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Heme/Lymph 1 > Red Blood Cells > Flashcards

Flashcards in Red Blood Cells Deck (48)
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1

Sites of production throughout the life

Embryo - Yolk sac during 3rd week
Liver - chief site from 3rd month til late pregnancy
Bone marrow - begins 4th month and is sole source in normal term baby
Spleen, lymph node, thymus - small
Infants, children - all skeleton active
Adults - axial skeleton

2

Increased demand can cause

Fatty marrow to become active
7-8 fold increase possible
Extramedullary hematopoiesis can occur

3

Common origin for cells we are talking about

Hematopoietic pluripotent stem cell

4

Stems cells have

Capcity for self-renewal as well as giving rise to committed stem cells

5

Earliest precursors can

Actively divide but NOT self replicate

6

Erythroid pathway

BFU-E - burst forming unit
CFU-E - colony forming unit
Stem cell factor and IL3,6 are grwoth factors
EPO affects

7

Normal adult bone marrow

1:1 ratio of fat to cells
Children have more cells, elderly may have less

8

When might marrow be more cellular

Stress, megaloblastic anemia and hemolytic anemias, and other dz

9

Aplastic anemia marrow appearance

Hypocellular with decreased precurosors and patients have low blood counts

10

Myeloid to erythroid ratio is

3:1

11

Red cell devleopment results in

Decreased size and loss of nucleus...increasing redness of cytoplasm

12

B-12 and folate importance

Needed for DNA replication...def cause arrest during S phase and death during maturation (ineffective erythropoiesis)

13

B-12 and folate cell appearance

Hypercellular marrow, hypersegemented neutrophils, cytoplasmic asyncrhony and macrocytic megaloblastic cells

14

Iron importance

Used to form heme or stored as ferritin...sideroblastic anemia is ferritin accumulation in mitochondria

15

Normal hemoglobin structure

4 globin chains and heme molecule
Adult has 2 alpha and 2 beta
Fetal has 2 alpha and 2 gamma
A2 has 2 alpha and 2 delta

16

Anemia

Decreased red cells

17

Polycythemia

Increased red cells
Primary - myeloproliferative disorders
Secondary - to increased erythropoietin

18

Measurement of hemoglobin, hematocrit and RBC count

Hemoglobin - spectrophotometry
Hematocrit - calculated or spun value
RBC count - electrical impedence

19

MVC, MHC, MCHC, RDW

Mean cell volume
Mean cell hemoglobin
Mean cell hemoglobin concentration
Red cell distribution width

20

MCV equation and how to read RDW and MCV

Width - RDW
Peak - MCV

MCV = (HCT*10)/RBC

21

Special equation

RBC*MCV=Hct*10

22

MCH vs MCHC

MCH= (Hb*10)/RBC
MCHC = (Hb*100)/HCT

MCHC more helpful because takes into account cell size

23

Newborns have

Higher hemoglobin and hematocrit...decreases during childhood then rises again

24

Reticulocyte count and interpretation

Could seem elevated in anemia even if insufficienct because there are fewer RBCs....Convert to mature RBCs in 1 day unless shift (2)

25

Corrected reticulocyte count and why correct?

=(retic%*hct%)/(45*1)

Corrects for anemia since there are fewer RBCs

26

Reticulocyte production index and interpretation

Corrected reticulocyte count/2

2 or less - hypoproliferative anemias
3 or more - hemolytic anemia

27

Reticulocyte index with types of anemias

Can't tell with erythropoiesis
Elevated in hemolytic
Decreased in hypoproliferative

28

Anisocytosis and when we see

Variation in size
Sideroblastic anemia
Increased RDW

29

Microcytosis and when we see

Small size
Low MCV
Iron def and thalassemia
Also often hypochromatic (decreased MCHC)
Normochromic microcytic sometimes seen in hemolytic anemias

30

Macrocytosis and when we see

High MCV
Folate, B12 def

31

Hypochromia and when we see

Often with microcytosis
MCV, MCH, and MCHC all decreased
Often with microcytosis

32

Hyperchromia and when we see

Increased Hb content
Large macrocytic may have increased MCH but MCHC is normal
True hyperchromia (MCHC increased) is associated with spehrocytosis

33

POlychromasia and when we see

Use Wright's stain...hemolysis and recent blood loss

34

Poikilocytosis

Variations in shape

35

Elliptocyte and ovalocytes and when we see

If mostly elliptocyte - hereditary elliptocytosis
Maccroovalocytes - B12 and folate def
Ellipto in small numbers - iron def, thalassemias, hemoglobinopathies

36

Target cells and when we see

Thalassemias, hemoglobinopathies, iron def, and oher hypochromic states
Also with liver dz and after splenectomy

37

Spherocytes and when we see

Have less SA/membrane, increased MCHC, and increased fragility
Hereditary speherocytosis and some types of hemolysis (warm antibody immune hemolysis)

38

Schistocytes and when we see

Hemolytic conditions like microangiopathic hemolytic anemia

39

Echinocytes and when we see

Artifact or hyperosmolairty/renal failure

40

Acanthocytes and when we see

Liver dz and post-splenectomy

41

Teardrop cells and when we see

Myeloproliferative dz, megaloblastic anemias, and thalassemias

42

SIckle cells

Polymerize into rigid crystal when exposed to decreased oxygen or pH

43

Hwoell-Jolly Bodies and when we see

Remnants of nucelar chromatin
Splenectomy, megaloblastic anemia, abnormal erythropoiesis, or severe hemolytic anemias

44

Heinz bodies and when we see

Denatured hemoglobin
G6PD

45

Basophilic stippling and when we see

Disorders of hemoglobin synthesis (like thalassemia)
Blue granules (RNA)
Reticulocytes

46

Pappenheimer bodies and when we see

Sideroblasdtic anemias and splenectomy
Fewer number than stippling

47

Normoblasts and when we see

Normal in fetus and young
Pathologic denoting excess demand on marrow (hemolytic disease like erythroblastosis fatalis or transfusions)

48

Rouleax formation and when we see

Stack of coins with increased plasma protein like plasma cell myeloma