Blood Flashcards
1
Q
Normal # Erythrocytes, Platelets, Leukocytes/mL
A
Millions, hundreds of thousands, thousands
2
Q
% of Total Leuokcytes: Neutrophils Lymphocytes Monocytes Eosinophils Basophils
A
50-70% 25-28% 6-8% 1.5-5% 0.1-0.5%
3
Q
Neutrophilia:
A
Bacterial infection
4
Q
Lymphocytosis:
A
Most viral infections, chronic lymphocytic leukemia
5
Q
Eosinophilia:
A
Parasitic infections, asthma, allergic reactions
6
Q
Monocytosis:
A
Recovery from an acute infection, tuberculosis, malaria
7
Q
Lymphocytopenia:
A
AIDS, other immunodeficiencies
8
Q
Thrombocytopenia:
A
Caused by many drugs (iatrogenic)
9
Q
Erythropenia:
A
Some anemias
10
Q
Pancytopenia (decreased numbers of all blood cell types):
A
Chemotherapy, radiation therapy, bone marrow failure
11
Q
polycythemia vera hematocrit can be?
A
70-80% hematocrit N male (42-54%) N female (38-46%)
12
Q
Plasma vs. serum
A
Plasma = serum + clotting factors
13
Q
CLINICAL CORRELATION: LIVER DISEASE & EDEMA
A
liver disease result in decreased albumin production, resulting in decrease in plasma osmotic pressure that can cause excessive movement of fluid into the extravascular tissues (edema)
14
Q
reticulocytes
A
immature RBCs, still contain few polysomes that will be lost after approx. 1 day
15
Q
Spectrin
A
spectrin tetramers link several different proteins together such as actin/ankyrin that are bound to transmembrane proteins ie glycophoryin C and band 3
16
Q
What do glycophoryin C and band 3 carry?
A
ABO blood group antigens
17
Q
Poiliocyte
A
abnormal shaped RBC
18
Q
spherocytes, elliptocytes
A
caused by defects in cytoskeleton - spectrin or anchoring protein complexes
19
Q
drepanocytes (sickle cells)
A
caused by defects in hemoglobin which causes it to form long rods that block passage of RBCs through capillaries
20
Q
Anisocytosis vs. Anisochromasia
A
abnormal size v. abnormal staining
21
Q
Normal range of platelets
A
150,000 – 450,000 platelets/microliter of blood
22
Q
Formation of platelets
A
Apocrine secretion of megakaryocyte in bone marrow formed by cytoplasm invaginations made by platelet demarcation channels
23
Q
Hyalomere
A
Clear outer region on platelets that contains microtubules
24
Q
Granulomere
A
Dense portion of platelets that has alpha granules (VMF, PDGF, Fibrinongen, P-selecting) delta granules (ADP, ATP, Ca++ and serotonin) and lysosomes
25
Open canalicular system:
invaginations of the plasma membrane of platelets;
| granules fuse with the invaginations for rapid secretion
26
Dense tubular system:
stores Ca++ needed for exocytosis of
| granules; not continuous with plasma membrane of platelet
27
Platelet mediated steps in damaged vessel repair:
1) adhesion (vWF)
2) aggregation (fibrinogen - primary hemostatic plug)
3) activation (secretion of stored and newly synthesized mediators - TXA2 - secondary hemostatic plug)
4) clot retraction
5) clot resorption
6) repair of vessel wall (PDGF)
28
PGI2
regulates platelet activation
29
Von Willebrand’s disease
no vWF
30
Bernard-Soulier syndrome
no platelet receptor for vWF
31
Glanzmann’s thrombasthenia
no fibrinogen receptor for platelets
32
Granulocytes
Neutrophils, eosinophils, basophils
33
Agranulocytes
Lymphocytes and monocytes
34
Diapedesis
leukocyte pathway for leaving circulation and going into tissues, rolling pathway formed by L-selectins with weak bonds, when immune response occurs, P-selectins and E-selectins interact with integrins on leukocytes, which form much stronger bonds and cell passes between endothelial cells into tissue
35
Leukocyte Adhesion Deficiences
LAD1 inhibits diapedesis because of lack of integrins
36
Neutrophils
polymorphonuclear, multiple nuclear lobes 2-5, >5 hypersegmented, have azurophilic (primary) and specific (secondary) granules
37
Azurophilic granules of Neutrophils
contain myeloperoxidase (MPO)
38
Neutrophils chemotaxis
histamine, IL-8, N-formyl-methionyl, activated complement fragments (C5a)
39
Neutrophils recognition of target
Fc receptors, complement receptors, scavenger receptors, TLRs
40
Killing mechanisms of Neutrophils
respiratory burst, antimicrobial mediators from specific and azurophilic granules
41
Chronic granulomatous disease
genetic defects characterized by a decreased or absent respiratory burst, leading to
recurrent bacterial & fungal infections, & a shortened life expectancy
42
Chediak-Higashi syndrome
genetic defect that interferes with targeting of proteins to azurophilic granules, leaving them without the mediators necessary to kill bacteria, often fatal in childhood
43
NETs
neutrophilic extracellular traps are webs of secreted ncDNA or mtDNA with antimicrobial granule proteins, formation of NETs kills the neutrophil, and rqs NADPH, linked to respiratory burst
44
Pus
dead neutrophils, removed by macrophages, pus is made of myolioperoxidase from azurophilic granules
45
Leukocytosis and 'shift to the left' are indicators of what?
Presents of neutrophils during acute inflammation
46
Time course of acute inflammation
1) edema, leaky vessel from histamines <24hrs
2) neutrophils in first wave around day 1
3) macrophages is second wave around day 2
47
Basophils
have common precursor with mast cells, primed by binding to IgE, and activated when Ag binds to IgE and cross-links, leads to degranulation, cytokine synthesis, synthesis and release of membrane phospholipids
48
Degranulation of basophils
Histamine, hep. sulfate, eosinophil and neutrophil chemotactic factors (ECF, NCF)
49
Cytokine synthesis of basophils
IL-4 and IL-13 promote class switching of plasma cells
50
LTC4 and PAF
leukotriene C4 produced from arachidonic acid and platelet activating factor both synthesized and released from basophils
51
Basophil functions
vasodilation, contraction of airways, increased mucus secretion, class switching, chemotaxis, itching
52
Type I hypersensitivity
b/c of basophil activation
Hay fever when the nasal mucosa is involved
Asthma when the bronchioles are involved
Hives (urticaria) when the skin is involved
Anaphylaxis (when activation is systemic rather than local)
53
Eosinophils
IL-5 stimulates maturation and release from BM, histamines and eotaxins stimulate diapedisis, have crystalloid embedded in amorphous matrix (EM), activated by cross-linking of IgG and IgA
54
Piecemeal degranulation
Selective degranulation of activated eosinophils
55
Specific granules of Eosinophils
```
Kill larvae/worms with:
Major basic protein (MBP) - major component of the crystalloid
Eosinophil cationic protein (ECP)
Eosinophil-derived neurotoxin (EDN)
Eosinophil peroxidase (EPO)
```
56
Functions of activated Eosinophils
1. kill parasites
2. phagocytize Ag-Ab complex (activation of complement)
3. activate and inactivate mast cells/basophil activity
4. antiviral affect against ssRNa
57
Asthma
eosinophils can contribute to lung damage
58
Large, pale vacuoles
indicator of monocytes
59
Well-developed golgi
indicator of monocytes
60
Macrophage functions
1. phagocytosis
2. APCs
3. secrete cytokines (IL-1, IL-6, IL-12)
4. wall off large particles, though formation of giant cell (syncitium) and epithelioid cells)
61
Macrophage function is increased by?
Type II IFN gamma
62
Macrophage-related cell populations
```
Osteoclasts in bone
Microglia in the CNS
Alveolar macrophages (dust cells) in lung alveoli
Kupffer cells in liver
Langerhans cells in the epidermis
Histiocytes in connective tissue
```
63
Osteoclasts and histiocytes are?
BM dependent, vs other macrophages that are established during fetal life and have self-renewal capacity
64
CD4 T cells function?
recognize Ag bound MHC II on macrophages, DCs, or B cells and activated CD8 and B cells
65
Russell body cells
old plasma cells (B cells) that can on longer secrete Ab, so form large vesicles
66
NK cell
Important for killing virus-infected cells and tumor cells, not specific for one individual Ag, depends on activating/inhibiting signals, azurophilic granules have perforin/granzyme
67
Mesoblastic/yolk sac phase
2/3 - 8 weeks - cells make blood islands that make endothelium and nucleated erythrocytes
68
Hepatic phase
2-7 months, produce anucleated erythrocytes, megakaryocytes and granulocytes
69
Splenic phase
overlaps with hepatic phase 3-7 months, limited degree of hematopoiesis
70
Myeloid/BM phase
6mo fetal life-death
71
Red marrow
birth - 5 years, high ratio of hematopoetic cells to adventitial/reticular/fat cells
72
Yellow marrow
replaces red marrow after 4-5 years of age, low ratio of hematopoetic cells to adventitial/reticular/fat cells, can revert to red BM if there is an increased demand
73
Difference between adventitial cells and white adipose tissue?
1. Adventitial cells do not respond to insulin, but respond to glucocorticoids
2. Adventitial cells do not release FA into blood during starvation
74
Compartments of BM
vascular and hematopoietic
75
Central longitudinal vein
sinusoids drain into collecting sinuses that drain into the central longitudinal vein that leaves BM through same nutrient foramina where nutrient arteries entered
76
Hematopoietic compartment contents
adventitial cells (secrete HGF), reticular fibers, macrophages (secrete HGF)
77
Hematopoiesis is monophyletic or polyphyletic?
Monophyletic - one BM precursor is pluripotent and gives rise to all elements of the blood
78
Cell surface markers of PHSC
CD34, CD90
79
CMP
common myeloid progenitors (CFU-GEMM) give rise to all blood cells except lymphocytes, multipotent
80
CLP
common lymphoid progenitors (CFU-L), multipotent
81
CMP and CLP express which common surface marker with PHSC?
CD34
82
Functions of macrophages in erythropoiesis
1. supply iron for heme synthesis
2. produce GFs and cytokines
3. phagocytize extruded nuclei and defective cells
83
Levels of erythropoiesis
1. Pluripotent stem cell
2. common myloid progenitor (CFU-GEEM)
3. BFU-E
4. CFU-E
5. Proerythroblasts
6. Basophilic erythroblasts
7. Polychromatophilic erythroblasts
8. Orthochromatic erythroblasts
9. Reticulocytes
84
Sideroblastic anemia
cannot synthesize heme, so abnormal mitochondria with iron build-up, which can be stained with prussian blue
85
Granulopoiesis
1. CMP CFU-GEMM
2. Myeloblasts
3. Promyelocytes
4. Metamyelocytes
5. Neutrophilic band or stab cell, eosinophilic myelocytes/basophilic myelocytes
86
Thrombopoiesis
1. CFU-Meg
2. Megakaryoblasts
3. Megakaryocytes
87
Endomitosis
replication of DNA, but not cytokinesis, how megakarytocytes are formed!
88
Early HGFs
Stem cell factor (SCF), IL-3
| Both target PHSC, CFU-GEMM and CFU-L
89
Intermediate HGFs
IL-7 (T/B cell precursors), GM-CSF (CFU-GEMM)
90
Late HGFs
IL-4 (Basophils/mast cells), IL-5 (eosinophils), G-CSF (neutrophils), M-CSF (monocytes), EPO (RBCs)
