General physiology and Physiology of blood

General physiology
**Important topics and lecture outline
1. Introduction to physiology
2. Membrane transport
3. Membrane potential
4. Na/K pump
5. Physiology of muscle contraction
6. Mcq from Roddi

1.Introduction to physiology Neuroendocrine

• Human body contains 100 trillion cell.
• Cell is the basic living unit(structural and functional) unit of human body.
• Human body has two basic control systems…1.Nervous system 2.Endocrine
system.
• About 60% of the human body is fluid.2/3rd of the fluid is intracellular and
1/3rd is extracellular.
• In the extracellular fluid are the ions and nutrients needed by the cells to
maintain cell life. Thus the extracellular fluid is called the Internal
environment(Millieu interieur)
• Homeostasis refers to maintenance of nearly constant condition in the
internal environment.
• Negative feedback refers that if some factor becomes excessive or deficient,
a control system initiates which consists of a series of changes that return
the factor toward a certain mean value thus maintaining homeostasis.
• Examples of negative feedback… most of the control system of the body act
by this mechanism.
a)control of blood pressure
 b)control of blood sugar
c)control of arterial oxygen and CO2 concentration

• Positive feedback occurs when the initiating stimulus causes more of the
same. Examples are
*Blood coagulation
* Nerve impulse conduction
*LH surge
*child birth
• Difference between ECF and ICF Topic 1 1 qns infinity star
Topic ECF ICF
1.Site Outside the cell Inside the cell
2.Ions Mainly Na+,K+,Ca++ &Cl- Contains mainly K,Mg,glucose
and amino acid.
3.Proteins Protein content is less Protein content is more
4.Ph pH 7.4 Ph.7.0
5. Tonicity Same as ICF Same as ECF
6.Volume 14 L 28L
7.Po2 35 mmhg 20 mmhg
8.Pco2 46 mmhg 50 mmhg
9.Anions Inorganic(Cl-,HCO3) Organic(protein and organic
phosphates
2.Membrane transport.. Topic 2
Membrane transport refers to passage of molecules and ions through
biological membrane.
Structure of Cell Membrane….
According to the fluid mosaic model,cell membrane is composed of a lipid
bilayer. There is two layers of phospholipid. These are interposed with
protein.
**The head end of the lipid bilayer is composed of phospholipid. This end is
hydrophilic.
**The tail is composed of fatty acid and it is hydrophobic.
**Two types of proteins are present in cell membrane.
1.Integral protein..
#act as carrier protein
# act as channel protein
# act as receptor
#act as enzyme
#act as second messenger
2.Peripheral proteins
#act as enzymes
#act as controller if transport substances
.
Classification of membrane transport..

*Movement of small molecules(Micromolecular transport)

1. Diffusion(Simple & facilitated)
2. Active Transport
3. Passive transport
*Movement of large molecules (Macromolecular transport)
1. Endocytosis(pinocytosis & phagocytosis)
 2. Exocytosis

*Signal transmission across the cell membrane

1. Cell surface receptor
2. Intracellular receptor
*Intracellular communication

Passive transport. Movement of substance along the concentration gradient(lower

to higher concentration)and does not require any metabolic energy.
Diffusion
… The continuous movement of movement of molecules in liquids or gases from a
higher concentration to lower concentration along the concentration gradient. The
energy that causes the diffusion is the energy of normal kinetic motion of the
substances. This is of 2 types:-
a)Simple diffusion means the kinetic movement of molecules or ions occurs
through (1) the interstices of the lipid bilayer eg.. Oxygen,nitrogen,CO2,alchohol
2)through the watery channels that penetrate all the way through some of the
large transport proteins eg. Water and lipid insoluble substances.
.b)Facilitated diffusion…it requires interaction with a carrier protein. Eg. Glucose.
**Protein channels has two important characteristics…
1. Selective permeability
2. They can be opened or closed through gates.
**There are 2 types of gates
1. Voltage gating…here the change of electrical potential across the cell is
responsible for opening or closing the gates.
Example…Na+channels are remain tightly closed when there is strong
negativity inside the cell. When negativity loses inside the cells, the gates
will open that allow large amount of Na+ influx inside the cell. This is an
important phenomenon of generating action potential. K+ channels will
open when Inside the cell membrane becomes positively charged. This is
responsible of terminating action potential.
2.Ligand gating…Protein gates are opened by binding of a chemical substance
with the protein, this causes a conformational change in the protein molecule that
opens or close the gates. This is called chemical gating or ligand gating.
Eg..Acetylcholine channel.
**Inner surface of the Na channels are strongly negatively charged whereas K+
channels are not negatively charged.
Comparison between simple and facilitated diffusion

**Simple diffusion proportionately increases with the concentration of the

diffusing substances but facilitated diffusion approaches up to a maximum which
is called V max.
Factors affecting the net rate of diffusion..
Directly proportional…
1.Lipid solubility
2.Number of protein channel
3.Concentration gradient
4.Number of protein channel
5.Tenperature
6.Electeical potential
Inversely proportional..
1.Thickness of membrane
2.Miolecular weight
Osmosis Topic 3
Osmosis is the flow of water across the semipermeable membrane from
a solution of low solute concentration to a solution with high solute
concentration.
Factors regulating osmotic pressure
1.The number of solute particle per unit volume of solution
2.Effect of ionization
3.Temperature
4.Volume
Difference between Osmosis and Diffusion
 Topic 4
Active transport…The movement of substance across the cell membrane against
the concentration gradient with the active expenditure of energy by the help of
carrier protein is called active transport.
**Criteria
1.Transport occurs from lower to higher concentration
2.Cell membrane is required
3.Carrier protein is required
4.Energy expenditure is needed
5.Need a carrier protein
Classification
1.Primary active transport.. Here the energy is required from the breakdown of
ATP or some other high energy phosphate compounds.
Examples…
1.Na+ – K+ ATP ase pump
2.Ca++ pump… present in sarcoplasmic reticulum
3.H+ -K+ ATP ase(Proton pump)… gastric parietal cell, late distal tubule of kidney

2.Secondary active transport… Here the energy is derived secondarily from the
ionic concentration gradient that have been created in the first place by primary
active transport.
Types…
a)Co transport (symport)…Movement of two substances in the same direction.
Example…..Na-Glucose co transport (intestine), Na Amino acid co transport
(intestine)
b)Counter transport (Antiport)….Movement of two substances in opposite
direction. Eg.. Na- K pump, Na-H+ pump
Na+ - K+ pump..

A transport process which pumps 3 Na+ from inside to outside through the cell
membrane and at the same time pumps 2K+ from outside to the inside against the
concentration gradient with the expenditure of energy by the help of carrier
protein.
Importance..
• It is responsible for membrane potential
• Helps in maintaining the normal cell volume
• It is the basis of nerve conduction
• It provides energy for secondary active transport.

**Endocytosis are if 2 types

a)Phagocytosis(Cell eating)…There are various substances (bacteria, dead
tissue or other visible substances which are seen are microscope.These are
engulfed by the poly morphoneuclear leukocytes. This us called
Phagocytosis.

b)Pinocytosis (cell drinking)…The substances which are ingested by the cell

are not visible under light microscope.
**Exocytosis…Process by which large molecules come out of the cell.
Na-K+ pump
**It is a transport process which pumps 3Na+ from the inside to outside through
the cell membrane and the same times
Resting Membrane Potential (RMP)
The potential difference across the cell membrane during resting condition is called
RMP.
**RMP of nerve fiber is -90 millivolt.
**RMP is always negative because
1.due to presence of K+ - Na+ leak channel
2.inside the cell are presence of negatively charged macromolecules that keep the
RMP negative.
3.Due to presence of NA+ -K+ pump.
Diffusion potential
A diffusion potential is the potential difference generated across a membrane
because of concentration difference of ions.
**Diffusion potential is calculated by Nernst equation(single ion) and Goldman
equation(Multiple ions).
Generation of RMP
• Contribution of K+ diffusion potential
• Contribution of Na+ diffusion through nerve membrane
• Contribution of Na+- K+ pump.
•
Action potential
Rapid changes in the membrane potential that spread rapidly along the nerve fibre
membrane is called action potential.
Stages of Action Potential
• Resting stage..-90 mv as RMP
• Depolarization stage.. due to influx if Na+ inside the cell
• Overshoot…when membrane potential crosses the ‘0’ level it is called
overshoot
• Repolarization state… inactivation of Na+ channel and opening if K+ channel
• Spike potential.. Sharp rise and sharp fall of repolarization
• Negative after potential.. After termination of spike potential the membrane
potential sometimes fails to reach at normal resting state.
• Hyperpolarization. Due to increase K+ conductance.
Plateau
In some instances the excited membrane does not repolarize immediately after
depolarization. This is mainly seen un case of cardiac muscle due to presence of
slow Ca++ channel.
Muscle physiology

Structure of skeletal muscle..

A.Muscle structure and filaments

**Each muscle fiber is multinucleated and behaves as a single unit.

**It contains bundles of myofibrils surrounded by sarcoplasmic reticula and
invaginated by transverese tubules(T Tubules)
**Each myofibril contains interdigitating thick and thin filaments arranged
longitudinally in sarcomeres.
**Repeating units of sarcomeres account for the unique banding pattern in striated
muscle. A sarcomere runs from Z line to Z line.
1.Thick filaments
*are present in the A band in the center of the sarcomere
*contains myosin
2.Thin filaments
*are anchored at the Z lines.
*are present in the A bands
*contain actin, tropomyosin and troponin
**Troponin is regulatory protein that permits cross bridge formation.
**It is a complex globuler protein..
• Troponin T attaches the troponin complex to tropomyosin
• Troponin I inhibit the interaction of actin and myosin
• Troponin C is calcium binding protein that when bound to calcium, permits
the interaction of actin and myosin.
**T tubules are extensive tubular network, open to the extracellular space,that
carry the depolarization from the sarcolenmal membrane to the cells interior.
**are located at the junctions of the A bands and I bands.
**Sarcoplasmic reticulum is the site of Ca++ storage.
Mechanism of muscle contraction..
• An action potential travels along a motor nerve to its endings on muscle
fibers
• At each ending the nerve secrets a small amount of the neurotransmitter
Acetylcholine
• The acetylcholine acts on a local area of the muscle fiber membrane to open
multiple ach gated channel through protein molecules floating in the
membrane.
• Opening of the ach channel causes large quantities of sodium ion to diffuse
to the interior of the muscle fiber membrane. This initiates an action
potential at the membrane.
• The action potential depolarizes the muscle membrane and much of the
muscle fiber. Here it causes the sarcoplasmic reticulum to release largw
quantities of calcium ions.
• The calcium ions initiate attractive force between the actin and myosin
causing slide along side.
• After a fraction if a second the calcium ions are pumped back into the
reticulum by a Ca++ membrane pump
**Isometric contraction generate force without shortening.
**Isotonic contraction shorten at a constant afterload. Here shortening of
sarcomere occurs.
 Blood Topic 5
Blood is a specialized fluid connective tissue consisting of a fluid
plasma in which are suspended a number of formed elements
(erythrocytes, leukocytes and thrombocytes)

Composition of blood..

Properties of blood…
 • Volume 5-6 liters
• Ph 7.36- 7.46
• Reaction slightly alkaline
• Specific gravity 1.052 - 1 . 060
• Viscosity 4 to 5 times more viscus than water
• Temperature 36 -38 °c
• Osmotic pressure 25 mmhg
• Taste Salty
• Color red due to presence of hemoglobin inside RBC
**Viscosity of blood depends on
• The amount of plasma protein
• Number and volume of Cellular elements
• CO2 tension
• Temperature
**Viscosity rises in
• Acidosis
• Hypercalcemia
• Hyperglycemia
• Polycythemia
• Cyanosis
• Diabetes mellitus
**Viscosity decreased in
• Anemia
• Fever
• Exercise
• Edema
• Lymphatic leukemia
• Malaria
• Rise of temperature
**Specific gravity increased in
 1. Loss of water from the body such as sweating, diarrhea, cholera
2. When water intake is inadequate
3. Exudation of fluid into tissue of serous cavity due inflammation, surgical
operation, burn etc.
Specific gravity falls in
1. Decrease water intake
2. Injection of saline and glucose into vein
3. Immediately after severe hemorrhage
Difference between plasma and serum..

Plasma proteins Topic 6

 *Normal value of plasma proteins 6.4- 8.3 gm/dl

Functions of plasma proteins

Properties of plasma proteins..

1. Precipitation by salt
2. Fractional Precipitation
3. Sedimentation by Ultracentrifuge
4. Electrophoretic mobility
5. Molecular weight
Basic biochemical features of plasma
Albumin
• Molecular weight..69000
• Serum level..3.5- 5.0 g/l
• The total Exchangeable albumin pool is 4- 5 g/kg body wt.38-45% of this
albumin is intravascular and much of it in the skin. Between 6- 10%
exchangeable pool is degraded per day. The albumin is transported probably
to the extravascular areas by vesicular transport across the wall of the
capillaries.
• Small amount of albumin freely filtered normally and this absorbed by
tubules.
• Carries CO2 as carbamino protein and carries Hb as carbamino Hb.
• Synthesis of albumin decreased during starvation.
• Synthesis of albumin increased in nephrosis.
• It is a first class protein containing essential and non essential amino acid.
• Precipitated by full saturation of ammonium sulphate and soluble in distilled
water.
• It has higher electrophoretic mobility.
• Normal albumin globulin ratio 1.7:1.It acts as a important liver function test.

Red blood corpuscle (RBC) Topic 7

**RBC is a circular, non nucleated bi concave disc.
**Thick in the periphery(2-2.2 micron) thin at the center.
**IN spite of having no nucleus RBC is considered as cell because
• Has a definite life span
• Caries its own metabolism by glycolysis and forms ATP
• Performs a lot of metabolic activities.
**RBC differs from other cell (peculiarities of RBC)
• Absence of nucleus
• Presence of hemoglobin 02 and CO2 carry
 • Absence of mitochondria and glycogen

**Functions of ATP
• ATP maintains the biconcave disc of RBC
• ATP serves various metabolic activities.
**Importance of absence of nucleus.
• It Provides more surface for Hb within the red cells and mire surface area for
diffusion.
• It also helps in maintaining the biconcave shape of RBC.
**Advantage of biconcave shape
• Increase surface area
• Easy gaseous exchange.

HB=
Morphology of RBC…,

Important enzymes present in RBC..

• Glucose 6 phosphate dehydrogenase
• Na+ - K+ ATP ase
• Carbonic anhydrase
• Phosphofructokinase
• Pyruvate kinase
Functions of RBC
• RBC contain Hb that carry O2 from blood to tissue and tissue to blood.
• Helps to maintain acid base balance.
• Helps to maintain Ion balance
• Maintain the viscosity of blood
• Contains antigen that determines blood group
• Various pigment can be found In Hb after disintegration of red cells e.g.
bilirubin, bilivardin etc.
Erythropoiesis
The process of formation of normal blood cells under normal physiologic condition
us known as erythropoiesis.
Sites of erythropoiesis Infinity Star

Factors responsible for erythropoiesis

Stages of erythropoiesis..
Erythrocyte maturation factor = Vit B12 and Folic acid , IFC.
Erythropoietin Topic 8
**It is a glycoprotein hormone necessary for erythropoiesis.
**Molecular weight..34000
**Composition.. 74% protein, 26% carbohydrate
** Source of erythropoietin… VVI
• Kidney(85%)
• Liver(15%)
• Spleen
• Salivary gland
• Brain
• Uterus
• Oviduct
Regulation of erythropoietin secretion VVI
**Secretion increased by
• Hypoxia
• High altitude
• Cobalt salt
• Androgens
• Respiratory alkalosis
**Secretion decreased in
• Anemia of chronic disease
• Chronic renal failure
• Malnutrition
Fate of RBC..
After passing 120 days in the circulation RBC destroyed in the RES, the Hb is
liberated from the RBC. The fate of Hb as follows
 Topic 9
Hemoglobin.. is a red oxygen carrying pigment. It is a conjugate protein having a
Molecular weight of 64,450.
Functions..
• It is essential for transport oxygen from lungs to tissues and CO2 from tissue
to lung
• Act as an important blood buffer
• Various pigment of bile,stool,urine e.g.billirubin, stercobillin, urobillin ate
formed from hemoglobin.
Normal values

Structure of hemoglobin..
**Hb consists of protein globin united with heme pigment.
*Heme is a tetrapyrole porphyrin ring containing Fe++
**The porphyrin nucleus consists of 4 pyrole rings joined together by 4 methyle
bridges.
**Globin is a long polypeptide chain synthesized by ribosome.There are 4 globin
chain…(2 alpha chain and 2 beta chain).
 VVI

Normal

Common abnormal hemoglobin..

Difference between adult and fetal hemoglobin..
Iron metabolism..
Distribution of body iron…
• Hemoglobin..65%
• Storage iron(2/3rd as ferritin, 1/3rd transferrin)…15-30%
• Myoglobin, in red muscle.. 4%
• Intracellular heme containing enzymes… 1%
• In combination with transferrin..0.1%
ESR Topic 10
When a sample of venous blood is mixed with suitable anticoagulant and is allowed
to stand vertically in a narrow tube,red cells tends to settle down gradually to the
bottom leaving the clear plasma above. The rate of sedimentation is calculated
within 1st hour. This is called Erythrocyte sedimentation rate(ESR)
**Can be done in two methods…

Roleaux formation..
The process by which red blood cells settle down is called roleaux formation.
**Roleaux formation us increased by increase fibrinogen and gamma globulin.
**The more the roleaux formation, the more is the ESR.
Causes of raised ESR.. VVI
Physiological..
• Old age
• Pregnancy
• Vaccination
• In female due to low PCV
• At high altitude
• In infant
Pathological
• . Acute and chronic inflammation
• Chronic infection such as TB
• Acute rheumatic fever
• Connective tissue disease.. SLE,rheumatoid artheritis
 • Neoplasm
• Multiple myeloma
• Anemia(Aplastic Anemia)
Causes of marked rise of ESR. > 100
• Aplastic anemia
• Multiple myeloma Metastatic Carcinoma ,
• Kala a zar
Dissiminated TB
• SLE
ESR decreased in
• Polycythemia
• Sickle cell anemia
• Congestive cardiac failure
• Hepatic failure
• Afibrinogenemia
Packed cell volume/Hematocrit value/PCV is the ratio of red blood cells to plasma
after centrifugation for a specific period.
Topic 11
PCV increases in
• Polycythemia
• Burn
PCV decreases in
• Anemia
• Pregnancy
• Soon after fluid transfusion
White blood corpuscle
Topic 12
Classification

Basic characteristics
Properties of WBC
• Diapedesis
• Chemotaxis
• Amoeboid movement
• Phagocytosis
 Life span of WBC
**Granulocytes.. 4- 8 hours in the circulating blood,4-5 days in the tissues
**Monocytes…10 -20 hours in circulation. Months or years in tissue
macrophage form
**Lymphocytes.. Weeks, months or even years

VVI

2 star

Infinity star

Functions of WBC
• Phagocytosis
• Antibody formation
• Formation of fibroblast
 • Antihistamine function
• Chemotaxis
• Act as scavenger

Hemostasis and Platelet… Topic 13

Platelet or thrombocyte is one of the formed elements of the body essential for
blood coagulation.
Morphology..
• Diameter 2- 4 micro meter
• Shape……… Oval
• Nucleus…. Absent
• Cytoplasm… divided inti 2 parts.
a)Hyalomere…outer layer contains granules, microtubules, microfilaments,
which contain thrombasthenin responsible for change of the shape of
platelet.
b)Chromatomere…central deeply stained area contains alpha
granules,glycogen granules, mitochondria, ribosomes, serotonin, ER,
phospholipid, ATP, ADP
• Normal count…1.5 lac to 3.0 lac/ cu.mm of blood
• Life span…8-12 days
Megakaryocyte..
The parent cell of platelet is called megakayocyte.
Function
 • Hemostasis
• Blood coagulation
• Phagocytosis
• Storage and transport of substances
• Vasoconstriction
• Endothelial cell formation
• Some antigenic function
• Liberate substance which helps in inflammation.
Infinity star

Hemostasis Topic 14
The term hemostasis means prevention of blood loss.
Events of hemostasis…
• Vascular constriction. Immediately after a blood vessel has been cut or
ruptured, the trauma to the blood vessel wall itself causes the smooth
muscle in the wall to contract.. This instantly reduces the flow of blood from
the ruptured blood vessel. The contraction results from
1. Local myogenic spasm
2. Local autacoid factors from the traumatized tissue, blood, platelet
3. Nervous reflex
• Formation of platelet plug
• Blood coagulation..

• Eventual growth of fibrous tissue…. to close the hole In the vessel

permanently. Once a clot is formed, fibroblasts are activated and they
deposit fibrous tissue into the blood clot to seal the hole permanently.
Clotting factor
 Coagulation factor = clotting factor

ECF

Essential clotting factor..

• Factor I – Fibrinogen
 • Factor II-Prothrombin
• Factor III-Tissue factor
• Factor IV-Ca++
Vitamin K dependent clotting factors…II, VII,IX X VVI
Extrinsic pathway for blood coagulation..
This pathway activates with a traumatized vascular wall or traumatized extra
vascular tissue that come in contact with blood.

fibrinogen Fibrin

Intrinsic pathway of blood coagulation…This pathway begins with trauma to the

blood itself or exposure of blood to collagen from a traumatized vessel wall.
Difference between extrinsic and intrinsic pathway…
 Topic 15
Anticoagulant… are the substances which prevent coagulation of blood by
interfering with the coagulation system.

VVI

Cause of increase bleeding time

Fate of clot… Cause of increase clotting time
• Clot retraction Cause of increase aPTT.
• Fibrinolysis
Bleeding time….The time required for cessation of bleeding from a small puncture
wound of the skin. Normal value 2-7 second
Clotting time…When the blood is removed from the body and kept in glass capillary
tube it coagulates forming fibrin thread. The elapse of time between withdrawal of
blood and formation of clot is called Clotting time.
**Normal value…5-8 mins
Clot retraction . .Within a few minutes after a clot is formed it begins to contract
and losses most of its fluid within 20 -60 mins and reduced in size butvbecome
tuffer,more solid and elastic.This is called clot retraction.
Substance containing heme iron..
• Hemoglobin
• Peroxidase
• Catalase
• Cytochrome
• Myoglobin
• Xanthine
• Tryptophan pyrolase
Substance containing non heme iron
• Transferrin
• Ferritin
• Hemosiderin
Previous question(General physiology and blood)
1.Inhibition of Na+, K+ -ATPase would result in increased (March18)
a)Increase in intracellular K+ concentration
b)Ca++ concentration
c)Intracellular Na+ concentration
d)Na glucose co transport
e)Na Calcium counter transport
FTTFF
2.Substances that can easily diffuse through cell membrane are(March 17)
a)oxygen
b)sodium
c)glucose
d)protein
e)CO2
TFFFT
3.Examples of active transport include (July 16)
a)Na reabsorption in the distal tubules of the kidney
b)Ca uptake by the sarcoplasmic reticulum of muscles
c)movement of O2 from pulmonary alveoli into blood
d)uptake of LDL cholesterol by the cell
e)chloride shift between RBC and plasma
TTFFT
4)Resting membrane potential of a cell (March 16)
a)is close to equilibrium potential of K+
b)determines its excitability
c)is calculated by Goldman equation
d) is close to equilibrium potential of Na+
e)is contributed by Na K pump
TFTFT
5.During isotonic contraction of skeletal muscle shortening occurs in(July 15)
a) A band
b) H band
c)I band
d)M line
e)Sarcomere
6.Glucose is transported into the cell by (July 13)
a) primary active transport
b)Na dependent facilitated diffusion
c)simple diffusion
d)endocytosis
e)secondary active transport
FFFFT
7.Positive feedback is useful in (July 10)
a)Blood clotting
b)Regulation of CO2 In ECF
c)child birth
d)generation of nerve signals
e)regulation of blood pressure
TFTFT
8.Primary active transport of hydrogen ion occurs in March 19)
a)ventricles of the brain
b)capillaries in the lungs
c)gastric glands
d)cortical collecting duct of kidney
e)osteoclasts of bone
FFTTT
9.Substances entering cells through simple diffusion(March 19)
a)Glucose
b)O2
c)CO2
d)amino acid
e)long chain fatty acid
FTTFT
10.ESR may be characteristically raised in (July 18)
a)ischemic stroke
b)osteoarthritis
c) rheumatic fever
d) sarcoidosis
e)SLE
11.Hemostasis is achieved by (July 18)
a)vasospasm
b) platelet plug formation
c)agglutination
d)aggregation of leukocytes
e)eventual growth of muscle tissue into clot
TTFFF
12.Vitamin K dependent clotting factors are (July 18)
a)fibrinogen
b)stable factor
c)plasma thromboplastin components
d)factor X
e)thromboplastin
FTTTF
13.Laboratory tests done on hemolysed blood cause (July 18)
a)Fall in serum Na+
b)increase un serum K+
c)rise in serum LDH level
d)decrease in serum glucose level
e)increase in serum bilirubin level
TTTTT
14.Erythropoitin production is decreased in
a)Renal failure
b)Decreased estrogen level
c)Anemia of chronic disorder
d)hemolytic anemia
e)hepatoma
TFTFF
15.Normal blood clotting requires(March 18)
a)inactivation of heparin
b)inactivation of plasmin
c)Calcium ions
d)vitamin K
e)vitamin C
TTTTF
16)Adult stem cells (March 18)
a) usually lineage specific
b)capable of trans differentiation
c)used for therapeutic cloning
d)endowed with developmental plasticity
e)used for production of knock out mice in experimental models
TTFTF
17.Total count if RBC increased in (March 18)
a)chronic pulmonary disease
b)high altitude
c)chronic renal failure
d)erythroblastosis fetalis
e)hypoxia
TTFFT
18.ESR raised in( July 17)
a)polycythemia
b)tuberculosis
c)multiple myeloma
d)congestive heart disease
e)anemia of chronic disorder
FTTFF
19.Avitaminosis K decreases synthesis of (March 17)
a)fibrinogen
b)prothrombin
c)factor VII
d)factor VIII
e)factor IX
FTTFT
20.Anticoagulants may be used in clinical laboratory are(March 17)
a)Na Oxalate
b)K oxalate
c)EDTA
d)Ethyl alcohol
e)Ca chloride
TTTFF
21.Regarding muscle spasm in hemostasis(March 17)
a)pain causes local myogenic spasm
b)endothelin 1 is secreted
c)factor VII is secreted
d)Thromboxane A2 is secreted
e)can last for many minutes
TTFTF
22.Bleeding time is increased in (March 17)
a)chronic aspirin ingestion
b)anemia
c)thrombocytopenia
d)vitamin C deficiency
e) Vitamin A deficiency
TFTTF
23.Bleeding time is characteristically increased in(March 17)
a)hemophilia
b) VWD
c)warfarin therapy
d)factor X deficiency
e)thrombocytopenia
FTFFT
24.Antibodies against both group A and group B antigens are found in a person
who belongs to blood group (March 17)
a)A
b)B
c)AB
d)O
e)Rh positive
FFFTF
25.Functions of plasma proteins are (March17)
a)maintain colloidal osmotic pressure
b)act as antibody
c)help in blood coagulation
d)maintain high level of capillary hydrostatic pressure
e)exchange respiratory gases
TTTFF
26.Specific gravity of blood increases in (March 17)
a)cholera
b)burn
c)plasma pheresis
d)5% glucose infusion
e)gastroenteritis
TTFFT
27.Coagulation factors generated in the liver are(July 16)
a)factor II
b)factor IV
c)factor VI
d)factor IX
e) factor X
TFFTT
28.Plasma proteins (March 16)
a)are essential for blood coagulation
b)are not synthesized in the liver
c)contain nucleus
d)maintain blood viscosity
e)maintain colloidal osmotic pressure
TFFTT
29.Primary factors of coagulation are (March 16)
a)Prothrombin time
b)calcium ion
c)factor IX
d)factor VIII
e)fibrinogen
TTFFT
30.Vitamin K is necessary for synthesis of (March 16)
a)factor X
b)prothrombin time
c)factor V
d)factor IX
e)fibrinogen
TTFTF
31.Causes of prolong prothrombin time are(March 16)
a)treatment with oral anticoagulant drug
b)DIC
c)Hemophilia A
d)deficiency of factor XI and XII
e)hemolytic disease of newborn
TTFFF
32.Essential hormone for erythropoiesis are(March 16)
a)testosterone
b)thyroxine
c)estrogen
d)thyroid stimulating hormone
e)prolactin
TTFFF
33.ESR depends on( July 15)
a)albumin
b)plasma viscosity
c)fibrinogen level
d)immunoglobulin
e)CRP
TTTTT
34.Prothrombin time is increased in the following condition(July 15)
a)acute liver failure
b)obstructive jaundice
c)hemophilia
d)Christmas disease
e)CRP
TTFFF
35.The hematocrit (PCV)
a)may be obtained by centrifugation of blood
b)may be calculated by multiplying the mean cell volume by the red cell count
c)rises in a patient who sustains wide spread burns
d)rises following injection of aldosterone
e)rises in macrocytic megaloblastic anemia such as pernicious anemia
TTTFF
36.Monocytes (March 15)
a)originate from precursor cells in lymph node
b)have horse shoe shaped nucleus
c)are phagocytic cells
d)are highly motile
e)have a transmit time of 1 to 2 days in the blood before reaching into the tissues
FFTTT
37.ESR is influenced by(March 15)
a)level of fibrinogen
b)albumin concentration
c)C reactive protein
d)immunoglobulin
e)plasma viscosity
TTTTT
38.Prothrombin activator consists of(March 15)
a)prothrombin
b)phospholipids
c)factor V
d)factor IX
e)activated factor X
FTTFT
39.Vitamin K dependent clotting factors are (July 14,March 14)
a)factor II
b)factor V
c)factor IX
d)factor X
e)factor XI
TFTTF
40.Stem cells (March 14)
a)are characterized by prolong self renewal
b)have capacity to differentiate into specialized cells
c)do not have any role in tissue homeostasis
d)are not found in adults
e)have role in tissue repair
TTFFT
42.The hematocrit(PCV). (March 14)
a)may be obtained by centrifugation of blood
b)may be calculated by multiplying the mean red cell volume by red cell count
c)rises in a patient who sustained wide spread burn
d)rises following ingestion of aldosterone
e)rises in pernicious (B12 deficiency) anemia
TFTTT
43.Following products are helpful in platelet aggregation(March 14)
a)thrombin
b)PDGF
c)VWF
d)ADP
e)Thromboxane A2
TFTTT
44.Essential substances for erythropoiesis are (March 14)
a)iron
b)protein
c)lead
d)gold salt
e)Cobalt
TTFFT
45.Nutritional requirements of erythropoiesis (March 14)
a)Erythropoietin
b) bile salts
c)amino acids
d)androgen
e)folic acid
FTTF5
46.Stem cells (March 13)
a)are characterized by prolong self renewal
b)have capacity to differentiate into specialized cell
c)do not have any role in tissue homeostasis
e)have role in tissue repair
TTFFT
47.The plasma of normal adult(March 13)
a)is about 60% water
b)accounts for 10% of body weight
c)contains 8 mmol/L of K
d)contains about 140 mmol of Na
e)contain xanthine and hypoxanthine
FFFTT
48.The following components can be prepared from a single unit of whole
blood(March 13)
a)Packed red cell concentrate
b)Factor VIII concentrate
c)Factor IX concentrate
d)platelet concentrate
e)FFP
49.Erythropoitin production is decreased in(March 13)
a)renal failure
b)decreased estrogen level
c)Anemia of chronic disease
d)hemolytic anemia
e)hepatoma
TFTFF
50.Antibodies of Rh system include(July 12)
a)anti C
b)anti B
c)anti A
d)anti D
e)anti E
TFFTT
51.Platelet activation is caused by (July 11)
a)collagen fibers
b)ADP
c)epinephrine
d)thromboplastin
e)prothrombin
TTFFT
52.Recognised features of hypersplenism include (July 11)
a)pancytopenia
b)erythroid hyperplasia
c)splenomegaly
d)jaundice
e) megaloblastic anemia
TFTFF
53.The plasma prothrombin time is increased in (July 11)
a)pancytopenia
b)erythroid hyperplasia
c)splenomegaly
d)jaundice
e)megaloblastic anemia
TFTFF
54.Essential hormone for erythropoiesis(July 11)
a)androgen
b)TSH
c)thyroxin
d)estrogen
e)erythropoietin
TFTFT
55.Haemoglobin (July 11)
a)is a conjugated protein
b)contains Fe ion
c)hyperbolic in O2 dissociation curve
d)contains 70% of total body iron reserved
e)consists of one heme and 4 polypeptide chain
TTFTF
56.Indication of bone marrow aspiration are (Jan 11)
a)kala a zar
b)Gaucher's disease
c)phenylketonuria
d)Galactosemia
e)Addison's disease
TTFFF
57.Transfusion transmitted infections are(March 18)
a)malaria
b)tuberculosis
c)AIDS
d)syphilis
e)gonorrhea
TFTTF
58.Following fluids are used during plasma exchange(July 17)
a)normal saline
b)hydroxyethyl starch
c)FFP
d)5% albumin
e)platelet rich plasma
TTTTT
59.Complications of blood transfusion (March 17)
a)hepatitis C
b)hemosiderosis
c)hyperkalemia
d)when group A blood is given to an AB recipient
e)CMV infection
TTTFT
60.After 7 days storage at 4°C in the blood bank the blood shows a decrease in the
(July 16)
a)concentration of K concentration
b)concentration of platelet
c)prothrombin time
d)mean corpuscular volume
e)concentration of dextrose
FTFFT
61.Immune blood group antibodies are(July 13)
a)occurs naturally
b)can cross placenta
c) can cause hemolytic disease of new born
d)are IgM in type
e)cannot cause intra vascular red cell destruction
FTTFT