Hematology Help A patient sustains severe damage to the kidn

Hematology Help

A patient sustains severe damage to the kidneys. Which of the following factors will be most affected?

a) EPO

b) TOP

c) GM-CSF

d) M-CSF

2. If nucleated red blood cells are seen in the peripheral blood, they most likely are:

a) Metarubricytes

b) Rubcricytes

c) Prorubricytes

d) Rubriblasts

Solution

Answer: a) EPO

Reason:

Chronic kidney damage is leading to affected levels of a glycoprotein hormone synthesized mostly in the kidney. The physiological stimulus for EPO production is tissue hypoxia, incase if any tissue hypoxia is sensed by cells in the kidney and liver have the ability of producing EPO, and secrete EPO into the plasma. So that, kidney damage in a patient has may not have adequate levels of EPO to stimulate erythropoisis. Further EPO is passed to the bone marrow, where it reacts to explicit cell surface receptors on its target cells i.e. the CFUE cells, result in the production of proerythroblasts, and basophilic erythroblasts and finally into mature erythrocytes.