优质血液讨论课要点.docx

1、优质血液讨论课要点第三章 血 液一、目的和要求 了解血量、血液的组成和有形成分的功能。熟悉血液的理化特性。掌握生理性止血机制，血液凝固及纤维蛋白溶解。二、重点和难点 重点:血液的理化特性、红细胞的生理特征与功能、红细胞生成的调节、血小板的生理特性与功能、生理性止血的机制、凝血基本过程、抗凝血系统及其作用、纤维蛋白溶解系统及纤溶过程。难点：凝血因子、凝血途径、抗凝血系统及其作用。三、讲授内容和要点血液的组成、理化特性及血液的功能。红细胞的生理特性与功能。红细胞生成的调节。白细胞的生理特征和功能。血小板的生理特性。生理性止血的基本过程。凝血因子、外源性和内源性凝血途径。抗凝血系统及其作用、纤维蛋白

2、溶解系统及纤溶过程。四、自学内容和要点白细胞和血小板的生成和调节。白细胞、血小板的破坏。血型与输血原则。五、参考复习题1. 正常人的血量是如何计算？试述血浆蛋白的种类及其生理功能。2. 试述血液的生理特性和红细胞的生理特性。红细胞有何功能？3缺乏铁、维生素B12和叶酸引起的贫血有何不同？为什么4. 血浆晶体和胶体渗透压主要由哪些物质形成？各有何生理功能？当将细细胞分别置于高渗、低渗、等渗但不等张和等渗等张溶液中，其容积发生何改变？5. 试述生理性止血的基本过程，详述其机制。6. 试述血凝的基本过程的三个步骤。内、外源凝血系统有何不同特点？两系统间有何关系？7. 当人生活在海平面时，为何外周血中

3、的红细胞（RBC） 数能维持相对稳定？当人生活在海平面进入4000 M高原生活六个月，RBC数有何变化？为什么？8. 血液在正常人心血管内为何不凝？怎样加快、延缓和防止血凝？为何医生在进行外科手术前要先给病人补充维生素？9. 如果已知某人血型为或，能否用其来测定未知血型？为何同型血相输还需作交叉配血？10. 血小扳有何生理特性？其主要功能是什么？试述血小板在生理性止血中的作用。11抗凝系统有哪些抗凝物质组成？各有何作用？其机制是什么?12. 简述纤溶系统的组成及纤溶过程。纤溶系统与血液凝固系统有何 关系？六、名词血浆(plasma)、血细胞(blood cells)、血浆蛋白(plasma p

4、rotein)、红细胞(erythrocytes)、白细胞(leukocytes)、血小板(platelets)、血细胞比容(hematocrit)、粘度(viscosity)、晶体渗透压（crystal osmotic pressure）、胶体渗透压(colloid osmotic pressure)、等张溶液(isotonic solution)、造血(hempooiesis)、可塑变形性(plastic deformation)、红细胞的悬浮稳定性(suspension stability) 、 红细胞沉降率 (erythrocyte sedimentation rate，ESR) 、红

5、细胞叠连(rouleaux formation) 、渗透脆性(osmotic fragility)、趋化性(chemotaxis)、生理性止血(hemostasis)、血液凝固(blood coagulation)、纤维蛋白溶解(fibrinolysis)、血清(serum)Teaching Program and key pointsDefine the following terms or phrasesESR, Hemostasis, Fibrinolysis, Hematocrit, Surface activation, The suspension stability of red

6、 cells, Blood coagulation, Internal environment, Diapedisis of white blood cell, Intrinsic pathway of blood clotting, Osmotic fragility of red cell, Blood volume, Blood sendimentation rate (ESR), Chemotaxis, Clotting factor, Blood coagulation, Anticoagulant, Osmotic fragility of red cell, Blood grou

7、p, Lysis of blood clot, Fibrinolysis,Briefly answer1.State briefly the events in hemostasis2.State briefly the regulatory factors of production of red cells and their actions3.Why blood coagulation does not take place in normal blood vessels?4.Describe briefly the role platelet plays in hemostasis5.

8、Define blood coagulation and state briefly the essential steps of blood coagulation6.State briefly the physiological characteristics7.Describe briefly the difference between plasma and serum8.Describe briefly the essential process of fibrinolysisThought Questions1. What are the events in hemostasis?

9、 Describe the mechanisms by which these events in hemostasis occur.2. What are the three steps of blood coagulation?3. Why is the concentration of red blood cell in the blood kept relative constant when a person lives at a given level?4. When a person moves from sea-level to a mountain of 4000- mete

10、rs high and lives there for six months, what will happen to his or her red cell concentration?5. Why doesnt blood clotting occur in normal cardiovascular system?6. How to accelerate, slow down, and prevent blood from coagulation?7. Why do doctors determine liver functions of patients and give some i

11、njections of vitamin K before operation?8. If a persons blood group is known (say A, or B), is it possible to identity the unknown blood groups of other persons? And how they are identified?9. What are the characteristics of platelets? And what is the physiological function of platelets?10. What is

12、the difference between intrinsic and extrinsic pathways? And what is the relation between the two?11. Why is it necessary to perform cross-match even though the same group is transfused?12. When red cells are placed in hypoosmotic solution, hyperoosmotic solution and isotonic solution respectively,

13、what will happen to the red blood cell?13. Why does not mentrual blood clot?14. What is osmotic pressure? What is the effect of hyper-, hypo-osmolality and on the cell volume?15. What is the function of plasma crystal and colloid osmotic pressure?Multichoice questions: There are five answers for eac

14、h question marked A,B,C,D and E. Only one answer is correct, you have to choose the best answer to the question and then blacken the corresponding letter with a pencil1.In an adult person, red blood cells are produced mainly byA. Liver B. SpleenC. Bone marrow of all bones throughout the bodyD. The b

15、one marrow of membranous bones E. The thymus2. Lack of vitamin B12 leads toA. Pernicious anemia B. Microcytic anemia C. Aplasia anemiaD. Sickle cell anemia E. Hemolytic anemia3. Which is the factor that accelerates erythrocyte sedimentation rate (ESR)?A. Increased number of red blood cell in the blo

16、odB. Increased number of white blood cell in the bloodC. Increased number of platelets in the blood D. Increased amount of albumin in the bloodE. Increased amount of globulin in the blood4. Which of the following measures can prevents blood from clotting?A. Adding some wood-dust into the bloodB. Smo

17、othing the inner surface of blood containerC. Putting blood in the test tube in ice-bathD. Removing free calcium ions from the bloodE. Making the inner surface of a container unwettable5. The factor that initiates the intrinsic pathway is to activateA. F III B. F IV C. F XII D. F X E. F VII6. A pers

18、ons serum contains agglutinin B, that persons blood group isA. A B. B C. O D. AB E. A or O7. Release of erythropoietin is mainly dependent onA. Number of red blood cells B. Blood volumeC. Number of white blood cells D. Oxygenation of tissueE. Number of platelets8. Under which of the following condit

19、ions, red blood cells maintain their volume?A. When they are placed in isosmotic urea solution (1.9% urea solution)B. When they are placed in 0.9% NaCl solutionC. When sodium pump is inactivated D. When they are placed in isoosmotic but not isotonic solutionE. When they are placed in sea-water9. Whi

20、ch of the following clotting factors initiates extrinsic pathway?A. F XII B. F III C. F V D. F X E. F XIII10. Adding homogenate of lung tissue to bloodA. Will accelerate blood clotting processB. Will slow down blood clotting processC. Will prevent blood clotting D. Will not affect blood clotting pro

21、cessE. Will cause hemolysis11. All the clotting factors are present in the blood except A. F II B. F III C. F VIII D. F XII E. F X12The normal pH value in the blood is A. 6.9-7.5 B. 7.2-7.5 C. 7.35-7.45 D. 7.25-7.45 E. 7.1-7.213. Erythropoietin acts to A. Promote proliferation and differentiation of

22、 hemopoietic stem cellsB. Promote proliferation and differentiation of BFU-EC. Promote proliferation and differentiation of CFU-ED. Promote maturation of progenitor red cells E. Promote release of red cells from bone marrow 14. The normal total blood volume of a normal person accounts forA. 7-8% of

23、body weightB. 7-8 of extracellular fluidC. 7-8% of total body fluidD. 7-8% of intracellular fluidE. 7.8% of connective tissue15. The principle substance that forms plasma colloid osmotic pressure isA. Na+ B.Cl- C. Albumin D. Globulin E. Fibrinogen16. Hemophilia A is due to lack of A. F XI B. F IX C.

24、F VIII D. F XII E. F V17. The principle substances that forms plasma osmotic pressure areA. K+ B. HCO3- C. Cl- and Na+ D. Albumin E. Globulin18. In which of the following solutions, partial hemolysis of normal red cells take place?A. 0.85% B. 1.9% C. 0.4% D. 0.3% E. 5 % glucose19. Lack of intrinsic

25、factor leads toA. Microcytic anemiaB. Maganocytic anemiaC. Hemolytic anemiaD. Aplastic anemiaE. Sickle anemia20. Under which of the following conditions, ESR is increased?A. An increase in albumin in the plasmaB. An increase in lecithin in the plasmaC. An increase in globulin in the plasmaD. A decre

26、ase in fibrinogen in the plasmaE. A decrease in cholesterol in the plasma 21. Which of the following solutions is both isoosmotic and isotonic?A. 0.7% NaClB.0.9% of NaClC. 5% of glucoseD. 0.85 % of NaCl1.9% of urea22. Lack of vitamin B12 leads toA. Microcytic anemiaB. Pernicious anemiaC. Hemolytic a

27、nemiaD. Aplastic anemiaE. Sickle anemia23. Which of the following factors accelerates the blood coagulation?A decrease in temperatureA decrease in blood calcium concentrationAdding some heparin into the bloodAdding some tissue homogenateProviding smooth surface of container contains blood24. The flu

28、id expressed out from blood clot is A. ICF B. ECF C. Plasma D. Serum E. Tissue factor25. Which of the following factors has nothing to do with platelet aggregation? A. ADP from tissueB. ADP from plateletC. F III from damaged tissueD. TXA2 synthesized by plateletE. Collagen26. The factor that promote

29、s the rouleaux formation of red blood cells is A. The number of red cellsB. Hb concentration C. Increased plasma albumin and globulin concentration D.Increased plasma globulin and fibrinogen concentrationE. Increased crystal substances in the plasma27. Prothrombin activator is composed of A. F V, Xa

30、, Ca2+ and PF3B. F XIIa, XIa, IXa and VIIIC. F III, VII and Ca2+D. F I, II, and Ca2+E. XIIa, III, and II28. The correct description about the action of heparin is A. It increases the affinity of antithrombin III for thrombinB. It inactivates the activity of thrombin directlyC. It blocks the formatio

31、n of prothrombin activatorsD. It prevents the activation of intrinsic pathway E. It prevent the activation of extrinsic pathway29. The principle hormone that regulates the production of red blood cells is A. AndrogenB. EstrogenC. EPOD. GHE. Thyroid hormone30. When red blood cells from a person whose ESR is increased into the normal serum, ESR willA. Not changeB. AccelerateC. Return to normalD. First return to normal and then decreaseE. First return to normal and then increase31. The wrong description about the physical and chemical characteristics is A.