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USMLE® Step 1 > USMLE (S1) Hematology / Oncology > Hematology - Anatomy > Flashcards

Hematology - Anatomy Flashcards

(70 cards)

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1
Q

Proerythroblasts, lymphoblasts, myeloblasts, monoblasts, and megakaryoblasts share what precursor cell type?

A

Pluripotent hematopoietic stem cells

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2
Q

Reticulocytes are precursors for what type of blood cell?

A

Erythrocytes

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3
Q

Lymphoblasts are the precursors for what two blood cell types?

A

B cells and T cells

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4
Q

When B cells and T cells mature, what do they become, respectively?

A

B cells mature into plasma cells whereas T cells become activated T cells

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5
Q

Monocytes develop from what immediate precursor blood cell type?

A

Monoblasts

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6
Q

What precursors indicate that a stem cell has differentiated into the platelet lineage?

A

Megakaryoblasts, which become megakaryocytes that form platelets

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7
Q

Neutrophils, eosinophils, and basophils differentiate from what common precursor blood cell type?

A

Myeloblasts

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8
Q

Promyelocytes, myelocytes, metamyelocytes, and stab cells are precursors for what three granulocytes?

A

Neutrophils, eosinophils, and basophils

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9
Q

In a normal blood sample, name the differential of white blood cells from most to least numerous.

A

Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils (remember: Neutrophils Like Making Everything Better)

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10
Q

What feature of the erythrocyte structure permits easy gas exchange of oxygen and carbon dioxide?

A

The biconcave disc shape permits a high surface area to volume ratio and facilitates gas exchange

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11
Q

What molecule do erythrocytes depend upon exclusively for energy?

A

Glucose; remember, they cannot use ketones for energy

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12
Q

What is the average lifespan of an erythrocyte in a normal human host?

A

120 days

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13
Q

Where does an erythrocyte obtain the adenosine triphosphate that it needs for energy?

A

Glucose: 90% is anaerobically degraded to lactate, whereas 10% goes to the hexose monophosphate shunt

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14
Q

What role does the erythrocyte play in acid/base physiology?

A

Erythrocytes carry carbon dioxide from the periphery to the lungs for elimination

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15
Q

How do erythrocytes facilitate transport of carbon dioxide away from the peripheral tissues?

A

The chloride-bicarbonate antiport produces a physiologic chloride shift, resulting in cellular loss of chloride and gain of bicarbonate (and thus carbon dioxide)

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16
Q

How would you describe a peripheral blood smear that shows an increased number of red blood cells and numerous immature red blood cells?

A

There is an erythrocytosis or polycythemia (increased number of cells) and a reticulocytosis (increased immature cells)

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17
Q

How would you describe a peripheral blood smear showing red blood cells of varying sizes and of varying shapes?

A

This smear exhibits anisocytosis (varying sizes) and poikilocytosis (varying shapes)

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18
Q

How do mature platelets form from large megakaryocyte precursors?

A

Small portions of cytoplasm fragment off of megakaryocytes

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19
Q

What is the role of platelets immediately following an injury such as a laceration?

A

Primary hemostasis; for example, they help prevent leakage of red blood cells from damaged vessels

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20
Q

What happens to platelets when they are in the presence of damaged endothelium?

A

Platelet activation; sticky platelets aggregate and interact with fibrinogen to form a hemostatic plug

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21
Q

What two types of granules do platelets contain?

A

Dense granules and alpha granules

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22
Q

What are the contents of the dense granules of platelets?

A
  • Adenosine diphosphate (ADP)
  • Calcium
  • Serotinin
  • Histamine.
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23
Q

What are the contents of the alpha-granules of platelets?

A
  • von Willebrand’s factor (vWf)
  • Fibrinogen
  • Fibronectin
  • Platelet factor four (PF4)
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24
Q

Where in the body would you typically find the most platelets at any one time?

A

Approximately one third of the platelet pool is stored in the spleen

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25
What is the life span of a platelet?
8-10 days
26
You note multiple small red lesions on the skin of a patient that do not blanche with pressure; what are two possible etiologies of these lesions?
These are petechiae, which can be caused by a low platelet count (thrombocytopenia) or dysfunctional platelets
27
Granulocytes and mononuclear cells are what kind of blood cells?
Leukocytes (*leuk* = white; *cyte* = cell)
28
Name three types of granulocytes.
Basophils, eosinophils, and neutrophils
29
Name two types of mononuclear cells.
Lymphocytes and monocytes
30
What is the main function of leukocytes?
To defend against infection
31
How many leukocytes are normally found per microliter or blood?
4000 to 10,000
32
What distinguishes the appearance of a basophil from other granulated cells?
The densely **baso**philic granules, which stain blue with **basic** stains
33
What molecules, normally seen as part of the inflammatory cascade, are contained in basophilic granules?
Histamine (which causes vasodilation) and other vasoactive amines, as well as leukotrienes (LTD-4)
34
Compare and contrast the function and location of basophils and mast cells.
Both types of cells mediate allergic reactions and secrete histamine; however, mast cells bind immunoglobulin E and are found in tissue, whereas basophils are found in the blood
35
What substances are released when mast cells degranulate?
Histamine, heparin, eosinophilic chemotactic factors
36
What stimulus causes mast cell degranulation?
Immunoglobulin E binding to receptors on the surface of the mast cell
37
You note many basophils on a peripheral smear of a patient undergoing an allergic reaction; do you also expect to see mast cells?
No; although both cells are involved in allergic reactions, basophils are found in the blood whereas mast cells are typically only found in tissues
38
What medication can prevent the release of inflammatory compounds from mast cells in a patient with asthma?
Cromolyn sodium, which stabilizes mast cell membranes and prevents degranulation
39
What distinguishes an eosinophil from other granulated cells?
They are full of large, uniform eosinophilic (pink) granules (*eosin* = a dye that stains pink; *philic* = loving)
40
What is the role of major basic protein, found in eosinophils?
Major basic protein is released to fight helminth and protozoan infections
41
Eosinophils are phagocytic cells, particularly in the presence of what?
Antigen-antibody complexes
42
How do eosinophils and mast cells interact during an allergic reaction?
Eosinophils produce histaminase and arylsulfatase to limit the inflammatory reaction from mast cell degranulation
43
Name five diagnoses to consider in a patient discovered to have eosinophilia.
**N**eoplasm, **A**sthma, **A**llergic reaction, **C**ollagen vascular disease, **P**arasites (remember: **NAACP**)
44
What is the appearance of granules found in neutrophils?
Large, spherical, azurophilic granules
45
Under the microscope you note a neutrophil with several granules; what organelle are you looking at?
Lysosome
46
What are the contents of the granules in neutrophils?
Hydrolytic enzymes, lysozyme, myeloperoxidase, and lactoferrin
47
A peripheral blood smear shows multiple neutrophils with nuclei that display 6, 7, and even 8 lobes; what lab tests are indicated?
B12 and folate tests; hypersegmented polys (neutrophils) are present in deficiencies of either vitamin
48
Would you expect to find monocytes in a tissue biopsy?
No. Monocytes are found in the blood, not the tissue; when they enter tissue they differentiate into macrophages
49
Describe the appearance of monocytes.
Large, kidney-shaped nucleus; frosted glass cytoplasm
50
What role do macrophages play in the immunologic response to extracellular pathogens?
They are antigen-presenting cells using major histocompatibility complex class II molecules (present phagocytosed extracellular pathogens)
51
Which cytokine causes activation of macrophages?
γ-Interferon
52
What molecules do dendritic cells express on their surfaces that are integral to their role as antigen-presenting cells?
Major histocompatibility complex II and Fc receptor
53
What are dendritic cells in the skin called?
Langerhans cells
54
What is the major function of B lymphocytes?
To produce antibodies
55
What is the function of T lymphocytes?
They control the cellular immune response and regulate the activity of B lymphocytes and macrophages
56
B lymphocytes are part of the _____ (cell-mediated/humoral) immune response.
Humoral
57
Where do B lymphocytes originate? Where do they mature?
They originate and mature in the bone marrow (remember: **B** = **B**one marrow)
58
After maturation, where do B lymphocytes migrate to from the bone marrow?
Peripheral lymphoid tissue (lymph node follicles, white pulp of spleen, other uncapsulated lymphoid tissue)
59
What kind of antibody response occurs when the body encounters an antigen it has previously seen?
Rapidly secreted, previously formed antibodies because B cells have antigenic memory
60
What is the response of a B cell after encountering a recognized antigen?
B cells differentiate into plasma cells and secrete antibodies
61
What major histocompatibility complex do B cells possess on the cell surface?
Major histocompatibility complex II, which allows B cells to act as antigen-presenting cells
62
What organelles create the appearance of the off-center nucleus and abundant cytoplasm in a plasma cell?
The rough endoplasmic reticulum and Golgi apparatus are plentiful (remember: the plasma cell is a protein (antibody) factory!)
63
How are plasma cells formed?
When B cells encounter a recognized antigen, they differentiate into plasma cells (which have antigenic memory)
64
You note that a patient;s bone marrow shows a monoclonal proliferation of plasma cells; what is the diagnosis?
Multiple myeloma
65
What is the site of origin for T lymphocytes? Where do they mature?
They originate in the bone marrow but mature in the thymus (remember: **T** cells mature in the **T**hymus)
66
Name the three types of mature cells into which T cells differentiate.
Cytotoxic T cells, helper T cells, and suppressor T cells
67
Which major histocompatibility complex and CD molecules are expressed by cytotoxic T cells?
Major histocompatibility complex I and CD8 (MHC CD = 8; MHC I CD8 = 8)
68
Which major histocompatibility complex and CD molecules are expressed by helper T cells?
Major histocompatibility complex II and CD4 (MHC CD = 8; MHC II CD4 = 8)
69
T lymphocytes mediate the _____ (cellular/humoral) immune response.
Cellular
70
What is the predominate type of lymphocyte found in the circulation?
T cells, which make up approximately 80% of circulating lymphocytes

USMLE (S1) Hematology / Oncology (5 decks)

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