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Blood Physiology

1. Josephine is in a car accident and loses 2 out of 6 liters of blood. She gets only plasma for replacement. How long will it take for her to get her RBC count back to normal? EPO increases RBC production about 5-fold and it takes an additional 2- 3 days for reticulocytes to mature into RBCs.

2. Alice is a vegetarian with iron-deficiency anemia. What would her RBCs look like (small or large, pale or red) and why? Would the Hb/blood volume and the Hb/packed RBC numbers be high or low (explain)? If Alice starts getting enough iron, how long would it take for her RBCs to look normal?

3. Joe has extensive liver damage from years of heavy drinking. He has swelling all over his body (systemic edema) and has decreased clotting after being cut. Explain why Joe has edema and clotting explain the mechanisms that cause these problems.

4. Inflammation can increase blood flow (vasodilation) to the injured area and also can increase permeability by causing endothelial cell retraction. Explain why increased blood flow and increased permeability BOTH cause local swelling or edma.

Solution Preview

1. Josephine is in a car accident and loses 2 out of 6 liters of blood. She gets only plasma for replacement. How long will it take for her to get her RBC count back to normal? EPO increases RBC production about 5-fold and it takes an additional 2- 3 days for reticulocytes to mature into RBCs.

To restore her blood level to normal, Josephine will need to restore 2 liters of blood. Under normal conditions, RBC production takes approximately 8 days, but it can be reduced to 5 days during extreme conditions (such as the one that Alice is in!) under the influence of EPO. When one donates blood, usually about a pint of blood (473.18 ml) is taken. The body requires approximately four weeks to fully replace this amount of blood in the body (the fluid is replaced within minutes though). If it takes 4 weeks/473.18 ml, it would take 4 weeks/0.47318 Liters. Diving that out, it would take 8.45 weeks to replace one liter of blood. Since Josephine needs 2 liters of blood, 8.45 weeks *2 L=16.9 weeks or approximately 17 weeks (4 months + 1 week) to replace the blood that she has lost.

2. Alice is a vegetarian with iron-deficiency anemia. What would her RBCs look like (small or large, pale or red) and why? Would the Hb/blood volume and the Hb/packed RBC numbers be high or low (explain)? If Alice starts getting enough iron, how long would it take for her RBCs to look normal?

Alice's red blood cells would look smaller and paler if a sample of blood was taken from her. The reason for the abnormal appearance of her blood ...

Solution Summary

The solution answers particular questions about blood loss and anemia as well as explaining the general concepts of blood physiology and the inflammation process. The particular questions answered include: physiology of iron deficiency anemia due to vegetarianism, the possible remedies for iron deficiency edema, physiology of alcoholic cirrhosis, and why swelling (edema) occurs both due to the inflammatory response in general and because of alcoholic cirrohsis.

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