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Hematology > Hematopoiesis and Cell Morphology > Flashcards

Hematopoiesis and Cell Morphology Flashcards

1
Q

Where is hematopoiesis in a fetus

A

the yolk sac, liver and spleen

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2
Q

Where is hematopoiesis in after birth

A

the bone marrow

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3
Q

What are hematopoietic tissues

A

bone marrow, lymph nodes, spleen, liver, thymus

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4
Q

What is red marrow

A

contain hematopoietic progenitors and developing cells

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5
Q

What is yellow marrow

A

inactive, mostly fat cells, macrophages and mesenchymal cells

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6
Q

What are the stromal cells in the marrow

A

endothelial, adipocytes, macrophages, lymphocytes, osteoblasts, osteoclasts

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7
Q

What is EPO

A

secreted in hypoxic states by the interstitial cells of the kidney to promote RBC production in the marrow

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8
Q

What is thrombopoietin

A

secreted by the liver and kidneys to develop megakaryocytes into platelets

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9
Q

What are cytokines

A

trigger differentiation/maturation

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10
Q

What does estrogen do in erythropoeisis

A

promotes erythropoiesis

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11
Q

What do androgens do in erythropoeisis

A

promote erythropoiesis by promoting EPO production

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12
Q

What do thyroid hormones do in erthropoiesis

A

promote erythropoiesis through increased HGB production

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13
Q

What are hematopoitic stem cells

A

cells that can self-renew to produce more HSC, mature into pluripotent or precursor cells that give rise to WBCs, RBCs and PLTs

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14
Q

What are the intrinsic factors that cause HSC differentiation

A

genes and genetic composition of the cell

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15
Q

What are the extrinsic factors that cause HSC differentiation

A

cytokines, growth hormones, hormones

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16
Q

What cells are in the stem cell pool

A

hematopoitetic stem cells

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17
Q

What cells are in the proliferation pool

A

common myeloid pregenitor, granulocyte macrophage progenitor cells, myelocytes

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18
Q

What cells are in the maturation pool

A

cells read for release into the peripheral blood (metamyeloctes, bands and segmented)

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19
Q

What are marginating cells

A

loosely lovalized to the walls of capillaries in tissues such as the liver, spleen and lung

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20
Q

What are physiological causes of leukocytosis

A

strenuous exercise, emotional stress, labour, increased epinephrine

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21
Q

What are pathological causes of leukocytosis

A

bacterial infection, neoplasms, acute hemorrhage, tissue damage, drugs and toxins, inflammatory disorders

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22
Q

What are primary lymph tissues

A

thymus, bone marrow, antigen independent maturation

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23
Q

What are secondary lymph tissues

A

spleen, lymph nodes, tonsils, mucosal lymph tissues, antigen dependent

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24
Q

Where are T cells made

A

thymus

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25
Q

Where are B cells made

A

bone marrow

26
Q

What are the CD markers for B lymphocytes

A

34, 45, 19, 20, 22, 24, kappa, lambda

27
Q

What is the purpose of B lymphocytes

A

produce antibodies and memory cells as well as cytokines for T-cell regulation

28
Q

What are the CD markers for T lymphocytes

A

34, 45, 1, 2, 3, 4, 5, 7, 8, 25

29
Q

Where do platelets originate from

A

the myeloid cell line

30
Q

What are the requirements for erythropoiesis

A

iron, B6, B12, folate, EPO

31
Q

How long do RBC survive in circulation

A

120 days

32
Q

What are the steps of erythropoiesis

A
  1. begins in the bone marrow
  2. reticulocytes are released into blood stream where they mature and circulate for ~120 days
  3. old and damaged erythrocytes are phagocytized by macrophages in the bone marrow, liver and spleen
  4. the globin is metabolized into amino acids and the cellular components are recycled
  5. the heme portion is broken down into biliverdin for transport and iron binds to transferrin for transport
  6. unused heme groups can be recycled or converted into bilirubin and used to make bile in the liver. Iron can be reused or transferred to ferritin for storage in the liver
33
Q

What are transmembrane proteins of RBCs used for

A

transport and adhesion sites
vertical membrane support
signal receptors
anchor bilayer to cytoskeleton

34
Q

What are peripheral proteins of RBCs used for

A

lateral membrane stability and blood group proteins

35
Q

What is cholesterol used for in RBCs

A

tensile strength, deformability at low temperatures, stability, anchoring proteins

36
Q

What are phospholipids used for in RBCs

A

fluidity and elasticity

37
Q

How does the RBC produce energy

A

the embden-meyerhoff pathway

38
Q

What is the hexose monophosphate shunt

A

it prevents oxidative damage to the cell by keeping proteins and membranes functional. It also keeps iron in the ferrous state

39
Q

What are the steps of the hexose monophosphate shunt

A
  1. G6P is reduces NADP to NADPH using G6P dehydrogenase
  2. NADPH converts glutathione to reduced glutathione
  3. reduced glutathione reduces and breaks down hydrogen peroxide to water and carbon dioxide
40
Q

What is the methemoglobin reductase pathway

A

maintains hemoglobin iron in the ferrous state for effective oxygen transport

41
Q

How can ferric heme iron be treated

A

infusing patients with saturated oxygen or 1% methylene blue

42
Q

What are the steps of the methemoglobin reductase pathway

A
  1. G3P is converted to 1-3 biphosphoglycerate
  2. G3P dehydrogenase reduces NADP to NADPH
  3. Methemoglobin reductase uses NADH to reduce methemoglobin to hemoglobin
43
Q

What is the Rapoport-Leubering Pathway

A

produces 2,3 biphosphoglycerate which competes with oxygen for the heme iron and allows oxygen to dissociate

44
Q

What does effective hemoglobin production require

A

protoporphyrins, globin chains, iron

45
Q

What are required for protoporphyrin production

A

glycine, succinyl CoA, vitamin B6, ALA synthase

46
Q

Where are alpha chains used

A

all hemoglobin

47
Q

Where are beta chains used

A

normal adult hemoglobin

48
Q

Where are gamma chains used

A

embryonic, fetal and neonatal hemoglobin

49
Q

Where are delta chains used

A

variant adut hemoglobin (A2)

50
Q

Where are epsilon chains used

A

embryonic hemoglobin

51
Q

Where are Zeta chains used

A

embryonic hemoglobin

52
Q

What are the hemoglobin quantities at birth

A

60-90% HGB F
10-40% HGB A

53
Q

What are the hemoglobin quantities from 6months - adulthood

A

1-2% HGB F
>95% HGB A
<3.5% HGB A2

54
Q

Where is iron absorbed

A

the duodenum

55
Q

In what form is iron absorbed

A

the ferrous form

56
Q

How is iron usage regulated

A

Copper, Zinc, Transporters (hepcidine)

57
Q

What is hemolysis

A

premature destruction of RBCs

58
Q

What can cause hemolysis

A

defect in RBCs
defect in environment

59
Q

What are clinical features of hemolysis

A

pallor, lethargy, jaundice, splenomegaly, gall stones, dark urine, bone deformity, leg ulcers

60
Q

What are lab findings of hemolysis

A

increased serum bilirubin
increased urine urobilinogen
increased fecal stercobilinogen
absent serum haptoglobins
increased lactate dehydrogenase
reticulocytes
bone marrow erythroid hyperplasia
schistocytes

61
Q

What is intravascular hemolysis

A

breakdown of red blood cells in circulation

62
Q

What is extravascular hemolysis

A

excessive removal of red cells by the RE system in the spleen and liver

Hematology (7 decks)

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