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Histo > Blood > Flashcards

Blood Flashcards

1
Q

Composition of blood

A
  • Plasma: water, electrolytes, plasma proteins, hormones, fats, aa, vitamins, carbs, lipoproteins, etc
  • RBCs (40-45%)
  • WBCs + Platelets

If you add an anticoagulant and centrifuge, then it sediments into layers due to different densities: RBC > WBC > plasma

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2
Q

Cytology of RBC

A
  • No nucleus or most organelles
  • Hemoglobin –> acidophilic
  • Biconcave disk maximizes SA for respiratory exchange
  • Flexible, elastic membrane to allow extravasation
  • Spectrin & actin for cytoskeleton
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3
Q

Life span & function of RBCs

A
  • Life span: ~120 days; surface area decreases w age–> rigid sphere
  • Fxn:
    • oxygen & CO2 transport by providing an environment for hemoglobin (globin + iron-containing heme)
    • has some enzymes for glycolytic & hexose monophosphate biochemical pathway
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4
Q

Blood O2 content in each type of bv: venous, lung, arterial, capillaries

A

The amount of O2 is highest in arteries and lung capillaries

Less in capillaries, where exchange occurs between blood & tissue

Least in venous

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5
Q

Hereditary spherocytosis

A

Defect in spectrin or ankyrin binding of spectrin –> round/convex, brittle RBC cell membrane

–>Gets trapped in splenic microcirculation and destroyed in large numbers (hemolysis).

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6
Q

Anemia

A

Iron deficiency from impaired RBC formation or excessive RBC destruction -> Inadequate hemoglobin –> weakness, pallor, breathlessness.

Hypochromic, microcytic RBCs.

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7
Q

Hemolytic anemia

A

RBCs are structurally abnormal and thus liable to damage, so they’re removed prematurely and in excess by the spleen

Seen in hereditary spherocytosis and sickle cell anemia (point mutation in hemoglobin gene)

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8
Q

Reticulocytes

A

Less mature RBCs released from bone marrow up to 2 days ago

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9
Q

Cytology of reticulocytes

A

Contains residual RNA –> blueish color

Red-blue in Wright stain, Blue in methylene blue

Makes up 1-2% of red blood cells

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10
Q

Neutrophils/neutrophilic granulocytes cytology

A
  • Prominent, lobed nucleus
    • Less mature neutrophils have a band-shaped or horse-shoe nucleu
  • Most numerous WBC in an adult
  • Azurophilic (primary) & Specific (secondary) granules
  • Glycogen, filaments, microtubules
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11
Q

Azurophilic (primary) granules

vs

Specific (secondary) granules

A
  • Azurophilic granules:
    • Large, electron-dense
    • Contain antibacterial substances for innate immunity.
      • Ex) Myeloperoxidase (can be stained), elastase, cathepsins, defensins
  • Specific granules
    • Myeloperoxidase-negative
    • Proteolytic enzymes secreted into extracellular environment. Ex) lactoferrin
    • Variable size, shape, density
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12
Q

___ granules appear first during neutrophil formation, but as the cell matures, their number falls and __ granules becomes twice as numerous.

A

Primary first

Secondary next

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13
Q

Frq of neutrophils

A

lives ~1-4 days, but half-life in blood is only 6-8 hours. It moves into the tissues in response to infection to tissue damage (myocardial infarct)

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14
Q

Functions of neutrophils

A

Active phagocytes against microorganisms, esp bacteria

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15
Q

Bone marrow will release more neutrophils in resonse to stimuli such as

A

bacterial infection, tissue necrosis, etc.

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16
Q

Neutrophil phagocytosis

A
  1. Chemotaxis attracts the neutrophil to devitalized tissue, bacteria, foreign bodies, complement components
  2. Blood borne antibody (IgG) to bind to surface antigen on bacteria
  3. Complement C3b binds Fc end of the antibody to activate complements, or neutrophil binds it (opsonization) for phagocytosis.
  4. Takes up particles in a phagosome
  5. Phagosome fuses with neutrophil granules (esp primary)
    1. Bacteria’s killing is enhances by hydrogen peroxide & superoxide
    2. Forms a residual body of degraded material
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17
Q

Eosinophils

A
  • Most have bilobed nucleus (N)
  • Ovoid-shaped granules (G)
    • Stain bright orange in a Romanowsky stain
    • In an EM slide, you can see a dense filamentous core of major basic protein (MBP) called crystalloids (C)
    • Contains lysosomal enzymes
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18
Q

Eosinophils circulate for ~8hrs.

What is eosinophils’ function?

A

Increased in parasitic infections (attacked by major basic protein); allergic reactions to stimuli like pollen; some drug drug reactions

Phagocytoses antigen-antibody complexes and inactivates mediators of inflammation like Leukotrienes.

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19
Q

Basophils cytology

A
  • Nucleus has 2-3 lobes, but often hard to see because of
  • Large, dark purple specific granules containing
    • heparin (anticoagulant)
    • histamine (vasodilator)
    • leukotriene, serotonin, eosinophil chemotactic factor
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20
Q

The least numerous WBC in peripheral blood is

A

Basophils

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21
Q

Difference between basophils and mast cells

A

Mast cells are in the bone marrow and tissue

Basophils are in peripheral blood

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22
Q

Basophil function

A

Hypersensitivity reaction:

  1. Bind IgE antibody
  2. When exposed to the corresponding antigen, it will release vasoactive substances
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23
Q

Largest cell in peripheral blood

A

Monocyte

24
Q

Monocytes are from bone marrow promonocytes; they spend ~1wk in blood and migrate into tissue where they become ___ or ___. They are the largest cell in the peripheral blood.

A

Tissue macrophages or histiocytes

25
Q

Appearance of monocytes

A
  • Large nucleus, usually in an eccentric position
  • Pale cytoplasm with fine granules
  • Microvilli on cell membrane
26
Q

Function of monocytes

A
  • Enters the tissue to differentiate into macrophages or tissue histiocytes
  • Helps with antigen interaction of immunocompetent cells
27
Q

Lymphocytes

A

Single, deeply-stained, spherical nucleus that takes up most of the cell; thin rim of lightly basophilic cytoplasm.

Includes T cells, B cells, and NK cells.

28
Q

T cells

A
  • Processed by the thymus and participate in cell-mediated immunity (e.g. graft rejection)
  • Cytotoxic T cells elaborate cytotoxic agents, making lymphokines.
  • Memory T cells survive for yrs/decades
29
Q

B-cells

A
  • Have immunoglobulin on their cell membrane to aid in humoral or antibody-mediated immunity
  • Divide & differentiate into plasma cells in tissue
  • Some are memory cells
30
Q

Plasma cells

A

derived from B-cells; have an eccenrically placed nucleus

Produces antibodies (immunoglobulins)

31
Q

NK cells

A

lack the surface antigens of T and B cells, so they don’t rquire prior stimulation to attack virus-infected or tumor cells

32
Q
A
33
Q

What are the mononuclear WBCs/agranulocytes?

A

Monocytes & lymphocytes

34
Q

Neutrophilia (increased circulating neutrophils) indicates ___

Eosinophilia indicates ____

Lymphocytosis indicates ____

A

Neutrophilia -> bacterial infection

Eosinophilia -> parasitic infections, some allergies

Lymphocytosis -> viral infections

35
Q

Neutropenia/agranulocytosis (reduced # of circulating neutrophils) can be caused by

A

bone marrow damage, such as in a tumor or in chemotherapy

diseases (e.g. autoimmune ones, splenomegalies)

36
Q

Lymphopenia (reduced # of lymphocytes) are associated with some rare inherited diseases, infections, and autoimmune diseases.

A

E.g. lupus, typhoid, brucellosis

37
Q

Leukemias

A

Maligant proliferation of white cell precursors in bone marrow

–> vast # of WBCs that spill over into the blood

38
Q

chronic vs acute leukemias

A

Chronic leukemias: well-differentiated proliferating cells; slow progression; bone marrow still produces some normal elements

Acute leukemias: proliferating cells are primitive precursor (blast cells); rapid progression; failure of bone marrow

39
Q

Platelets are derived from

A

Bone marrow megakaryotcytes

40
Q

When platelets become activated, the microtubular system…

A

Squeezes the granules to the center, releasing the contents, and triggering the coagulation system.

41
Q

Function of platelets

A

Hemostasis (stop bleeding) by aggregating and releasing contents of alpha & dense granules –> coagulation cascade involves plasma factors to form a blood clot.

42
Q

Steps of hemostatsis

A
  1. Platelet’s membrane glycoproteins adhere to von Willebrand factor on exposed collagen on damaged blood vessels
  2. Platelet actin, myosin, and mts cause reversible platelet moulding and adhesion along a broad surface
  3. Releases granule contents through the canalicular system and synthesize thromboxane
  4. Thromboxone, ADP, Ca2+ mediate adhesion of other platelets
  5. Platelet phospholipids (w/ Ca2+) activate blood clotting cascade -> fibrin formation
43
Q

Thrombocytopenia

A

Severe reduction in the # of plate lets –> spontaneous bleeding looks like a bruises/patches (ecchymoses)

44
Q
A
45
Q

Thrombocytosis

A

Excessive circulating platelets due to a burst of bone marrow hyperactivity after acute blood loss.

46
Q

Name each

A

A- lymphocyte

B- monocyte

C- neutrophil

D-eosinophil

E- basophil

47
Q

Unlike plasma, serum lacks

A

fibrinogen, which is formed in clot formation.

You get serum by centrifuging blood as is, without anticoagulant.

48
Q

Name these

A

Neutrohil, eosinophil, basophil

49
Q

Name these

A

monocyte, lymphocyte

50
Q

Whats the disease?

A

Hypochromic (pale) and microcytic (small) RBCs, central pallor –> less hemoglobin than normal –> iron deficiency –> anemia

51
Q

Hereditary elliptocytosis

A

autosomal dominant ; self-association of spectrin subunits, defective binding of spectrin to ankyrin, protein 4.1 defects

-> RBCs are oval

52
Q

Anemia, jaundice, splenomegaly, and hemolytic anemia are common clinical features of what two diseases?

A

spherocytosis and elliptocytosis

53
Q
A
54
Q

In sickle cell anemia, glutamic acid is replaced by ____ .

A

Valine.

-> Hb S causes chronic hemolytic anemia & obstruction of postcapillary venules.

55
Q

Difference between agranulocytes and granulocytes

A

Both have primary granules, but only granulocytes have specific/secondary granules

56
Q

A granulocytes are __nuclear.

A

mononuclear.

57
Q

Hypersegmented (too many lobes) neutrophils indicates

A

Megaloblastic anemia, resulting from vitamin B12 deficiency

Histo (20 decks)

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