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Microanatomy > Blood > Flashcards

Blood Flashcards

1
Q

Normal # Erythrocytes, Platelets, Leukocytes/mL

A

Millions, hundreds of thousands, thousands

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2
Q 
% of Total Leuokcytes:
Neutrophils 
Lymphocytes
Monocytes
Eosinophils
Basophils
A 
50-70%
25-28%
6-8%
1.5-5%
0.1-0.5%
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3
Q

Neutrophilia:

A

Bacterial infection

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4
Q

Lymphocytosis:

A

Most viral infections, chronic lymphocytic leukemia

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5
Q

Eosinophilia:

A

Parasitic infections, asthma, allergic reactions

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6
Q

Monocytosis:

A

Recovery from an acute infection, tuberculosis, malaria

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7
Q

Lymphocytopenia:

A

AIDS, other immunodeficiencies

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8
Q

Thrombocytopenia:

A

Caused by many drugs (iatrogenic)

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9
Q

Erythropenia:

A

Some anemias

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10
Q

Pancytopenia (decreased numbers of all blood cell types):

A

Chemotherapy, radiation therapy, bone marrow failure

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11
Q

polycythemia vera hematocrit can be?

A 
70-80% hematocrit 
N male (42-54%)
N female (38-46%)
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12
Q

Plasma vs. serum

A

Plasma = serum + clotting factors

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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)

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14
Q

reticulocytes

A

immature RBCs, still contain few polysomes that will be lost after approx. 1 day

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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

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16
Q

What do glycophoryin C and band 3 carry?

A

ABO blood group antigens

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17
Q

Poiliocyte

A

abnormal shaped RBC

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18
Q

spherocytes, elliptocytes

A

caused by defects in cytoskeleton - spectrin or anchoring protein complexes

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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

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20
Q

Anisocytosis vs. Anisochromasia

A

abnormal size v. abnormal staining

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21
Q

Normal range of platelets

A

150,000 – 450,000 platelets/microliter of blood

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22
Q

Formation of platelets

A

Apocrine secretion of megakaryocyte in bone marrow formed by cytoplasm invaginations made by platelet demarcation channels

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23
Q

Hyalomere

A

Clear outer region on platelets that contains microtubules

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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

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25
Q

Open canalicular system:

A

invaginations of the plasma membrane of platelets;

granules fuse with the invaginations for rapid secretion

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26
Q

Dense tubular system:

A

stores Ca++ needed for exocytosis of

granules; not continuous with plasma membrane of platelet

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27
Q

Platelet mediated steps in damaged vessel repair:

A

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)

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28
Q

PGI2

A

regulates platelet activation

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29
Q

Von Willebrand’s disease

A

no vWF

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30
Q

Bernard-Soulier syndrome

A

no platelet receptor for vWF

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31
Q

Glanzmann’s thrombasthenia

A

no fibrinogen receptor for platelets

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32
Q

Granulocytes

A

Neutrophils, eosinophils, basophils

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33
Q

Agranulocytes

A

Lymphocytes and monocytes

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34
Q

Diapedesis

A

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

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35
Q

Leukocyte Adhesion Deficiences

A

LAD1 inhibits diapedesis because of lack of integrins

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36
Q

Neutrophils

A

polymorphonuclear, multiple nuclear lobes 2-5, >5 hypersegmented, have azurophilic (primary) and specific (secondary) granules

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37
Q

Azurophilic granules of Neutrophils

A

contain myeloperoxidase (MPO)

38
Q

Neutrophils chemotaxis

A

histamine, IL-8, N-formyl-methionyl, activated complement fragments (C5a)

39
Q

Neutrophils recognition of target

A

Fc receptors, complement receptors, scavenger receptors, TLRs

40
Q

Killing mechanisms of Neutrophils

A

respiratory burst, antimicrobial mediators from specific and azurophilic granules

41
Q

Chronic granulomatous disease

A

genetic defects characterized by a decreased or absent respiratory burst, leading to
recurrent bacterial & fungal infections, & a shortened life expectancy

42
Q

Chediak-Higashi syndrome

A

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
Q

NETs

A

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
Q

Pus

A

dead neutrophils, removed by macrophages, pus is made of myolioperoxidase from azurophilic granules

45
Q

Leukocytosis and ‘shift to the left’ are indicators of what?

A

Presents of neutrophils during acute inflammation

46
Q

Time course of acute inflammation

A

1) edema, leaky vessel from histamines <24hrs
2) neutrophils in first wave around day 1
3) macrophages is second wave around day 2

47
Q

Basophils

A

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
Q

Degranulation of basophils

A

Histamine, hep. sulfate, eosinophil and neutrophil chemotactic factors (ECF, NCF)

49
Q

Cytokine synthesis of basophils

A

IL-4 and IL-13 promote class switching of plasma cells

50
Q

LTC4 and PAF

A

leukotriene C4 produced from arachidonic acid and platelet activating factor both synthesized and released from basophils

51
Q

Basophil functions

A

vasodilation, contraction of airways, increased mucus secretion, class switching, chemotaxis, itching

52
Q

Type I hypersensitivity

A

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
Q

Eosinophils

A

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
Q

Piecemeal degranulation

A

Selective degranulation of activated eosinophils

55
Q

Specific granules of Eosinophils

A 
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
Q

Functions of activated Eosinophils

A
  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
Q

Asthma

A

eosinophils can contribute to lung damage

58
Q

Large, pale vacuoles

A

indicator of monocytes

59
Q

Well-developed golgi

A

indicator of monocytes

60
Q

Macrophage functions

A
  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
Q

Macrophage function is increased by?

A

Type II IFN gamma

62
Q

Macrophage-related cell populations

A 
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
Q

Osteoclasts and histiocytes are?

A

BM dependent, vs other macrophages that are established during fetal life and have self-renewal capacity

64
Q

CD4 T cells function?

A

recognize Ag bound MHC II on macrophages, DCs, or B cells and activated CD8 and B cells

65
Q

Russell body cells

A

old plasma cells (B cells) that can on longer secrete Ab, so form large vesicles

66
Q

NK cell

A

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
Q

Mesoblastic/yolk sac phase

A

2/3 - 8 weeks - cells make blood islands that make endothelium and nucleated erythrocytes

68
Q

Hepatic phase

A

2-7 months, produce anucleated erythrocytes, megakaryocytes and granulocytes

69
Q

Splenic phase

A

overlaps with hepatic phase 3-7 months, limited degree of hematopoiesis

70
Q

Myeloid/BM phase

A

6mo fetal life-death

71
Q

Red marrow

A

birth - 5 years, high ratio of hematopoetic cells to adventitial/reticular/fat cells

72
Q

Yellow marrow

A

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
Q

Difference between adventitial cells and white adipose tissue?

A
  1. Adventitial cells do not respond to insulin, but respond to glucocorticoids
  2. Adventitial cells do not release FA into blood during starvation
74
Q

Compartments of BM

A

vascular and hematopoietic

75
Q

Central longitudinal vein

A

sinusoids drain into collecting sinuses that drain into the central longitudinal vein that leaves BM through same nutrient foramina where nutrient arteries entered

76
Q

Hematopoietic compartment contents

A

adventitial cells (secrete HGF), reticular fibers, macrophages (secrete HGF)

77
Q

Hematopoiesis is monophyletic or polyphyletic?

A

Monophyletic - one BM precursor is pluripotent and gives rise to all elements of the blood

78
Q

Cell surface markers of PHSC

A

CD34, CD90

79
Q

CMP

A

common myeloid progenitors (CFU-GEMM) give rise to all blood cells except lymphocytes, multipotent

80
Q

CLP

A

common lymphoid progenitors (CFU-L), multipotent

81
Q

CMP and CLP express which common surface marker with PHSC?

A

CD34

82
Q

Functions of macrophages in erythropoiesis

A
  1. supply iron for heme synthesis
  2. produce GFs and cytokines
  3. phagocytize extruded nuclei and defective cells
83
Q

Levels of erythropoiesis

A
  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
Q

Sideroblastic anemia

A

cannot synthesize heme, so abnormal mitochondria with iron build-up, which can be stained with prussian blue

85
Q

Granulopoiesis

A
  1. CMP CFU-GEMM
  2. Myeloblasts
  3. Promyelocytes
  4. Metamyelocytes
  5. Neutrophilic band or stab cell, eosinophilic myelocytes/basophilic myelocytes
86
Q

Thrombopoiesis

A
  1. CFU-Meg
  2. Megakaryoblasts
  3. Megakaryocytes
87
Q

Endomitosis

A

replication of DNA, but not cytokinesis, how megakarytocytes are formed!

88
Q

Early HGFs

A

Stem cell factor (SCF), IL-3

Both target PHSC, CFU-GEMM and CFU-L

89
Q

Intermediate HGFs

A

IL-7 (T/B cell precursors), GM-CSF (CFU-GEMM)

90
Q

Late HGFs

A

IL-4 (Basophils/mast cells), IL-5 (eosinophils), G-CSF (neutrophils), M-CSF (monocytes), EPO (RBCs)

Microanatomy (10 decks)

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