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hematology > Hematopoiesis > Flashcards

Hematopoiesis Flashcards

1
Q

Continuous, regulated process of renewal, proliferation, differentiation, and maturation of all blood cell lines

A

Hematopoiesis

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2
Q

These processes result in the formation, development, and specialization of all functional blood cells that are released from the bone marrow into the circulation

A

Renewal, proliferation, differentiation, and maturation

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3
Q

System that serves as a functional model to study stem cell biology, proliferation, and maturation and their contribution to disease and tissue repair

A

Hematopoietic system

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4
Q

Hematopoiesis in healthy adults is restricted primarily to the

A

Bone marrow

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5
Q

During fetal development, the restricted, sequential distribution of cells is initiated in the

A

Yolk sac

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6
Q

Hematopoiesis is considered to begin around the eighteenth day of embryonic development after fertilization. True or False?

A

False; nineteenth

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7
Q

Formation of primitive erythroblasts is seen in what stage of hematopoiesis?

A

Mesoblastic or Yolk Sac Phase

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8
Q

It is known as the stage for primitive hematopoiesis

A

Mesoblastic or Yolk Sac Phase

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9
Q

How does yolk sac hematopoiesis differ from hematopoiesis that occurs later in the fetus and adult?

A

Yolk sac hematopoiesis occurs intravascularly (or within developing blood vessels)

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10
Q

The major site of adult blood formation in the embryo

A

Yolk sac

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11
Q

Embryonic hemoglobins formed by immature erythrocytes in the yolk sac

A

Gower-1
Gower-2
Portland

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12
Q

Globin chain combination of Gower I

A

2 epsilon 2 zeta

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13
Q

Globin chain combination of Gower II

A

2 alpha 2 epsilon

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14
Q

Globin chain combination of Portland

A

2 zeta 2 gamma

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15
Q

The hepatic phase of hematopoiesis begins at 5 to 7 gestational weeks. True or False?

A

True

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16
Q

Event that signals the beginning of definitive hematopoiesis with a decline in primitive hematopoiesis of the yolk sac

A

Development of erythroblast; in addition to the appearance of lymphoid cells

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17
Q

Major site of hematopoiesis during the second trimester of fetal life

A

Liver

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18
Q

Hematopoiesis in the fetal liver reaches its peak by the _____ month of fetal development, then gradually declines after the _____ month, retaining minimal activity until _____ weeks after birth

A

Third
Sixth
1 to 2

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19
Q

The first fully developed organ in the fetus

A

Thymus

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20
Q

Major site of T cell production in fetus

A

Thymus

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21
Q

Organ that produce B cells in fetus

A

Kidney and spleen

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22
Q

Production of megakaryocytes begins during what stage of hematopoiesis?

A

Hepatic Phase

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23
Q

Hepatic stage of hematopoiesis occurs intravascularly or extravascularly?

A

Extravascularly

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24
Q

Hemoglobins produced during the hepatic phase of hematopoiesis

A

Fetal hemoglobin (Hb F)
Adult hemoglobin (Hb A)

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25
Q

Predominant hemoglobin in hepatic stage of hematopoiesis

A

Fetal hemoglobin (Hb F)

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26
Q

Percentage of adult hemoglobin (Hb A) in hepatic stage of hematopoiesis

A

<1%

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27
Q

Globin chain combination fetal hemoglobin (Hb F)

A

2 alpha 2 gamma

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28
Q

Hematopoiesis in the bone marrow

A

Medullary (Myeloid) Phase

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29
Q

Site of medullary hematopoiesis

A

Medulla or inner part of the bone cavity

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30
Q

Medullary hematopoiesis begins between the fifth and sixth month of fetal development. True or False?

A

False; fourth and fifth

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31
Q

Myeloid-to-erythroid ratio during medullary hematopoiesis

A

Gradually approaches 3:1 to 4:1 (normal adult levels)

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32
Q

Primary site of hematopoiesis by the end of 24 weeks’ gestation

A

Bone marrow

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33
Q

Measurable levels of erythropoietin (EPO), granulocyte col- ony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), and hemoglobins F and A can be detected in medullary hematopoiesis. True or False?

A

True

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34
Q

Main type of hematopoiesis during the second and third trimester of pregnancy

A

Medullary (Myeloid) Phase

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35
Q

Hemoglobins produced during medullary hematopoiesis

A

Hb A
Hb A2

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36
Q

Globin chain combination adult hemoglobin (Hb A)

A

2 alpha 2 beta

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37
Q

Globin chain combination adult hemoglobin (Hb A2)

A

2 alpha 2 delta

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38
Q

In adult hematopoiesis, the red marrow is found only in the

A

Ribs
Sternum
Scapula
Skull
Vertebrae
Pelvic bone
Proximal end of long bones

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39
Q

Site of adult hematopoietic tissue

A

Bone marrow (major site)
Lymph nodes
Spleen
Liver
Thymus

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40
Q

Primary site of adult hematopoiesis

A

Bone marrow

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41
Q

Secondary site of adult hematopoiesis

A

Liver and spleen

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42
Q

Reference range for normal adult Hgb

A

Hb A: 95-97%
Hb A2: 2-3%
≤1%: Hb F

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43
Q

Type of hematopoiesis seen during compensatory state such in case of bone marrow failure, certain diseases, malignancies, and infection

A

Extramedullary hematopoiesis

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44
Q

Type of hematopoiesis that results to hepatomegaly and splenomegy

A

Extramedullary hematopoiesis

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45
Q

Formation and activation of blood cells outside the bone marrow

A

Extramedullary hematopoiesis (EMH)

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46
Q

Extramedullary hematopoiesis (EMH) occurs mainly in

A

Liver and spleen

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47
Q

Two major components of normal bone marrow

A

Red marrow
Yellow marrow

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48
Q

Composition of red marrow

A

Developing blood cells and their progenitors

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49
Q

Composition of yellow marrow

A

Adipocytes (fat cells), with undifferentiated mesenchymal cells and macrophages

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50
Q

Hematopoietically active marrow

A

Red marrow

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51
Q

Hematopoietically inactive marrow

A

Yellow marrow

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52
Q

One of the largest organs in the body, is located within the cavities of the cortical bones

A

Bone Marrow

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53
Q

During infancy and early childhood, all the bones in the body contain primarily yellow (inactive) marrow. True or False?

A

False; red (active) marrow

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54
Q

The process of replacing the ac- tive marrow by adipocytes (yellow marrow) during development

A

Retrogression

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55
Q

Retrogression occurs between 8 and 9 years of age. True or False?

A

False; 5 and 7

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56
Q

The ratio of the red marrow to the yellow marrow

A

Marrow cellularity

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57
Q

Marrow cellularity in adults

A

Approximately equal amounts of red and yellow marrow in hematopoietic active sites

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58
Q

Marrow cellularity, typically increases with age. True or False?

A

False; decreases

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59
Q

Yellow marrow is capable of reverting back to active marrow. True or False?

A

True

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60
Q

Cells originated from mesenchymal cells that migrate into the central cavity of the bone

A

Stromal cells

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61
Q

Stromal cells include:

A

Perivascular
Adipocytes (fat cells)
Lymphocytes
Endothelial cells
Glial cells
Reticular adventitial cells (fibroblasts)
Osteoblasts
Osteoclasts
Macrophages

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62
Q

Broad, flat cells that form a single continuous layer along the inner surface of the arteries, veins, and vascular sinuses

A

Endothelial cells

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63
Q

Large cells with a single fat vacuole

A

Adipocytes

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64
Q

Cells involved in cytokine production

A

Macrophages
Adipocytes
Lymphocytes
Endothelial cells

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65
Q

Bone-forming cells

A

Osteoblasts

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66
Q

Bone-resorbing cells

A

Osteoclasts

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67
Q

Responsible for the incomplete layer of cells on the abluminal surface of the vascular sinuses

A

Reticular adventitial cells

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68
Q

Stromal cells play a critical role in the regulation of hematopoietic stem and progenitor cell survival and differentiation. True or False?

A

True

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69
Q

The nutrient and oxygen requirements of the marrow are fulfilled by the

A

Nutrient and periosteal arteries, which enter via the bone foramina

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70
Q

The nutrient artery supplies blood only to the marrow. True or False?

A

True

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71
Q

Periosteal arteries provide nutrients for the osseous bone and the marrow. True or False?

A

True

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72
Q

Hematopoietic cells located in the end-osteal bed receive their nutrients from the

A

Nutrient artery

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73
Q

Key stromal cells thought to support HSCs in bone marrow niches

A

Osteoblasts
Endothelial cells
Mesenchymal stem cells
CXCL12-abundant reticular cells
Perivascular stromal cells
Glial cells
Macrophages

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74
Q

Ratio between granulocyte lineage and erythrocyte lineage

A

Myeloid:Erythroid Ratio

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75
Q

Normal Myeloid:Erythroid Ratio

A

3:1

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76
Q

Excluded from the M:E ratio are

A

Lymphocyte and its precursors, plasma cells, monocytes and its precursors, histiocytes,
nonnucleated erythrocytes, and nonhematopoietic stromal cell

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77
Q

M:E ratio during infection. Interpret the results

A

6:1; Increase

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78
Q

M:E ratio during leukemia. Interpret the results

A

25:1; Increase

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79
Q

M:E ratio during myeloid hyperplasia. Interpret the results

A

20:1; Increase

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80
Q

M:E ratio during myeloid hypoplasia. Interpret the results

A

3:20; Decrease

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81
Q

M:E ratio during erythroid hyperplasia. Interpret the results

A

1:20; Decrease

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82
Q

M:E ratio during erythroid hypoplasia. Interpret the results

A

5:1;Increase

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83
Q

Used to evaluate hematopoietic cell production

A

M:E Ratio

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84
Q

Normocellular marrow cellularity value

A

Marrow has 30 to 70% HSCs

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85
Q

Hypercellular/Hyperplastic marrow cellularity value

A

Marrow has >70% HSCs

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86
Q

Hypocellular/Hypoplastic marrow cellularity value

A

Marrow has <30% HSCs

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87
Q

Aplastic marrow cellularity value

A

Marrow has few or no HSCs

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88
Q

Types of Bone marrow Specimen

A

Direct aspirate smears
Anticoagulated aspirate smears
Crush smears
Histologic/ Cell block
Imprints/ Touch preparation
Concentrate/ Buffy coat smear

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89
Q

Most commonly used site for BM collection

A

Posterior iliac crest

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90
Q

Most commonly used site for BM collection for newborn and infants

A

Upper end of tibial bone

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91
Q

Instrument/s used for Trephine (Core) biopsy

A

Trephine biopsy needle / Jamshidi needle / Westerman-Jensen needle

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92
Q

Instrument/s used for Bone marrow Aspirate

A

Aspiration needle / University of Illinois sternal needle

93
Q

Bone marrow smears should be retained for

A

10 years

94
Q

Bone Marrow Differential requires counting at least 500, and preferably 1000 cells be counted. True or False?

A

True

95
Q

Two most common erythrocytic stages with fried egg appearance

A

Polychromatophilic and orthochromic normoblast

96
Q

The largest cell in the Bone Marrow

A

Megakaryocyte

97
Q

The most predominant cell in the Bone Marrow

A

Metamyelocyte

98
Q

the largest cell in the Venous Blood

A

Monocytes

99
Q

The bone marrow is estimated to be capable of producing approximately 2.5 billion erythrocytes, 2.5 billion platelets, and 1-billion granulocytes per kilogram of body weight daily. True or False?

A

True

100
Q

Appearance of osteoblasts

A

Water-bug or comet appearance

101
Q

Osteoblasts are commonly mistaken as

A

Plasma cells

102
Q

Osteoclasts are commonly mistaken as

A

Megakaryocyte

103
Q

The identification and origin of HSCs can be determined by immunophenotypic analysis using

A

Flow cytometry

104
Q

Cytokines that exert a negative influence on hematopoiesis

A

TGF-Beta
TNF-Alpha
Interferons

105
Q

Cytokines or Hematopoietic growth factors that exert a positive influence on HSCs and progenitor cells

A

KIT ligand
FLT3 ligand
GM-CSF
IL-1
IL-3
IL-6
IL-11

106
Q

Organ that synthesize coagulation factors

A

Liver

107
Q

Macrophages that remove senescent cells and foreign debris from the blood that circulates through the liver

A

Kupffer cells

108
Q

The largest lymphoid organ in the body

A

Spleen

109
Q

Amount of blood contained in the spleen of a healthy individual

A

350 mL

110
Q

Three types of splenic tissue

A

White pulp
Red pulp
Marginal zone

111
Q

Cells in white pulp

A

Lymphocytes
Macrophages
Dendritic cells

112
Q

Cells in marginal zone

A

Macrophages
Memory B cells
CD4 T cells

113
Q

Cells in red pulp

A

Specialized macrophages

114
Q

The spleen uses two methods for removing senescent or abnormal RBCs from the circulation:

A

Culling
Pitting

115
Q

Process in which the cells are phagocytized with subsequent degradation of cell organelles

A

Culling

116
Q

Process in which splenic macrophages remove inclusions or damaged surface membrane from the circulating RBCs

A

Pitting

117
Q

The spleen serves as a storage site for platelets. True or False?

A

True

118
Q

Approximate amount of platelet sequestered in the spleen

A

30% of the total platelet count

119
Q

The combination of the slow pas- sage and the continued RBC metabolism creates an environment that is acidic, hypoglycemic, and hypoxic. True or False?

A

True

120
Q

Splenectomy will lead to

A

Pancytosis

121
Q

Hypersplenism will lead to

A

Pancytopenia

122
Q

How does sickled RBCs lead to autosplenectomy

A

In sickle cell anemia, repeated splenic infarcts caused by sickled RBCs trapped in the small-vessel circulation of the spleen cause tissue damage and necrosis, which often results in autosplenectomy

123
Q

Spontaneous splenic infarction leading to hyposplenism

A

Autosplenectomy

124
Q

Graveyard of the RBCs

A

Spleen

125
Q

Storage site of blood cells

A

Spleen

126
Q

Area in white pulp where B cells reside

A

Primary follicles

127
Q

Area in white pulp where activated B cells reside

A

Germinal center or Secondary follicle

128
Q

Area in white pulp where T cells reside

A

PALS (periarteriolar lymphoid sheaths)

129
Q

Cord of billroth is seen in

A

Red pulp

130
Q

The red pulp makes up more than one half of the total volume of spleen. True or False?

A

True

131
Q

Poikilocytes produced by pitting

A

Bite cells

132
Q

Inclusion bodies of RBC in person with G6PD Deficiency

A

Heinz bodies

133
Q

RBC lifespan

A

120 days

134
Q

Old senescent RBCs are deformable. True or False?

A

False; rigid

135
Q

The absence of splenic function)

A

Asplenia

136
Q

Fluid portion of blood that escapes into the connective tissue and is characterized by a low protein concentration and the absence of RBCs

A

Lymph

137
Q

Three main functions if lymph nodes

A

They are a site of lymphocyte proliferation
They are involved in the initiation of the specific immune response to foreign antigens
They filter particulate matter, debris, and bacteria entering the lymph node via the lymph

138
Q

Infection or inflammation of the lymph node due to increased numbers of microorganisms entering the nodes

A

Adenitis

139
Q

Site of T cell production

A

Bone marrow

140
Q

Site of T cell maturation

A

Thymus

141
Q

Site of B cell production

A

Bone marrow

142
Q

Site of B cell maturation

A

Bone marrow

143
Q

Two major types of hematopoietic progenitor cells

A

Noncommitted or undifferentiated HSCs
Committed progenitor cells

144
Q

Two theories describing the origin of hematopoietic progenitor cells

A

Monophyletic theory
Polyphyletic theory

145
Q

Theory suggesting that all blood cells are derived from a single progenitor stem cell called a pluripotent hematopoietic stem cell

A

Monophyletic theory

146
Q

Theory suggesting that each of the blood cell lineages is derived from its own unique stem cell

A

Polyphyletic theory

147
Q

Most widely accepted theory among experimental hematologists

A

Monophyletic theory

148
Q

Cells capable of self-renewal, are pluripotent and give rise to differentiated progeny, and are able to reconstitute the hematopoietic system of a lethally irradiated host

A

Hematopoietic Stem Cells

149
Q

The undifferentiated HSCs can differentiate into progenitor cells committed to either lymphoid or myeloid lineages. True or False?

A

True

150
Q

Lineage-specific progenitor cells which proliferates and differentiates into T, B, and natural killer lymphocyte and dendritic lineages

A

Common lymphoid progenitor

151
Q

Lineage-specific progenitor cells which proliferates and differentiates into individual granulocytic, erythrocytic, monocytic, and megakaryocytic lineages

A

Common myeloid progenitor

152
Q

Number of cells produced by the bone marrow

A

2.5 billion erythrocytes, 2.5 billion platelets, and 1 billion granulocytes per kilogram of body weight daily

153
Q

Most of the cells in normal bone marrow are precursor cells at various stages of maturation. True or False?

A

True

154
Q

Three possible fates of HSCs

A

Self-renewal
Differentiation
Apoptosis

155
Q

Explain the symmetric division

A

Both daughter cells may follow the path of differentiation, leaving the stem cell pool

156
Q

Explain the asymmetric division

A

One daughter cell may return to the stem cell pool and the other daughter cell may follow the path of differentiation or undergo apoptosis

157
Q

Model suggesting that the HSC randomly commits to self-renewal or differentiation

A

Stochastic model of hematopoiesis

158
Q

Model suggesting that the microenvironment in the bone marrow deter- mines whether the HSC will self-renew or differentiate

A

Instructive model of hematopoiesis

159
Q

Model suggesting that HSCs receive low-level signals from the hematopoietic inductive microenvironment to amplify or repress genes associated with commit- ment to multiple lineages

A

Multilineage priming model

160
Q

A bipotential progenitor cell of mesodermal origin that gives rise to hematopoietic and endothelial lineages

A

Hemangioblast

161
Q

Changes in the nucleus during cell maturation

A

Loss of nucleoli
Decrease in the diameter of the nucleus
Condensation of nuclear chromatin
Possible change in the shape of the nucleus
Possible loss of the nucleus

162
Q

Changes in the cytoplasm during cell maturation

A

Decrease in basophilia
Increase in the proportion of cytoplasm
Possible appearance of granules

163
Q

HSCs exist in the marrow in the ratio of

A

1 per 1000 nucleated blood cells

164
Q

Can be calculated to establish the percentage of cells in mitosis in relation to the total number of cells

A

Mitotic index

165
Q

Factors affecting the mitotic index

A

Duration of mitosis and the length of the resting state

166
Q

Normal mitotic index

A

1% to 2%

167
Q

Increased mitotic index implies

A

Increased proliferation

168
Q

Rate of mitosis in case of megaloblastic anemia

A

Prolonged

169
Q

G0

A

Resting stage

170
Q

G1

A

Cell growth and synthesis of components necessary for cell division

171
Q

S

A

DNA replication

172
Q

G2

A

Premitotic phase

173
Q

M

A

Mitosis

174
Q

A group of specific glycoproteins that regulate the proliferation, differentiation, and maturation of hematopoietic precursor cells

A

Hematopoietic growth factors or cytokines

175
Q

Diverse group of soluble proteins that have direct and indirect effects on hematopoietic cells

A

Cytokines

176
Q

Cytokines include:

A

Interleukins (ILs)
Lymphokines
Monokines
Interferons
Chemokines
Colony-stimulating factors (CSFs)

177
Q

Responsible for stimulation or inhibition of production, differentiation, and trafficking of mature blood cells and their precursors

A

Cytokines

178
Q

Normal physiologic process that eliminates unwanted, abnormal, or harmful cells

A

Apoptosis/programmed cell death

179
Q

KIT ligand is also known as

A

Stem cell factor (SCF)

180
Q

Characteristics shared by interleukins

A
  1. They are proteins that exhibit multiple biologic activities, such as the regulation of autoimmune and inflammatory reactions and hematopoiesis.
  2. They have synergistic interactions with other cytokines.
  3. They are part of interacting systems with amplification
    potential.
  4. They are effective at very low concentrations.
181
Q

A complex, regulated process for maintaining adequate numbers of eryth- rocytes in the peripheral blood

A

Erythropoiesis

182
Q

Erythropoiesis occurs in the

A

Bone marrow

183
Q

Earliest identifiable colony of RBCs

A

Burst- forming unit-erythroid (BFU-E)

184
Q

Serves as a differentiation factor that causes the CFU-E to differentiate into pronormoblasts

A

EPO

185
Q

The earliest visually recognized erythrocyte precursors in the bone marrow

A

Pronormoblasts

186
Q

Lineage-specific glycoprotein produced in the renal peritubular interstitial cells

A

EPO

187
Q

Small amount of EPO is produced by the liver. True or False?

A

True

188
Q

Stimulus that activates production and secretion of EPO

A

Oxygen availability in the kidney

189
Q

Two major categories of leukopoiesis

A

Myelopoiesis
Lymphopoiesis

190
Q

Main site of production of TPO

A

Liver

191
Q

Cytokines are used as priming agents to increase the yield of HSCs during apheresis for transplantation protocols. True or False?

A

True

192
Q

Foundation of the adult hematopoietic system

A

Hematopoietic stem cells (HSCs)

193
Q

Three types of human stem cell

A

Totipotential
Pluripotential
Multipotential

194
Q

The most versatile type of stem cell

A

Totipotential stem cells

195
Q

It is an ideal environment of HSC is the allowance for: Self renewal, Proliferation and Differentiation, Apoptosis

A

Hematopoietic microenvironment

196
Q

Specialized cells within the BM that provide protective and nourishing environment to the HSCs

A

Stromal cells

197
Q

Function of stromal cells

A

Secrete substances that make up the extracellular matrix which are essential for cell growth and support of the HSCs

198
Q

Origin of dendritic cells

A

CLP

199
Q

Precursor of dendritic cells

A

Monocytes

200
Q

RBC precursors

A

Rubriblast to Reticulocyte

201
Q

Granulocyte precursors

A

Myeloblast to Band cells

202
Q

Platelet precursors

A

Megakaryoblast
Promegakaryocyte
Megakaryocyte

203
Q

Not a true leukocyte

A

Mast cell

204
Q

Mature cell/s developed from G-M (Granulocyte-Monocyte) Progenitor

A

Basophil
Neutrophil
Eosinophil
Monocyte
Macrophage

205
Q

Mature cell/s developed from E-B (Eosinophil-Basophil) Progenitor

A

Basophil
Eosinophil

206
Q

Mature cell/s developed from M-E (Megakaryocyte-Erythrocyte) Progenitor

A

Platelets
RBCs

207
Q

Mature cell/s developed from CMP (Common Myeloid Progenitor)

A

Granulocytes
Erythrocytes
Monocytes/Macrophages
Megakaryocytes

208
Q

Mature cell/s developed from CLP (Common Lymphoid Progenitor)

A

Lymphocytes (B cell, T cell, and NK cell)
Plasma cells
Dendritic cells

209
Q

Functional characterization of HSCs can be accomplished through in vitro techniques using

A

Culture assays

210
Q

Lymphoid pan T cell marker/s

A

CD2
CD3

211
Q

Helper / Inducer T cell marker/s

A

CD4

212
Q

Suppressor / Cytotoxic T cell marker/s

A

CD8

213
Q

Pan Myeloid cell marker/s

A

CD13
CD33

214
Q

Monocyte marker/s

A

CD11
CD14

215
Q

Lymphoid, pan B cell marker/s

A

CD19
CD20

216
Q

Hematopoietic stem cell marker/s

A

CD34

217
Q

NK Cell marker/s

A

CD16
CD56

218
Q

Pre-CALLA (Common acute
lymphoblastic leukemia) marker/s

A

CD10

219
Q

CFU-GEMM cell line

A

Granulocyte
Erythrocyte
Megakaryocyte
Monocyte

220
Q

CFU-E cell line

A

Erythrocyte

221
Q

CFU-Meg cell line

A

Megakaryocyte

222
Q

CFU-M cell line

A

Monocyte

223
Q

CFU-GM cell line

A

Granulocyte, monocyte

224
Q

CFU-BASO cell line

A

Myeloid to basophil

225
Q

CFU-EO cell line

A

Myeloid to eosinophil

226
Q

CFU-G cell line

A

Myeloid to neutrophil

227
Q

CFU-pre-T cell line

A

T lymphocyte

228
Q

CFU-pre-B cell line

A

B lymphocyte

hematology (4 decks)

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