Data______________

Tema 4. Funcţiile sângelui. Constantele sângelui. Elementele figurate ale

sângelui. Hemostaza si grupele sangvine

Lucrul individual
Enumeră substanţele folosite ca anticoagulant.________________________________
_____________________________________________________________________
_____________________________________________________________________
______________
Cum se obţine plasma şi serul din probele de sânge?___________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Defineşte Hematocritul.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________

Notează valorile corecte pentru hematocrit în dependenţă de vârstă şi sex.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Completează valorile corespunzătoare hematocritului în tabelul următor:

Eritrocitoza, definiţia, cauza, tipurile
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Eritropenia, definiţia, cauza, tipurile

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Anemia, definiţia
_____________________________________________________________________
_____________________________________________________________________
____________________
Completează tabelul, ce urmează.

Tipul anemiei Cauza anemiei Mecanismul de

producere
Anemia aplastică

Anemia
megaloblastică

Anemia hemolitică

Anemia
posthemoragică

Care sunt tipurile de hemoglobină cunoscută, începând cu viaţa embrionară?

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Care sunt valorile normale ale concentraţiei sanguine a hemoglobinei?

_____________________________________________________________________
_____________________________________________________________________
______________________

Care este capacitatea de fixare a O2 de către Hb (în condiţii de completă oxigenare)?

_____________________________________________________________________
_____________________________________________________________________
_________________________________

Care sunt variaţiile patologice ale concentraţiei de hemoglobină?

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Explică variaţiile fiziologice ale concentraţiei hemoglobinei în funcţie de vârstă şi
sex.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Explică variaţiile concentraţiei hemoglobinei în funcţie de altitudine.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Explică modificările concentraţiei hemoglobinei produse de efortul fizic.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
______________________________
În ce situaţii concrete se recomandă determinarea concentraţiei hemoglobinei la un
pacient?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Ce modificări temporare ale parametrilor eritrocitari crezi că au loc în orele, care

urmeză după ce se donează o unitate (500 ml) de sânge?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Cum influenţează numărul de hematii valoarea concentraţiei hemoglobinei?

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Care sunt parametrii sanguini, care se modifică în anemii şi, care este sensul acestei
modificări?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Care sunt valorile normale ale V.S.H. ?

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Enumeră factorii eritrocitari, care modifică V.S.H.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Explică mecanismul prin care fiecare factor eritrocitar modifică V.S.H.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Enumeră factorii plasmatici, care modifică V.S.H.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Explică mecanismul prin care fiecare factor plasmatic modifică V.S.H.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Explică de ce valoarea V.S.H. la bărbaţi este mai mică decât la femei.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Explică de ce temperaturile scăzute pot modifica unele componente ale plasmei cu

repercusiuni asupra valorii V.S.H. şi vâscozităţii sângelui.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
________________________________

Explică cum se modifică valoarea V.S.H. şi valoarea hematocritului în cazul expunerii

organismului la temperaturi crescute.
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Explică creşterea valorii V.S.H. în infecţii şi inflamaţii.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

In cazul infestării organismului cu paraziţi creşterea valorii V.S.H.-ului este specifică?

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Completează tabelul, ce urmează:

 Factorii care influenţează V.S.H.
1
2
cresc V.S.H. 3
Factori 4
eritrocitari …
1
2
scad V.S.H. 3
4
…
1
2
cresc V.S.H. 3
Factori 4
plasmatici …
1
2
scad V.S.H. 3
4
…

1. Următorii subiecţi au grupele sanguine:

- subiectul 1: 0, Rh D+ __________________________________________________
- subiectul 2: AB, Rh D+ ________________________________________________
- subiectul 3: A, Rh D+__________________________________________________
- subiectul 4: A, Rh D-
___________________________________________________
- subiectul 5: B, Rh D+__________________________________________________
Să se stabilească cui poate dona sânge fiecare dintre aceşti subiecţi.

În tabelul de mai jos înscrie cu DA sau NU compatibilitatea dintre donator şi primitor,

în cazul administrării de plasmă.
Pe lamele de mai jos notează serurile adăugate pe fiecare godeu. Haşurează godeurile
corespunzătoare grupelor_______ şi ______ . Argumentează de ce este aglutinare în
godeul respectiv.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Haşurează godeurile în care ai avut aglutinare la determinarea în laborator a propriei

Grupe sanguine.

_____________________________________________________________________
_______________________________________________________

Dintre lamele de mai jos alege-le pe acelea, care corespund grupelor ____ şi ____.

_____________________________________________________________________
_____________

Un subiect cu grupa sanguină ___, RhD____ are nevoie urgentă de transfuzie în

cantitate de cel puţin 1 l de sânge. Ce sânge alegi ? De ce ?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Ce fel de imunoglobuline sunt anticorpii din sistemul Rh? Ce consecinţe are prezenţa
lor?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

În tabelul de mai jos înscrie cu DA sau NU compatibilitatea dintre donator şi primitor

în sistemul 0AB şi Rh.

Explorarea seriei albe:

A. Modificari cantitative (enumeră, indică cauza)____________________________

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________
B. Modificari calitative (enumeră, indică cauza)_____________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________
Cum se numeşte scăderea procentului de neutrofile în formula leucocitară şi cu ce se
asociază scăderea marcată a lor? De ce?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________

Analizează următoarele formule leucocitare, subliniind valorile care nu sunt normale

şi precizează câteva posibilităţi de diagnostic.
a. Pacient, 24 ani: L=16000/mm3; NN=3%, NS=74%, E=2%, B=0%, Lf=16%,
M=5%.
b. Pacient, 1 an: L=11000/mm3; NN=1%, NS=46 %, E=3%, B=0%,Lf=45%, M=5%.
c. Pacient, 16 ani: L=8600/mm3; NN=1%, NS=58%; E=14%, B=0%; Lf=21%,
M=6%.
d. Pacient, 34 ani: L=19400/mm3; Mielocite=1%, Metamielocite=2%; NN=6%,
NS=72%, E=2%, B=1%, Lf=12 %, M=4%.
_a.______________________________________________________________
_________________________________________________________________
_b.______________________________________________________________
_______________________________________________________________
_c.______________________________________________________________
_________________________________________________________________
_d.______________________________________________________________
_________________________________________________________________

Completează tabelul ce urmează.

Factorul Sinteza- Dependenţa Roluri principale în coagulare

-denumirea locul de vit.
K(+/-)
FI
FII
FIII
FIV
FV
 FVI
FVII
FIII
FIX
FX
FXI
FXII
FXIII

Care sunt evenimentele majore ale hemostazei primare?

_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________

Schiţează reacţiile din cascada coagulării pe cale extrinsecă.

Schiţează reacţiile din cascada coagulării pe cale intrinsecă.

Semnătura profesorului ____________________________
 Data______________

Tema 1. Lichidele. Fiziologia excreţiei.

Lucrul individual
Numeşte rolurile multiple ale rinichilor în homeostazie.
1.___________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
2.___________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
3.___________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
4.___________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
5.___________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
6.___________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
7.___________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

8.___________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
9.___________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
10.__________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

RFG prezintă ______ % din fluxul plasmatic renal, valoarea fiind egală cu
____ml/min sau ________l/zi.
Numeşte factorii determinanţi pentru RFG:
(1)__________________,care prezintă______________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________
(2)__________________,care prezintă______________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Desenează rezumatul forţelor, ce determină presiunea netă de filtrare la nivelul renal:

Autoreglarea RFG şi fluxul sanguin renal se realizeaza în diapazonul larg de la _____

mm Hg în caz de hipotensiune pîna la ______în caz de creştere a tensiunii arteriale
prin 2 mecanisme:
1._____________________________________, care reprezintă______________
poate fi explicat prin activarea canalelor pentru Ca la nivel de _______________ în
caz de_____________________ şi inactivarea lor în caz
de___________________________________________________________________
2.___________________________________________________________________
__, care prezintă _______________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________şi poate fi explicat prin schema, ce urmează:

La nivelul tubulilor renali proximali sodiul este absorbit prin

transportul_____________________, apa fiind absorbită prin_________ în cantitatea
de _____________ din volumul total RFG.
Desenează mecanismul absorbtiei asociate a apei cu Na+ la nivelul tubulilor
proximali:
La nivelul tubulilor renali proximali glucoza şi aminoacizii sunt absorbite prin
mecanismul___________________________ în cantitatea de___________% din
filtratul glomerular.
Desenează mecanismul absorbţiei asociate a apei cu glucoză şi aminoacizi la nivelul
tubulilor proximali:

Indică aportul zilnic de apă. _____________________________________________

Indică pierderea zilnică de apă. ___________________________________________

_____________________________________________________________________
_____________________________________________________________________
______________________
Indică principiul metodei diluţiei substanţei indicatoare. _______________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Osmoza. Definiţia.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
____________________________________________
Desenează schema: efectul soluţiei izotonice, hipertonice şi hipotonice asupra
volumului celular.

Desenează diagrama Darrow-Yannet. Indică compartimentele lichidiene ale

organismului.

Explică schimbările în volum a eritrocitelor prin întroducerea lor în următoarele

soluţii:

1. 200 mOsm NaCl

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________
2. 400 mOsm NaCl
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________
3. 150 mmol NaCl
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________
4. 300 mmol NaCl
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________
5. 200 mOsm NaCl +200 mOsm urea (trece rapid prin membranele celulare)
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________
6. 300 mOsm urea
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________
7. 500 mOsm urea
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________
8. 200 mOsm NaCl +200 mOsm glicerol (trece lent prin membranele celulare)
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________

Utilizând diagrama Darrow-Yannet, determină modificările volumului şi osmolarităţii

compartimentelor lichidiene, asociate cu următoarele situaţii:
1. Pierderea soluţiei izotonice (hemoragie).

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________
2. Pierderea soluţiei hipotonice (diabetes insipidus).
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________
3. Ingestia NaCl în cantităţi mari.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________
4. Ingestia apei distilate sau perfuzia soluţiei hipotonice.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
______________________________________
5. Perfuzia soluţiei izotonice.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________
6. Perfuzia soluţiei hipertonice.

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________
7. Insuficienţa adrenală primară.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________

Semnătura profesorului ____________________________