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POM > Blood Cells > Flashcards

Blood Cells Flashcards

1
Q

Where are blood cells made?

A

Bone marrow.

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2
Q

Lifespan of neutrophil

A

7-10 hours.

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3
Q

What are blood cells derived from?

A

Pluripotent haemopoietic stem cells

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4
Q

What is haemopoiesis?

A

Formation and development of blood cells.

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5
Q

What are the two essential characteristics of HSC’s?

A

Some daughter cells remain as HSC’s and so pool of HSC’s isn’t depleted. Can follow a differentiation pathway.

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6
Q

Sites of haemopoiesis throughout life?

A

Yolk sac. Liver (principal source of blood in foetus) and spleen. Bone marrow.

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7
Q

What regulates Haemopoiesis?

A

Genes, transcription factors, growth factors and microenvironment.

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8
Q

Disruption to the regulation of haemopoeisis can cause what? How can regulation be disrupted?

A

A disturbance in the balance between proliferation and differentiation which can lead to leukaemia or bone marrow failure.

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9
Q

What is erythropoiesis?

A

Production of red blood cells.

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10
Q

Where is TPO produced?

A

Liver.

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11
Q

What does TPO (Thrombopoietin) do?

A

Stimulates megakaryocyte and platelet production.

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12
Q

What do G-CSF, G-M CSF do?

A

Stimulate granulocyte and monocyte production.

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13
Q

What does the word ‘blast’ mean?

A

Immature. Erythroblast = immature red blood cell.

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14
Q

What would you see if you stain erythroblasts with methylene blue?

A

Will appear blue due to RNA content but erythrocytes wouldn’t appear blue.

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15
Q

Name of condition if you have lots of reticulocytes?

A

Polychromasia.

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16
Q

What is required for erythropoiesis?

A

Iron, Folic acid, Vitamin B12 and Erythropoietin

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17
Q

What is microcytic anaemia?

A

Small red blood cells.

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18
Q

What is macrocytic anaemia?

A

Large red blood cells.

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19
Q

What causes microcytic anaemia?

A

Iron deficiency or a reduction in iron availability.

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20
Q

What causes an iron deficiency?

A

Blood loss, insufficient intake, increased requirement.

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21
Q

What causes Macrocytic anaemia?

A

B12, folic acid deficiency, liver disease or ethanol toxicity..

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22
Q

What is erythropoietin?

A

A growth factor that is required in erythropoiesis.

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23
Q

Where is erythropoietin produced?

A

Kidney.

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24
Q

When is erythropoietin produced?

A

In response to hypoxia to boost red blood cell production in order to carry oxygen to tissues. In response to anaemia.

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25
Q

Which is the best absorbed form of iron?

A

Ferrous (Fe2+)

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26
Q

How is the amount of iron in the blood controlled?

A

Iron absorption is controlled. Liver stores a small amount. Most of the iron is recycled (creation and destruction of red blood cells).

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27
Q

What destroys red blood cells?

A

Splenic macrophages.

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28
Q

What does hepcidin do?

A

Blocks absorption of iron and blocks release of storage iron from the liver.

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29
Q

When is hepcidin released?

A

In response to high storage iron in the liver.

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30
Q

What happens when iron storage is low?

A

Hepcidin production is downregulated. More iron is absorbed and released from iron storage in liver.

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31
Q

What controls rate of erythropoeisis?

A

EPO increases rate. Low levels of iron (due to hepcidin) and proinflammatory cytokines (IL6, TNF, IFN) decrease rate.

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32
Q

What causes megaloblastic anaemia?

A

A deficiency in vitamin b12 and folic acid.

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33
Q

How is megaloblastic anaemia caused?

A

Vitamin b12 and folic acid are required for DNA synthesis. Needed for Deoxythymidine triphosphate. One of the four nucleoside triphosphates in DNA.

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34
Q

What do you see in megaloblastic anaemia?

A

Red blood cells grow in size but can’t divide.

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35
Q

What causes a b12 deficiency?

A

Inadequate intake. Malabsorption. Lack of stomach acid.

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36
Q

How is B12 absorbed?

A

Gastric parietal cells release intrinsic factor (IF) which binds to B12. IF - B12 complex is absorbed.

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37
Q

What is pernicous anaemia?

A

Destruction of gastric parietal cells. No release of intrinsic factor and so no absorption of B12

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38
Q

Breaking down of haem group gives?

A

Bilirubin (excreted in bile).

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39
Q

Breaking down of globin gives?

A

Amino acids (reused).

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40
Q

What affects red blood cell function?

A

Cellular metabolism, Integrity of the membrane ,haemoglobin structure and function

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41
Q

Why is red blood cell biconcave structure important?

A

Increased manouverability in capillaries.

42
Q

What is the cause of spherocytes?

A

Disruption in vertical linkages - spectrin and ankyrin

43
Q

Spherocyte feature on blood film?

A

Lack central pallor. Round, regular outline.

44
Q

What is the cause of eliptocytes?

A

Disruption in horizontal linkages.

45
Q

What causes eliptocytes to be present in blood?

A

Hereditary Elliptocytosis. Iron deficiency

46
Q

Why is G6PD important?

A

Protects red blood cells from oxidation by producing glutathione.

47
Q

What can G6PD deficiency cause? What can you see in a blood film?

A

Severe intravascular haemolysis. Bite cells.

48
Q

What are heinz bodies?

A

Clumps of irreversibly denatured hemoglobin seen in bite cells when you stain with methylene blue.

49
Q

What is polycthaemia?

A

Too many red blood cells.

50
Q

Polycthaemia causes?

A

Blood doping, High altitude, Splenomegaly (due to hypoxia), kidney carcinoma and polycthaemia vera.

51
Q

Difference between polycthaemia vera and polycthaemia?

A

Polycthaemia vera is independent of EPO. Myeloproliferative disorder.

52
Q

MCV equation?

A

Hct (l/l) *1000 / RBC

53
Q

MCH equation?

A

Hb / RBC

54
Q

MCHC equation?

A

Hb/Hct

55
Q

What is anaemia?

A

Reduction in haemoglobin.

56
Q

Two principle causes of anaemia?

A

Failure of production or destruction of red blood cells.

57
Q

What is poikilocytosis?

A

Abnormal-shaped red blood cells in the blood.

58
Q

Low iron blood test result?

A

Low ferritin and high transferrin.

59
Q

Thalassaemia key markers.

A

Raised HBA2, increased RBC, normal MCHC, normal Hb (slightly decreased).

60
Q

Anaemia of chronic disease markers?

A

High CRP, high ferritin (due to increased hepcidin in inflammatory state) and low transferrin.

61
Q

What is Thalassaemia?

A

Defect in globin.

62
Q

Tests for macrocytic anaemia?

A

Liver function test. B12 and folic acid tests.

63
Q

What does polychromasia indicate?

A

Haemolytic anaemia (destruction of red blood cells).

64
Q

What can be observed in megaloblastic anaemia?

A

Hypersegmented neutrophils.

65
Q

Sickle cell disease markers?

A

Increased HbS and HbF and no HbA. Increased reticulocytes. Low Hb.

66
Q

What may a sickle cell patient require?

A

Prophylactic antibiotics as they are functionally hyposplenic. Folic acid supplements as there is increased red cell turnover.

67
Q

Normocytic anaemia causes?

A

Gastrointestinal haemorrhage, bone marrow failure or hypersplenism.

68
Q

Polycthaemia risks?

A

Thrombosis.

69
Q

When may howell jolly bodies be present in a person’s blood?

A

Hyposplenic individuals such as sickle cell disease patients.

70
Q

What are leukocytes derived from?

A

Myeloblast.

71
Q

What are the granulocytes?

A

Neutrophil, Eosinophil and basophil.

72
Q

What does a neutrophil look like?

A

Multilobed ( 3-5 lobes).

73
Q

What does an eosinophil look like?

A

Pink colour. Bi-lobed.

74
Q

What does a basophil look like?

A

Very granulated. Bi-lobed.

75
Q

What does a monocyte look like?

A

Kidney shaped lobe.

76
Q

What pathogen do neutrophils target?

A

Bacteria and fungi.

77
Q

What are eosinophils involved in?

A

Parasite infections and allergens. Regulate type I hypersensitivity by inactivating histamines and leukotrienes.

78
Q

What are basophils involved in?

A

Allergy. Type I hypersensitivity.

79
Q

Basophils and mast cell difference?

A

Basophils are in circulation while mast cells are tissue resident.

80
Q

How do basophils modulate inflammatory responses?

A

By releasing heparin and proteases.

81
Q

What does transient leukocytosis indicate?

A

Infection.

82
Q

What does persistent leukocytosis indicate?

A

Blood cell disorder.

83
Q

What cell has the biggest impact on white blood cell count?

A

Neutrophils.

84
Q

Causes of neutrophilia?

A

Infection, inflammation, tissue damage and CML.

85
Q

Normal physiological causes of neutrophilia?

A

Pregnancy and excercise.

86
Q

What may neutrophilia be accompanied with?

A

Left shift (increase in non segmented neutrophils). Toxic granulation.

87
Q

What are non segmented neutrophils called?

A

Band forms.

88
Q

What is toxic granulation?

A

Present when there is an increase in the number of large cytoplasmic granules within circulating neutrophils.

89
Q

Neutropenia causes?

A

Chemotherapy, radiotherapy, autoimmune disorders or severe infection.

90
Q

Eosinophilia causes?

A

Parasitic infection or allergy. CML.

91
Q

Basophilia causes?

A

CML.

92
Q

Monocytosis causes?

A

Infection or chronic inflammation.

93
Q

Lymphopenia causes?

A

HIV, radiotherapy, chemotherapy or use of corticosteroids.

94
Q

Transient low lymphocyte cause?

A

Severe infection.

95
Q

Persistent high lymphocyte cause?

A

Chronic lymphocytic leukaemia.

96
Q

Leukemia symptoms?

A

Hepatomegaly, splenomegaly and leukocytosis.

97
Q

What would be seen in acute lymphoblastic leukemia?

A

Lymphoblasts.

98
Q

What would be seen in acute myeloid leukemia?

A

Myeloblasts.

99
Q

What would be seen in chronic lymphocytic leukemia?

A

Mature lymphoid cells.

100
Q

What would be seen in chronic myeloid leukemia?

A

Mature myeloid cells

101
Q

Most abundant cytoskeletal protein in erythrocytes?

A

Spectrin.

102
Q

What does hepcidin bind to in the duodenum?

A

Ferroportin.

POM (41 decks)

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