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Haem 1 Flashcards

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1
Q

All blood cells derived from…

A

multipotent haemopoietic stem cells

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2
Q

Common myeloid progenitor cells give rise to

A

red cells, granulocytes, monocytes and platelets

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3
Q

Lympoid stem cells give rise to

A

B cell, T cell and NK cell

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4
Q

What must a stem cell be able to do

A

Ability to self-renew and produce mature progeny

i.e. divide into two cells with different characteristics, one another stem cell and the other a cell capable of differentiating to mature progeny

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5
Q

State the pathway of red blood cell production

A

myeloid stem cell -> proerythroblast –> erythroblast –> normoblast–> reticulocyte –> erythrocytes

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6
Q

What does erythropoiesis require, and where is this synthesised

A

presence of erythropoietin Kidney (90%), liver (10%)

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7
Q

What is erythropoietin released in response to

A

Hypoxia

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8
Q

From which cell types is erythropoietin released

A

Juxtatubular Interstitial Cell of kidney (interstitial fibroblasts in the kidney)

Hepatocyte and Interstitial Cells of liver

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9
Q

How long do erythrocytes survive

A

120 days

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10
Q

Function of erythrocyte

A

Its main function is oxygen transport

It also transports some carbon dioxide

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11
Q

How are erythrocytes destroyed

A

destroyed by phagocytic cells of the spleen

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12
Q

Aside from proerythroblasts, what else do myeloid progenitors give rise to

What cells to myeloblasts give rise to?

A

Myeloblast (which give rise to granulocytes and monocytes)

Mast cell

Megakaryoblast

Proerythroblast

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13
Q

What is needed for granulocyte and monocyte formation from myeloblasts

A

Cytokines such as G-CSF, M-CSF, GM-CSF and various interleukins

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14
Q

Outline path to neutrophil production from myeloblast

A

myeloblast –> Promyelocyte (=progranulocyte)

  • -> neutrophilic myelocyte
  • -> Band form
  • ->Neutrophil

https://mds.marshall.edu/sm_images/2/

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15
Q

How long does neutrophil survive in circulation, where does it go after this time

A

The neutrophil granulocyte survives 7–10 hours in the circulation before migrating to tissues

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16
Q

Function of neutrophil

A

defence against infection; it phagocytoses and then kills micro-organisms

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17
Q

What other cells do myeloblasts give rise to other than neutrophils

A

Basophil and eosinophl

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18
Q

Main function of eosinophil

A

defence against parasitic infection

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19
Q

Differentiate time spent in circulation between neutrophil and eosinophil

A

eosinophil spends less time in the circulation than does the neutrophil

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20
Q

Overall role of basophils

A

role in allergic responses (in the acute, immediate hypersensitivity response, with mast cells)

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21
Q

How long do monocytes spend in circulation

A

several days

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22
Q

2 functions of monocytes

A

migrate to tissues where they develop into macrophages and other specialized cells that have a phagocytic and scavenging function

AND
store and release iron

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23
Q

Aside from myeloblast and proerythryoblasts, what else can myeloid progenitor cells form

A

megakaryocytes and thence platelets

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24
Q

Platelets survive about x days in the circulation

A

10

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25
Role of platelets
Platelets have a role in primary haemostasis Platelets contribute phospholipid, which promotes blood coagulation
26
Where to lymphocytes circulate
to lymph nodes and other tissues and then back to the blood stream
27
Differentiate anisocytosis and Poikilocytosis
AC: red cells show more variation in size than is normal PC:red cells show more variation in shape than is normal
28
Differentiate micro and macrocytosis also leads to terms microcyte and macrocyte
Micro red cells are smaller than normal Macro: red cells are larger than normal
29
State 3 types of macrocytes
Round macrocytes Oval macrocytes Polychromatic macrocytes (shows new cells released from the bone marrow.... 'basophilic' because the ribosomes have taken up the dye, showing it is a reticulocyte)
30
State the 3 types of anaemia
Microcytic – describes red cells that are smaller than normal or an anaemia with small red cells Normocytic – describes red cells that are of normal size or an anaemia with normal sized red cells Macrocytic – describes red cells that are larger than normal or an anaemia with large red cells
31
What causes pale region in about a third of the diameter of red cell
disk shape of the red cell; the centre has less haemoglobin and is therefore paler
32
What is hypochromia
larger area of central pallor than normal lower haemoglobin content and concentration and a flatter cell
33
T/F Hypochromia often associated with macrocytosis
f: Hypochromia and microcytosis often go together
34
What is hyperchromia
cells lack central pallor thicker than normal or because their shape is abnormal
35
2 important types of hyperchromic cells and when they are seen
spherocytes (HS, AIHA) and irregularly contracted cells (G6PD deficiency, upon exposure to oxidants, and then even more following removal of heinz bodies)
36
How do spherocytes form
loss of cell membrane without the loss of an equivalent amount of cytoplasm so the cell is forced to round up... this is due to mutations to membrane proteins that usually allow flexibility (or AIHA!).... the surface is not properly thethered to the cell cytoskeleton so membrane can be lost
37
t/f all of the cells spherical in hereditary spherocytosis
f
38
Differentiate spherical and irregularly contracted cells
Spherical- rounded, regular outline irregularly contracted cells- irregular in outline but are smaller than normal cells both lost central pallor
39
What causes irregularly contracted cells
oxidant damage to the cell membrane and to the haemoglobin
40
Define polychromasia
increased blue tinge to the cytoplasm of a red cell | It indicates that the red cell is young
41
How to detect young cells
look for polychromasia or do a reticulocyte stain This exposes living red cells to new methylene blue, which precipitates as a network or ‘reticulum’
42
Which is more reliable way of detecting young cells
identification of reticulocytes (not looking for polychromasia)
43
State the different types of poikilocytes
``` Spherocytes Irregularly contracted cells Sickle cells Target cells Elliptocytes Fragments ```
44
What are target cells
cells with an accumulation of haemoglobin in the centre of the area of central pallor
45
When do target cells occur
obstructive jaundice, liver disease, haemoglobinopathies and hyposplenism Target cells appear in conditions that cause the surface of the red cell to increase disproportionately to its volume. This may result from a decrease in hemoglobin, as in iron deficiency anemia, or an increase in cell membrane.
46
When do Elliptocytes occur
hereditary elliptocytosis and in iron deficiency (in the latter, cells will be hypochromic, aka pencil cells)
47
What causes sickle cells
polymerization of haemoglobin S when it is present in a high concentration
48
Other name for fragments
schistocytes
49
Where do fragments arise from
indicate that a red cell has fragmented
50
What is Rouleaux and why do they form
stacks of red cells The resemble a pile of coins (think a rolex is expensive like coins!) They result from alterations in plasma proteins
51
Differentiate Rouleaux an agglutinates
Red cell agglutinates differ from rouleaux in that they are irregular clumps, rather than tidy stacks They usually result from antibody on the surface of the cells
52
What is Howell‒Jolly body and why
nuclear remnant in a red cell | The commonest cause is lack of splenic function
53
When are atypical lymphocytes normally seen?
term is used to describe the abnormal cells present in infectious mononucleosis (‘glandular fever’) =atypical mononuclear cell
54
What is left shift
increase in non-segmented neutrophils or that there are neutrophil precursors in the blood ... occurs when bone marrow releases immature leukocytes in response to inflammatory cytokines
55
What is Toxic granulation
heavy granulation of neutrophils
56
Why does Toxic granulation result
infection, inflammation and tissue necrosis (but is also a normal feature of pregnancy)
57
What is Hypersegmented neutrophil
increase in the average number of neutrophil lobes or segments
58
What is Hypersegmented neutrophil caused by
from a lack of vitamin B12 or folic acid (so in megaloblastic anaemia)
59
t/f/ erythroblasts have nuclei but erythrocytes don't
t
60
What is polychromic (as a macrocytic cell)
2 colours- there is a blue tinge to the cell... this means the ribosomes are taking up the basic dye (so called basophilic) and so it reflects a young cell, recently released from th bone marrow,`
61
Why do hypochromia and microcytosis often go together
They both result from defects in haemoglobin synthesis
62
What type of oxidant damage cuase irregularly contacted cells
Ingested oxidants or those produced by the body in infection or sepsis
63
When can red cells be fragmented
e.g. dodgy heart valve fitted
64
What is thrombosytosis and thrombocytopenia
too many/not enough platelets
65
What is left shift a sign of
Infection (leading to increased proportion of band cells, myelocytes of promyelocytes compared to th e red cells)
66
How many lobes in a normal neutrophil nucleus
3/4
67
Slide 68?
Hypersegmented cell | and ovale macrocytes
68
Slide 69
irregularly contracted cell
69
Why can there be Howell Jolli body in sick cell disease
Because the sick cells block blood supply to spleen leading to reduced splenic function
70
Slide 77
Polychromatic macrocyte
71
Which lineage do dendritic cells come from
myeloid

Blood (12 decks)

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