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Haemotology > Red Blood Cells > Flashcards

Red Blood Cells Flashcards

1
Q

Where do all blood cells originate from

A

Bone marrow

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2
Q

Where are the blood cells derived from

A

Haemopoietic stem cells

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3
Q

What gives rise to erythrocytes

A

Myeloid stem cells

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4
Q

Table of the blood cells

A
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5
Q

What are the HSC characteristics

A

Self-renew (daughter cells remain as HSC)

Differentiate to daughter cells

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6
Q

Stem cell hierarchy

A
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7
Q

Where are HSC developed in fetus

A

3 wks in the mesoderm (yolk salk)

6-8 wks liver takes over and remains principal until shortly before birth

10 wks bone marrow

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8
Q

Where is HSC developed in children

A

Bone marrow everywhere

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9
Q

Where is HSC developed in adults

A

Pelvis, femur, sterum and proximal arm and thigh

Other sites may retain their ability

Haemopoiesis may occur outside the bone marrow

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10
Q

What is haemopoiesis regulated by

A

Genes, transcription factors, growth factors and microenvironment

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11
Q

What are haemopoietic growth factors

A

Glycoprotein hormones which bind to cell surface receptors

Regulates proliferation and differentiation of HSC

Regulate function of mature blood cells

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12
Q

What is the role of erythropoietin

A

Induces erythropoiesis

Synthesised in the kidney

Glycoprotein

Stimulates bone marrow to produce more red blood cells

Direct cause or reduced oxygen to the kidney

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13
Q

How are granulocytes and monocytes regulated

A

G-CSF

Granulacyte Macrophage Colony Stimulating Factors

Cytokines e.g. interleukins

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14
Q

What is the role of thromopoietin

A

Platelet production

Megakaryocytopiesis

Produced by cells of the bone marrow

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15
Q

Development of red blood cells

A
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16
Q

Why do we need iron

A

Oxygen transport in haemoglobin

DNA synthesis

Mitchondrial proteins

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17
Q

Where is haem iron (Fe2) found

A

Red meat

Fish

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18
Q

Where is non-haem iron found

A

Grains

Beans

Plant based food

Dairy

Nuts

Soya beans - contains phytates which reduce iron absorption

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19
Q

What reducing substances are required to absorb non-haem iron

A

Ascorbic acid

Vitamin C

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20
Q

Why is it important to regulate iron absorption

A

Iron can form free radicals which can damage tissues

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21
Q

What is the molecule that transports iron

A

Transferrin

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22
Q

What is hepcidin

A

Regulates absorption of iron

Ferroportin - Fe3

Ferritin - Fe2

Iron is shed into the gut lumen otherwise

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23
Q

What cytokines are produced in inflammatory response

A

IFNy - reduction in erythropoiesis

IL-1 TNFa and IL-6 mediate hepcidin

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24
Q

How does hepcidin cause anaemia?

A

Prevent uptake of iron

25
Q

What is folate/folic acid and B12 used for

A

Synthesis of Thymine

Inhibits DNA synthesis

26
Q

What does the deficiency of Vitamin B12 and folate affect

A

Rapidly dividing cells

Bone marrow - cells can grow but cannot divide (megablastic erythropoesis)

Epithelial surfaces of mouth and gut

Gonads

27
Q

Sources of B12

A

Meat

Liver and Kidney

Fish

Oyster and clams

Eggs

Milk and cheese

28
Q

Folic acid

A

Green leafy vegetables

Cauliflower

Brussels sprout

Live and kidney

Whole grain cereals

Yeast

Fruit

29
Q

How is B12 absorped

A

Cleaved by HCl in stomach

Binds to intrinsic factor

Binds to receptors in the ileum

30
Q

Vitamin B12 deficiency

A

Inadequate intake

Lack of acid in stotmach

Inadequate secretion of IF

Malabsorption

31
Q

When do folic acid requirements increase

A

Pregnancy

Increased red cell production

32
Q

How are red blood cells destroyed

A

Phagocytic cells of the spleen

Haem Bulirubin is excreted in bile

33
Q

What does erthrocyte function depend on

A

Integrity of the membrane

Haemoglobin structure

Cellular metabolism

34
Q

Why are erythrocytes binconcave

A

Help them maneouver

Made up of a lipid bilayer supported by cytoskeleton and transmembrane proteins

Maintain integrity and elasticity

35
Q

What is hereditary spherocytosis

A

Disruption of vertical linkages in membrane

Spherocytes

Loss of cell membrane without loss of cytoplasm

Red cells become less flexible and undergo haemolysis

36
Q

What is hereditary elliptocytosis

A

Disruption of horizontal linkages

Elliptocytes - occurs in iron deficiency as well

37
Q

What is haemoglobin made up of

A

2 a and 2 b globin chain bound to a haem group

Each haem group consists of ferrous iron held in a ring known as porphyrin

At birth it is 2 a and 2 y chains

38
Q

What is the type of haemoglobin in foetus

A

Haemoglobin F

39
Q

Bohr shift

A
40
Q

How are RBC highly adapted

A

Generation of ATP

maintenance of haemoglobin function, membrane integrity and RBC volume

41
Q

Glucose-6-phosphate dehydrogenase

A

Can cause intermittent severe intravascular haemolysis as a result of infection or exposure to oxidant

Normally hemizygous males as X linked

May be food

Distribution parallels malaria, selective advantage

42
Q

Picture of G6PD

A

Irregularly contracted cell

Loss central pallor

Hemighost because of loss of cell membrane

Oxidant damage

Heinz bodies found

43
Q

Size of red blood cells

A
44
Q

Causes of microcytosis

A

Iron deficiency

Anaemia of chronic disease

Defect in globin synthesis (thalassaemia)

45
Q

Different types of macrocytes

A

Round

Oval

Polychromatic

46
Q

Causes of macrocytosis

A

Lack of vitamin B12 or folic acid (megaloblastic anaemia)

Liver disease and ethanol toxicity

Haemolysis (polychromasia)

Pregnancy

47
Q

What is the colour of RBC

A

1/3 is pale due to lack of haemoglobin

48
Q

What is hypochromia

A

Cells have a larger central pallor

Lower haemoglobin content

Hympochromia and microcytosis often go together

49
Q

Polychromasia

A

Increased blue tinge

Cell is young

50
Q

What does new methylene blue stain do

A

Stain higher RNA content in reticulocytes

51
Q

When does reticulocytosis happen

A

Response to bleeding

Red cell destruction

52
Q

Anisocytosis

A

Variation in size than normal

53
Q

Poikilocytosis

A

Variation in shape of red blood cells

54
Q

What are target cells

A

Accumulation of haemglobin in central pallor

Can occur in obstructive jaudice

Liver disease

Haemoglobinopathies

Hyposplenism

55
Q

Why does sickle cell have that shape

A

Haemoglobin S happens where the are one or two copies of an abnormal B globin gene

Haemoglobin S is less soluble than Haemoglobin A

Chartrge glutamic acid replaces by an uncharged valine molecule

56
Q

What are red cell fragments

A

Schistocytes

Shearing process caused by platelet rich blood clots

57
Q

Reference range

A

Carefully defined reference range

58
Q

How to interpret blood count

A

Anaemia?

Blood count?

Clinical history?

Haemotology (9 decks)

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