Blood & WBCs Flashcards
The average adult has how much blood?
4 to 6 liters
Males have more
What is the goal of hematology class?
Analyze blood & body fluids
Diagnosis & monitoring disease
What is blood composed of?
Plasma - ˜55%
Blood cells - ˜45%
What is plasma composed of?
91% water
9% biochemicals
What are blood cells composed of?
Mostly red blood cells
1% are platelets & WBC (buffy coat)
What are the reference ranges for cellular components - WBC
4.8 - 10.8 x 10ˆ9/L
What are the reference ranges for cellular components - RBC
Females - 4.2 - 5.4 x 10ˆ12/L
Males - 4.7 - 6.1 x 10ˆ12/L
What are the reference ranges for cellular components - platelets
150 - 400 x 10ˆ9/L
What are the components of blood tested?
- whole blood
- cells
- plasma - in vivo & in vitro
- serum - in vitro
What is in vivo plasma?
The liquid part of blood
What is In vitro plasma?
Plasma from anticoagulated blood
What color tube is used for a whole blood sample?
Lavender
What does EDTA do in the lavender tube?
Prevents coagulation by binding or chelating calcium in the form of a potassium or sodium salt
What are lavender tubes used for?
Whole blood sample
Anti-coagulant that preserves cell morphology & inhibits platelet aggregation or clumping
What is an example of a hematology screening test?
Complete blood count (CBC)
What are the parts of CBC?
- Quantifying
- Calculating the RBC indices (size/shape)
- WBC differential
What does the CBC quantify?
WBC, RBC, hemoglobin (Hgb), hematocrit (HCT), platelets
How does CBC calculate RBC indices?
From the RBC count, Hgb, & HCT
Defines the size & hemoglobin content of the RBCs
What does the WBC differential from CBC do?
Enumerates the five types of WBCs
Morphology of RBCs & platelets
What are the components of the Wright stain?
Methylene blue
Eosin
Buffer
What does the methylene blue stain?
Nuclear material
RNA
What type of stain is the wright stain?
Differential
What color do RBCs stain from the wright stain?
Pink
What is hematopoiesis?
The production of blood cells
Where is most blood cell production limited to at birth?
Bone marrow
What is the adult hematopoietic system?
Tissues & organs regulating the proliferation, maturation, & destruction of blood cells
What are the organs & tissues that makes up the adult hematopoietic system?
Bone marrow
Thymus
Spleen
Lymph nodes
The bone marrow is the site of cell development for what?
Myeloid cells
Erythroid cells
Megakaryocytic cells
Early stages of lymphoid cells
Where are the sites of later lymphoid cell development?
Thymus
Spleen
Lymph nodes
What are spleen & lymph nodes?
Secondary lymphoid tissues
Posses immunocompetent T & B cells
T & B cells further differentiate & divide in response to antigens into what?
Effector & memory cells
What are two types of bone marrow hematopoiesis?
Medullary hematopoiesis
Extramedullary hematopoiesis
What is medullary hematopoiesis?
Blood cell production in the bone marrow
What is extramedullary hematopoiesis?
Blood cell production in hematopoietic tissue other than in bone marrow
In the liver & spleen
What types of cells are present in bone marrow?
Myeloid (WBC) precursors & storage of mature cells
Red cell precursors
Platelet precursors
Fat
What is the adult cellularity in bone marrow?
50%
How do you determine cellularity?
Take 100 minus the patient’s age, +/- 10
What is bone marrow hyperplasia?
Excessive development of normal cells
Occurs with all conditions of increased or ineffective hematopoiesis
The concentration of WBCs is affected by what events?
Physiologic events
Pathologic events
Age
What are examples of physiologic events that affect the concentration of WBCs?
Pregnancy
Time of day
Activity level
What are examples of pathologic events that affect the concentration of WBCs?
Infections
Immune-regulated responses
Quantitative & qualitative disorders
What is the leukocyte concentration in peripheral blood (PB)?
Neutrophils: 50-70% of total WBC Lymphocytes: 20-44% Monocytes: 2-6% Eosinophils: 0-4% Basophils: 0-2%
What is the size of a segmented neutrophil?
9-15 mcM
What are the parts of a segmented neutrophil?
Nucleus
Cytoplasm
What are the characteristics of the nucleus of a segmented neutrophil?
Segmented with 2 or more lobes connected by a thin nuclear filament
Condensed chromatin
What are the characteristics of the cytoplasm of a segmented neutrophil?
Pink/tan to clear color
Many granules
What do the granules in neutrophils contain?
Lipids, carbs, & proteins
What is the function of a neutrophil?
Host defense
Move to site of foreign agent, engulf, & destroy
What are the four steps in the innate immune response?
- adherence
- migration/chemotaxis
- phagocytosis
- bacterial killing
What is the size of a small lymphocyte?
7-10 mcM
What are the characteristics of a lymphocyte cytoplasm?
Small rim, sky blue
Few granules
What are the characteristics of a lymphocyte neutrophil?
Same size of a RBC
Occupies about 90% of the cell
Chromatin deeply condensed, stains deep purple
Nucleoli rarely visible
What is the function of a lymphocyte?
Recognize & react with specific antigens
Work with macrophages to eliminate pathogens
Provide long-lasting immunity to previously encountered pathogens
What is the lifespan of Lymphocytes?
Several years
Hours
Days
What are the characteristics of size in a mature erythrocyte?
7-8 microns
Biconcave disk “central pallor”
Average volume 90 fL
What are the functions of a mature leukocyte?
Host defense in tissues
How do leukocytes fight infection?
Phagocytosis by granulocytes & monocytes
Development of adaptive immune response by monocytes & lymphocytes
Where do leukocytes develop from?
Pluripotential HSC
How do leukocytes develop?
Stem cell proliferates & differentiates
Mature cells enter peripheral blood (PB) or stay in bone marrow until needed
What are the types of leukocytes that develop?
Granulocytes
Monocytes
Lymphocytes
What are the types of granulocytes?/
Monocytes
Basophils
Eosinophils
How does age affect concentration of WBCs?
Few immature granulocytic cells can be found in circulation
What are the concentrations of WBCs from birth to 8 years old?
Birth: WBC count is high - 9-30 x 10ˆ9/L
1 week after birth: WBC count drops to 5-21 x 10ˆ9/L
8 years old: average WBC continues to drop to 8 x 10ˆ9 /L
What is the size of a monocyte?
12-20 mcM
What are the characteristics of a monocyte
Horseshoe or bean shaped
Numerous folds - brainlike convolutions
Chromatin loose & linear, lacy patter
What are the characteristics of the cytoplasm of a monocyte?
Blue-gray
Evenly dispersed with fine, dustlike membrane-bound granules
Vacuoles frequently seen
What are the functions of a monocyte?
Host defense in tissues as macrophages
Active in innate & adaptive IR
Ingest & kill microorganisms
What is the size of a mature eosinophil?
12-15 mcM
What does the nucleus of a eosinophil look like?
No more than 2 or 3
Blue/purple
What does the cytoplasm of an eosinophil look like?
Completely filled with granules
Pink in color
What is the function of an eosinophil?
Influenced by the cellular arm of the adaptive immune system (T cells)
Pro-inflammatory cells associated with allergic diseases, parastic infections
What is the size of a mature basophil?
10-15 mcM
What does the nucleus of a basophil look like?
Segmented
What is a major characteristic of a basophil?
Many dark purple granules obscuring both the background of the cytoplasm & the nucleus
What are the functions of a basophil?
Mediators of inflammatory response
Receptors for IgE
How do basophils mediate inflammatory response?
Immediate hypersensitivity reactions
Ex) Asthma
How are basophils receptors for IgE?
When IgE attaches the cell is activated for degranulation
It releases enzymes that are basoactive, bronchoconstrictive, & chemotactic
What is a buffy coat?
Where WBCs are in a blood sample