You have a patient with prostate cancer. The cancer causes blood vessels to weak
ID: 3523120 • Letter: Y
Question
You have a patient with prostate cancer. The cancer causes blood vessels to weaken and burst. The patient has a dangerously low Ht and needs a blood transfusion. When you test his blood for type, here are the results: Anti-A- agglutination, Anti-B- agglutination, Anti-Rh- no reaction.
1. List all blood types he can receive.
When you enthusiastically suggest that blood transfusions will help him, he protests that his religious beliefs disallow him from accepting transfusions. You will need to find a way to help his own body both retain the blood he has, and make new blood.
2. Based only on what we've learned so far re: blood and endocrine, come up with hypotheses about how you could do each.
3. Propose a mechanism of how EPO might work: what cells might it target, would it enter them, and what sorts of proteins might it activate?
4. There is a drug called aminocaproic acid that prevents fibrinolysis. Why would this help? Propose a mechanism for how it might work.
5. Where is EPO made?
6. EPO secretion increases when blood O2 levels decline. Do you think the patient's own production of EPO is higher or lower than normal, given his blood loss? Explain.
Explanation / Answer
1. The patient has AB- blood type so he can receive AB- blood.
AB- blood has A and B antigen and no A and B antibodies hence agglutination occurs with anti-A(antibody) and anti-B antibody.
The individual is Rh negative and has no Rh antigen but Rh antibody present hence no agglutination with anti Rh antibody.
2. Two hypothesis to support blood formation :
a)the blood can be retained by treatment of the artery through surgery.
b)iron rich diet to stimulate production of blood cells.
Iron is an important component of blood and constitutes haemoglobin.
3. EPO or erythropoeitin targets the bone marrow cells which are responsible for production of red blood cells(erythroid cells).
EPO binds with the receptors on the bone marrow erythroid cells.
EPO is a glycoprotein which influence the phosphorylation signalling cascade which include kinase proteins.
4. In fibrinolysis the blood clot is broken down by the action of actived plasminogen.
Aminocaproic acid is a derivative of lysine which binds to plasminogen and inhibits the activation.
Blood loss can be caused by breaking down blood clots hence the action of aminocaproic acid is responsible for the prevention of blood loss.
5.EPO is made in liver and kidney.
6.EPO secretion is directly related to blood stimulation which carries oxygen via haemoglobin.
Hence oxygen levels in blood are related to the amount of red blood cells present.
Given the blood loss of the patient , the EPO secretion will increase since the O2 levels have drastically reduced.
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