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Year 2 - Haem > 1 - Physiology of blood cells and haematological terminology > Flashcards

1 - Physiology of blood cells and haematological terminology Flashcards

1
Q

What are all blood cells ultimately derived from?

A

Pluripotent haematopoietic stem cells

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2
Q

What two lineages can pluripotent haematopoietic stem cells give rise to?

A

Lymphoid

Myeloid

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3
Q

What cells are derived from the multipotent myeloid precursor?

A

Megakaryocytes
Granulocyte-Monocyte
Erythroid

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4
Q

What cells are derived from the multipotent lymphoid precursor?

A

T cells
B cells
NK cells

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5
Q

Give the steps from multipoint myeloid stem cell to erythrocytes

A

multipotent myeloid stem cell —–> proerythroblasts —–> erythroblasts —–> erythrocytes

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6
Q

What are some common features of blasts?

A

They have a large nucleus and a small amount of cytoplasm

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7
Q

How does the colour of red cells change as they mature?

A

When they are immature they are more blue/purple

As they mature they become pinker

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8
Q

what does _blast refer to?

A

a precursor

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9
Q

Which cells produce (erythropoietin) EPO? What can trigger the production of EPO?

A

EPO is mainly produced in the kidneys by the juxtatubular interstitial cells
It is also produced to a lesser extent by the liver
EPO production is stimulated by hypoxia

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10
Q

What is erythropoesis?

A

the process of producing red blood cells

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11
Q

What is erythropoietin?

A

a hormone secreted by the kidneys that increases the rate of production of red blood cells in response to falling levels of oxygen in the tissues

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12
Q

What is the life span of a red blood cell?

A

120 days

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13
Q

Define anisocytosis

A

red cells show more variation in SIZE than is normal

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14
Q

Define poikilocytosis

A

red cells show more variation in SHAPE than is normal

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15
Q

What can be used as a reference in a blood film to determine whether the red blood cells are microcytic or macrocytic?

A

Lymphocytes are generally all the same size

normally a red cell is bit smaller than a lymphocyte

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16
Q

Define hypochromia.

A

The red cells have a larger area of central pallor than normal (paler than normal)
NOTE: normal red cells have a central pallor that covers around 1/3 of the red cell diameter

NOTE: hypochromia and microcytosis tend to go together

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17
Q

Define hyperchromia.

A

The red cells lack a central pallor

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18
Q

What may cause hyperchromia?

A

cells shape is thicker than normal or abnormal

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19
Q

State two important types of hyperchromatic cells.

A

Spherocytes

Irregularly Contracted Cells

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20
Q

What is responsible for the round shape of the spherocytes in spherocytosis?

A

It is caused by a loss of cell membrane that is not accompanied by an equivalent loss of cytoplasm

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21
Q

State a genetic cause causing spherocytes

A

Hereditary spherocytosis

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22
Q

What usually causes the formation of irregularly contracted cells?

A

Oxidant damage

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23
Q

Define polychromasia.

A

An increased blue tinge to the cytoplasm of a cell

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24
Q

What are reticulocytes?

A

red blood cells that are slightly younger than the mature RBCs

25
Q

What can reticulocytes be stained with?

A

Methylene blue

26
Q

State six different types of poikilocytosis.

A 
Spherocytes 
Elliptocytes
Fragments
Irregularly contracted cells 
Target cells 
Sickle cells
27
Q

What are target cells? State some causes of target cells in the blood film.

A

Target cells have an accumulation of haemoglobin in the middle of the central pallor
It is caused by obstructive jaundice, hyposplenism, liver disease, haemoglobinopathies

28
Q

State two causes of eliptocytosis.

How can you differentiate between them under a microscope?

A
  • Hereditary eliptocytosis
  • —-> nothing wrong with haemoglobin production and hence colour
  • Iron deficiency
  • —-> can’t produce haemoglobin so will appear as hypochromic
29
Q

What biochemical phenomenon causes the sickling of red blood cells?

A

Polymerisation of haemoglobin S when present in a high concentration

30
Q

What is another name for fragments?

A

Schistocytes

31
Q

What is the appearance of fragments?

A

don’t look like full cells
small pieces of red blood cells
will have a red colour and a central parlour, it is just the shape that is different

32
Q

State two different ways in which red blood cells can clump together and describe why they happen.

A

Rouleaux – like a stack of coins – it is cased by a change in plasma proteins pushing the red cells together

Agglutinates – irregular clumps – caused by antibodies on the cell surface making the cells stick together

33
Q

What is a Howell-Jolly Body and what is it usually caused by?

A

This is a nuclear remnant in the red cells (very precise dot)
This is most commonly caused by a lack of splenic function (the spleen should remove these tiny bits of nuclear material)

34
Q

Which cytokines are important in the differentiation of myeloblasts to granulocytes and monocytes?

A

G-CSF
M-CSF
GM-CSF

35
Q

Describe the appearance of myeloblasts

A

large nucleus and little cytoplasm (like pro erythroblasts)

36
Q

How long do neutrophils survive for in the circulation?

A

7-10 hours

37
Q

Describe the appearance of a neutrophil

A

segmented nucleus

lots of granules

38
Q

What is the main role of neutrophils?

A

defence against infection - phagocytoses and kills microorganisms

39
Q

What is the main role of eosinophils?

A

Parasitic infections

40
Q

Describe the shape of the nucleus of an eosinophil.

A

Eosinophils have a bilobed nucleus

41
Q

What is the main role of basophils?

A

They are involve in the allergic response

42
Q

Describe the appearance of basophils.

A

They have lots of dark blue dots in the cytoplasm (granules)

Often there are so many that you can’t even see the nucleus

43
Q

Describe the appearance of monocytes.

A

They have a kidney bean shaped nucleus

They are large

44
Q

Other than phagocytosis, what is another role of macrophages?

A

They store and release iron

45
Q

How long do platelets survive for in the circulation?

A

10 days

46
Q

What term is used to describe having too many white blood cells?

A

Leucocytosis

47
Q

What term is used to describe having too many platelets?

A

Thrombocytosis

48
Q

What is meant by leucopenia?

A

top few white cells

49
Q

What is meant by neutropenia?

A

too few neutrophils

50
Q

What term is used to describe a decrease in the number of lymphocytes?

A

lymphopenia

51
Q

What is the normal appearance of a lymphocyte?

A

normally small and round with a large nucleus and little cytoplasm

52
Q

Describe the appearance of an atypical lymphocyte. What can cause these to appear in a blood film?

A

An atypical lymphocyte will have a large nucleus and a LARGE AMOUT OF FAINT CYTOPLASM
This is typical of having a viral infection and is seen in glandular fever (infectious mononucleosis)

53
Q

What is ‘left shift’?

A

An increase in the number of non-segmented neutrophils or having a lot of neutrophil precursors in the blood

One of the first steps in segmenting is that it becomes a slightly more squashed looking nucleus that has more of a band shape
If the blood film has a lot of band form nuclei = LEFT SHIFT

54
Q

What does left shift suggest?

A

you are fighting an infection because the bone marrow is producing lots of lymphocytes

55
Q

What is toxic granulation? What can cause it?

A

This is the heavy/dense granulation of neutrophils
It results from infection, inflammation and tissue necrosis
It is also a feature of normal pregnancy

56
Q

What is hypersegmentation of neutrophils? What can cause it?

A

An increase in the average number of neutrophil lobes or segments
It usually relies on a lack of Vitamin B12 or folic acid

57
Q

What are erythrocytes?

A

red blood cells

58
Q

What is a granulocyte?

A

a white blood cell with secretory granules in its cytoplasm, e.g. an eosinophil or a basophil.

59
Q

What are megakaryocytes?

A

cells responsible for the production of platelets (thrombocytes)

Year 2 - Haem (10 decks)

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