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M2 Hematology > 1. Hematopoiesis > Flashcards

1. Hematopoiesis Flashcards

1
Q

what are the 8 types of cells we will typically see in a smear?

A

neutrophil (mature), neutrophil (immature/band), platelet, basophil, eosinophil, RBC, monocyte, lymphocyte

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2
Q

what is the main fxn of an RBC?

A

carry 02

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3
Q

what is the main fxn of platelets?

A

clot formation, a main component of hemostasis.

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4
Q

what is the main fxn of lymphocytes?

A

(B and T cells) respond to viral and other infections

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5
Q

what are the main fxns of monocytes, neutrophils, eosinophils, and basophils?

A

respond to bacterial, fungal and parasitic infections

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6
Q

lymphocytes: general appearance?

A

round nuclei, minimal cytoplasm, no granules

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7
Q

monocytes: general appearance?

A

indented nucleus, more cytoplasm than lymphs

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8
Q

basophils: general appearance?

A

intense blue granules

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9
Q

eosinophils: general appearance?

A

intense red granules which are stained by eosin dye

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10
Q

mature neutrophils: general appearance?

A

3 lobes, pale granules

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11
Q

immature neutrophils: general appearance?

A

“bands” - nucleus has not yet separated into 3 lobes

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12
Q

in the CBC, what does WBC mean?

A

total number of all white blood cells per mm3 (microliter)

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13
Q

in the CBC, what does the platelet count mean?

A

total number of platelets per mm3 (microliter)

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14
Q

in the CBC, what does the hematocrit mean?

A

volume red cells/volume plasma

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15
Q

in the CBC, what does the hemoglobin mean?

A

spectrophotometric meas of hemoglobin absorbance

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16
Q

all the blood cells arise from what?

A

common hematopoietic stem cell

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17
Q

a stem cell can generate what two general types of cells?

A

lymphoid stem cells and myeloid precursors

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18
Q

what cells come from the lymphoid stem cell?

A

NK lymphocytes, T lymphs, B lymphs

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19
Q

what cells come from the myeloid precursor?

A

platelets, monocytes, neutrophils, RBCs

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20
Q

what is the shorthand for writing blood count values on a chart?

A

WBCs are on the left, platelets on the right. Hematocrit on bottom, hemoglobin on top

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21
Q

what cell surface protein identifies HSCs?

A

CD 34 (glycoprotein)

22
Q

most of the time, HSCs are in what part of the cell cycle?

A

G0.

23
Q

how might it benefit HSCs to spend time in G0 (in quiescent state)?

A

resistant to toxic insults such as radiation or chemicals - because are able to repair DNA before entering the cell cycle at some later time point.

24
Q

can HSCs generate non-hematopoietic cells?

A

yes, according to recent mouse experimental data. however, this theory of HSC ‘plasticity’ remains controversial.

25
Q

what are the sites of hematopoiesis in the developing fetus?

A

first few weeks: yolk sac
6 wks til 6-7 months: liver/spleen
liver/spleen continue thru postpartum week 2
at 6-7 months, the bone marrow picks up, eventually becoming the only source.

26
Q

in the adult, where is hematopoiesis taking place?

A

axial skeleton, proximal ends of femurs and humeri.

27
Q

in times of need, what organs may be recruited for hematopoiesis?

A

liver/spleen. also, the bone marrow that has been replaced by fat may revert to hematopoiesis.

28
Q

production of each type of blood cell controlled by what?

A

cytokines or interleukins

29
Q

growth factors responsible for hematopoietic development?

A

glycoprotein hormones

30
Q

what is the source of these glycoprotein hormones?

A

local cells in marrow (T-cells, macrophages, endothelial cells, fibroblasts) or come from circulation (ie erythropoietin from kidney)

31
Q

biological effects of the growth factors and glycoprotein hormones mediated by what?

A

specific cell surface receptors

32
Q

what is the stimulus to produce more RBCs?

A

02 levels in kidney, which lead to erythropoietin production

33
Q

what is the stimulus to produce more WBCs?

A

inflammation, invasion of microbes

34
Q

biological effect of erythropoietin?

A

erythrocyte production

35
Q

what does interleukin 3 do?

A

stimulates proliferation and differentiation of granulocyte, macrophage, eosinophil, mast cell, magakaryocyte, Tcell, Bcell, and early myeloid stem cells.

36
Q

what is G-CSF?

A

granulocyte colony stimulating factor

37
Q

what does G-CSF do?

A

stimulates granulocyte lineage proliferation and differentiation. stimulates early myeloid stem cells. increases neutrophil phagocytosis. releases neutrophils from bone marrow.

38
Q

what is GM-CSF?

A

granulocyte-macrophage colony stimulating factor

39
Q

what does GM-CSF do?

A

stimulates granulocyte, macrophage, and megakaryocyte proliferation and differentioation, stims myeloid stem cells. in presence of erythropoietin, stimulates erythropoeises. enhances phagocytic activity of neutrophils.

40
Q

what does interleukin-1 do?

A

activates resting T cells, co-factor for T cell and B cell proliferation. stimulates early myeloid stem cells. induces production of G-CSF, GM-CSF, Il-6, CSF-1, IL-3, IL-2 (growth factors)

41
Q

what does interleukin-2 do?

A

growth factor for T cells

42
Q

when evaluating a patient with anemia, what is one of the first points of differentiation?

A

the cause of the anemia: whether from disrupted erythropoiesis or some other effect (hemorrhage)

43
Q

increased production of RBCs leads to increased what in the blood?

A

reticulocytes, which have mRNA in them. can be detected via staining.

44
Q

if the number of reticulocytes is increased in response to anemia, what is the conclusion?

A

source of anemia is not RBC production problems.

45
Q

in normal patients, how do the erythropoietin levels normally increase in response to anemia?

A

exponentially

46
Q

what is pancytopenia?

A

decreased WBC, neutrophils, hemoglobin, platelets

47
Q

what is the first line treatment for aplastic anemia?

A

immunosuppression, to lessen the autoimmune reaction

48
Q

how will a bone marrow biopsy look in a pt with pancytopenia?

A

acellular

49
Q

while waiting for transplant, what might be administered to support blood counts?

A

G-CSF, erythropoietin, and platelet transfusions

50
Q

what is the etiology of aplastic anemia?

A

autoimmune destruction of the HSCs

51
Q

if a pt does not respond to immunosuppression, what is the next option?

A

allogenic HSC transplantation.

52
Q

is there a cytokine for platelets that is clinically available?

A

no, have to do transfusions

M2 Hematology (15 decks)

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