General Overview (RBCs)

what is crucial for oxygen delivery from the lungs to the tissues and transporting CO2 from tissues back to the lungs?

hemoglobin

about how big are RBCs?

6-8 microns

what is measured in a photometer at 540nm after the addition of drabkin’s reagent?

hemoglobin

what reagent converts hemoglobin to cyanmethemoglobin?

drabkin’s reagent

what refers to the ratio of packed volume of RBCs to the volume of whole blood?

hematocrit

what is the normal ratio range of hematocrit?

45-50%

within how many hours should a blood smear be prepared?

4 hours of collection

within how many hours should an evacuated EDTA specimen be analyzed?

5 hours of collection

generally, at what temperature should edta specimens be stored at (facility dependent)?

room temperature until analysis

an EDTA specimen must be filled within ±___% of the stated volume?

10

EDTA tubes should be filled appropriately because there will be an imbalance of anticoagulant to sample ratio. excess EDTA in the sample may result in erroneously low ____.

cell counts; hematocrit

what cells have cytoplasmic granules with neutral pH and pick up some staining characteristics from both stains (thiazine-eosinate complex)?

neutrophils

what are the two dyes used in romanowsky stains?

eosin y and methylene blue

what dye is basic and stains acidic cellular components (RNA, DNA, basophil granules) from blue-grey to dark blue?

methylene blue

RNA, DNA, basophil granules are ____ components.

acidic

what dye is acidic and stains basic cellular components (hemoglobin and eosinophilic granules) from light/deep pink to red or orange in color?

eosin

hemoglobin and eosinophilic granules are ____ components.

basic

what reflects RBC diameter (volume) on a wright-stained smear?

MCV

what is the normal range of MCV?

80-100 fL

what does an MCV of <80 refer to?

microcytic anemia

what does an MCV of 80-100 refer to?

normocytic anemia

what does an MCV of >100 refer to?

macrocytic anemia

what reflects the weight of hemoglobin in the average RBC?

MCH

what refers to the concentration of the average RBC (Hgb/HCT)?

MCHC

what is the normal range of MCH?

26-34 pg

what is the normal range of MCHC?

32-36 g/dL

what does an MCHC of <32 refer to?

hypochromic anemia

what reflects the degree of volume variation?

RDW

what term refers to a variation in diameter?

anisocytosis

if cells are similar in size, the RDW is ____.

low

if some cells are little and some are big, the RDW is ____.

high

what is the normal range of RDW?

12-14.5

what refers to RBCs that contain RNA?

reticulocytes

what percent of RBCs do reticulocytes normally make up?

1.5-2.5%

after how many hours will RNA in reticulocytes break down and will allow the RBCs to be normochromic?

24-48 hours

what is the reference interval for WBC count in an adult?

4.5-11 × 10⁹/L

what is the reference interval for WBC count in a newborn?

9-10 × 10⁹/L

what is the reference interval for WBC count in a child over 1?

5-17 × 10⁹/L

what is the reference level of platelets?

150-450 × 10⁹/L

what phase of hematopoiesis refers to the yolk sac and AGM?

mesoblastic

what phase of hematopoiesis refers to the liver and spleen?

hepatic

what phase of hematopoiesis refers to bone marrow?

medullary

what phase of hematopoiesis refers to development around the 19th day after fertilization?

mesoblastic

what phase of hematopoiesis refers to embryonic hemoglobins (Gower I, Gower II, Portland) present?

mesoblastic

what phase of hematopoiesis refers to development at 5-7 weeks?

hepatic

what phase of hematopoiesis refers to recognizable clusters developing erythroblasts, granulocytes, and monocytes present?

hepatic

what phase of hematopoiesis refers to HbF and small amounts of HbA present?

hepatic

what phase of hematopoiesis involves the contribution of other organs (thymus, spleen, kidneys)?

hepatic

what phase of hematopoiesis refers to development between the fourth and fifth month of fetal development?

medullary

by the end of which week will bone marrow become the primary hematopoietic site?

week 24 (6 months)

what cells are produced by mesenchymal cells that support hematopoietic cells and myeloid development?

stromal cells

what phase of hematopoiesis refers to HbF and HbA present?

medullary

____ lymphoid organ development refers to bone marrow for T and B cells and thymus for T cell development.

primary

____ lymphoid organ development refers to spleen, lymph nodes, and mucosa-associated lymphoid tissue (MALT).

secondary

what refers to hematopoietically active marrow?

red marrow

in bone marrow, what radiated out from the cortex into a central cavity forming honeycomb structures?

trabeculae

what refers to cells specialized for fat storage in connective tissue?

adipocytes

during infancy and childhood, all bones are ____ and by the age of 4, adipocytes will increase in number.

red marrow

what refers to hematopoietically inactive marrow (mostly fat cells and adipocytes)?

yellow marrow

how is % bone marrow cellularity calculated?

100 - age (± 10%)

what stain is used for bone marrow aspirate or imprint examination?

prussian blue iron stain

what term refers to being capable of giving rise to several different cell types?

pluripotent

what gives rise to CFU-GEMM?

pluripotent stem cells

what gives rise to BFU-E?

CFU-GEMM

what are the two erythroid progenitors?

BFU-E; CFU-E

which erythroid progenitor is less responsive to EPO (only a few EPO receptors, larger colonies in culture)?

BFU-E

which erythroid progenitor is highly responsive to and dependent on EPO for survival (has many EPO receptors, smaller colonies in culture)?

CFU-E

the size of the nucleus of an erythroid cell decreases as they mature (decrease in nucleus/cytoplasm ratio). true or false?

true

what becomes coarser and denser as erythroid cells mature?

chromatin

what term refers to highly dense?

pyknotic

the more RNA in the cytoplasm (the most active the protein synthesis), the more basophilia. true or false?

true

the more hemoglobin in the cytoplasm, the less basophilia. true or false?

true

what are the 3 types of hemoglobins found in a normal adult?

HbA, HbA2, HbF

which marrow does not produce blood cells?

yellow marrow

what is the preferred site of collection for bone marrow specimens?

posterior iliac crest (spine) of the pelvis

what is a potential but less preferred collection site for bone marrow?

anterior superior iliac crest (spine) of the pelvis

what specimen is preferred for bone marrow studies that can reduce the speed of cell death?

heparin

what pathophysiologic change of the liver may result in hemoglobin metabolizing to bilirubin (icterus, icteric, icter) and jaundice?

hemolytic anemia

stem cells and progenitors can be morphologically recognizable on a smear. true or false?

false

which cell(s) is found only in the bone marrow?

pronormoblast, basophilic normoblast, polychromatic normoblast, orthochromic normoblast

which cells are located 1-2 days in the bone marrow and 1 more day in peripheral blood and will become a mature RBC due to the spleen polishing the membrane and pitting out inclusions?

polychromatic erythrocytes (reticulocytes)

what is the life span of a pronormoblast?

24 hours

what is the lifespan of a basophilic normoblast?

24 hours

what is the lifespan of polychromatic normoblasts?

30 hours

what is the lifespan of orthochromic normoblasts?

48 hours

hypoxia may stimulate ____.

erythropoiesis

cytokines by macrophages may stimulate ____.

erythropoiesis

what pathway detoxifies accumulated peroxide?

hexose monophosphate

what pathway diverts glucose-6-phosphate (G6P) to pentose phosphate by the action of glucose-6-phosphate dehydrogenase (G6PD)?

hexose monophosphate

what is the most common RBC enzyme deficiency?

G6PD deficiency

what refers to a rare dominant hereditary disorder where glutamate replaces valine in position 67 on the beta chain of the hemoglobin molecule?

Hgb M

what disorder causes a permanently increased level of methemoglobin ranging between 15-30%?

Hgb M

patients with which disorder are cyanotic and do not exhibit any other symptoms?

Hgb M

what percent of an erythrocyte are proteins?

52%

what percent of an erythrocyte are CHO?

8%

what percent of an erythrocyte are lipids?

40%

what refers to programmed cell death?

apoptosis

what binds to globin chains of hemoglobin and maintains hemoglobin in deoxygenated form and facilitates O2 delivery to tissues?

2,3-BPG

____ refers to Fe2+.

hemoglobin

____ refers to Fe3+.

methemoglobin