LEC 1 Peripheral Blood & Cytomorphology Flashcards

Dr. Jesus Delgado-Calle To define the formed elements of blood. Learn the characteristic morphologic features of erythrocytes, neutrophils, lymphocytes, plasma cells, monocytes, eosinophil, basophils, macrophages, platelets and their precursors. Be able to provide a brief introduction of cellular function for each blood cell.

1
Q

Where are blood cells formed in the embryo?

A

Yolk sac

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2
Q

As development progresses, where in the body does blood formation occur?

A

Spleen, Liver, & Lymph Nodes

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3
Q

Once developed, what assumes the task of forming the blood cells for the entire organism?

A

Bone Marrow

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3
Q

Once developed, what assumes the task of forming the blood cells for the entire organism?

A

Bone Marrow

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4
Q

Where does hematopoesis occur in children?

What bones?

A

marrow of the long bones such as femur and tibia

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5
Q

Where does hematopoeisis occur in adults?

What bones?

A

Pelvis, Cranium, Vertebrae, and Sternum

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6
Q

Where does maturation, activation, and growth of lymphoid cells occur?

A

Spleen, Thymus, and Lymph Nodes

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7
Q

What is the common precursor cell for all blood cells?

A

Multipotent Hematopoeitic Stem Cell

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8
Q

What percentage of the blood is plasma?

A

55%

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9
Q

What percentage of the blood is made up of erythrocytes?

A

45%

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10
Q

What is the buffy coat and where is it located?

A

Leukocytes; Located between the plasma and erythrocytes of a centrifuged specimen

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11
Q

In a hematological analyzer, the small aperture serves what role?

A

determines platelet number and size

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12
Q

In a hematological analyzer, the large aperture serves what role?

A

determines RBC number and size

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13
Q

Explain the concept of electrical impedance as it relates to hematological analyzers.

A
  • Whole blood is passed between two electrodes through an aperture so narrow that only one cell can pass through at a time
  • The impedance changes as a cell passes through
  • The change in impedance is proportional to cell volume, resulting in a cell count and measure of volume.

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14
Q

How does flow cytometry function as it relates to a hematological analyzer?

A
  • A single-cell stream passes through a laser beam
  • The absorbance is measured, and the scattered light is measured at multiple angles to determine the cell’s granularity, diameter, and inner complexity

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15
Q

What information does flow cytometry tell us about the blood cells?

A

Morphology

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16
Q

What suffix means decreased?

A

-enia

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17
Q

What suffix means increased?

A

-cytosis

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18
Q

What is the purpose of fluorescence light in flow cytometry?

A

Enables the detection of surface proteins using specific antibodies

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19
Q

In flow cytometry, where is the forward scatter located and what does it measure?

A
  • Located in line with the laser intercept
  • Considered a measure of the relative cell size

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20
Q

In flow cytometry, where is the side scatter located and what does it measure?

A
  • Located perpendicular to the laser beam intercept
  • used to measure the relative complexity of the cell (granularity)

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21
Q

What 2 dyes are used in H&E staining?

A

Haemotoxylin & Eosin

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22
Q

How does eosin work?

A
  • acidic dye
  • stains basic structures red or pink

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23
Q

How does Hematoxylin work?

A
  • basic dye
  • stains the nucleus (nucleic acids) and other parts of the cytoplasm that have RNA purple
  • the rest of the cytoplasm stains pink

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24
Q

What is another name for a platelet?

A

Thrombocyte

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25
Q

What is the precursor cell of thrombocytes?

A

Megakaryocyte

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26
Q

What is the function of platelets?

A
  • Help control blood loss from broken vessels
  • Begin clotting process to prevent bleeding

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27
Q

How and where does thrombopoeisis occur?

A
  • In the bone marrow
  • Megakaryocyte’s membrane projections break up into smaller fragments

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28
Q

What is the average lifespan of platelets?

A

7-10 days

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29
Q

What are the components of a thrombocyte?

A
  1. Open canalicular system: internal membrane structure connected to cell surface
  2. Granules: dense, alpha, and lysosomal. Contain proteins & factors necessary for several steps of the coagulation cascade
  3. Microtubules: preserve the elliptic shape of resting platelets & play a critical role in cytoskeleton reorganization during platelet activation

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30
Q

Do thrombocytes have a nucleus?

A

NO

They are also the smallest blood cell

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31
Q

What is the precursor of an erythrocyte?

A

Proerythroblast

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32
Q

What is the fuction of erythrocytes?

A

transport oxygen and carbon dioxide between the lungs and tissues

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33
Q

How does formation of erythrocytes occur?

A

Formation starts in the bone marrow and ends in the blood stream when reticulocytes complete their maturation.

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34
Q

What is the lifespan of an RBC?

A

about 120 days

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35
Q

What are the characteristics of an erythrocyte?

A
  • Biconcave shape
  • Contains hemoglobin (red color)
  • lacks nucleus and most organelles
  • great flexibility allowing for easy movement through narrow vessels and capillaries

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36
Q

In which erythrocyte precursor does hemoglobin synthesis begin?

A

Erythroblast

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37
Q

An erythroblast loses its nucleus and some organelles to become what?

A

a reticulocyte

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38
Q

Reticulocytes spend about how much time in the marrow and how much time in the blood?

A
  • 3 days in marrow
  • 1 day in blood

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39
Q

A reticulocyte can function as an erythrocyte can, but it lacks what morphological feature that is characteristic of erythrocytes?

A

Biconcavity

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40
Q

A reticulocyte loses its remaining organelles to become what?

A

an erythrocyte

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41
Q

What percentage of circulating RBCs are reticulocytes?

A

~1%

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42
Q

What are the 3 types of granulocytes?

A
  • Neutrophils
  • Eosinophils
  • Basophils

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43
Q

What is the precursor cell of granulocytes?

A

Myeloblast

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44
Q

What is the function of granulocytes?

A

white blood cells that help the immune system fight off infection (innate immune response)

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45
Q

How and where are granulocytes formed?

A

Form in the bone marrow and released to the bloodstream when necessary. Short-lived (hours to few days).

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46
Q

What are the characteristics of granulocytes?

A
  • most common type of WBC
  • Bi-lobed nucleus
  • large cytoplasmic granules (can be stained by basic dyes)
  • upon infection or inflammation, granulocytes migrate to the area and release the content of their granules to fight infeciton

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47
Q

What is the function of basophils?

A

Fight parasitic infections and mediate allergic reactions

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48
Q

What are some characteristics of basophils?

A
  • short life span
  • least numerous granulocyte
  • bi or tri-lobed nucleus
  • large number of dark blue (purplish) cytoplasmic granules that obscure their nuclei
  • upon activation, granule’s content is released (histamine) and contribute to inflammatory response

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49
Q

What is the function of neutrophils?

A

Phagocytes that provide protection against certain types of acute infections (bacteria or fungi)

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50
Q

What are the characteristics of neutrophils?

A
  • Produced in the bone marrow in large numbers. Enter the circulation and migrate to tissues to complete their function
  • Short life span
  • 3-5 nuclear lobes joined by strands of genetic material
  • contain numerous secondary pale, lilac-colored granules

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51
Q

What is a band neutrophil?

A
  • immature neutrophil
  • kidney bean shaped nucleus with mature chromatin and no nucleoli
  • secondary granules only

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52
Q

What is the function of eosinophils?

A

Clear parasitic infections and mediate inflammation.

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53
Q

What are the characteristics of eosinophils?

A
  • Produced in the bone marrow in large numbers. Enter the circulation and migrate to tissues to complete their function
  • tissue life span of 2-5 days
  • nucleus usually with 2 lobes connected by thin chromatin filament
  • secondary granules are eosinophilic (red-orange)
  • upon activation, granule’s content is released (degranulation) and contribute to the inflammatory response

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54
Q

What is the precursor cell of a monocyte?

A

Myeloblast

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55
Q

What is the function of a monocyte?

A

Replenish macrophages and dendritic cells to elicit immune response

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56
Q

What are some characteristics of monocytes?

A
  • Made in bone marrow and travel through the blood to tissues where it becomes a macrophage (or a dendritic cell)
  • Lifespan in blood-> few days
  • Kidney shaped indented nucleus
  • Cytoplasm is gray to pale blue
  • Rare to no granules
  • Vaculoles

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57
Q

What is the precursor of a macrophage?

A

Myeloblast

really a monocyte, but monocyte precursor is myeloblast

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58
Q

What is the function of macrophages?

A

detection, phagocytosis, and destruction of bacteria and other harmful organism

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59
Q

What are some characteristics of macrophages?

A
  • Formed from monocytes that leave the blood and differentiate in affected tissues/organs. Can also differentiate in the bone marrow
  • Long-lived cells: more than 3 days to a week
  • Large spherical cells with pseudopodia
  • Vesicles (phagosomes) contain engulfed particles, bacteria
  • Lysosomes contain digestive enzymes
  • Secondary lysosomes: fused phagosomes and lysosomes

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60
Q

What is the precursor cell of lymphocytes?

A

Lymphoblasts

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61
Q

What is the function of lymphocytes?

A

Recognize antigens in pathogens and remove the pathogens or pathogen-infected cells

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62
Q

What are some characteristics of lymphocytes?

A
  • Generated in the bone marrow. T cells mature in the thymus and B cells in the bone marrow.
  • average life span is a week to a few months, but a few live for years, providing a pool of long-lived T and B cells.
  • Slightly larger than RBC
  • High N:C ratio with round nucleus
  • Cytoplasm is scant, light blue with NO GRANULES

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63
Q

Explain memory cells with respect to lymphocytes.

A

B cells and T cells produce memory cells that will ‘remember’ each specific pathogen encountered and are able to make a strong response if the pathogen is detected again.

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64
Q

How do you differentiate between an inactive and an active lymphocyte?

A
  • Inactive: smaller and rounder with higher N:C ratio
  • Active: (atypical lymphs) appear more spread out and seem to “stick” to surrounding cells. less round nucleus and cytoplasm

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65
Q

What is the precursor cell for plasma cells?

A

B-cells

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66
Q

What is the function of a plasma cell?

A

terminally differentiated B cells that secrete antibodies, important for immune protection

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67
Q

What are some characteristics of plasma cells?

A
  • Formed in bone marrow & differentiate from B cells with help of helper T cells
  • short-lived plasma proliferating cells with a life span of 3–5 days, and long-lived plasma cells (non-proliferating cells with a life span of several months to lifetime)
  • 2-3x larger than RBC
  • Round eccentrically placed nucleus
  • basophilic (blue) cytoplasm w prominent perinuclear hof (clearing)
  • professional secretory cells: release antibodies that circulate in the blood and lymph, where they bind to and neutralize or destroy antigens.

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68
Q

Identify the circled cell in the image:

A

Activated Lymphocyte

Also called an atypical lymphocyte

69
Q

Identify the circled cell in the image:

A

Adipocyte

70
Q

Identify the circled cell in the image:

A

Basophil

71
Q

Identify the circled cell in the image:

A

Eosinophil

according to Dr. Delgado, but I would call this a segmented neutrophil

Eosinophils typically have a very redish-orange cytoplasm. Very easy to ID

72
Q

Identify the circled cell in the image:

A

Lymphocyte

73
Q

Identify the circled cell in the image:

A

Lymphocyte

74
Q

Identify the cells in the image indicated by the arrows:

A

Megakaryocytes

75
Q

Identify the circled cell in the image:

A

Monocyte

76
Q

Identify the circled cell in the image:

A

Segmented Neutrophil

77
Q

Identify the circled cell in the image:

A

Segmented Neutrophil

78
Q

Identify the circled cell in the image:

A

Neutrophilic Metamyelocyte

79
Q

Identify the circled cell in the image:

A

Neutrophilic Myelocyte

80
Q

Identify the circled cell in the image:

A

Neutrophilic Stab

also called a band neutrophil

81
Q

Identify the cell shown in the electron microscopy image:

A

Platelet

82
Q

Identify the circled cell in the image:

A

Platelet

83
Q

Identify the circled cell in the image:

A

Erythrocyte

84
Q

Identify the circled cells in the image:

A

Segmented Neutrophils

85
Q

Identify cells A-G in the following image

A
  • A: Neutrophilic Stab (band)
  • B: Monocyte
  • C: Lymphocyte
  • D: Eosinophil
  • E: Segmented Neutrophil
  • F: Basophil
  • G: Erythrocyte