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Yr 2 MCD - Haem > 1 - Physiology of Blood Cells & Haematological Terminology > Flashcards

1 - Physiology of Blood Cells & Haematological Terminology Flashcards

1
Q

Anisocytosis

A

RBCs that show more variation in size than is normal.

Patient’s red blood cells are of unequal sizes.

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2
Q

Poikilocytosis

A

RBCs that show more variation in shape than is normal.

The presence of poikilocytes in the blood.

Poikilocytes are abnormally shaped red blood cells.

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3
Q

Microcyte

A

A red cell that is smaller than normal

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4
Q

Microcytic Anaemia

A

Describes RBCs that are smaller than normal or an anaemia with small RBCs.

The presence of small, often hypochromic, RBCs in a peripheral blood smear and is usually characterized by a low MCV.

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5
Q

Microcytosis

A

Red cells are smaller than normal.

A condition in which RBCs are unusually small as measured by their MCV.

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6
Q

Macrocyte

A

A red cell that is larger than normal.

Can be round, oval or polychromatic in shape.

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7
Q

Macrocytic anaemia

A

Describes RBCs that are larger than normal or an anaemia with large RBCs.

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8
Q

Macrocytosis

A

A condition in which there is an enlargement of RBCs with near-constant hemoglobin concentration, and is defined by a MCV of greater than 100 femtolitres.

Red cells are larger than normal

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9
Q

Normochromic

A

Normal RBCs that have about a third of the diameter that is pale.

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10
Q

Normocytic

A

Describes RBCs that are of normal size or an anaemia with normal sized RBCs.

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11
Q

Hypochromic/Hypochromatic

A

Red cells that show hypochromia (often goes with microcytosis).

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12
Q

Hypochromia

A

A condition in which the cells have a larger area of central pallor than normal (larger pale area in centre of cell).

Less staining because less haemoglobin to give a pink colour.

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13
Q

Polychromasia

A

A disorder where there is an abnormally high number of immature red blood cells found in the bloodstream

Describes an increased blue tinge to the cytoplasm of a red cell. Indicates that the red cell is young.

20% larger than mature red cells in circulation.

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14
Q

Elliptocyte

A

Poikilocyte that is elliptical in shape.

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15
Q

Spherocyte

A

Poikilocyte that is spherical in shape.

Have round, regular outline and lack central pallor.

Result from loss of cell membrane without loss of equivalent cytoplasm. Therefore, the cell is forced to round up.

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16
Q

Target Cell

A

Poikilocyte with an accumulation of haemoglobin in the centre of the area of central pallor.

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17
Q

Sickle Cell

A

Poikilocyte that sickle or crescent shaped.

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18
Q

Fragment/Schistocyte

A

Poikilocytes that are small pieces of red cells.

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19
Q

Rouleaux

A

Fairly regular stacks of RBCs.

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20
Q

Agglutination

A

Irregular clumps of RBCs.

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21
Q

Howell-Jolly body

A

A nuclear remnant in a red cell.

Stain darker purple than normal RBCS, like the nucleus from which it is derived.

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22
Q

Leucocytosis

A

Too many white cells.

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23
Q

Leucopenia

A

Too few white cells.

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24
Q

Neutrophilia

A

Too many neutrophils.

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25
Q

Neutropenia

A

Too few neutrophils.

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26
Q

Lymphocytosis

A

Too many lymphocytes.

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27
Q

Atypical Lymphocyte/Atypical Mononuclear Cell

A

Abnormal lymphocyte.

Often the term is used to describe the abnormal cells present in infectious mononucleosis (‘glandular fever’) due to primary infection with EBV.

Can get these cells in other infections.

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28
Q

Eosinophilia

A

Too many eosinophils.

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29
Q

Monocytosis

A

Too many monocytes.

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30
Q

Thrombocytosis

A

Too many platelets (thrombocytes).

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31
Q

Thrombocytopenia

A

Too few platelets (thrombocytes).

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32
Q

Toxic granulation

A

Is heavy granulation of neutrophils.

It results from infection, inflammation and tissue necrosis (but is also a normal feature of pregnancy).

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33
Q

Left shift

A

An increase in non-segmented neutrophils or that there are neutrophil precursors in the blood.

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34
Q

Hypersegmented Neutrophil

A

There is an increase in the average number of neutrophil lobes or segments.

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35
Q

Reticulocytosis

A

Too many reticulocytes (immature RBCs).

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36
Q

Erythrocyte: life span and major function?

A

120 days; Oxygen Transport

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37
Q

Neutrophil: life span and major function?

A

7-10 hours; Defence against infection by phagocytosis and killing of microorganisms Can carry out function in circulating blood as well as in tissues

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38
Q

Monocyte: life span and major function?

A

Several days; Defence against infection by phagocytosis and killing of microorganisms

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39
Q

Eosinophil: life span and major function?

A

Slightly shorter than 7-10 hours; Defence against parasitic infection Also involved in allergic reactions (which are disadvantageous)

40
Q

Lymphocyte: life span and major function?

A

Very variable; Humeral and cellular immunity

41
Q

Platelet: life span and major function?

A

10 days; Haemostasis

42
Q

Erythrocytosis

A

Too many RBCs.

43
Q

Where do blood cells originate?

A

In the bone marrow

44
Q

Where are all blood cells ultimately derived from?

A

Multipotent haemopoietic stem cells

45
Q

What are the two overall categories of blood cells that derive from multipoint hameopoietic stem cells?

A

Lymphoid Stem Cells

Myeloid Stem Cells

46
Q

What blood cells come from Myeloid Stem Cells/Precursors?

A

Granulocytes and Monocytes (neutrophils, eosinophils, basophils)

Erythroid (RBCs)

Megakaryocyte (and then platelets)

47
Q

What blood cells come from Lymphoid Stem Cells?

A

T Cells

B Cells

NK Cells

48
Q

What are the essential characteristics of stem cells and how are they achieved?

A

Ability to self-renew and produce mature progeny

HOW IT IS ACHIEVED

Ability to divide into two cells with different characteristics, one another stem cell and the other a cell capable of differentiating to mature progeny

49
Q

Describe red blood cell lineage.

A

Multipotent Haemopoietic Stem Cells

Myeloid Stem Cells/Precursor

Proerythroblast

Early Erythroblast

Intermediate Erythroblast

Late Erythroblast

Polychromatic Erythrocyte

Mature Erythocytes (RBCs)

EACH DIVISION PRODUCES 2 CELLS (RESULTING IN AMPLIFICATION)

50
Q

What does erythroid mean?

A

Relating to erythrocytes

51
Q

How can you tell if a cell is primitive?

A

Chromosome pattern being delicate and diffuse Big nucleolus

52
Q

Describe a proerythroblast

A

Chromosomal pattern is very delicate and diffuse

Large cells

Very basophilic cytoplasm, because its packed with ribosomes that will eventually produce haemoglobin.

53
Q

What is the process of producing red blood cells called?

A

Erythropoiesis

54
Q

What hormone is required to produce erythrocytes and why is it synthesised?

A

Erythropoietin

Synthesised mainly in the kidney as a response to hypoxia/anaemia.

This then increases bone marrow activity

This increases red cell production.

55
Q

Where is erythropoietin synthesised?

A

90%

  • in kidneys
  • in juxtatubular interstitial cells

10%

  • in liver
  • liver parenchymal cells (hepatocytes) and interstitial cells
56
Q

How long do erythrocytes survive in the bloodstream?

A

120 days in the bloodstream

57
Q

What is the main function of erythrocytes?

A

Oxygen transport

Also transport some carbon dioxide

58
Q

Where are erythrocytes destroyed?

A

Mainly destroyed by phagocytic cells of the spleen Can also be destroyed by phagocytes in any area of the body.

59
Q

How is carbon dioxide transported around the body?

A

Most is transported in the plasma

Small amount transported bound to Haemoglobin

60
Q

Describe white blood cell lineage from Myeloid Stem Cells/Precursors.

A

Multipotent Haemopoietic Stem Cells

Myeloid Stem Cells/Precursor

Myeloblasts and Monoblasts

  • big nucleolus
  • diffuse chromosomal pattern

Promyelocyte

  • primary granules start being forming from golgi zone

Myelocyte

  • has primary and secondary granules

Band Form

  • immature neutrophil
  • nucleus is in shape of a band
  • matures to condensation of chromatin and lobulation of nucleus

Neutrophil (or other granulocyte or monocyte)

THIS IS SPECIFICALLY THE NEUTROPHIL PATHWAY

61
Q

What is needed for white blood cell differentiation from myeloid stem cells?

A

Certain cytokines e.g.

  • G-CSF (Granulocyte Colony Stimulating Factor)
  • M-CSF (Monocyte Colony Stimulating Factor)
  • GM-CSF (Granulocyte Macrophage Stimulating Factor)
  • and various interleukins
62
Q

How do neutrophils get out of the bloodstream to carry out their main function in tissues?

A

Circulating neutrophil In blood vessels

Neutrophil becomes adhesive

Sticks to endothelium either by:

  • changes to endothelium
  • or
  • changes to neutrophil

Rolls along endothelium

Exits by diapedesis

Migrates through tissues due to chemokine signals

Carries out function of phagocytosis in tissues

Death of neutrophil

63
Q

What cells are granulocytes?

A

Neutrophils

Eosinophils

Basophils

64
Q

How long do eosinophils spend in the circulation?

A

Less time than neutrophils

Neutrophil = 7-10 hrs

Eosinophil = slightly shorter than 7-10 hrs

65
Q

How do different granulocytes and monocytes stain?

A

Neutrophil

Eosinophil

  • bigger granules
  • more pinky-red

Basophil

  • densely stained

Monocytes

  • larger than neutrophils
  • very fine granular cytoplasm
  • large lobular nucleus

Megakaryocyte

  • large cell
  • granular cytoplasm

Lymphocyte

  • high nucleus:cytoplasm ratio
  • big nucleus
  • granules
66
Q

Basophil: life span and major function?

A

Several days; Role in allergic responses

67
Q

How do monocytes carry out their main function?

A

Migrate into tissues

Develop in macrophages (histiocytes) and other specialised phagocytic/scavenging cells

Macrophages phagocytose microorganisms/dying cells/dead cells

68
Q

What are the main functions of macrophages?

A

Phagocytose microorganisms

Phagocytosing dead and dying cells

Store and release iron (by breaking down erythrocytes)

69
Q

How long do platelets survive in circulation?

A

10 days

70
Q

What cells give rise to platelets?

A

Multipotent haemopoietic stem cells

Then Myeloid Stem Cells/Precursors

Then Megakaryocytes

Then Platelets

71
Q

What are two main functions of platelets?

A

Primary haemostatsis

  • adhere to gap by sticking to endothelium
  • form platelet plug

Contribute to phospholipid

  • promotes blood coagulation
72
Q

What is special about lymphocyte circulation?

A

Have the ability to recirculate to lymph nodes and other tissues and then back to the blood stream

(Contrasts to myeloid cells because once they leave bloodstream, they don’t reenter)

73
Q

How long do lymphocytes live in circulation?

A

Intravascular life span is very variable.

74
Q

What do granules in lymphocytes contain?

A

Cytotoxic proteins

75
Q

What causes hypochromia?

A

It is the result of the disk shape of the red cell; the centre has less haemoglobin and is therefore paler.

The cell is also flatter.

Area of central pallor is enlarged.

Less haemoglobin to give a pink colour.

e.g. could be due to thalassemia, with less synthesis of one of the globin chains

76
Q

What proportion of normal red cells is pale?

A

Normally about a third of the diameter.

It’s in the middle of the cell and is known as central pallor.

77
Q

What causes hyperchromia?

A

Cells lack central pallor/area of central pallor is reduced due to:

  • thicker than normal
  • abnormal shape (e.g. may lack central thinner area)

Cells stain more densely

78
Q

Hyperchromic/Hyperchromatic

A

Red cells that show hyperchromia.

Hyperchromatic cells come in two main types; spherocyte and irregularly contracted cells.

79
Q

Hyperchromia

A

A condition in which the cells have a reduced/no area of central pallor compared to normal (smaller/no pale area in centre of cell).

More staining because more haemoglobin to give a pink colour.

80
Q

What is hereditary spherocytosis?

A

Inherited condition of defect in red cell membranes.

Surface part of the membrane is not correctly tethered to the cytoskeleton of the cell.

Therefore, parts of the membrane are lost as the cell ages.

Spherocytes can come in intermediate forms where they have not completely rounded up yet.

81
Q

Irregularly Contracted Cells

A

Irregularly contracted cells are irregular in outline.

Smaller than normal cells.

Have lost their central pallor.

82
Q

What usually causes irregularly contracted cells?

A

Oxidant damage to the cell membrane and to haemoglobin/other proteins.

Oxidant damage due to:

  • ingestion of oxidant substances
  • generation of oxidants during, for example, sepsis or infection
83
Q

How does the body attempt to protect itself against oxidants?

A

Glucose-6-Phosphate Dehydrogenase

If deficient in the enzyme, more likely to have oxidant damage and develop haemolytic anaemia with irregularly contracted cells

84
Q

What is another way to detect young cells?

A

Do a reticulocyte stain.

Use new methylene blue.

Precipitates a network (reticulum) of reticulocytes.

85
Q

In what situations would a person have increased numbers of reticulocytes?

A

If they had just suffered a haemorrhage or if they had haemolytic anaemia.

86
Q

Why would you count reticulocytes instead of polychromatic cells?

A

Both give you similar information

However, it is easier to count and identify reticulocytes through the new methylene blue test when they form a reticulum.

They can be reliably counted.

The degree of blueness of a polychromatic cell is highly subjective.

87
Q

When do target cells occur?

A
  • obstructive jaundice
  • liver disease
  • haemoglobinopathies
  • hyposplenism (spleen removed or not functioning well)
88
Q

When do elliptocytes occur?

A

Hereditary Elliptocytosis

  • nothing wrong with body’s ability to make haemoglobin
  • problem with membrane of red cells

Iron Deficiency

  • defect in synthesis of haemoglobin
  • due to lack of iron
89
Q

When do sickle cells occur?

A

Result from the polymerisation of haemoglobin S when it is present in a high concentration.

Cells are very dense due to loss of water.

Sickle Cell Anaemia

  • inherit gene from both parents = only Hb S
90
Q

When do fragements/schistocytes occur?

A

Cell is defective and therefore fragments OR Normal cell is subjected to abnormal stress that cause it fragment

  • eg. vigorous exercise in inadequate shoes
  • eg. bad heart valve causing turbulent blood flow
91
Q

What causes Rouleaux formations?

A

Alterations in plasma proteins

  • cause red cells to stick together
  • normal RBCs repel each other and don’t stick
92
Q

What causes agglutination formations?

A

Antibody on the cell surfaces

Bind between RBCs

93
Q

What is the commonest cause of Howell-Jolly bodies?

A

Lack of splenic function/No spleen

Spleen normally removes the cells from circulation in a process called ‘pitting’.

94
Q

Why are white cells called by this name?

A

When blood is centrifuged, the small part made up of these cells appears as an off-white colour.

95
Q

Lymphopenia

A

Is the condition of having an abnormally low level of lymphocytes in the blood.

96
Q

What is the difference between signs and symptoms?

A

Sign

  • something you or the patient can see/feel - any objective evidence of disease.
  • a phenomenon that can be detected by someone other than the individual affected by the disease.
  • e.g. a large abdominal mass

Symptom

  • only the patient can tell you/describe a symptom
  • any subjective evidence of disease, a phenomenon that is experienced by the individual affected by the disease
  • e.g. lethargy
97
Q

What are some of the signs and symptoms of iron deficiency?

A

Symptoms

  • shortness of breath
  • fatigue

Signs

  • pallor
  • changes in nails

Yr 2 MCD - Haem (12 decks)

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