3. HEMO CLS

1. What is hematopoiesis?

Formation and development of blood cells.

2. Where does prenatal hematopoiesis begin?

In the yolk sac.

3. Which organs support prenatal hematopoiesis after the yolk sac?

Spleen and liver, followed by bone marrow.

4. Which site becomes the major hematopoietic organ near birth?

Bone marrow.

5. What adult bones are major sites of hematopoiesis?

Skull, sternum, pelvis, ribs, and vertebrae.

6. What type of adult bone contains most active hematopoietic tissue?

Flat bones.

7. What does CFU mean?

Colony-forming unit, an early progenitor cell that can form specific blood cell colonies.

8. What does GEMM represent in CFU-GEMM?

Granulocyte, erythrocyte, monocyte, and megakaryocyte lineages.

9. Which progenitor gives rise to the erythroid lineage?

CFU-E.

10. Which committed progenitor is associated with granulocyte and monocyte development?

CFU-GM.

11. Which committed progenitor gives rise to eosinophils and basophils?

CFU-GM involving EO and BASO differentiation.

12. Which progenitor gives rise to megakaryocytes?

CFU-MK.

13. Which progenitor gives rise to T cells, NK cells, and B cells?

CLP, or common lymphoid progenitor.

14. What does EPO stand for?

Erythropoietin, a hormone that stimulates RBC production.

15. What does TPO stand for?

Thrombopoietin, a hormone that stimulates platelet production through megakaryocytes.

16. What is the erythroid maturation sequence in bone marrow?

Rubriblast, prorubricyte, rubricyte, metarubricyte, reticulocyte, then erythrocyte.

17. What is the final mature cell of the erythroid lineage?

Erythrocyte.

18. What is a reticulocyte?

An immature RBC that has lost its nucleus but still contains residual RNA.

19. What is the neutrophil maturation sequence in bone marrow?

Myeloblast, promyelocyte, myelocyte, metamyelocyte, band neutrophil, then segmented neutrophil.

20. What is the final mature cell of the neutrophil lineage?

Segmented neutrophil.

21. What is the monocyte maturation sequence?

Monoblast, promonocyte, then monocyte.

22. What tissue cell does a monocyte become?

Macrophage.

23. What is the megakaryocyte maturation sequence?

Megakaryoblast, promegakaryocyte, megakaryocyte, then platelet.

24. What is another name for a platelet?

Thrombocyte.

25. What is the lymphoid maturation sequence in bone marrow?

Lymphoblast, prolymphocyte, then lymphocyte.

26. Which mature cells come from the lymphoid lineage?

NK cells, T cells, B cells, and plasma cells.

27. What does IL mean in hematopoiesis charts?

Interleukin, a cytokine that regulates immune and hematopoietic cell growth.

28. What does GM-CSF mean?

Granulocyte-macrophage colony-stimulating factor.

29. What does M-CSF mean?

Macrophage colony-stimulating factor.

30. What does G-CSF mean?

Granulocyte colony-stimulating factor.

31. What does SCF mean?

Stem cell factor.

32. What is hemoglobin?

The RBC protein that carries oxygen and contains heme plus globin chains.

33. What two components must be present for heme synthesis?

Iron and protoporphyrin.

34. What is protoporphyrin?

The porphyrin ring that binds iron to form heme.

35. What is transferrin?

The iron transport protein in plasma.

36. What is ferritin?

The main iron storage protein.

37. What is hemosiderin?

A long-term iron storage form.

38. What can excess iron in the body cause?

Hemochromatosis with organ damage.

39. What is hemochromatosis?

Excess iron accumulation that can damage organs.

40. What are the heme precursor steps listed in order?

Delta-aminolevulinic acid, porphobilinogen, uroporphyrinogen, coproporphyrinogen, protoporphyrin, then heme.

41. What combines with globin to form hemoglobin?

Heme.

42. What are porphyrias?

Disorders caused by blocked enzymatic steps in heme synthesis, leading to porphyrin buildup.

43. What happens when a heme synthesis enzyme step is blocked?

Porphyrin intermediates accumulate.

44. What are early porphyria findings listed in this source?

Dark urine, abdominal pain, neurologic symptoms, and intermittent purple urine.

45. What porphyria is associated with early neurovisceral symptoms?

Acute intermittent porphyria, also called AIP.

46. What are late porphyria findings listed in this source?

Photosensitivity and facial hair.

47. What porphyria is associated with photosensitivity and facial hair?

Porphyria cutanea tarda.

48. What does globin synthesis produce?

Globin chains that combine with heme to form hemoglobin types.

49. Which chromosomes carry major globin genes?

Chromosome 16 carries alpha-like genes, and chromosome 11 carries beta-like genes.

50. Which hemoglobins are found in the newborn period?

Gower I, Gower II, Portland, HbF, HbA2, and HbA.

51. Which hemoglobin is the major adult hemoglobin?

HbA.

52. What is the approximate adult percentage of HbA?

About 95%.

53. What is the approximate adult percentage of HbA2?

About 2%.

54. What is the approximate adult percentage of HbF?

Less than 1%.

55. What is HbF?

Fetal hemoglobin.

56. What is the oxygen affinity of HbF compared with adult HbA?

HbF has higher oxygen affinity.

57. What does a left shift of the oxygen dissociation curve mean?

Oxygen is not released to tissue adequately.

58. What does a right shift of the oxygen dissociation curve mean?

Oxygen is released to tissue more easily.

59. What does decreased temperature do to the oxygen dissociation curve?

Shifts it left.

60. What does decreased CO2 do to the oxygen dissociation curve?

Shifts it left.

61. What does decreased hydrogen ion concentration do to the oxygen dissociation curve?

Shifts it left.

62. What does increased pH do to the oxygen dissociation curve?

Shifts it left.

63. What does decreased 2,3-DPG do to the oxygen dissociation curve?

Shifts it left.

64. What does increased HbF do to the oxygen dissociation curve?

Shifts it left because HbF has high oxygen affinity.

65. What does increased temperature do to the oxygen dissociation curve?

Shifts it right.

66. What does increased CO2 do to the oxygen dissociation curve?

Shifts it right.

67. What does increased hydrogen ion concentration do to the oxygen dissociation curve?

Shifts it right.

68. What does decreased pH do to the oxygen dissociation curve?

Shifts it right.

69. What does increased 2,3-DPG do to the oxygen dissociation curve?

Shifts it right.

70. What anticoagulant chelates calcium?

K3EDTA.

71. What does K3EDTA prevent in a blood specimen?

Clotting by chelating calcium.

72. What anticoagulant works through antithrombin?

Heparin.

73. What is the principle of the hemoglobin test in this source?

Hemoglobin is converted to cyanmethemoglobin using potassium cyanide and potassium ferricyanide.

74. What is cyanmethemoglobin?

A stable hemoglobin derivative measured spectrophotometrically in the classic hemoglobin method.

75. What are hemoglobin testing sources of error listed in this source?

Lipemia or icterus, high WBC count, resistant hemoglobins such as HbS or HbC, and excess hemolysis.

76. What is the female hemoglobin reference range in this source?

12 +/- 2 g per dL.

77. What is the male hemoglobin reference range in this source?

14 +/- 2 g per dL.

78. What is methemoglobin?

Hemoglobin with oxidized iron in the Fe3+ state that cannot bind oxygen.

79. What causes carboxyhemoglobin?

Carbon monoxide poisoning.

80. What color is associated with carboxyhemoglobin?

Cherry-red color.

81. What is sulfhemoglobin?

Hemoglobin containing sulfur that cannot bind oxygen.

82. What is hematocrit?

The percentage of blood volume made up of packed red cells.

83. What does Hct measure?

Packed cell volume as a percent.

84. Which specimens can be used for microhematocrit?

Fingerstick, EDTA, or heparinized samples.

85. What sample problem can falsely increase hematocrit?

Trapped plasma.

86. What smear-related layer can cause an Hct reading error?

The buffy coat.

87. What clay plug problem can cause an Hct reading error?

An uneven clay plug.

88. What instrument problem can cause an Hct reading error?

Improper centrifugation time or speed.

89. How does excess EDTA affect RBCs?

It causes RBC shrinkage.

90. How is automated hematocrit calculated?

MCV multiplied by RBC count, divided by 10.

91. What can cold agglutinins do to automated Hct-related calculations?

Cause falsely high MCV and falsely low RBC count.

92. What is the male Hct reference range in this source?

47 +/- 5%.

93. What is the female Hct reference range in this source?

42 +/- 5%.

94. What is a manual cell count?

A cell count performed microscopically using a hemocytometer.

95. What diluent is used for manual WBC and platelet counts in this source?

1.98 mL of 1% ammonium oxalate.

96. What sample volume is added for the manual WBC or platelet count?

0.02 mL of sample.

97. What is the dilution for the manual WBC or platelet count?

1:100 dilution.

98. What does a hemocytometer do?

Provides a ruled counting chamber for manual cell counts.

99. What is the depth of the hemocytometer chamber?

0.1 mm.

100. What is the formula for hemocytometer cell counts?

Number of cells counted divided by total volume, multiplied by dilution factor.