Blood Flashcards
what is plasma
the majority blood component, liquid base of blood contains plasma proteins, albumin, coagulation factors, antibodies, glucose, electrolytes
which are the granulocytes?
neutrophils, eosinophils, basophils
which are the lymphocytes?
T cells, B cells, NK cells
what are platelets?
fragments of cytoplasm enclosed in a plasma membrane, anuclear and SUPER SMALL
what is the difference between plasma and serum
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)
commonly used blood tests?
hematocrit, CBC, CBC with Diff, morphology analysis
what is hematocrit?
the fraction of whole blood composed of RBC
common causes of decreased hematocrit?
anemias, bleeding, RBC destruction, infection, pregnancy
common causes of increased hematocrit?
exercise, dehydration, congenital heart disease, cor pulmonale, erthrocytosis, hypoxia (low oxygen)
what could changes in hematocrit indicate?
anemia, erythrocytosis, changes in plasma volume
what does CBC test
quantity of blood cells (hemoglobin) through hemocytometer by hand or flow cytometry
what stains are usually used for morphology analysis
wright, giemsa, methylene blue
describe RBC
anucleate biconcave discs, cause a spot of pallor in the middle
life span RBC
120 days
what removes RBC from circulation?
macrophages in the spleen (and other)
what are reticulocytes
immature RBC that are slightly larger than mature RBC, no nucleus
what is clearly visible with methylene blue stain in a reticulocyte?
reticular, mesh like network of rRNA
when would you see acutely increased reticulocytes
after destruction of RBC that bone marrow needs to replace
when would you see chronically increased reticulocytes?
chronic hemolytic anemia
what would indicate that the bone marrow is damaged or faulty?
if there is anemia with low turnover of RBC synthesis, bone marrow is not functioning
what makes RBC?
bone marrow
what is the main protein that contributes to the biconcave shape of the RBC?
spectrin
what occurs if there is disruption in spectrin?
RBC loses biconcave shape and becomes sphere, seen in spherocytosis, decreases lifespan of the cell
what is the function of glycoproteins and band 3 protein on the surface of RBC?
antigens determine blood type, prevent RBC aggregation, function as cation channels
what are the key membrane components of the RBC?
glycophorins and band 3 protein
what proteins maintain membrane structure through their interaction with the cytoskeleton?
spectrin, ankyrin
how is hemoglobin measured?
CBC
what is rouleaux formation?
RBC stacked together in long chains
cause of rouleaux formation?
increased plasma proteins, particularly fibrinogen and immunoglobulin
surface charge of RBC
negative, keeps RBC separated
consequence of increased globulins on surface of RBC
globulins neutralize the surface and make it sticky
what is sickle cell
narrow, curved cells with pointed ends, caused by mutation of 6th AA of betaHb from glu to val (makes neutral)
what is thalassemia?
inherited disorder of Hb synthesis, disordered production of alpha or beta
what is characteristic of thalassemia?
target cells

what is hereditary spherocytosis associated with
deficiencies in spectrin, band 3, protein 4.2, or combined spectrin/ankyrin deficiency
consequence of spherocytosis
hemolytic anemia, so releases more reticulocytes
where are nucleated RBC found
newborns, rarely in older age
when (disease states) are increased nucleated RBC found?
premature release from marrow due to neoplasms or heart failure
when would howell-jolly bodies be seen?
hyposplenism, megaloblastic anemia, hemolytic anemia
what are howell-jolly bodies?
inclusions of nuclear chromatin remnants/fragmented nuclear chromatin
what are the granular leukocytes?
basophils, neutrophils, eosinophils
what are the agranular leukocytes?
lymphocytes, monocytes
where are B cells derived from?
bone marrow
what is the function of B cells
producing antibodies, responsible for humoral immunity
what do B cells differentiate into?
plasma cells
what are T cells derived from?
bone marrow, and mature in the thymus
function of T cells
secrete cytokines that influence other leukocytes, and are responsible for cell mediated immunity, and promote B cell differentiation
what is CD4+
helper T cells
what is CD8+
cytotoxic T cells
what are the supressor T cells?
CD4, FOXP3, CD25
what are NK cells?
natural killer cells, the innate immune system that is specialized to kill infected/neoplastic cells and produce cytokines
characteristics of neutrophils?
have 3-4 lobed nuclei connected with fine chromatin strands, are larger than RBC
what is the prominence of neutrophils?
60-70% of the total leukocytes, most numerous
what is a Barr body?
an inactive X chromosome in a female somatic cell, in the neutrophils of females only (each excess X chromosome will form one Barr body)
what is a band neutrophil
a less mature neutrophil, moderate abundant cytoplasm staining pale blue to pink (not purple or red), indented nucleus, beginning to segment
what would increased band neutrophils in blood indicate?
infection or inflammation
function of the neutrophil?
is continuously generated in the bone marrow, eliminates intracellular or extracellular pathogens
mechanisms of elimination of pathogens by neutrophils
- phagocytosis
- release into extracellular spaces/degranulation
- immobilize or kill through releasing neutrophil extracellular traps (NETs)
what is a NET
neutrophil extracellular trap (NET), a complex of nucleosomes that are decorated with myeloperoxidase (MPO), neutrophil elastase, and cathepsin G
when are NETs released
in response to infection or inflammatory stimuli to bind and kill microbes
when would you see neutrophillic infiltration in the tissues
acute or current inflammation
characteristics of eosinophils
bilobed nuclei, abundant and large eosinophilic granules
when would an increased number of eosinophils be seen in the tissue?
parasitic infections, asthma, allergic reactions
what do the eosinophilic granules contain
major basic protein, peroxidase, eosinophilic catatonic protein, and histaminase
function of eosinophils
- trapping substances
- killing cells
- antiparasitic and bactericidal activity
- immediate allergic response
- modulate inflammatory responses - when basophils release bioactive proteins, eosinophils come to modulate them
how many eosinophils in the leukocytes?
1-5%
absolute count eosinophils
less than 500/microliter
absolute count neutrophils
2.8x10^3/microliter
percentage of basophils in the leukocytes
less than 1%
characteristis of basophils
irregular/bilobed nuclei that are concealed by large basophilic specific granules
what do basophils contain in their cytoplasm
platelet activating factors, eosinophil chemotactic factors, granules that contain histamine and heparin
what activates basophils?
IgE and other factors
function of basophils
mediator of allergic reactions, recruit eosinophils to come modulate inflammation
when would basophils be elevated?
CML!!, rheumatoid arthritis, ulcerative colitis, myeloproliferative disorders, other inflammatory processes and neoplasms
absolute count of monocytes?
0-1 x 10^3/microliters
percentage of monocytes in the leukocytes
0-8%
where do monocytes develop?
myelo-monocytic stem cells in bone marrow
characteristic of monocytes
kidney or c shaped nuclei, moderate number of scattered azurophilic granules but NO specific granules, may see cytoplasmic vacuoles
how to test immunoglobulin in blood?
test the serum
how to test fibrinogen in the blood?
test plasma
clinical significance of monocytes
they migrate into tissue and are transformed into macrophages
when would monocytes be increased?
chronic infections, autoimmune disorders, neoplasms
when would monocytes be decreased?
marrow failure, AIDS, hairy cell leukemia
what are the monocyte-macrophage systems throughout the body?
- kupffer cells in the liver
- microglia in the CNS
- osteoclasts in bone
absolute count of lymphocytes?
1-5x10^3/microliters
percentage of leukocytes
20-40%
characteristics of lymphocytes
round/oval nuclei with scant to moderate cytoplasm, similar size to RBC
what would a reactive lymphocyte look like?
larger than RBC, has large cytoplasmic dock on the periphery of the cytoplasm
maturation of the T lymphocytes
common lymphoid precursor in bone marrow, travels to thymus, differentiates into mature naive T lymphocytes
maturation of B lymphocytes
common lymphoid precursor, stays in bone marrow, immature B lymphocytes, mature B lymphocytes, plasma
characteristic of plasma cells
clock face nucleus/heterochromatin peripherally dispersed, small dense and eccentric nucleus, enlarged golgi forms pale perinuclear region, LARGE, round/oval
function of plasma cells
produce large quantities of antibodies that are widely distributed in connective tissue
what are the terminally differentiated B-lymphocytes
plasma cells
what occurs during acute/active inflammation?
increase in neutrophils
what occurs with chronic inflammation?
increased lymphocytes and plasma cells
absolute value of platelets?
150-400x10^3/microliters
function of the projections that branch off platelets?
help reach damaged blood vessels to stop bleeding
what is a granulomere?
central region of platelet containing organelles and granules like alpha, delta and lambda
what is a hyalomere?
lighter staining peripheral zone of platelet containing marginal bundle of microtubules, actin, myosin (projections)
function of hyalomere?
maintain platelet discoid shape, contact during clot formation
what is alpha granules?
largest of the granules at 300-500 micrometers, contain fibrinogen, PDGF, and other platelet specific proteins
what are delta granules
250-300micrometers, contain calcium ions, pyrophosphate, ADP, ATP, take up and store serotonin
what are lambda granules
175-200micrometers, take contain lysosomes to help with fibrinolysis
what is primary aggregation
when platelets aggregate at areas with damaged endothelium and form platelet plugs
what is secondary aggregation
aggregated platelets release the contents of their alpha and delta granules
functions of platelets
- primary aggregation
- secondary aggregation
- blood coagulation
- clot retraction
- clot removal
how do platelets contribute to blood coagulation
release fibrinogen from alpha granules that are converted into fibrin (making dense fibrous mat to which more platelets and blood attach and make thrombus)
how do platelets contribute to clot retraction
interactions of platelet actin, myosin and ATP
how do platelets contribute to clot removal
proteolytic enzyme plasmin, formed from plasminogen, and hydrolytic enzymes/lysosomes released by lambda granules
what is thrombocytopenia
platelet count of less than 150x10^3 per microliter
etiology of thrombocytopenia
- marrow failure like aplastic anemia
- increased platelet consumption by autoimmune/heparin etc
- sequestration by chronic alcohol abuse, dilution
what are petechiae?
pin point superficial bleeding in skin
signs of thrombocytopenia?
- easy or excessive bruising
- petechiae
- prolonged bleeding
- spontaneous bleeding from nose or gums
- blood in urine or stools
another name for platelets?
thrombocyte