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BL Unit 1 > BL Pan Schowinsky lecture review > Flashcards

BL Pan Schowinsky lecture review Flashcards

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1
Q

What information can you get about RBCs directly from a CBC?

A

Number, percentage in blood (also retics), hemoglobin concentration, red cell distribution width

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2
Q

What information can you get about RBCs indirectly from a CBC?

A

RBC volume, Hemoglobin per cell. Equations: MCV = HCT/RBC; MCH = HGB/RBC; MCHC = MCH/MCV

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3
Q

What information can you get about WBCs directly from a CBC?

A

Number, percentage

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4
Q

What information can you get about platelets directly from a CBC?

A

Number, size

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5
Q

What principle is used to obtain RBC and WBC count?

A

Coulter principle. WBCs and Hb on one side,

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6
Q

In general how many RBCs, WBCs, and platelets should an adult have?

A

4-6 trillion RBCs, 4-11 billion RBCs, and 150-400 billion platelets

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7
Q

Neutrophils?

A

40-70%, # 1.8-6.6

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8
Q

Lymphocytes?

A

20-50%, #1.0-4.8

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9
Q

Monocytes?

A

2-11%, #0.2-0.9

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10
Q

Eosinophils?

A

0-6%, #0.01-0.4

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11
Q

Basophils?

A

0-2%, #0.01-0.2

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12
Q

Characteristics of Iron deficiency anemia?

A

Decrease RBC, HGB, MCV, MCH, MCHC, HCT. Increased RDW. Small RBCs, target cells, hypochromic

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13
Q

Characteristics of spherocytosis?

A

Increased MCHC. No central pallor, spherical

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14
Q

Characteristics of G6PD deficiency?

A

Heintz bodies, bite cells

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15
Q

When might you see bite cells?

A

G6PD deficiency

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16
Q

When might you see schistocytes?

A

Mechanical heart valve damage, burns, disseminated intravascular coagulation

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17
Q

When might you see target cells?

A

Thalassemia, Hb C, iron deficiency, liver disease

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18
Q

When might you see sickle cells?

A

Sickle cell disease

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19
Q

When might you see basophilic stipling?

A

Lead poisoning, porphyria. Might also be seen in thalassemia, myelodysplasia, sideroblastic anemia, infection

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20
Q

What are Heintz bodies?

A

Denatured hemoglobin that has precipitated

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21
Q

What is basophilic stipling?

A

Aggregated RNA (ribosomes)

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22
Q

What are Howell-Jolly bodies?

A

Nuclear remnants

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23
Q

When might you see Howell-Jolly bodies?

A

Spleen removal, megaloblastic anemia, myelodysplasia

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24
Q

What is a Dohle body?

A

Condensed RNA in WBCs, neutrophils. Associated with infection, burns, inflammation.

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25
What is toxic granulation?
Increase in the number of granules that can be caused due to rapid WBC division during invetion and marrow recovery
26
When might you see hypersegmented neutrophils?
B12 and folate deficiency (megaloblastic anemia)
27
Name the embryonic sites of hematopoeisis.
Yolk sac up to 3 mo.
28
Name the fetal sites of hematopoeisis.
Liver and spleen 2 mo. to 7 mo.
29
Name the adult sites of hematopoeisis.
Bone marrow
30
What cells produce regulatory factors and adhesion molecules that maintain hematopoiesis?
Stromal cells
31
What are stromal cells?
Marrow cells that produce a protein framework, regulatory factors, and adhesion molecules that promote and maintain hematopoeisis.
32
Describe characteristics of hematopoietic stem cells.
Rare, express CD34 and CD117, asymmetric cell division, can become all blood cell types.
33
What can multipotent hematopoietic progenitor differentiate in to?
Can become all lymphoid and myeloid lineages.
34
What can oligopotent hematopoietic progenitor differentiate in to?
Either myeloid progenitors or lymphoid progenitors.
35
What can lineage restricted hematopoietic progenitor differentiate in to?
Restricted to one type of cell.
36
Approximately how many cells can one burst forming unit produce?
2000
37
Describe the changes that occur during the stages of erythropoiesis.
As erythropoiesis progresses, progenitors get smaller in size, change from blue staining to red staining, have a decreased NC ratio, eventually lose their nuclei.
38
List the stages of erythropoiesis.
Pronormoblast-->basophilic normoblast-->polychromatophilic normoblast-->orthochromic normoblast-->reticulocytes-->erythrocyte
39
At which stage of erythropoiesis does mitosis stop? (also the most common erythrocyte precursor in bone marrow)
Polychromaticophilic normoblast
40
How long does erythropoiesis take and how long do mature RBCs survive?
2-7 days to get to orthochromic normoblast. 1 day to extrude nucleus. Retics mature for 2-3 days before released into peripheral blood. Approx 1 day to mature in blood. (5-11 days total) RBCs live ~120 days.
41
What triggers EPO release?
Hypoxia
42
What does EPO do? (4 things)
Promotes stem cells to become pronormoblasts, increase mitosis and maturation, increases hemoglobin production, inreases retic release.
43
Name the granulocytes.
Neutrophil, eosinophil, basophil
44
List the stages of granulopoiesis.
Myeloblast-->promyelocyte-->myelocyte-->metamyelocyte-->band-->seg
45
What are Auer rods?
Feature of myeloblasts seen only in abnormal conditions.
46
Describe the changes that occur during the stages of granulopoiesis.
Decrease in size, decrease in primary granules, increase in secondary granules, decrease # of nucleoli, nucleus becomes a kidney shape then band then seg
47
Which cytokine initiates neutrophil production?
Granulocyte-colony stimulating factor
48
How long does granulopoiesis take?
3-6 days for myeloblast to myelocyte. 5-7 from metamyelocyte to seg. (9-13 days total)
49
Which pool is represented more in marrow - younger granulocytes or older?
Younger - metas to segs
50
What is the life span of a neutrophil?
~5 days in the blood. 1-2 days when activated in the tissue.
51
What are in neutrophil granules?
Myeloperoxidase
52
What is the life span of an eosinophil?
8-12 days
53
What cytokin initiates eosinophil production?
IL-5
54
What cytokin initiates basophil/mast cell production?
Basophils: IL-3; Mast cells: Stem Cell Factor
55
Which features distinguish a mast cell from a basophil?
Mast cells have prominent blue granules, but the nucleus is visible and the nucleus is round rather than lobed. Also mast cells are mostly found in solid tissues.
56
How long do monocytes live?
20 days in peripheral blood before becoming macrophages.
57
What stimulates monocyte production?
Monocyte-colony stimulating factor
58
Name the stages of monopoiesis.
Monoblast-->promonocyte-->promonocyte-->monocyte
59
Describe the changes that occur during the stages of monopoiesis.
While the cells stay approx the same size, cytoplasm stays blue but gains vacuoles, nucleus goes from pink to dark blue and ovoid to kidney/seg shaped.
60
Which cytokine initiates platelet production?
Thrombopoietin
61
What kind of sample can you take to look at proper hematopoiesis?
Bone marrow biopsy or aspiration
62
What is the most common site of bone marrow aspiration?
Inominate bone - posterior iliac crest
63
What things to pathologists look for in bone marrow smear?
Cell differential, cell morphology, iron content
64
What things to pathologists look for in bone marrow biopsy?
Cellularity, myeloid:erythroid ratio, megakaryocyte frequency, focal findings
65
What is the normal myeloid:erythroid ratio in bone marrow?
2:1-4:1
66
What is the rule of thumb for normal bone marrow cellularity?
100%-age
67
Define cytopenia.
A decrease in the number of blood cells.
68
Describe the clinical findings of a cytopenia due to increased destruction.
Decreased peripheral cells but compensatory marrow hyperplasia
69
Describe the clinical findings of a cytopenia due to decreased production.
Marrow may be depleted and growth factor levels may be increased or decreased. If increased, then they are not getting a response.
70
What dermatological finding is indicative of thrombocytopenia?
Petechiae
71
Petechiae may be indicative of what hematological condition?
Thrombocytopenia
72
Differential for thromocytopenia due to increased destruction?
Immune thrombocytopenic purpura, post-transfusion thrymbocytopenia, drug induced (quinidine), mechanical (disseminated intravascular coagulation, heart valve)
73
What unusual type of platelet might be seen in increased thrombopoiesis?
Giant platelet
74
Differential for neutrophilia?
Infection, inflammation, drugs (steroids), stress, tumors, neoplasm
75
What clinical findings favor leukemoid reaction as a cause of neutrophilia?
Symptoms of infection or inflammation, toxic appearing neutrophils (like they?ve been eating bad stuff), normal basophils (because basophils is rare outside of cases of leukemia), normal megakaryocytes
76
What clinical findings favor CML as a cause of neutrophilia?
asymptomatic, enlarged spleen and liver, neutrophils look healthy, absolute basophilia
77
What is the differential diagnosis for microcytic and hypochromic anemia?
Iron deficiency, anemia of chronic disease, hemoglobinopathy, primary marrow disease
78
What additional information is necessary to determine the cause of microcytic anemia?
Serum iron, tranferrin, TIBC, serum soluble transferrin receptor, percent transferrin saturation, fecal occult blood test, colonoscopy. For B12 or folate deficiency: serum B12 and folate, homocysteine, methylmalonic acid, schilling test, bone marrow examination
79
Besides RBC values, what might be seen in the CBC if anemia is due to bleeding?
Increased platelet count
80
What type of cell is characteristic of chronic lymphocytic leukemia?
Smudge cells

BL Unit 1 (5 decks)

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