the volume of the RBC

Question 17

responsible for 90% of ATP generation

Answer 17

EMP

Question 18

processes/reactions in stage 1 emp

Answer 18

phosphorylation, isomerization, diphosphorylation

Question 19

end product of emp

Answer 19

end product: 3GP

Question 20

3rd stage of emp, product:

Answer 20

pyruvate

Question 21

Produces (reduced) NADPH and reduced glutathione

Answer 21

HMP

Question 22

prevents iron of Hgb from being oxidized (maintains ferrous state)

Answer 22

Methemoglobin reductase pathway

Question 23

2,3 DPG generation

Answer 23

RLP

Question 24

What form

B chains are closer together

Answer 24

Relaxed form

Question 25

What form | B chains are farther

Answer 25

Tensed form

Question 26

Is the effect pH has on HGB-oxygen affinity

Answer 26

HGB-DISSOCIATION CURVE

Question 27

Increase pH is a shift to ?? (inc or dec HGB affinity for O2)

Answer 27

left | increased HGB affinity for O2

Question 28

example of shift to left

Answer 28

hyperventilation

Question 29

Decrease pH --> shift to ??( increased or decreased HGB affinity for O2)

Answer 29

right | decreased HGB affinity for O2

Question 30

example of shift to right

Answer 30

EXERCISE | RENAL FAILURE

Question 31

is a measure of in vivo RBC survival following transfusion

Answer 31

RBC viability

Question 32

The FDA requires an average 24-hour post transfusion RBC survival of

Answer 32

more than 75%

Question 33

biochemical changes due to loss of RBC viability

Answer 33

Storage lesion:

Question 34

increases ADP levels, thereby driving glycolysis toward the synthesis of ATP

Answer 34

adenine

Question 35

chelates Ca, prevents clotting

Answer 35

Citrate (sodium citratre/citric acid):

Question 36

maintains pH during storage; necessary for maintenance of 2,3 DPG

Answer 36

Monobasic sodium phosphate

Question 37

substrate for ATP production( cellular energy)

Answer 37

Dextrose

Question 38

prod’n of ATP, extends shelf life from 21 days to 35 days

Answer 38

Adenine

Question 39

These are preserving solutions that are added to the RBCs after removal of plasma with or without platelets

Answer 39

additive solutions

Question 40

The additive solution is contained in a ___ and is added to the RBCs after most of the plasma has been expressed

Answer 40

satellite bag

Question 41

The additive solution is contained in a satellite bag and is added to the RBCs after ___

Answer 41

most of the plasma has been expressed

Question 42

Benefits of additives (3)

Answer 42

Extends the shelf life of RBCs (42 days) Allows for the harvesting of more plasma and platelets from the unit Produces an RBC concentrate of lower viscosity that is easier to infuse

Question 43

(AS-1; Baxter Healthcare)

Answer 43

Adsol

Question 44

(AS-3, Pall Corporation)

Answer 44

Nutricel

Question 45

(AS-5, Terumo Corporation)

Answer 45

Optisol

Question 46

ALL three additives have (3)

Answer 46

saline, adenine, and glucose.

Question 47

AS-1 and AS-5 also contains ___ (protects against storage-related hemolysis)

Answer 47

mannitol

Question 48

AS-3 contains __ and ___ (for the same purpose)

Answer 48

citrate and phosphates

Question 49

purpose of mannitol, citrate and phosphates

Answer 49

protect against storage-related hemolysis

Question 50

None of the additives solutions maintain ___ throughout the storage time

Answer 50

2.3 DPG

Question 51

ALL (AS-1 to AS-5) of the additive solutions are approved for HOW MANY days of storage for packed RBCs

Answer 51

42

Question 52

Used for autologous units & storage of rare blood types

Answer 52

RBC Freezing

Question 53

RBC Freezing involves the addition of cryoprotective agent to RBCs that are how many days old

Answer 53

less than 6 days old

Question 54

2 concentrations of glycerol

Answer 54

high conc-glycerol (40% w/v) Most BB used high-conc. Glycerol low conc. Glycerol (20% w/v)

Question 55

commonly used as cryoprotective agent and is added to RBCs slowly with vigorous shaking to permeate the RBCs

Answer 55

glycerol

Question 56

FDA licenses frozen RBCs to be stored up ?? years

Answer 56

10

Question 57

Transfusion of frozen cells must be preceded by a ____ process

Answer 57

deglycerolization

Question 58

what are the saline conc. in deglycerolization

Answer 58

12% saline, 1.6% saline, 0.2% dextrose in saline

Question 59

has traditionally been used in the deglycerolizing process.

Answer 59

A commercially available cell-washing system

Question 60

what must be monitored during deglycerolization

Answer 60

excessive hemolysis | osmolality

Question 61

has been developed that allows the glycerolization and deglycerolization to be performed under closed system.

Answer 61

ACP 215 (Haemonetics)

Question 62

Process by which ATP and 2,3 DPG levels are restored or enhanced by metabolic alterations

Answer 62

rbc rejuvenation

Question 63

only FDA approved rejuvenation solution sold in the US

Answer 63

Rejuvesol:

Question 64

rejuvenation solution currently approved for use with CPD, CPDA-1 and CPD/AS-1 RBCs

Answer 64

Rejuvesol:

Question 65

composition of rejuvesol

Answer 65

Contains phosphate, inosine, pyruvate and adenine

Question 66

temp and time for rejuvenation incubation

Answer 66

1 hr 37C

Question 67

volume of rejuvenation solution

Answer 67

50 ml

Question 68

Following rejuvenation, the RBCs can be washed to remove the rejuvenation solution and transfused within how many hours.

Answer 68

24