Exercise No.

26
The Blood Groups

1. Explain how blood type is determined in the ABO blood group system.
 A blood sample is needed. The test to determine your blood group is called ABO typing. Your
blood sample is mixed with antibodies against type A and B blood. Then, the sample is checked
to see whether or not the blood cells stick together. If blood cells stick together, it means the
blood reacted with one of the antibodies. The second step is called back typing. The liquid part of
your blood without cells (serum) is mixed with blood that is known to be type A and type B.
People with type A blood have anti-B antibodies. People with type B blood have anti-A
antibodies. Type O blood contains both types of antibodies.

2. How does one develop Rh antibodies?

 Rhesus antibodies are produced by a Rhesus negative woman in response to exposure to Rhesus
antigens in the blood of her Rhesus positive baby. The ‘positive’ or ‘negative’ part in a person’s
blood group (eg O positive, AB negative, etc) refers to whether their blood cells carry the Rhesus
protein. Rhesus negative individuals will react to the Rhesus protein by producing antibodies
against it,

3. What is HDN? Explain how HDN is acquired.

 Hemolytic disease of the newborn (HDN) is a blood problem in newborn babies. It occurs when
your baby's red blood cells break down at a fast rate. It's also called erythroblastosis fetalis.
 HDN happens most often when an Rh negative mother has a baby with an Rh positive father. If
the baby's Rh factor is positive, like his or her father's, this can be an issue if the baby's red blood
cells cross to the Rh negative mother. This often happens at birth when the placenta breaks away.
But it may also happen any time the mother’s and baby's blood cells mix. This can occur during a
miscarriage or fall. It may also happen during a prenatal test. These can include amniocentesis or
chorionic villus sampling. These tests use a needle to take a sample of tissue. They may cause
bleeding.

References:

Hemolytic Disease of the Newborn (HDN). (n.d.). Retrieved from

https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02368

Rhesus Antibodies Test - HealthEngine. (2018, December 17). Retrieved from

https://healthengine.com.au/info/rhesus-antibodies-test

Blood typing: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved from

https://medlineplus.gov/ency/article/003345.htm
 Exercise No. 27
Coagulation Time

1. What causes the absence of intravascular clotting?

 When the proteins used in your normal clotting process become overly active, it can cause
(Disseminated Intravascular Coagulation (DIC). Infection, severe trauma (such as brain injuries or
crushing injuries), inflammation, surgery, and cancer are all known to contribute to this condition. In
some cases of DIC, small blood clots form in the blood vessels. Some of these clots can clog the
vessels and cut off the normal blood supply to organs such as the liver, brain, or kidneys. Lack of
blood flow can damage and cause major injury to the organs.

2. What is the importance of determining clotting time?

 The time taken for blood to clot mainly reflects the time required for the generation of thrombin. of
the plasma concentration of prothrombin or of some of the other factors is low or if the factor is
absent or functionally inactive, clotting time will be prolonged. Clotting time is done in 2 main ways
prothrombin time (PT) or partial thromboplastin time (pTT). This is important to determine if the
patient doesn0t have any clotting disorders such as hemophilia or liver disease, to monitor
anticoagulant therapy such as warfarin or heparin, or to check whether the patient may need
transfusions of blood products after having a large hemorrhage. Clotting time is an important test
because it checks to see if five different blood clotting factors (factors I, II, V, VII, and X) are
present.

3. Discuss the mechanism of hemostasis.

 Platelets are key players in hemostasis, the process by which the body seals a ruptured blood vessel
and prevents further loss of blood. Although rupture of larger vessels usually requires medical
intervention, hemostasis is quite effective in dealing with small, simple wounds. Hemostasis includes
three steps that occur in a rapid sequence: (1) vascular spasm, or vasoconstriction, a brief and intense
contraction of blood vessels; (2) formation of a platelet plug; and (3) blood clotting or coagulation,
which reinforces the platelet plug with fibrin mesh that acts as a glue to hold the clot together. Once
blood flow has ceased, tissue repair can begin. Failure of any of these steps will result in hemorrhage
—excessive bleeding.

References:

OpenStax. (2013, March 6). 18.5 Hemostasis. Retrieved from

https://opentextbc.ca/anatomyandphysiology/chapter/18-5-hemostasis/

Prothrombin Time and INR. (n.d.). Retrieved from https://wa.kaiserpermanente.org/kbase/topic.jhtml?

docId=hw203083

Disseminated intravascular coagulation (DIC): MedlinePlus Medical Encyclopedia. (n.d.). Retrieved from
https://medlineplus.gov/ency/article/000573.htm
 Exercise No. 28
Bleeding Time

1. Can there be prolonged bleeding time with normal clotting time or vice versa? Explain your answer.
 There can be a prolonged bleeding time with normal clotting time or a shortened bleeding time with
abnormal clotting time. This is because bleeding time depends upon the depth of the wound and the
degree of hyperemia in the body part influenced by tissue fluids, the elasticity of the surrounding
tissues, and the chemical effects of the destroyed platelets, and not exactly pertaining to the ability of
the blood to clot which is measured by the clotting time.

2. Enumerate the advantages and disadvantages of using the earlobe as puncture site for determining
bleeding time.

Advantages of skin puncture using

the earlobe:
1. It is less painful due to lesser
nerve endings.
2. There is more free flow of blood
due to thinner skin
3. There is less tissue juice
contamination of blood due to
lesser tissue and muscles in the
earlobe
4. It is ideal when searching for
abnormal cells
Advantages of skin puncture using
the earlobe:
1. It is less painful due to lesser
nerve endings.
2. There is more free flow of blood
due to thinner skin
3. There is less tissue juice
contamination of blood due to
lesser tissue and muscles in the
earlobe
4. It is ideal when searching for
abnormal cells
Advantages of skin puncture using
the earlobe:
1. It is less painful due to lesser
nerve endings.
2. There is more free flow of blood
due to thinner skin
3. There is less tissue juice
contamination of blood due to
lesser tissue and muscles in the
earlobe
4. It is ideal when searching for
abnormal cells
Advantages of skin puncture using
the earlobe:
1. It is less painful due to lesser
nerve endings.
2. There is more free flow of blood
due to thinner skin
3. There is less tissue juice
contamination of blood due to
lesser tissue and muscles in the
earlobe
4. It is ideal when searching for
abnormal cells
Advantages of skin puncture using
the earlobe:
1. It is less painful due to lesser
nerve endings.
2. There is more free flow of blood
due to thinner skin
3. There is less tissue juice
contamination of blood due to
lesser tissue and muscles in the
earlobe
4. It is ideal when searching for
abnormal cells
 Advantages of skin puncture using the earlobe
1. It is less painful due to lesser nerve endings.
2. There is more free flow of blood due to thinner skin.
3. There is less tissue juice contamination of blood due to lesser tissue and muscles in the earlobe
4. It is ideal when searching for abnormal cells

 Disadvantages of skin puncture using the earlobe

1. Poor reproducibility and unreliable test results due to variability of earlobe thickness and
variability of puncture death.
2. Outdated and rarely used site for puncture as new methods use the forearm for an improved
sensitivity and reproducibility.

References:
Data sheet answers on expt 26-30. (n.d.). Retrieved from
https://www.scribd.com/document/289994692/Data-sheet-answers-on-expt-26-30

Exercise No. 29
Hyperemia or Congestion

1. What are the signs of hyperemia?

Active hyperemia is characterized by:
  flushed face
 bright eyes
 contracted pupils
 throbbing of the carotids
 the patient is irritable and restless, with insomnia
 in the rare cases there will be delirium or convulsions
Passive hyperemia is characterized by:
 there is dullness of the intellect
 the pupils are dilated
 the patient lies passive
 the face is pale or dusky in color
 the pulse is small
 the tissues relaxed
 the extremities are cold.
2. After differentiating active from passive hyperemia, what type of hyperemia is produced by
70%isopropyl alcohol? Explain.

 Active Hyperemia is produced by 70% isopropyl alcohol since it causes more local vasodilation
which is a characteristic of active hyperemia since it is thought that vasodilators (released from
active muscle fibers) can stimulate a local capillary endothelial cells which, in turn, causes the
conduction of a vasodilatory signal to upstream arterioles, this then elicits arteriolar vasodilation
consequently, creating a pathway of least resistance so blood flow can be precisely direct to
capillaries supplying the metabolically active tissue.

References:
Hyperemia. (n.d.). Retrieved from https://www.henriettes-herb.com/eclectic/thomas/cerebr-
hyperemia.html
Seymour, T. (2017, September 15). Hyperemia: Causes, symptoms, and treatment. Retrieved from
https://www.medicalnewstoday.com/articles/319416#treatment