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Haematology Sahils questions > Red Blood Cells > Flashcards

Red Blood Cells Flashcards

1
Q

What is haemopoeisis?

A

Formation of blood cellular components

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2
Q

What is another name for red blood cells?

A

Erythrocyte

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3
Q

Where are red blood cells produced and what are they derived from?

A

Produced in the bone marrow.
Derived from Haematopoietic stem cells - myeloid progenitor

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4
Q

How many blood cells does the human body produce per day?

A

173 billion blood cells

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5
Q

What do haematopoietic stem cells have the ability to do?

A

Self renew: some daughter cells remain as haematopoietic stem cells
Differentiate into mature progeny

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6
Q

Where are HSCs derived from in embryonic development?

A

Yolk sac in early embryo development.
Liver around 6-8 weeks
Bone marrow

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7
Q

How long does it take bone marrow to develop haematopoietic development?

A

10 weeks

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8
Q

Where does haemopoiesis occur in adults?

A

Long bones such as pelvis, sternum and femur.

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9
Q

What is haemolysis?

A

Rupture and disruption of RBCs

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10
Q

What is erythropoiesis?

A

Production of RBCs

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11
Q

Where is Erythropoietin synthesised?

A

Kidney

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12
Q

What do haemopoietic growth factors regulate?

A

Haemopoiesis

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13
Q

What gives rise to a pro-erythroblast?

A

common myeloid progenitor

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14
Q

What are the 4 things required for erythropoiesis?

A

Iron
Vitamin B12
Folate
Erythropoietin

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15
Q

What causes microcytic anaemia?

A

Lack of iron (iron deficiency)

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16
Q

What cause macrocytic anaemia?

A

Vitamin B12 or folate deficiency

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17
Q

What is erythropoietin and when would it produce RBCs

A

Glycoprotein cytokine that regulates erythropoiesis
In response to hypoxia, it stimulates bone marrow to produce more RBCs when low O2 to kidney, in order to increase O2

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18
Q

What are the major functions of iron?

A

transport of O2 in haemoglobin
Mitochondrial proteins cytochrome a, b and c

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19
Q

List 3 signs that may indicate a person has iron deficiency.

A

koilonychia- spooning of nails
Glossitis- inflammation of the tongue
Angular stomatitis- inflammation of corners of the mouth

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20
Q

What is the best absorbed form of iron?

A

Ferrous iron (Fe 2+)

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21
Q

Why is excess iron bad?

A

There is no physiological mechanism by which iron is excreted

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22
Q

What regulates the absorption or iron in the gut?

A

Hepcidin

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23
Q

What is an enterocyte?

A

intestinal absorptive cell

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24
Q

What suppresses hepcidin synthesis?

A

Erythropoetic activity

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25
Q

What does Ferric Iron (Fe 3+) need to be absorbed?

A

Vitamin C (Ascorbic acid)

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26
Q

What are folate and Vitamin B12 needed for?

A

For dTTP synthesis needed for synthesis of thymidine

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27
Q

What does vitamin B12 bind to in the stomach during its absorption?

A

Intrinsic Factor

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28
Q

What is pernicious anaemia?

A

Anaemia caused by a deficiency in Intrinsic Factor

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29
Q

Where is IF made?

A

Gastric Parietal Cells

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30
Q

A lack of which foods in diet can lead to a vitamin B12 deficiency/

A

Meat
Fish
Eggs

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31
Q

Where does the absorption of folate take place?

A

Duodenum and jejunum

32
Q

When do the requirements for folate increase?

A

Pregnancy
Low RBC count (sickle cell anaemia)

33
Q

How long do red cells circulate for?

A

120 days

34
Q

Where do red cells undergo phagocytosis?

A

spleen

35
Q

What is released from the haem (porphyrin ring) when it is recycled?

A

Fe 2+

36
Q

What is iron bound to on its way back to the bone marrow?

A

Transferrin

37
Q

What does the catabolism of haem produce and where is the product excreted?

A

Globin is broken down into bilirubin
Excreted in bile

38
Q

Describe the red cell membrane?

A

Made up for lipid bilayer supported by protein cytoskeleton
Contains transmembrane proteins to maintain shape and flexibility.

39
Q

What happens to red blood cells during hereditary spherocytosis?

A

The vertical linkages made by spectrin and ankyrin are disturbed. Cells become spherical and lose central pallor.

40
Q

What causes hereditary spherocytosis>

A

Disruption of vertical linkages.
Loss of cell membrane without loss of cytoplasm
RBCs become less flexible.

41
Q

What happens to spherocytes

A

Prematurely removed by the spleen due to less flexibility

42
Q

What causes hereditary elliptocytosis?

A

Disruption of horizontal linkages
Lack of Iron

43
Q

What is a haem group made out of?

A

Fe 2+
1 porphyrin ring

44
Q

What is the difference in composition between adult and foetal haemoglobin?

A

Adult- 2 alpha 2 beta chains
Foetal- 2 alpha 2 gamma chains

45
Q

What is co-operativity?

A

Binding of first O2 to Hb changes the structure so that it is easier to add another O2 molecule

46
Q

Explain the Bohr effect.

A

High CO2
Low pH
More dissociation and so easy offloading of O2 to respiring cells (right shift)

47
Q

Which shift of the sigmoid curve showing saturation of Hb at different ppO2 does HbF give?

A

Left shift (as HbF has a higher affinity for oxygen)

48
Q

What is 2,3 DPG and how does it work

A

Organic phosphate product
Modulates O2 affinity of Hb by binding to Hb in response to anaemia, hypoxia and high altitude.

49
Q

Factors causing a Left shift of O2 dissociation curve.

A

HbF
Myoglobin
Carbon Monoxide

50
Q

Factors causing a Right Shift of O2 dissociation curve

A

Carbon Dioxide inc
Decrease in pH
2,3 DPG inc
Temperature inc
HbS

51
Q

What is G6PD

A

Glucose-6-phosphate dehydrogenase is an enzyme in the hexose monophosphate shunt

52
Q

Why is the hexose monophosphate shunt important

A

The shunt is lightly coupled to glutathione metabolism to protect RBCs from oxidant damage

53
Q

When are oxidants generated in the blood?

A

During infection
Exogenous (drugs/broad beans)

54
Q

What does G6PD deficiency cause?

A

Causes severe intravascular haemolysis from oxidant damage.

55
Q

How can you tell there is a G6PD deficiency from looking under a microscope

A

Bite cells- irregular contracted with no central pallor
Hb is denatured and forms inclusions called Heinz Bodies.

56
Q

What are some causes of microcytosis?

A

Iron Deficiency
Anaemia of Chronic Disease
Defect in Globin Synthesis

57
Q

What is anaemia of chronic disease?

A

When there is inflammation, hepcidin is increased.
This decreases the Iron supply as ferroportin is blocked in duodenum and jejunum enterocytes.

58
Q

What is thalassemia

A

Defect in globin synthesis

59
Q

What is Beta-thalassemia

A

Defect in the Beta Globin Chain Synthesis

60
Q

What is Alpha-thalassemia

A

Defect in the Alpha globin chain synthesis

61
Q

What does the term ‘major’ refer to in thalassemia?

A

A significant impairment in the alpha/beta chain synthesis

62
Q

What specific types can macrocytes be?

A

Round
Oval
Polychromatic

63
Q

What are the causes of macrocytosis?

A

Lack of Vitamin B12 or folic acid
Liver Disease and ethanol toxicity
Haemolysis (polychromasia)
Pregnancy

64
Q

What portion of the red blood cell has less haemoglobin and is therefore paler.

A

A third of the diameter from the centre (less Hb therefore less red)

65
Q

What does the term hypochromia refer to?

A

Erythrocytes have a larger area f central pallor than normal.

66
Q

What often comes with hypochromia?

A

Microcytosis
(iron deficiency and thalassemiaP

67
Q

What does the term polychromasia mean?

A

Increased blue tinge to the cytoplasm of the cell

68
Q

What does a blue tinge in a blood film indicate?

A

Red cell is young (erythocyte)

69
Q

What is polychromasia associated with?

A

Macrocytosis

70
Q

What is reticulocytosis.

A

Presence of increased number of reticulocytes

71
Q

When may reticulocytosis occur

A

Response to bleeding
Response to red cell destruction (haemolysis)

72
Q

What does the term anosocytosis refer to

A

Red cells showing more variation in size than usual.

73
Q

What does the term poikilocytosis refer to>

A

Red cells showing more variation in shape than usual.

74
Q

What is meant by haematocrit.

A

The proportion of red blood cells in your blood
Same as Packed cell volume however not measured through centrifugation

75
Q

What is mean by the term packed cell volume.

A

Proportion of a column of centrifuged blood occupied by red blood cells.

Haematology Sahils questions (4 decks)

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