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Medical Histology > Blood > Flashcards

Blood Flashcards

1
Q

what is plasma

A

the majority blood component, liquid base of blood contains plasma proteins, albumin, coagulation factors, antibodies, glucose, electrolytes

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2
Q

which are the granulocytes?

A

neutrophils, eosinophils, basophils

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3
Q

which are the lymphocytes?

A

T cells, B cells, NK cells

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4
Q

what are platelets?

A

fragments of cytoplasm enclosed in a plasma membrane, anuclear and SUPER SMALL

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5
Q

what is the difference between plasma and serum

A

serum is the liquid part of blood after it has coagulated, so devoid of clotting factors (fibrinogen), whereas plasma is the liquid part of blood that has been anticoagulated (treated or in bloodstream)

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6
Q

commonly used blood tests?

A

hematocrit, CBC, CBC with Diff, morphology analysis

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7
Q

what is hematocrit?

A

the fraction of whole blood composed of RBC

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8
Q

common causes of decreased hematocrit?

A

anemias, bleeding, RBC destruction, infection, pregnancy

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9
Q

common causes of increased hematocrit?

A

exercise, dehydration, congenital heart disease, cor pulmonale, erthrocytosis, hypoxia (low oxygen)

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10
Q

what could changes in hematocrit indicate?

A

anemia, erythrocytosis, changes in plasma volume

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11
Q

what does CBC test

A

quantity of blood cells (hemoglobin) through hemocytometer by hand or flow cytometry

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12
Q

what stains are usually used for morphology analysis

A

wright, giemsa, methylene blue

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13
Q

describe RBC

A

anucleate biconcave discs, cause a spot of pallor in the middle

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14
Q

life span RBC

A

120 days

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15
Q

what removes RBC from circulation?

A

macrophages in the spleen (and other)

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16
Q

what are reticulocytes

A

immature RBC that are slightly larger than mature RBC, no nucleus

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17
Q

what is clearly visible with methylene blue stain in a reticulocyte?

A

reticular, mesh like network of rRNA

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18
Q

when would you see acutely increased reticulocytes

A

after destruction of RBC that bone marrow needs to replace

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19
Q

when would you see chronically increased reticulocytes?

A

chronic hemolytic anemia

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20
Q

what would indicate that the bone marrow is damaged or faulty?

A

if there is anemia with low turnover of RBC synthesis, bone marrow is not functioning

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21
Q

what makes RBC?

A

bone marrow

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22
Q

what is the main protein that contributes to the biconcave shape of the RBC?

A

spectrin

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23
Q

what occurs if there is disruption in spectrin?

A

RBC loses biconcave shape and becomes sphere, seen in spherocytosis, decreases lifespan of the cell

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24
Q

what is the function of glycoproteins and band 3 protein on the surface of RBC?

A

antigens determine blood type, prevent RBC aggregation, function as cation channels

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25
Q

what are the key membrane components of the RBC?

A

glycophorins and band 3 protein

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26
Q

what proteins maintain membrane structure through their interaction with the cytoskeleton?

A

spectrin, ankyrin

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27
Q

how is hemoglobin measured?

A

CBC

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28
Q

what is rouleaux formation?

A

RBC stacked together in long chains

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29
Q

cause of rouleaux formation?

A

increased plasma proteins, particularly fibrinogen and immunoglobulin

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30
Q

surface charge of RBC

A

negative, keeps RBC separated

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31
Q

consequence of increased globulins on surface of RBC

A

globulins neutralize the surface and make it sticky

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32
Q

what is sickle cell

A

narrow, curved cells with pointed ends, caused by mutation of 6th AA of betaHb from glu to val (makes neutral)

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33
Q

what is thalassemia?

A

inherited disorder of Hb synthesis, disordered production of alpha or beta

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34
Q

what is characteristic of thalassemia?

A

target cells

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35
Q

what is hereditary spherocytosis associated with

A

deficiencies in spectrin, band 3, protein 4.2, or combined spectrin/ankyrin deficiency

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36
Q

consequence of spherocytosis

A

hemolytic anemia, so releases more reticulocytes

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37
Q

where are nucleated RBC found

A

newborns, rarely in older age

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38
Q

when (disease states) are increased nucleated RBC found?

A

premature release from marrow due to neoplasms or heart failure

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39
Q

when would howell-jolly bodies be seen?

A

hyposplenism, megaloblastic anemia, hemolytic anemia

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40
Q

what are howell-jolly bodies?

A

inclusions of nuclear chromatin remnants/fragmented nuclear chromatin

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41
Q

what are the granular leukocytes?

A

basophils, neutrophils, eosinophils

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42
Q

what are the agranular leukocytes?

A

lymphocytes, monocytes

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43
Q

where are B cells derived from?

A

bone marrow

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44
Q

what is the function of B cells

A

producing antibodies, responsible for humoral immunity

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45
Q

what do B cells differentiate into?

A

plasma cells

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46
Q

what are T cells derived from?

A

bone marrow, and mature in the thymus

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47
Q

function of T cells

A

secrete cytokines that influence other leukocytes, and are responsible for cell mediated immunity, and promote B cell differentiation

48
Q

what is CD4+

A

helper T cells

49
Q

what is CD8+

A

cytotoxic T cells

50
Q

what are the supressor T cells?

A

CD4, FOXP3, CD25

51
Q

what are NK cells?

A

natural killer cells, the innate immune system that is specialized to kill infected/neoplastic cells and produce cytokines

52
Q

characteristics of neutrophils?

A

have 3-4 lobed nuclei connected with fine chromatin strands, are larger than RBC

53
Q

what is the prominence of neutrophils?

A

60-70% of the total leukocytes, most numerous

54
Q

what is a Barr body?

A

an inactive X chromosome in a female somatic cell, in the neutrophils of females only (each excess X chromosome will form one Barr body)

55
Q

what is a band neutrophil

A

a less mature neutrophil, moderate abundant cytoplasm staining pale blue to pink (not purple or red), indented nucleus, beginning to segment

56
Q

what would increased band neutrophils in blood indicate?

A

infection or inflammation

57
Q

function of the neutrophil?

A

is continuously generated in the bone marrow, eliminates intracellular or extracellular pathogens

58
Q

mechanisms of elimination of pathogens by neutrophils

A
  1. phagocytosis
  2. release into extracellular spaces/degranulation
  3. immobilize or kill through releasing neutrophil extracellular traps (NETs)
59
Q

what is a NET

A

neutrophil extracellular trap (NET), a complex of nucleosomes that are decorated with myeloperoxidase (MPO), neutrophil elastase, and cathepsin G

60
Q

when are NETs released

A

in response to infection or inflammatory stimuli to bind and kill microbes

61
Q

when would you see neutrophillic infiltration in the tissues

A

acute or current inflammation

62
Q

characteristics of eosinophils

A

bilobed nuclei, abundant and large eosinophilic granules

63
Q

when would an increased number of eosinophils be seen in the tissue?

A

parasitic infections, asthma, allergic reactions

64
Q

what do the eosinophilic granules contain

A

major basic protein, peroxidase, eosinophilic catatonic protein, and histaminase

65
Q

function of eosinophils

A
  1. trapping substances
  2. killing cells
  3. antiparasitic and bactericidal activity
  4. immediate allergic response
  5. modulate inflammatory responses - when basophils release bioactive proteins, eosinophils come to modulate them
66
Q

how many eosinophils in the leukocytes?

67
Q

absolute count eosinophils

A

less than 500/microliter

68
Q

absolute count neutrophils

A

2.8x10^3/microliter

69
Q

percentage of basophils in the leukocytes

A

less than 1%

70
Q

characteristis of basophils

A

irregular/bilobed nuclei that are concealed by large basophilic specific granules

71
Q

what do basophils contain in their cytoplasm

A

platelet activating factors, eosinophil chemotactic factors, granules that contain histamine and heparin

72
Q

what activates basophils?

A

IgE and other factors

73
Q

function of basophils

A

mediator of allergic reactions, recruit eosinophils to come modulate inflammation

74
Q

when would basophils be elevated?

A

CML!!, rheumatoid arthritis, ulcerative colitis, myeloproliferative disorders, other inflammatory processes and neoplasms

75
Q

absolute count of monocytes?

A

0-1 x 10^3/microliters

76
Q

percentage of monocytes in the leukocytes

77
Q

where do monocytes develop?

A

myelo-monocytic stem cells in bone marrow

78
Q

characteristic of monocytes

A

kidney or c shaped nuclei, moderate number of scattered azurophilic granules but NO specific granules, may see cytoplasmic vacuoles

79
Q

how to test immunoglobulin in blood?

A

test the serum

80
Q

how to test fibrinogen in the blood?

A

test plasma

81
Q

clinical significance of monocytes

A

they migrate into tissue and are transformed into macrophages

82
Q

when would monocytes be increased?

A

chronic infections, autoimmune disorders, neoplasms

83
Q

when would monocytes be decreased?

A

marrow failure, AIDS, hairy cell leukemia

84
Q

what are the monocyte-macrophage systems throughout the body?

A
  1. kupffer cells in the liver
  2. microglia in the CNS
  3. osteoclasts in bone
85
Q

absolute count of lymphocytes?

A

1-5x10^3/microliters

86
Q

percentage of leukocytes

87
Q

characteristics of lymphocytes

A

round/oval nuclei with scant to moderate cytoplasm, similar size to RBC

88
Q

what would a reactive lymphocyte look like?

A

larger than RBC, has large cytoplasmic dock on the periphery of the cytoplasm

89
Q

maturation of the T lymphocytes

A

common lymphoid precursor in bone marrow, travels to thymus, differentiates into mature naive T lymphocytes

90
Q

maturation of B lymphocytes

A

common lymphoid precursor, stays in bone marrow, immature B lymphocytes, mature B lymphocytes, plasma

91
Q

characteristic of plasma cells

A

clock face nucleus/heterochromatin peripherally dispersed, small dense and eccentric nucleus, enlarged golgi forms pale perinuclear region, LARGE, round/oval

92
Q

function of plasma cells

A

produce large quantities of antibodies that are widely distributed in connective tissue

93
Q

what are the terminally differentiated B-lymphocytes

A

plasma cells

94
Q

what occurs during acute/active inflammation?

A

increase in neutrophils

95
Q

what occurs with chronic inflammation?

A

increased lymphocytes and plasma cells

96
Q

absolute value of platelets?

A

150-400x10^3/microliters

97
Q

function of the projections that branch off platelets?

A

help reach damaged blood vessels to stop bleeding

98
Q

what is a granulomere?

A

central region of platelet containing organelles and granules like alpha, delta and lambda

99
Q

what is a hyalomere?

A

lighter staining peripheral zone of platelet containing marginal bundle of microtubules, actin, myosin (projections)

100
Q

function of hyalomere?

A

maintain platelet discoid shape, contact during clot formation

101
Q

what is alpha granules?

A

largest of the granules at 300-500 micrometers, contain fibrinogen, PDGF, and other platelet specific proteins

102
Q

what are delta granules

A

250-300micrometers, contain calcium ions, pyrophosphate, ADP, ATP, take up and store serotonin

103
Q

what are lambda granules

A

175-200micrometers, take contain lysosomes to help with fibrinolysis

104
Q

what is primary aggregation

A

when platelets aggregate at areas with damaged endothelium and form platelet plugs

105
Q

what is secondary aggregation

A

aggregated platelets release the contents of their alpha and delta granules

106
Q

functions of platelets

A
  1. primary aggregation
  2. secondary aggregation
  3. blood coagulation
  4. clot retraction
  5. clot removal
107
Q

how do platelets contribute to blood coagulation

A

release fibrinogen from alpha granules that are converted into fibrin (making dense fibrous mat to which more platelets and blood attach and make thrombus)

108
Q

how do platelets contribute to clot retraction

A

interactions of platelet actin, myosin and ATP

109
Q

how do platelets contribute to clot removal

A

proteolytic enzyme plasmin, formed from plasminogen, and hydrolytic enzymes/lysosomes released by lambda granules

110
Q

what is thrombocytopenia

A

platelet count of less than 150x10^3 per microliter

111
Q

etiology of thrombocytopenia

A
  1. marrow failure like aplastic anemia
  2. increased platelet consumption by autoimmune/heparin etc
  3. sequestration by chronic alcohol abuse, dilution
112
Q

what are petechiae?

A

pin point superficial bleeding in skin

113
Q

signs of thrombocytopenia?

A
  1. easy or excessive bruising
  2. petechiae
  3. prolonged bleeding
  4. spontaneous bleeding from nose or gums
  5. blood in urine or stools
114
Q

another name for platelets?

A

thrombocyte

Medical Histology (10 decks)

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