Lecture 5 - Hematology Flashcards by Robert Enders

What all does blood transport?

oxygen and other nutrients, waste products, hormones, heat, and cells

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Polycythemia

when at higher elevation, the body will compensate and make more blood cells to be able to take up more oxygen

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Blood with anticoagulant

plasma
buffy coat (leukocytes, and platelets)
erythrocytes

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Blood without anticoagulant

serum

clot

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Contents of plasma

proteins and ions (solutes) and water

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Contents of serum

proteins and ions.

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Romanovsky-type color stains

basophilic - blue
azurophilic - purple
eosinophilic - orange
neutrophilic - pink

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Differential count

Neutrophil - 60-70%
Eosinophil - 2-4%
Basophil - .5%
lymphocyte - 28%
Monocyte - 5%

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Neutrophils

60-70%. Attack bacteria. Lobulated nucleus. Can sometimes see a barr body. Both non specific and specific granules

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Eosinophil

2-4%. Attack parasites. Granules have an internum stripe (major basic protein to attack, neurotoxin). Migrate through diapedesis and chemotaxis. Limits inflammation

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Basophil

.5%. mediate inflammation. Large granules containing heaprin, proteases, histamine, eosinophil chemotactic factor

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Lymphocyte

28%. mediate humoral (B cells) and cellular (T cells) immunity. Large nucleus and typically have a halo appearance

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Monocyte

5%. become phagocytic macrophages. Typically have some sort of change in the shape of the nucleus.

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Granulocytes

Neutrophils, Eosinophils, and basophils.

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Agranulocytes

Lymphocytes and monocytes

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Proteins found in plasma

albumin, globulin (antibodies), and fibrinogen

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Organic and inorganics in plasma

organics: lipids, carbohydrates, amino acids, and organic wastes
inorganics: potassium, sodium, chloride, etc.

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Albumin

contributes to osmotic pressure

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Globulins

include immunoglobulins and transport that bind small ions, hormones, etc.

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Fibrinogen

function in forming blood clots

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RBC

no nucleus. short life span (120 days). flexible shape

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3 membrane proteins in RBC

glycophorin, anion transporter channel, and ankyrin

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Anion transporter channel in RBC

allows HCO3- to cross in exchange for Cl-. Facilitates release of CO2 in the lung

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Causes of anemia

hemorrhage, insufficient production of RBCs (low epo from diseased kidney), RBCs with insufficient hemoglobin (iron deficiency), accelerated RBC destruction (sickle cell)

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Removal of RBCs

Most are done in the spleen, some in liver and bone marrow. Little done in the blood vessels.

Barr body

inactivated X chromosome. Thus from female

Nonspecific granules

primary lysosomes, dark staining.

Diapedesis

RBCs exiting and squeezing through endothelium

Chemotaxis

move toward the chemotaxic factor to attack the bacteria

2 modes of killing of bacteria

oxygen-dependent (creates hydrogen peroxide - then bleach) and oxygen-independent (lysosomal degradation)

How does eosinophils limit inflammation?

inactivating leukotrienes and histamine

4 responses to mast cells/basophils

chemoattraction of eosinophils; increased permeability of blood vessels (histamine); constriction of smooth muscle; hyper secretion of mucus by goblet cells

APC cell mechanism

Acquired immunity. antigen is presented to the major histocompatability complex which presents it to a T cell. If recognized as foreign, it will then stimulate B cells to produce antibodies to bind to the bacteria.

Secretions of platelets

serotonin - vasoconstriction; platelet-derived growth factor - endothelial cell mitosis

Hyalomere of platelet

peripheral microtubules and microfilaments to hold it together.

Hemostasis steps

vasoconstriction; platelets form the primary plug (adhere to collagen fibers); clotting cascade (platelets release fibrinogen -> fibrin which acts as a mesh)

3 phages in fetal blood development

primite erythroblasts; hepato-spleno-thymic phase (precursors of granulocytes and mega); medullo-lymphatic phase (bone marrow & lymph nodes produce all cell types)

Hemocytoblast

pluripotential stem cell. common precursor to all blood cell types

Myeloid stem cells

erythrocytes, megakaryocytes, granulocytes, and monocytes

Lymphoid stem cells

lymphocytes only (T and B)

T lymphocytes

Cellular immunity

B lymphocytes

humoral immunity

What do monocytes become when they leave blood?

Macrophages

Red marrow

hematogenous (young) and is very active

Yellow marrow

adipose cells (older).

Erythropoiesis

RBC formation. If detect low blood oxygen levels, erthropoietin is released causing differentiation of progenitors to reticulocytes.

Progression to erythrocyte

Proerythroblast, basophilic erythroblast, polychromatic erythroblast, normoblast (off center nucleus), reticulocyte, and erythrocyte.

Stage with a nucleus with checkerboard of heterochromatin

basophilic erythroblast

3 divisions of erythroblasts

proerythroblast, basophilic erythroblast, and polychromatophilic erythroblast (sense RNA is condensed)

Reticulocytes histologically distinct feature

No nucleus, but may have RNA remnants.

Myeloblast

no granules present

Promyelocyte

nonspecific granules (lysosomes) developed from golgi

Myelocyte

specific granule

Metamyeloctye

lobulation begins (kidney bean shape)

What occurs before and after a band cell

Before: metamyelocyte After: full lobulation

Band neutrophil accumulation indicates what?

bacterial infection. Thus more neutrophils are being produced.

Thrombopoiesis

stem cell to megakaryocyte and then platelet production

Hodgkin's lymphoma

characterized by the presence of giant Reed-Sternberg cells (5 subtypes) - large cell type

Non-Hodgkin's lymphoma

12 B cell types, 12 T cell types.

Acute vs chronic leukemia

acute: immature cells in development and progresses rapidly (denser packing is seen) chronic: more mature cells in development thus less aggressive