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Lactate

The patient has a blood disorder called thrombotic thrombocytopenic purpura which is causing their red blood cells to destroy. Management includes plasmapheresis to remove antibodies, corticosteroids to reduce antibody production, and immunosuppressants like rituximab. Plasmapheresis removes plasma containing harmful antibodies and replaces it with healthy plasma to stop the destruction of red blood cells and platelets.

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Shanica Paul-Richards
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45 views

Lactate

The patient has a blood disorder called thrombotic thrombocytopenic purpura which is causing their red blood cells to destroy. Management includes plasmapheresis to remove antibodies, corticosteroids to reduce antibody production, and immunosuppressants like rituximab. Plasmapheresis removes plasma containing harmful antibodies and replaces it with healthy plasma to stop the destruction of red blood cells and platelets.

Uploaded by

Shanica Paul-Richards
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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4a. the patient has hemolytic anemia likely thrombotic thrombocytophenic purpura.

The peripheral
blood smear shows schistocytes, which indicates the destruction of the RBC. Management of these
cases are usually include plasmapheresis (the removal of persons blood plasma and replacing it with
donor plasma i.e fresh frozen plasma), corticosteroids and other immunosuppressant.

Plasmapheresis removes plasma which has the offending antibodies in it and replaced it with healthy
plasma. The affected antibodies are aimed at the destruction of the red blood cells and platelets
resulting in thrombocytopenia and anemia.

Corticosteroids and other immunosuppressants are aimed at reducing the production of antibodies by
the immune system. An example of an immunosuppressant is Rituximab, which reduces the B
lymphocytes thus reducing the production of the inhibitor.

Frederiksen H, Schmidt K. The incidence of idiopathic thrombocytopenic purpura in adults increases with
age. Blood. 1999 Aug 1. 94(3):909-13. [Medline].

Zeller B, Helgestad J, Hellebostad M. Immune thrombocytopenic purpura in childhood in Norway: a


prospective, population-based registration. Pediatr Hematol Oncol. 2000 Oct-Nov. 17(7):551-8.
[Medline].

Reese JA, Li X, Hauben M, Aster RH, Bougie DW, Curtis BR, et al. Identifying drugs that cause acute
thrombocytopenia: an analysis using 3 distinct methods. Blood. 2010 Sep 23. 116(12):2127-33.
[Medline]. [Full Text].

2a. Detail the overall mechanism in which pyruvate undergoes in its aerobic metabolism
After Glycolysis process is complete, glucose is converted into two Pyruvates. Glycolysis can occur
anaerobically (Red blood cells/ erythrocytes, exercising skeletal muscle) or aerobically.

Pyruvate then enters the mitochondria. In the presence oxygen, Pyruvate is then converted to acetyl
CoA by pyruvate dehydrogenase. In the process NAD is reduced to NADH and Carbon dioxide is
produced. Other cofactors and coenzymes used by pyruvate dehydrogenase includes: thiamine
pyrophosphate from the vitamin thiamine, lipoic acid, coenzyme A from pathothenate, FAD(H2) from
riboflavin, and NAD(H) from niacin

Acetyle CoA, can then enter one of two pathways. The citric acid cycle for ATP production or the fatty
acid synthesis pathway.

2. b Which products of ADP degradation increase in concentration in the blood during multiple sprint
sports and why?

During multiple sprint sports the muscles need quick bursts of energy. Cells rely on existing ATP and
stored up high energy phosphate called creatine phosphate.
In the early stages of hard exercise, the existing ATP needed to carry out muscle contraction is rapidly
used up but the overall ATP levels do not significantly drop since ATP is quickly replenished by three
sources:

1. Creatine phosphate + ADP  creatine + ATP


2. 2 ADP <-> AMP + ATP (adenylate kinase enzyme)
3. Anerobic glycolysis  2 ATP

During this period of exercise, the muscle cells excrete large amounts of Lactate into the bloodstream
from the anerobic glycolytic pathway, causing the blood pH to drop. Aerobic metabolism begins to
generate much more ATP in an effort to sustain muscle contraction. Creatine phosphate hydrolyzes to
creatinine and is filtered through kidneys

c.

A spectrophotometer is an instrument that can be used to indirectly determine the amount of a


compound present. It works by shining a light onto the sample, then the spectrophotometer measures
the amount of light that was absorbed.

So we put the sample into a cuvette and get a number called absorbance. What good does that do? How
do we use that information to determine the concentration of the compound of interest in the sample?
In order to do this, we use Beer's Law. Beer's Law is that the absorbance, through a known length, is
directly proportional to the concentration of the solution. In other words, as long as we know how far
the light traveled through the sample, then we can determine the concentration of the solution based
on the absorbance.

An efficient and inexpensive spectrophotometric method has been developed for the determination of
lactic acid in the individual state and in food and biological and cultural liquids. The method is based on
the spectrophotometric determination of the colored product of the reaction of lactate ions with
iron(III) chloride at 390 nm.

Lactic, fumaric and malic acids are commonly used in food and pharmaceutical industries. During
microbial production of these compounds, it is important to determine their concentrations in the
fermentation broth with a rapid and sensitive method. Spectrophotometry is commonly used. However,
UV-spectral overlap between these organic acids makes it difficult to determine each of them
individually from the mixture. In order to overcome this problem, statistical methods, namely principal
component regression (PCR) and partial least squares1 methods, were tested and compared with
conventional HPLC techniques. The absorbance data matrix was obtained by measuring the absorbances
of 21 ternary mixtures of lactic, fumaric and malic acids in a wavelength range of 210–260 nm.
Calibration and validation were performed by using the data obtained in a mixture of these organic
acids. The prediction abilities of the methods were tested by applying them to fermentation broths. The
precision of the PCR method was better than that of the partial least squares-1 method. In the PCR
method, the correlation coefficients between actual and predicted concentrations of the organic acids
were calculated as 0.970 for lactic acid and 0.996 for fumaric acid in fermentation broths. The
concentration of malic acid was not detected due to its low concentration in samples. These results
show that the PCR method can be applied for simultaneous determination of lactic, fumaric and malic
acids in fermentation broths

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