Hematology High-Yield Biomedical Sciences Flashcards

Biomedical Sciences, Sourced from emma_dip and leizlyance on Quizlet

Fetal erythropoiesis

Young Liver Synthesizes Blood

Yolk sac (3-8 weeks)

Liver (6 weeks-birth)

Spleen (10-28 weeks)

Bone marrow (18 weeks to adult)

HbF has higher affinity for _____ than HbA due to less __________.

O2, 2,3-BPG.

Location of adult hematopoiesis

Bone marrow of the sternum, pelvis, cranium, and vertebral bodies.

What is HbA2?

Form of adult hemoglobin, found in smaller amounts.

Carrying capacity of 1 hemoglobin

1 Fe2+, 1 O2

Universal recipient blood type

AB

Universal donor blood type

O

What antibody does Rh+ blood type carry?

None

Rh+ group antigen on RBC surface

Rh(D)

Rh- antibody

Anti-D IgG

O antibodies in plasma

Anti-A and Anti-B (mostly IgG, some IgM)

What type of immunoglobulin is anti-B and anti-A antibodies in plasma?

IgM

Which statement is false?

Blood type Rh+ can receive blood only from Rh+ blood types is false. As patients with Rh+ can receive blood from both Rh+ and Rh- due to no surface antigens found on Rh- blood type.

3 multiple choice options

Myeloid stem cells can differentiate into

Erythroblasts, Megakaryoblasts, myeloblasts, or monoblasts

Erythropoiesis pathway

Myeloid cell --> in bone marrow --> erythroblast --> reticulocyte --> in blood --> erythrocyte

Thrombopoiesis pathway

Myeloid cell --> in bone marrow --> megakaryoblast --> megakaryocyte --> in blood --> platelets

Granulocytopoiesis pathway

Myeloid cell --> in bone marrow --> myeloblast --> band cell --> neutrophil

Myeloblast --> in blood --> basophil, eosinophil

Monocytopoiesis pathway

Myeloid cell --> in bone marrow --> monoblast --> in blood --> monocyte --> in tissue --> macrophage

Neutrophil specific granules contain

Leukocyte alkaline phosphatase (LAP)

Collagenase

Lysozyme

Lactoferrin

Neutrophil azurophilic granules (lysosomes) contain

Proteinases, acid phophatase, myeloperoxidase, B-glucoronidase.

Neutrophil chemotactic agents

C5a, IL8, LTB4, 5-HETE, kallikrein, platelet-activating factor (PAF), N-formylmethionine (bacterial protein).

Vitamin B12 or folate deficiency leads to what in neutrophils?

Hypersegmented neutrophils (nucleus with 6+ lobes).

Left shift

increase in the number of immature neutrophils in response to disease

Most abundant protein in blood circulation

Albumin

Function of albumin

Maintain oncotic pressure, transport proteins

Cells that create albumin

Hepatocytes

Anisocytosis

variation in RBC size

poikilocytosis

cells are irregularly shaped

RBC contain _______ antiporter to allow export of ________ and transport of _____ from the periphery to the lungs for elimination.

Cl-/HCO3- antiporter; HCO3-; CO2

Source of energy for RBCs

glucose

Which of these statements about thrombocytes is false

Lifespan is of 60-90 days is false. That is the lifespane of neonate RBCs. The lifespan of pl8elets is 8-10 days.

3 multiple choice options

1/3 of platelets stored in this organ

Spleen

vWF receptor

Gp1b

Fibrinogen receptor

GpIIb/IIIa

Lipid A from bacterial LPA binds ______ on macrophages to initiate septic shock

CD14

Macrophage function

APC, phagocytose bacteria, cellular debris, old RBCs

Macrophages function as APC via ______

MHC II

__________ are an important cellular component of granulomas, where they may fuse to form giant cells.

Macrophages

Dendritic cells express _________ and __________ receptors on their surface.

MHC II and Fc

Microcytic MCV level

<80 fL

Normocytic anemia MCV level

80-100 fL

Macrocytic MCV level

>100 fL

Microcytic anemia examples

TAIL

Thalassemias

Anemia of chronic disease

Iron deficiency (late)

Lead poisoning

Causes of normocytic nonhemolytic anemia

Iron deficiency (early)

Anemia of chronic disease

Aplastic anemia

Chronic kidney disease

Acute blood loss (hemorrhage)

Causes of intrinsic normocytic hemolytic anemia

Membrane defect: hereditary spherocytosis, paroxysmal nocturnal hemoglobinuria

- Enzyme deficiency: G6PD deficiency, pyruvate kinase def

- Hemoglobinopathies: sickle cell anemia, HbC disease

Causes of extrinsic normocytic hemolytic anemia

Autoimmune, microangiopathic, macroangiopathic, infections

Macrocytic megaloblastic anemia causes

DNA affected.

- Defective DNA synthesis: folate def, vit B12 def, orotic aciduria

Macrocytic nonmegaloblastic anemia causes

Diamond-Blackfan anemia, liver disease, chronic alcohol overuse.

What is hematopoeisis?

Differentiation of blood cells

-occurs in the bone marrow

-can also occur in liver and spleen (extra medullary) --> mainly in utero, drops off after birth when bone marrow takes over

-liver and spleen can help out during infection or pathological cause

Acanthocytes and Echinocytes can be seen in what pathology? What are they?

Liver disease

-RBC's with projections

What are schistocytes and what pathology are they associated with?

Fragmented RBCs

-hemolytic anemias (DIC, TTP, HUS, etc)

What are degmacytes and what pathology are they associated with?

-Bite cells

-d/t removal of Heinz bodies by spleen

-G6PD deficiency

What are spherocytes and what pathology are they associated with?

-small, spherical cells without central pallor

-seen in hereditary spherocytosis or autoimmune hemolytic anemia

What are macro-ovalocytes and what pathology are they associated with?

-abnormally large and oval shaped RBCs

-seen in megaloblastic anemia

What are target cells and what pathology are they associated with?

-RBCs with central hemoglobin surrounded by clear zone and then a peripheral ring of hemoglobin

-d/t alteration in cell membrane or hemoglobin content

-seen in Hemoglobin C disease (type of beta thalassemia), Asplenia, Liver disease, Thalassemia

HALT said the hunter to his TARGET

What can hematopoeitic stem cells differentiate into?

1. common lymphoid progenitor

2. common myeloid progenitor

what can common lymphoid progenitor cells differentiate into?

-lymphoblasts and then naive B cells, pre-T cells or NK cells

-can also become an immature dentritic cells which then moves into tissue and becomes lymphoid dentritic cell

What can myeloblast cells differentiate into?

band (immature) neutrophils, basophils and eosinophils (become mature once enter bloodstream)

Neutrophils increase in response to what kind of infection?

Bacterial

What can common myeloid progenitor cells differentiate into?

-myeloblast

-promonocyte --> monocyte (once in blood) --> macrophase (once in tissue) OR can become myeloid dendritic cells

-mast cell precursor (mast cell once in blood)

-megakaryocytes --> platelets (rupture which releases platelets)

-erythroblasts (via erythropoitein) --> erythrocytes (RBCs)

Plasma composition

92% water

7% plasma proteins

1% other solutes

3 main types of blood cells

erythrocytes, leukocytes, thrombocytes

-erythrocytes = 99%

total blood volume

6L

Hematocrit levels

males 42%-52%

females 37%-47%

What colour do erythrocytes stain?

-bright pink or red bc of hemoglobin (wrights stain)

Features of erythrocytes

-Biconcave discs

-Anucleate

-essentially no organelles

-Filled with Hemoglobin (Hb) for gas transport

-Contain the plasma membrane protein spectrin and other proteins

-survive in circulation for 120 days

features of platelets

-No nucleus

-Small cell fragments

-Helps blood clot around a wound

-

Describe the 2 classes of leukocyes?

1. Granulocytes

-neutrophils

-baseophils

-eosinophils

2. Agranulocytes

-monocytes

-lymphocytes (B and T)

Do the lobes of nuclei in nutrophils increase or decrease in numbers with age?

increase

How many cytoplasmic granules do neutrophils have?

1. Azurophilic granules (lysosomes)

-proteinases, acid phosphatase, myeloperoxidase, beta glucuronidase

2. Specific granules (bind neutral, basic or acidic stains)

-leukocyte alkaline phosphatase, collagenase, lysozyme, lactoferrin

Increased myeloid proliferation in response to bacterial infections for example, will cause a _______ (left/right) in neutrophils

Left shift

-increase in number of band cells/immature neutrophils

What cells are anucleate, lack organelles and use glucose as fuel?

Erythrocytes

What is the lifespan of platelets?

8-10 days

Platelets are able to bind to what via the GpIb receptor?

von Willebrand factor

Platelets are able to bind to what via the GpIIb/IIIa receptor?

Fibrinogen

Platelets contain dense granules consisting of what four things?

Ca2+

ADP

Serotonin

Histamine

CASH

Which cells differentiate into macrophages in tissues?

monocytes

Macrophages phagocytose bacteria, cellular debris and old RBC's. What activates them?

Activated by y-interferon

Can macrophages function as APC? How?

Yes, via MHC2

What type of blood cell is involved in granulomas found in TB, sarcoidosis, etc

macrophages

2 types of granules in platelets?

Dense (CASH) and alpha granules (4 f's)

Platelets contain alpha granules consisting of what four things?

vWF

Fibrinogen

Fibronectin

Platelet Factor 4

4 F's

Describe the granules in basophils

Large purple granules (vs pink in eosinophils)

What blood cell is most active against helminthic infections?

Eosinophil

Eosinophils are highly phagocytic for what?

antigen-antibody complexes

What 5 things do eosinophils produce?

1. Histaminase

2. Major basic protein (helminthotoxin)

3. Eosinophil peroxidase

4. Eosinophil cationic protein

5. Eosinophil derived neurotoxin

7 causes of eosinophilia? (PACCMAN)

P = Parasites

A = Asthma

C = Churg-Strauss (eosinophilic granulomatosis w polyangiitis)

C = Chronic adrenal insufficiency

M = Myeloproliferative disorders

A = Allergic processes

N = Neoplasia (ex. hodgkin lymphoma)

NK cells have cytoplasmic lytic granules that contain what? What happens when they are released?

-Perforin

-Granzymes

When released, act on target cells to induce apoptosis

-recognizes infected cells via cell surface proteins

B cells originate and mature where? Following this where do they migrate to and what do they do when an antigen is encountered?

-Originate/mature in bone marrow

-Migrate to peripheral lymph tissue (LN follicles, white pulp of spleen, uncapsulated lymph tissue)

-When encounter Ag, differentiate into plasma cells and produce antibodies and memory cells

T cells originate and mature where?

-Originate in bone marrow

-Mature in thymus

-Differentiate into cytotoxic T cells, helper T cells and regulatory T cells

Cytotoxic T cells express CD_ and recognize MH_

Cytotoxic T cells express CD8 and recognize MH1

Helper T cells express CD_ and recognize MH_

Helper T cells express CD4 and recognize MH2

What is necessary for T cell activation?

CD28 costimulatory signal

80% of circulating lymphocytes are what type of cell?

T cells

B cells mediate the ____________ immune response while T cells mediate the _______________ immune response

B cells mediate the humoral immune response while T cells mediate the cellular immune response

What blood cells mediate systemic allergic reaction? Which ones mediate local tissue allergic reactions?

Systemic = Basophils

Local = Mast cells

Mast cell granules are similar to which other blood cell? What 4 things do they contain?

Similar to basophils; contain basophilic granules:

-histamine

-heparin

-tryptase

-eosinophil chemotactic factors

Where do mast cells bind? What happens after?

Fc portion of IgE binds to the mast cell membrane

-activated by tissue trauma, C3a and C5a, cross linking by antigen

-results in degranulation and release of histamine, heparin, tryptase and eosinophil chemotactic factors

What cells are highly phagocytic APC's that serve as a link between innate and adaptive immune systems? What do they expresson their surface?

Dendritic cells

-express MHC2 and Fc receptors on cell surface

What do basophilic granules contain?

-Heparin (anticoagulant)

-Histamine (vasodilator)