CLSC 131 Final Studyguide

Cell that carries gasses

Red Blood Cells (Hemoglobin)

Cell responsible for fighting immunity

Lymphocytes

Cell responsible in hemostasis

Platelets

Cell involved in buffering blood and what component of that cell

Red Blood Cells (Hemoglobin)

Site(s) for extramedullary Hematopoiesis

Spleen, liver, and Lymph nodes

First stage where hgb is recognized

Polychromatophilic Normoblast (Rubricyte)

Last stage capable for mitosis

Rubricyte (Polychromatophilic Normoblast)

Polychromatophilic Normoblast is another name for what cell

Rubricyte

Name the RBCs that are normally seen in peripheral blood

Polychromatophilic Erythrocytes (Reticulocytes) and Erythrocyte (Mature Red Blood Cell)

Give examples of megaloblastic Erythropoiesis

Vitamin B12 Deficiency

Pernicious Anemia

Folic Acid Deficiency

What cell size is seen in megaloblastic Erythropoiesis

Macrocytes

What cell size do we see in IDA

Microcytes

Give two examples of Microcytic anemia and state which is seen more frequently

Iron Deficiency Anemia (IDA)- more common

Thalassemia

Name the stain used for peripheral smears

Wrights Stain

Name two stained used for Reticulocytes

New Methylene Blue

Brilliant Cresyl Blue

Normal values for reticulocytes (ages)

Adults: 0.5-2.5%

Neonates: 2.0-6.0%

What are we actually seeing stained in a retic

Residual Ribosomal RNA (Cytoplasmin RNA)

Mitochondria

Ribosomes

What is the purpose for doing a retic count

To estimate the rate at which new RBCs are entering the peripheral blood from the bone marrow

An increased count shows that there is increased bone marrow production of RBCs or rapid RBC regeneration

Define Erythropoiesis

Erythro: red

-poiesis: Formation

Erythropoiesis: Formation of Red Blood Cells

Define anisocytosis

Variation in the size of the erythrocytes

Define poikilocytosis

Variation in the shape of erythrocytes

Define asynchronism

A defect which causes the cytoplasm and the nucleus to develop at different rates

Echinocyte/Burr Cell

Acanthocyte

Codocyte (Target Cell)

Drepanocyte (Sickle Cell)

Elliptocyte

Ovalocyte

Schistocyte

Dacrocyte (Teardrop)

Stomatocyte (Mouth or cup Cells)

Keratocyte (Blister)

Spherocytes

Helmet (Bite Cell)

Microcytes

Macrocytes

Basophilic Strippling

Howell-Jolly Bodies

Cabot Rings

Siderocytic Granules

Pappenheimer Bodies

Heinz Bodies

Malaria

Hemoglobin Crystal CC

Hemoglobin Crystal SC

A decrease in the normal Globin chain synthesis of the heme part of the hgb molecule is called

Hemoglobinopathies

Calculation for a retic count

Number of Reticulocytes Counted

——————————————————————- x100

1000 (Total RBC's Counted)

(Round to the 1st Decimal place)

Recall what inclusions are seen in Wrights Stain and what inclusions need a supravital stain

a. Basophilic Strippling: Wrights Stain

b. Howell-Jolly Bodies: Wrights Stain

c. Cabot Rings: Wrights Stain

d. Siderocytic Granules: Prussian Blue Stain

e. Pappenheimer Bodies: Wrights Stain

f. Heinz Bodies: New Methylene Blue, Crystal Violet

g. Malaria: Wrights Stain

h. Hemoglobin Crystal CC: Wrights Stain

i. Hemoglobin Crystal SC: Wrights Stain

What makes up Basophilic Strippling

Made up of ribosomes, protoporphyrin, and mitochondrial remnants (RNA)

What Makes up Howell-Jolly Bodies

Inclusion is predominantly composed of DNA

What Makes up Cabot Rings

Inclusion is thought to be past of the Mitotic spindle, part of the microtubule, or fragment from the nuclear membrane (Nuclear Remnant)

What makes up Siderocytic Granules (Pappenheimer Bodies)

RBCs contain small iron particles (ferritin)

What Makes up Heinz Bodies

Denatured (precipitated) Hemoglobin

What Makes up Malaria

Parasite that lives in RBCs

What Conditions lead to Basophilic Stippling

i. Lead poisoning

ii. Megaloblastic Anemia

iii. Other Severe Anemias

iv. Normal in neonate RBCs

What conditions lead to Howell-Jolly Bodies:

i. Splenectomy

ii. Hemolytic Anemia

iii. Megaloblastic Anemia

iv. Thalassemia

v. Sickle Cell Anemia

What condition leads to Siderocytic Granules (Pappenheimer Bodies)

i. Iron- Loading Anemias

ii. Hemolytic Anemias

iii. Hyposplenism

What conditions lead to Heinz Bodies

i. Congenital Hemolytic Anemia

ii. Hemolytic Anemia secondary to oxidizing drugs

iii. Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD)

iv. Splenectomy

What Conditions lead to Hemoglobin Crystal CC

i. Hemoglobin CC

ii. Patient is homozygous for Hemoglobin C instead of Hemoglobin A

iii. Crystals increase after Splenectomy

iv. Resembles a "Bar of Gold"

What conditions lead to Hemoglobin Crystal SC

i. Patient inherits abnormal Hemoglobin S and abnormal Hemoglobin C

Define Polychromatophilic RBCs and list their characteristics

When RBCs stains pale, blue-gray color on the wrights stain

These cells are usually reticulocytes

It indicates an increased number of reticulocytes

Polychromasia: Wrights Stain

Reticulocytes: New Methylene Blue or Brilliant Cresyl Blue

State the hormone involved in RBC production

Erythropoietin- a glycoprotein

- Produced primarily by the kidney

What circumstances increase Erythropoietin production

i. Hypoxia- Lack of oxygen

ii. Pituitary Hormones

iii. Adrenal Gland Hormones

iv. Testosterone (Androgenic Hormones)

v. Thyroid Hormones

Note the stages in granulocytes for non-specific (primary granules) and specific (secondary granules)

Primary Granules: Promyelocyte

Secondary Granules: Myeocyte

Stage of granulocytes where we can differentiate between neutrophil, eosinophil, or basophil

Metamyelocyte

WBC stages that can undergo mitosis

Myeloblast

Promyelocyte

Myelocyte

Tissue macrophage is associated with what cell

Monocytes

WBCs which are in the maturing/storage pool

Metamyelocytes (45%)

Banded Neutrophils (35%)

Segmented Neutrophils (20%)

WBC granulocytes NORMAL for the peripheral blood

Banded Neutrophils

Segmented Neutrophils

Basophils

Eosinophils

First Line of Defense

Skin-Epithelial Barriers

Second Line of Defense

Phagocytosis

Third Line of Defense

B-Lymphocytes

Which cell if the last to arrive at the infection site

Monocytes

Cell associated with Mast Cell

Basophils

CD4

T helper/effector cells- Release cytokines (lymphokines) to activate other immune cells (B-cells)

Decreased in AIDS

CD8

T- suppressor/cytotoxic cells- Suppress other immune cells

Organ Transplant rejection

Cell responsible for Cellular Immunity

T-Lymphocytes

Cell responsible for humoral immunity

B lymphocyte

May- Hegglin Anomaly

• 50% of these patients have bleeding disorders

• Inherited-Platelet disorders

Pelger Huet

• Inherited

o Pince-new Form

o Functionally Normal

Psudo Pelger-Huet

• Round Nucleus

• Clumped Chromatin

• Hypogranulation

• Granulocytic Leukemia

Chédiak-Higashi Syndrome

• Very rare

• Children die very young

• Albinism

• Silver hair

• Bleeding Problems

Function of Natural Killer Cells

Immunity against viral and tumor cells that do not require any tiger recognition

Function of Platelets

Important for blood coagulation:

i. Maintains blood vessel integrity- keep strong/healthy

ii. Acts as plugs

iii. Initiate the formation of fibrin

Promotes vascular healing

Receptors on platelets for fibrinogen and VonWillebrand Factor

Coagulation Factors

Role of PF3

Platelet Factor 3 (procoagulant)

- Participates in the activation on the clotting Factors to form Fibrin

Characteristics of the maturation of a platelet

a) Increase in Nuclear Lobes (Endomitosis-Genetic Material Replicating)

b) Increase in Cell size

c) Increased Cytoplasmic Grannulation

Components of alpha and dense granules

Alpha: Coagulation Factors, Platelet Factor 4, Platelet Derived Growth Factor (PDGF)

Dense: Serotonin, ADP

Glanxmann's Disease

Inherited- diseased platelet aggregation to dense granule components such as ADP; Serotonin

Defect in the Glycoprotein IIb/IIIa complex which binds fibrinogen in the presence of Calcium and initiates platelet Aggregation

VonWillebrand's Disease

Platelets fail to adhere to collagen, decrease in Factor VIII

VIII has 2 parts, vWf is just on of the two

ITP

Idiopathic Thrombocytopenia Purpura- develops an antibody against own platelets

Bernard Soulier Disease

Rare inherited disorder, Platelets fail to adhere to collagen

- Defect in the Glycoprotein Ib complex

Giant Platelet Syndrome (60%-80% of the platelets have increased Diameter (2.5-2.0 um in diameter)), Only 2-4% function normally

DIC and the results of DIC

Disseminated Intravascular Coagulation

Massive Coagulation uses up Platelets in forming Clots

Thrombocytopenia

a decease in the number of platelets

Thrombocytosis

an increase in the number of platelets >450x10^9/L

Asprin's effects on platelets

Aspirin suppresses the enzyme Cyclooxygenase which prevents the release of granules and thereby decreases platelet aggregation

Enzyme activity returns seven days or when new plates are produced

The belted ing time in normal persons are increased 1-2 minutes after a single dose of aspirin

Tests to measure platelet function

Platelet counts

Bleeding time

Clot retraction test

Semiquatitative test for hgb

Specific Gravity

Major Basic protein is affiliated with what

The granular content within Eosinophils

Mesoblastic Period

first 2-8 weeks of fetal lifedevelops in then yolk sac. Mesenchymal stem cellsfrom primitive nucleated red cells