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Hematalogy Lecture > The Erythrocyte > Flashcards

The Erythrocyte Flashcards

1
Q

 overall, as normal RBCs mature what changes are seen?

A

-cell size decrease
-nuclear chromatin pattern becomes denser
-Nucleoli disappear
-amount and color of cytoplasm changes
-size of nucleus decreases greater than the size of the cell (N:C) ratio 

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2
Q

Production of total population of mature red blood cells and their precursors in blood, bone marrow, and other sites.

A

Erythropoiesis 

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3
Q

When viable red blood cells (Both in number and quality) are delivered to the circulation to function effectively

A

Effective erythropoiesis

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4
Q

How is effective erythropoiesis measured?

A

By reticulocyte (retic) and total RBC counts

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5
Q

When RBCs are unable to deliver sufficient O2 to the tissues (Either due to numbers or quality) resulting in anemia, thus causing hypoxia

A

Ineffective erythropoiesis

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6
Q

A decrease in circulating RBC mass and/or Hemoglobin content

A

Anemia

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7
Q

Lack of oxygen in body tissues

A

Hypoxia

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8
Q

______________ are the primary site for storage of iron in the bone marrow (nurse cell)

A

Macrophages

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9
Q

_____________ is the protein that binds and transports iron to either storage or developing red blood cells

A

Transferrin

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10
Q

______________ cells are the lining cells of the bone marrow and blood vessels. 

A

Endothelial

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11
Q

What are the six stages of RBC naturation/amplification?

A

• Pronormoblast (rubriblast or Proerythroblast) “-blast”
• basophilic normoblast
• polychromatic normoblast
• orthochromic normoblast
• reticulocyte “retic-“
• Erythrocyte

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12
Q

What is the size of a pronormobalst (blast)? 

A

12-20 micrometers

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13
Q

What is the N:C ratio for pronormoblast (blasts)?

A

High ratio at 8:1

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14
Q

Contains nucleoli and fine chromatin, round to slightly oval shape 

A

”blast”

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15
Q

cytoplasm: Very basophilic (High RNA content, lots of organelles), with lighter staining perinuclear area around Golgi (not always visible) 
Very blue

A

“Blast”

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16
Q

What is the size of basophilic Normoblasts? 

A

10-15 Micrometers

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17
Q

Nucleus Is round, coarser chromatin, no visible Nucleoli*

A

Basophilic normoblast 

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18
Q

Cytoplasm temporary even more basophilic (Royal blue); Golgi may be visible as light area near nucleus

A

Basophilic normoblast 

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19
Q

What is the N:C ratio for Basophilic normoblasts? 

A

6:1

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20
Q

Can hemoglobin be seen in the basophilic normoblast stage? 

A

Hemoglobin is being synthesized but cannot be seen yet, Can only see RNA at this stage

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21
Q

What is the size of polychromatic normoblasts? 

A

10-12 micrometers

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22
Q

The nucleus is round, sometimes eccentric, smaller, with coarser chromatin 

A

Polychromatic normoblast 

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23
Q

What is the first stage you can see hemoglobin?

A

Polychromatic normoblast 

-gives blue/gray color

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24
Q

What is the N:C ratio for polychromatic normoblasts?

A

4:1

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25
Q

Cytoplasm is opaque, violet-blue or grayish color (Due to Hgb Synthesis)
*polychromasia 

A

Polychromatic normoblast 

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26
Q

What is the last stage capable of mitosis? 

A

Polychromatic normoblast 

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27
Q

What is the last stage to have a nucleus? 

A

Orthochromic normoblast

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28
Q

What is the size of orthochromic normoblasts?

A

8-10 micrometers

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29
Q

Pyknotic (Degenerated nuclear chromatin, very dark), Eventually extruded

A

Orthochromic normoblast

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30
Q

The cytoplasm is polychromasia (Blue/gray) 

A

Orthochromic normoblast 

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31
Q

Which stage do automated analyzers mistake for WBCs? 

A

Orthochromic normoblast

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32
Q

What percentage of orthochromic normoblasts are scene in circulation?

A

Only small percentage

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33
Q

What is the N:C ratio for Orthochromic normoblast?

A

1:2

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34
Q

What stage is typically called “ Nucleated red” ?

A

Orthochromic normoblast

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35
Q

A WBC count must be corrected if _____ or more Orthochromic normoblasts, “ Nucleated red”, are present on a 100 cell WBC differential

A

5

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36
Q

Immature RBCs are called…

A

Reticulocytes “retic-“ 

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37
Q

What is the cell size of Reticulocytes?

A

7-9 micrometers (nearly normal)

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38
Q

No nucleus present. Varying degrees of polychromasia (Variation in cytoplasmic color, usually a bluish tinge, May have basophilic stippling) 

A

Reticulocytes

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39
Q

”awkward stage” but can still function and deliver oxygen

A

Reticulocytes

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40
Q

What is the basophilic stippling seen in reticulocytes?

A

Leftover RNA aggregates 

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41
Q

Reticulocytes reside in marrow for ___ day(s), And then retained in the spleen for pitting and polishing for a few days, then released as a mature cell

A

1

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42
Q

What is it called when the spleen removes RNA inclusions?

A

“Pitting” 

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43
Q

Do all Reticulocytes show stippling? 

A

No, but show Polychromasia

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44
Q

Reticulocytes are ___________ Larger and bumpier than RBCs

A

Slightly

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45
Q

What is a very old nickname for retics? 

A

“Shift cell”

-if not visible as basophilic stippling residual RNA can be stained with a supravital stain (“in living sate”), Using either new methylene blue (common) or brilliant cresyl blue stain (rarer) 

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46
Q

What stain is used to identify retics? 

A

New methylene blue

47
Q

What is the cell size of erythrocytes?

A

7-8 micrometers

48
Q

no nucleus present, has distinctive central pollor; No protein or Hgb made; No mitochondria present

A

Erythrocyte

49
Q

What is the lifespan of erythrocytes? How far does it travel in that time?

A

120 days
300 miles

50
Q

The collection of all Erythrocytes throughout the body

A

erythron

51
Q

Refers only to the cells in circulation (Not in marrow or spleen)

A

RBC mass

52
Q

Diminished availability of oxygen to the body tissues. Occurs when the oxygen tension in the cells is decreased

A

Hypoxia

53
Q

EPO Is produced primarily in the kidneys in response to?

A

Degree of oxygenation

54
Q

What hormone functions to maintain normal RBC mass?

A

Erythropoietin EPO

55
Q

Initiates a cascade of events that lead to increased RBCs in circulation

A

EPO

56
Q

What are some of the cascade events caused by EPO? 

A

-allows early release of reticulocytes
-Increase number of mature erythrocytes
-Reduces marrow transit time

57
Q

An Influx of reticulocytes means that the marrow is functioning….

A

Normally

58
Q

RBCs are removed from circulation after 120 days by ___________.

A

Hemolysis (Occurs after decrease RBC flexibility)

59
Q

What is the most common Type of erythrocyte destruction? 

A

Extravascular hemolysis (Recycles RBCs) 

60
Q

What is the least common type of Erythrocyte destruction ?

A

Intravascular hemolysis (Occurs within the lumen of blood vessels and cannot be recycled)

61
Q

-Loss of glycolytic enzymes leads to increased sodium and decreased potassium in cell = Spherocytes
-macrophages in spleen and liver (i.e., Reticuloendothelial system)

A

Extravascular hemolysis

62
Q

Anemia is measured through ______levels 

A

EPO

63
Q

 What are the two Common causes of anemia? 

A

Decreased RBC and hemoglobin levels

64
Q

What three elevated levels correlate with increased destruction of RBCs? 

A

-increase in urobilinogen measured in stool
-Increased serum bilirubin and LDH levels
-Increase serum haptoglobin

65
Q

Measurement of RBC production in destruction can also be assess through what ratio? 

A

Erythroid marrow M:E ratio

1:1 - hyperplasia
> 4:1 Indicates hypoplastic marrow (not enough RBC produced) 

66
Q

M:E ratio is only used when from ___________ and not Peripheral blood. 

A

Bone marrow

67
Q



A
68
Q

What are the four basic functions that the components of the RBC membrane allow it to perform?

A

-maintain cell shape and deformability
-Maintain osmotic balance between plasma and cell membrane
-Support cell surface antigens/markers
- allow nutrients and iron passage selectively into an out of cell (selective permeability) 

69
Q

More cholesterol in the membrane = 

A

More rigidity (This will affect the plasma membrane permeability to electrolytes And nonelectrolyte)

This helps to maintain the plasma membranes appropriate surface area to volume ratio

70
Q

What is the composition of RBC membrane?

A

-lipids (some Glycolipids)
-Cholesterol
-RBC peripheral membrane proteins
-Integral plasma membrane proteins

71
Q

What are the RBC peripheral membrane proteins that line the inner membrane surface?

A
  1. Spectrin (bands 1,2)
  2. actin (band 5)
  3. Ankyrin
  4. Band 4.1
72
Q

(RBC peripheral membrane proteins)
The major component of RBC cytoskeleton. Made of long filamentous rods of alpha and beta subunits, loosely woven together; Has ATPase activity; Contributes to pliancy 

A

Spectrin (bands 1,2)

73
Q

(RBC Peripheral membrane proteins)

Small globular proteins which work with spectrin filaments

A

Actin

74
Q

(RBC peripheral membrane protein)

Anchors Band 3

A

Ankyrin

75
Q

(RBC peripheral membrane protein)

Binds Spectrin to glycophorin C

A

Band 4.1

76
Q

What is the function of the RBC peripheral membrane proteins?

A

Underline the lipid bilayer on the cytoplasmic face and directly regulate pm shape and properties. 
* necessary for microcirculation

77
Q

What protein contributes to pliability of the cell, and keeps it elastic and held together?

A

Spectrin

78
Q

What are the integral p.m. proteins of RBCs? 

A
  1. Band 3
  2. Glycophorin A
  3. Glycophorin C
79
Q

RBCs are ______________ charged. 

A

Negatively

80
Q

(integral p.m. protein)
anion Exchange transporter protein for Cl- and HCO3- and Attaches cytoskeleton to phospholipid bilayer 

A

Band 3 (AE1)

81
Q

(Integral p.m. protein)
Blood group antigen (Ag) Also helps stabilize p.m.

A

Glycophorin A

82
Q

(integral p.m. protein)
Attaches cytoskeleton to lipid bilayer

A

Glycophorin C

83
Q

What is the advantage of Zeta potential that repels RBC’s away from each other in circulation? 

A

Prevents clumping and clotting

84
Q

Band 3 and all the glycophorins are ____________, which help give RBC’s overall negative charge, called Zeta potential.

A

Sialoglycoprotiens

85
Q

Energy is ______ needed to effect O2 and CO2 exchange through RBC plasma membrane.

A

NOT

86
Q

What is energy required for in erythrocyte energy metabolism?

A

-preserve plasma membrane shape
-Maintenance of intracellular gradients
-Maintenance of membrane the phospholipid
-Protection of cell proteins from denaturation
-Initiation and maintenance of glycolysis

87
Q

Erythrocyte energy metabolism involves what metabolic pathways?

A

anaerobic glycolysis

-Embden-Meyerhof Pathway (EMP)
-Methemoglobin Reductase Pathway
-Rapaport-Leubering Pathway (RLP) or Shunt (Unique for a Erythrocytes)

88
Q

What metabolic pathway is responsible for 90 to 95% of cells glucose generation? 
-net gain 2 ATP
-2,3-BPG and NADH

A

EMP

89
Q

This is a cofactor in maintaining hemoglobin

A

NADH

90
Q

-This helps with the offloading of oxygen, Regulates oxygen delivery to tissues
-provided in the EMP pathway

A

2,3-BPG (2,3-bisphosphoglycertate)

91
Q

EMP rate is regulated by….

A

ATP concentration

Increased ATP = allosteric regulator
Increased ATP = decreased glycolysis 

92
Q

-adjunct pathway to EMP that uses NADH produced from glycolysis*
-This NADH acts as coenzyme for Hgb-M reductase 

A

Methemoglobin reductase pathway

93
Q

 NADH acts as coenzyme for Hgb-M reductase. What would this enzyme do?

A

Supports the reduction of methoglobin to hemoglobin

Hgb-M Fe3+ (ferric) —-> Hgb Fe2+ (ferrous)

94
Q

Deficiency of ____________ Causes chronic cyanosis. 

A

Hgb-M reductase

-Hgb-M levels should never reach >2%

95
Q

What Metabolic pathway is unique to RBCs? 

A

Rapaport- Luebering Pathway (RLP)

96
Q

This pathway helps regulate oxygen transport inside the RBC by producing 2,3-BPG, an allosteric regulator of Hgb. The presence of this molecule enhances O2 offloading! 

A

RLP

97
Q

RLP makes….

A

*** 2,3-BPG

98
Q

What is the aerobic glycolysis Pathway for Erythrocyte metabolism?

A

Hexose Monophosphate Pathway (HMP) aka Pentose-Phosphate Shunt

99
Q

-this pathway is responsible for 5 to 10% of glucose consumption
-Controlled by Glucose-6-Phosphate Dehydrogenase (this helps Reduce RBC sensitivity to oxidative damage!)
-main purpose is to maintain NADP and reduced glutathione 

A

(HMP) Hexose Monophosphate Pathway

100
Q

What is the main purpose of HMP? 

A

-maintain NADP and reduced glutathione 

101
Q

What prevents oxidative damage to RBC’s in the HMP?

A

G-6-PD (Glucose-6-Phosphate Dehydrogenase)

102
Q

HMP also makes _______, which is used by nucleated RBC’s during nucleic acid metabolism. 

A

Ribulose-5-phosphate (R-5-P)

103
Q

Glutathione peroxidase converts RBC ___________ to water. 

A

Hydrogen peroxide (H2O2) 

104
Q

If H2O2 builds up, it causes oxidation of Hgb to ______ (Which is unable to bind 02, thus excess levels cause hypoxia) 

A

MetHgb

Hgb Fe2+ (ferrous) —-> MetHgb Fe3+ (ferric)

105
Q

EPO is produced in the ___________ in response to _________. 

A

Kidneys, hypoxia

106
Q

Total of all erythrocytes in the body

A

Erythron

107
Q

What is the normal adult M:E ratio? 

A

1.5:1 to 3.3:1

108
Q

What is the average range for retics?

A

0.5 - 2.5 %

109
Q

Which pathways are used to achieve ATP in RBC’s?

A

All pathways discussed

110
Q

What is the normal absolute retic count range?

A

20 to 115 x 10^9/L

111
Q

How do you calculate ARC? (Absolute reticulocyte count) 

A

Retic (%) x RBC count (x10^12/L)

Divided by

100

112
Q

What does CFU-GEMM stand for?

A

Colony forming unit - Granulocyte, erythrocyte, megakaryocyte, monocyte

113
Q

What does GM-CSF stand for?

A

Granulocyte macrophage colony stimulating factor 

Hematalogy Lecture (35 decks)

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