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Hematology I > Module 1 > Flashcards

Module 1 Flashcards

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1
Q

Hematopoiesis

A

Production and development of blood cells, characterized by the constant restoring of the various cells of the blood

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2
Q

Myeloid cells

A

Blood cells that are normally produced in the bone marrow

Erythrocytes, platelets, neutrophils, eosinophils, basophils, monocytes

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3
Q

Non-myeloid cells

A

Blood cells normally produced outside of the bone marrow

Lymphocytes

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4
Q

Medullary hematopoiesis

A

The normal production of blood cells (myeloid cells) in the bone marrow

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5
Q

Extra-medullary hematopoiesis

A

The production of myeloid cells outside the bone marrow

Abnormal in adults, but normal in the fetus and newborn

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6
Q

Three phases of hematopoiesis

A

Mesoblastic phase
Hepatic phase
Myeloid phase

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7
Q

When do the three phases of hematopoiesis take place?

A 
Mesoblastic = 2nd to 12th week of gestation
Hepatic = 6th week of gestation to 2 weeks postpartum
Myeloid = 20th week of gestation to death
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8
Q

What happens in the mesoblastic phase of hematopoiesis?

A

In the yolk sac and embryo primitive blood stem cells are formed
RBCs only
Blood vessels and the heart grow, and the heart beats and blood cells are pumped through the vessels

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9
Q

What happens in the hepatic phase of hematopoiesis?

A

Liver and spleen are involved in the production of erythrocytes first, then granulocytes, then monocytes
Lymph nodes start producing lymphocytes
Bone and bone marrow formation begins

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10
Q

What happens in the myeloid phase of hematopoiesis?

A

Lymph nodes continue to produce lymphocytes
All other blood cells are produced in the bone marrow
Liver and spleen retain the potential for hematopoiesis in the adult, but are inactive

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11
Q

Location of red bone marrow in adults

A

Anterior and posterior iliac crests of the pelvis
Sternum
Proximal ends of the long bones (humerus, femur)
Spinous processes of the vertebrae

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12
Q

Where are myeloid cells produced in infants and young children?

A

All bones

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13
Q

Where are non-myeloid cells produced?

A

All lymphatic tissues including nodes in the lymphatic system and areas in the spleen, tonsils, liver, and marrow

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14
Q

Active bone marrow

A

Red bone marrow

Where hematopoiesis occurs

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15
Q

Inactive bone marrow

A

Yellow bone marrow

Little hematopoiesis occurs

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16
Q

Granulocytes

A

Neutrophils
Eosinophils
Basophils

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17
Q

Agranulocytes

A

Monocytes

Lymphocytes (T cells and B cells)

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18
Q

Hematopoietic inductive microenvironment (HIM)

A

The optimum environment for the multiplication and differentiation of blood cells, that exists in the bone marrow

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19
Q

Liver’s involvement in hematopoiesis

A

Principal site of cell production during the hepatic phase

In adults, extra-medullary hematopoiesis (abnormal) and the breakdown of hemoglobin

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20
Q

Spleen’s involvement in hematopoiesis

A

Production of cells during the hepatic phase

In adults, extra-medullary hematopoiesis (abnormal) and the removal of old and damaged red blood cells

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21
Q

Thymus’s involvement in hematopoiesis

A

The production and maturation of T-lymphocytes

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22
Q

Lymph node’s involvement in hematopoiesis

A

The formation of new lymphocytes

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23
Q

CFU-S

A

Colony forming unit - Stem
Aka. pluripotential blood stem cell or multipotent lymphohematopoietic stem cell
Partly differentiated from reticulum cells

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24
Q

CFU-S can differentiate into:

A

CFU-L (lymphoid stem cell) or CFU-GEMM (myeloid stem cell)

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25
CFU-L
Colony forming unit - Lymphoid | Lymphoid stem cell
26
CFU-GEMM
Colony forming unit - Granulocyte, erythroid, monocyte, megakaryocyte Myeloid stem cell
27
Blast cells
The earliest stages of blood cells that can be visually recognized as the precursor to a particular cell line
28
Colony stimulating factors (CSF) and interleukins (IL) are secreted by:
Macrophages, lymphocytes, and bone marrow cells (fibroblasts, endothelial cells)
29
Erythropoietin (EPO) is secreted mainly by:
The kidneys
30
Thrombopoietin (TPO) is secreted mainly by:
The liver
31
Lymphokine
A cytokine produced by a lymphocyte
32
Monokine
A cytokine produced by a monocyte or macrophage
33
Erythropoietin actions and effects
Induces maturation and mitosis in BFU-E, CFU-E, pronormoblast and developing NRBC; raised concentration of EPO over long periods of time also induces increased production of other myeloid cells
34
Thrombopoietin actions and effects
Induces maturation and mitosis in the CFU-Meg and developing megakaryocytes
35
Hormone that induces maturation and mitosis in BFU-E, CFU-E, pronormoblast and developing NRBC; raised concentration over long periods of time also induces increased production of other myeloid cells
Erythropoietin
36
Hormone that induces maturation and mitosis in the CFU-Meg and developing megakaryocytes
Thrombopoietin
37
Growth factors produced by monocytes and macrophages
Tissue necrosis factor Interleukin-1 Interleukin-6
38
Tissue necrosis factor and interleukin-1 actions and effects
Work together to activate and stimulate cytokine production by T lymphocytes and bone marrow cells
39
Growth factors produced by T lymphocytes
Interleukin-3 | Interleukin-5
40
Interleukin-3 actions and effects
Induce differentiation and mitosis of the CFU-S into either the CFU-GEMM or the CFU-L
41
Interleukin-5 actions and effects
Induces eosinophil growth and function
42
Granulocyte/Monocyte stimulating factor is secreted by:
Bone marrow stromal cells
43
Granulocyte/Monocyte stimulating factor actions and effects
Induces differentiation and mitosis of the CFU-GEMM into several series committed stem cells: CFU-Eo, CFU-GM, CFU-baso, BFU-E and BFU-meg. It also stimulates the phagocytic and cytotoxic functions of neutrophils and macrophages
44
Effective hematopoiesis
Normal 85% or more of developing blood cells in the bone marrow are successfully produced and released into the blood circulation
45
Ineffective hematopoiesis
Abnormal | Less than 85% of developing blood cells are produced normally and released into the blood
46
How can the bone marrow increase cell production?
1. "Shift to the left" - releasing immature forms from the marrow into the blood 2. Increasing the number of mitoses in developing cells 3. Accelerating the maturation time between mitoses 4. Expanding hematopoiesis into inactive areas (extra-medullary hematopoiesis)
47
N/C ratio
Nuclear/cytoplasmic ratio The size of the nucleus / the size of the cytoplasm As the cell matures, generally the N/C ratio decreases (Smaller nucleus than cytoplasm)
48
What generally happens to the cell size as a blood cell matures?
It decreases
49
What generally happens to the nucleus as a blood cell matures?
Decrease in nuclear size, loss of nucleoli, increased clumping and coarseness of chromatin and darkening in staining colour of chromatin
50
What generally happens to the cytoplasm as a blood cell matures?
Changes in colour from darker blue basophilia to other colours (e.g. pink)
51
Order of cells in erythrocyte series production
``` Pronormoblast / Rubriblast Basophilic normoblast / Prorubricyte Polychromatic normoblast / Rubricyte Orthochromatic normoblast / Metarubricyte Polychromatophilic / Reticulocyte Erythrocyte ```
52
Most important property of the RBC membrane
Selective permeability
53
The most important active transport mechanisms in the RBC membrane
Sodium/potassium pump and the calcium pump
54
Why is the calcium pump important in the RBC?
The accumulation of calcium in the RBC membrane makes it less elastic so it cannot bend as easily - the calcium pump moves calcium out of the RBC and back into the plasma
55
Charge of RBC membranes in the blood
Negative charge - repels all other RBCs which helps protect the cell from damage
56
What makes up most of the cytoplasm in an RBC?
Hemoglobin (90%)
57
How many hemoglobin molecules are in a normal RBC?
250 million
58
Where is heme synthesized?
The mitochondria and cytoplasm of the developing nucleated RBCs and reticulocytes (in the bone marrow)
59
Where is globin synthesized?
The ribosomes of the developing nucleated RBCs | Synthesis is stimulated by the presence of free heme
60
Site where heme bonds to globin
Histidine
61
Embryonic hemoglobins
Hb Gower1, Hb Portland, Hb Gower2 | Produced in first 12 weeks of gestation
62
Fetal hemoglobin
HbF (α2γ2) At birth, >75% of total Hb In adults,
63
HbA2
α2δ2 | Adult Hb, minor component
64
HbA
α2β2 Adult Hb, major component Usually 96%-98% of total Hb
65
HbA1c
HbA plus a molecule of glucose attached to the β-polypeptides Normal: 5% of total Hb
66
Reduced Hb
HbA in which the iron atoms of the hemes are in the ferrous (Fe2+) state This reduced state is required for binding oxygen
67
Oxyhemoglobin (HbO2)
Reduced HbA that is carrying O2 bound to some or all of the iron atoms of the hemes
68
Deoxyhemoglobin (Hb)
Reduced HbA that is NOT carrying O2 bound to the iron atoms of the hemes
69
Methemoglobin (MetHb)
HbA in which the iron atoms of the hemes are in the ferric (Fe3+) state Cannot bind O2
70
Concentration of MetHb in normal blood
2% of total Hb
71
Carboxyhemoglobin (HbCO)
HbA that is bound to carbon monoxide instead of O2 | Affinity of Hb for CO is far greater than its affinity for O2
72
Sulfhemoglobin (Verdoglobin)
Formed from the reaction of HA with soluble inorganic sulphides and H2O2
73
Which of the myeloid cells is found only in the bone marrow and why?
Megakaryocyte – its cytoplasm disintegrates into platelets in the marrow
74
Blood cells are of what origin?
Mesodermal or connective tissue origin
75
What develops first - the heart or the bones?
The heart
76
When does the liver assume main responsibility for production of blood?
At the 6th week of gestation (hepatic stage)
77
Can become any connective tissue cell
Reticulum cell
78
Committed to become any myeloid cell
CFU-GEMM
79
Largest hematopoietic cell
Megakaryocyte
80
Nuclear/cytoplasmic asynchrony
Nucleus or cytoplasm develops faster or slower than is normal
81
Stromal cells in the bone marrow
Fibroblasts, endothelial cells, blood cells
82
Immediate progeny of the CFU-GEMM
BFU-E, CFU-meg, CFU-GMEo, CFU-baso
83
What parts of the erythrocyte plasma membrane may act as antigens?
Glycoproteins, glycolipids
84
What parts of the erythrocyte plasma membrane maintain the shape of the cell?
Actin and spectrin
85
What parts of the erythrocyte plasma membrane are lipids?
Phospholipids and cholesterol
86
The full name for NAD
Nicotinamide adenine dinucleotide
87
The full name for NADP
Nicotinamide adenine dinucleotide phosphate
88
Which energy pathways are lost after the RBC extrudes its nucleus and other cellular organelles?
Krebs cycle and the electronic transport system
89
Hematocrit is also known as:
Packed cell volume (PCV)
90
Packed cell volume (PCV) is also known as:
Hematocrit
91
Pathway in an RBC that produces NADPH
Pentose shunt
92
Where does hematopoiesis occur during the hepatic phase?
Liver, spleen, bone marrow, lymph nodes
93
Blast cell for the erythrocyte series
Pronormoblast / Rubriblast
94
What erythrocyte enzyme converts most of the CO2 moved from the tissues to the lungs into HCO3- ?
Carbonic anhydrase
95
To bind O2 the iron atom in heme must be in which state?
Reduced
96
Under normal circumstances, what is most important in determining the 02 affinity of Hb at the lungs and the tissues?
pH
97
What by-product is formed and excreted by the lungs as the result of Hb catabolism inside a macrophage?
CO
98
What is the microscopic appearance of the nucleus in an orthochromatic normoblast?
Pyknotic
99
Which 2 biochemicals begin the reaction of heme synthesis?
Glycine and succinyl CoA
100
What factor/hormone activates and induces the CFU-GEMM?
Granulocyte/monocyte stimulating factor(GM-CSF)
101
Polypeptide formula for Hb Portland
zeta2 gamma2
102
Which substance in erythrocytes prevents oxidation of cell proteins?
NADPH

Hematology I (4 decks)

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