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HEMATOLOGY > Erythrocyte Production and Destruction > Flashcards

Erythrocyte Production and Destruction Flashcards

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1
Q

RBCs are formally called erythrocytes, but may also be called

A

normoblasts

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2
Q

erythrocyte precursors develop from two progenitors known as

A

burst-forming unit-erythroid (BFU-E) and colony-forming unit-erythroid (CFU-E)

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3
Q

BFU-E, gives rise to what colonies?

A

large colonies

because they are capable of multisubunit colonies (called bursts)

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4
Q

CFU-E gives rise to what colonies?

A

smaller

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5
Q

how many weeks does it take for the BFU-E to mature to the CFU-E

A

1 week

and another week for the CFU-E to become a pronormoblast

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6
Q

while at the CFU-E stage, the cell completes approximately how many divisions before maturing further

A

3-5 divisions

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7
Q

how many days are required to produce a mature RBC from the BFU-E.

A

18 - 21 days

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8
Q

what is the earliest morphologically recognizable erythrocyte precursor

A

pronormoblast

derived via the BFU-E and CFU-E from pluripotent hematopoietic stem cell

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9
Q

in hematology, what stain is commonly used

A

modified Romanowsky stain

such as Wright or Wright-Giemsa

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10
Q

The stage of maturation of any blood cell is determined by careful examination of the?

A

nucleus and cytoplasm

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11
Q

as erythroid precursors mature, several general trends affect their appearance such as:

A
  1. Overall diameter of the cell decrease
  2. Nucleus diameter decreases more rapidly than diameter of the cell ; N:C ratio decreases
  3. Nuclear chromatin pattern becomes coarser, clumped, and condensed
  4. Nucleoli disappear.
  5. Cytoplasm changes from blue to gray-blue to salmon pink
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12
Q

what will be the appearance of nuclear chromatin develop when it becomes even coarser and more clumped as the cell matures

A

raspberry-like appearance

dark staining (chromatin) distinct from white appearance (parachromatin)

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13
Q

morphologic feature used to identify and stage red blood cell and white blood cell precursors.

A

nucleus-to-cytoplasm (N:C) ratio

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14
Q

fill in the blanks

if the nucleus takes up less than 50% of the area of the cell, the proportion of nucleus is ____ and the ratio is ______

A

lower ; lower

e.g., 1:5 or less than 1

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15
Q

fill in the blanks

if the nucleus takes up more than 50% of the area of the cell, the ratio is _____

A

higher

e.g., 3:1 or 3

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16
Q

what is the diameter

Pronormoblast

A

12–20 um

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17
Q

what is the diameter

Basophilic normoblast

A

10–15 um

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18
Q

what is the diameter

Polychromatic normoblast

A

10–12 um

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19
Q

what is the diameter

Orthochromic normoblast

A

8–10 um

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20
Q

Nucleus to Cytoplasm Ratio

Pronormoblast

A

8:1

1-2 nucleoli

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20
Q

what is the diameter

Bone marrow polychromatic

A

8–10 um

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21
Q

Nucleus to Cytoplasm Ratio

Basophilic normoblast

A

6:1

0-1 nucleoli

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22
Q

Nucleus to Cytoplasm Ratio

Polychromatic normoblast

A

4:1

0 nucleoli

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23
Q

Nucleus to Cytoplasm Ratio

Bone marrow polychromatic

A

no nucleus

0 nucleoli

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24
# Nucleus to Cytoplasm Ratio Polychromatic normoblast
1:2 | 0 nucleoli
25
# bone marrow transit time Pronormoblast
24 hr
26
# bone marrow transit time Pronormoblast
24 hr
27
# bone marrow transit time Polychromatic normoblast
30 hr
28
# bone marrow transit time Orthochromic normoblast
48 hr
29
# bone marrow transit time Orthochromic normoblast
24 - 48 hr
30
# normoblastic to rubriblastic pronormoblast
rubriblast
31
# normoblastic to rubriblastic normoblastic to rubriblastic
Prorubricyte
32
# normoblastic to rubriblastic Polychromatic (polychromatophilic) normoblast
Rubricyte
33
# normoblastic to rubriblastic Orthochromic normoblast
Metarubricyte
34
# normoblastic to rubriblastic Polychromatic (polychromatophilic) erythrocyte
Polychromatic (polychromatophilic) erythrocyte
35
nucleus is round to oval, containing one or two nucleoli and the **purple red chromatin** is open and contains few, if any, fine clumps
Pronormoblast (Rubriblast)
36
the cytoplasm is **dark blue** because of the concentration of ribosomes and RNA
Pronormoblast (Rubriblast)
37
this is where globin production begins
Pronormoblast (Rubriblast)
38
the chromatin stains **deep purple-red.** Nucleoli may be present early in the stage but disappear later
Basophilic Normoblast (Prorubricyte)
39
the cytoplasm may be a **deeper, richer blue ** than in the pronormoblast
Basophilic Normoblast (Prorubricyte)
40
Detectable hemoglobin synthesis occurs
Basophilic Normoblast (Prorubricyte)
41
no nucleoli are present
Polychromatic (Polychromatophilic) Normoblast (Rubricyte)
42
# cytoplasm the color produced is a mixture of **pink and blue**, resulting in a
murky gray-blue
42
# cytoplasm first stage in which the **pink color** associated with stained hemoglobin can be seen
Polychromatic (Polychromatophilic) Normoblast (Rubricyte)
43
polychromatophilic means
“many color loving”
44
hemoglobin synthesis increases, and the accumulation begins to be visible as a pinkish color in the cytoplasm.
Polychromatic (Polychromatophilic) Normoblast (Rubricyte)
45
nucleus is completely condensed (i.e., pyknotic)
Orthochromic Normoblast (Metarubricyte)
46
increase in the salmon pink color of the cytoplasm reflects nearly complete hemoglobin production
Orthochromic Normoblast (Metarubricyte)
47
# True or False orthochromic normoblast is capable of division
FALSE | it not capable because of the condensation of the chromatin
48
hemoglobin production continues on the remaining ribosomes using messenger RNA produced earlier. Late in this stage, the nucleus is ejected from the cell
Orthochromic Normoblast (Metarubricyte)
49
RBC precursor that ejects its nucleus
pyrenocyte
50
small fragments of nucleus are left behind if the projection is pinched off before the entire nucleus is enveloped. These fragments are called
Howell-Jolly bodies
51
# True or False Polychromatic (Polychromatophilic) Erythrocyte or Reticulocyte **has no nucleus**
TRUE
52
has the same cytoplasmic color as mature RBC (salmon pink) with remnant of residual RNA (bluish tinge) that can be visualized using vital stain
Polychromatic (Polychromatophilic) Erythrocyte or Reticulocyte
53
the penultimate stage cell
Polychromatic (Polychromatophilic) Erythrocyte or Reticulocyte
54
# True or False No nucleus is present in mature RBCs
TRUE
55
it is a biconcave disc with central pallor
Mature Erythrocyte
56
term describing the dynamics of RBC production and destruction
Erythrokinetics
57
name given to the collection of all stages of erythrocytes throughout the body
Erythron | erythron is distinguished from the RBC mass
58
* A hormone produced by the kidney. * A circulating Glycoprotein * Acts mainly on CFU – E * Stimulates RBC production
Erythropoietin
59
how EPO stimulates RBC production
* Rescue cells from apoptosis * Release retics from the BM early * Reduce marrow transit time of cells
60
essential for the synthesis of Hemoglobin
iron
61
iron deficiency causes
* microcytic * hypochromic anemia
62
what is a Cyanocobalamine
vitamin B12
63
vitamin B12: Cyanocobalamine deficiency causes
megaloblastic anemia or pernicious anemia
64
needs the Intrinsic Factor (IF) from the gastric juice for absorption in the small Intestine
vitamin B12: Cyanocobalamine
65
* Important in the making of DNA * is also called Extrinsic Factor of Castle
vitamin B12: Cyanocobalamine
66
is found in meat & dairy products.
vitamin B12: Cyanocobalamine
67
what is senescence
RBCS are continually aging
68
2 major pathways for RBC removal
* Extravascular Hemolysis * Intravascular Hemolysis
69
# destruction of RBCs as old RBCs removed, are replaced by ____ from the bone marrow.
younger RBCs
70
# destruction of cells Old RBCs removed by macrophages located in the
reticuloendothelial system (RES) | spleen most important organ
71
90% of destruction of RBCs occurs
extravasculary
72
old or damaged RBCs phagocytized by RES cells and digested by lysosomes
extravascular hemolysis
73
hemoglobin molecules disassembled and broken down into component parts
extravascular hemolysis
74
Iron returned by transferrin to bone marrow.
Extravascular hemolysis
75
# True or False in extravascular hemolysis, globin is broken down into amino acids and is returned to amino acid pool
True
76
# Extravascular hemolysis what is disassembled into carbon monoxide, which is expelled
protoporphyrin ring
77
# Extravascular hemolysis the remaining component, ________, is converted to ________ and carried by albumin to liver.
biliverdin ; bilirubin
78
# Extravascular hemolysis in liver, bilirubin is conjugated to ______ and excreted with bile into intestine.
bilirubin glucuronide
79
# Extravascular hemolysis Bilirubin glucuronide is converted by bacteria and excreted in the stool as
stercobilinogen.
80
# Extravascular hemolysis small amount of __________ is reabsorbed into the blood circulation and then excreted through kidneys in the urine.
urobilinogen
81
in extravasculary hemolyisis both _______ and ______ can be measured in plasma and used as indicators of the amount of extravascular hemolysis occurring.
** unconjugated (prehepatic) **and **conjugated bilirubin (posthepatic)
82
only 5-10% hemolysis occurs in this pathway
intravascular hemolysis
83
mechanical or fragmentation hemolysis
intravascular hemolysis
84
RBCs break down within lumen of blood vessel, releasing hemoglobin directly into bloodstream.
intravascular hemolysis
85
in intravascular hemolysis hemoglobin disassociates into globin dimers and picked up by
protein carrier - haptoglobin.
86
# intravascular hemolysis ________ complex is too big to be excreted through kidneys. Complex is carried to liver where it is further catabolized.
hemoglobin-haptoglobin
87
at this point, pathway in liver identical to extravascular pathway.
intravascular hemolysis
88
# True or False haptoglobin levels increase in intravascular hemolysis.
FALSE | should be DECREASE
89
# intravascular hemolysis as haptoglobin levels diminish, unbound hemoglobin _____ and _____ are rapidly filtered by the glomeruli in the kidneys, reabsorbed by the renal tubular cells, and converted to hemosiderin.
alpha and beta dimers
90
# intravascular hemolysis The renal tubular uptake can process as much as ______ of filtered hemoglobin.
5 g/day
91
# True or False in intravascular hemolysis, hemoglobin may also appear in urine (hemoglobinuria).
TRUE
92
# Modified True or False Hemoglobin that is neither bound by haptoglobin nor directly excreted in the urine is oxidized to methemoglobin. The heme groups in methemoglobin are released and taken up by another transport protein, albumin
First statement is true, Second statement is false | transport protein should be **hemopexin**
93
The combined depletion of ____ and ______ and the presence of methemalbuminemia and hemosiderinuria can be seen in cases of intravascular hemolytic anemia
haptoglobin and hemopexin

HEMATOLOGY (2 decks)

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