bone marrow Flashcards

1
Q

discuss the life spans of RBCs and platelets

A

RBC- 120 days

platelet- 10 days

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2
Q

where does hematopoiesis take place in the 3rd week of development?

A

in the blood islands of the yolk sac

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3
Q

where does hematopoiesis take place in the 2nd trimester of development?

A

major- liver

minor- spleen

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4
Q

when does the bone marrow begin to participate in hematopoiesis?

A

beginning in the 2nd trimester and persisting though adulthood

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5
Q

what are blood cells derived from?

A

pleuripotent hemopoetic stem cells (HSC)

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6
Q

where can HSC cells be isolated from? (4)

A

umbilical cord blood, fetal liver, fetal and adult bone marrow

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7
Q

what are the 2 cell types that HSCs can differentiate into?

A

1- common myeloid progenitor

2- common lymphoid progenitor

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8
Q

what cells arise from common myeloid progenitor cells?

A

neutrophils, mast cells, macrophages, platelets and erythrocytes

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9
Q

what cells arise from common lymphoid progenitor cells?

A

natural killer cell, T cells and plasma cells

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10
Q

describe the formation of a mature erythrocyte (10)

A
1- HSC
2- common myeloid progenitor cell
3- erythrocyte/megakaryocyte progenitor
4- erythrocyte progenitor
5- proerythroblast
6- basophilic erythroblast
7- polychromatophilic erythroblast
8- orthochromatophilic erythroblast/normoblast
9- reticulocyte
10- mature RBC
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11
Q

describe a proerythroblast

A

large cell with 3-5 nucleoli, lacking hemoglobin, lots of free ribosomes that give cytoplasm blue color

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12
Q

what forms when proerythroblast undergoes mitosis?

A

basophilic erythroblast

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13
Q

describe a basophilic erythroblast

A

blue cytoplasm 2/2 ribosomes synthesizing hemoglobin, coarse chromatin

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14
Q

what forms when basophilic erythroblast undergoes mitosis?

A

polychromatophilic erythroblast

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15
Q

describe a polychromatophilic erythroblast

A

checkerboard pattern of nucleus 2/2 clumping chromatin

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16
Q

what forms when a polychromatophilic erythroblast undergoes mitosis?

A

orthochromatophilic erythroblast

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17
Q

describe an orthochromatophiic erythroblast

A

high amounts of hemoglobin, dark and condensed nucleus,(that will soon be extruded)

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18
Q

how does a reticulocyte form?

A

nucleus of an orthochromatophilic erythroblast is extruded

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19
Q

what is another name for an orthochromatophilic erythroblast ?

A

normoblast

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20
Q

what is high retic count? what do high reticulocyte counts indicate?

A

over 1-2%, blood loss

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21
Q

what type of stain can be used to identify reticulocytes?

A

supravital stain

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22
Q

what is another name for reticulocyte?

A

polychromatophilic erythrocyte

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23
Q

what hormone controls erythrocyte formation?

A

EPO

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24
Q

where is EPO synthesized?

A

kidneys

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25
Q

bonus- who used EPO (procrit) as a performance enhancing drug?

A

Lance Armstrong

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26
Q

what causes the kidney to release EPO?

A

EPO is released in response to low blood oxygen concentration

27
Q

what happens to old RBCs?

A

they are phagocytized by macrophages n the spleen, bone marrow and liver

28
Q

what happens to the bilirubin from heme after the RBC is destroyed?

A

conjugated in the liver and secrete in bile (makes feces brown), white feces = bad

29
Q

what hormone controls platelet formation?

A

thrombopoietin from the liver and kidneys

30
Q

describe the formation of a platelet (7)

A
1- HSC
2- common myeloid progenitor cell
3- megakaryocyte/erythrocyte progenitor cell 
4- megakaryocyte-committed progenitor
5- megakaryoblast 
6- megakaryocyte
7- platelets
31
Q

describe a megakaryoblast

A

large, non-lobed nucelus, participates in endomitosis to reach ploidy of 8n-64n

32
Q

what is endomitosis?

A

reproduction of nuclear elements without cytoplasmic division or chromosome movements

33
Q

describe a megakaryocyte

A

larger than a megakaryoblast, multi-lobed nucleus, platelets seen in peripheral fields

34
Q

describe thrombocytopenia

A

decreased platelets that put pt at increased risk of bleeding

35
Q

below what platelet threshold can spontaneous bleeding occur?

A

20,000

36
Q

describe the general events in week 1 and week 2 of granulopoiesis

A

week 1- mitotic (proliferative phase), stops at late myelocyte
week 2- post-mitotic (differentiation) phase, metamyelocyte to mature myelocyte

37
Q

where are neutrophils stored?

A

bone marrow and vascular reserve (circulating pool)

38
Q

what causes increase in circulating neutrophils?

A

infection, inflammation, strenuous exercise

39
Q

describe the formation of a granulocyte (9)

A
1- HSC
2- common myeloid progenitor
3- granulocyte/monocyte progenitor
4- myeloblast
5- promyelocyte
6- myelocyte
7- metamyelocyte
8- band/stab cell 
9- neutrophil
40
Q

describe a promyelocyte

A

round nucleus
nucleolus present
basophilic cytoplasm with azurophilic granules

41
Q

describe a myelocyte

A

flattened nucelus

42
Q

what will differentiate between neutrophil, eosinophil and basophil?

A

granules present

43
Q

describe a metamyelocyte

A

kidney bean nucleus

specific granules now outnumber azurophilic granules, increasingly pale cytoplasm

44
Q

describe a band cell

A

horseshoe nucleus

45
Q

when will increased band cells be present?

A

in the setting of inflammation or infection

46
Q

describe a mature neutrophil

A

distinct, multi-lobed nucleus, fine granules +- barr body

47
Q

where is red bone marrow found?

A

medullary cavity of young long bones and spaces of spongy bone

48
Q

what cell cords are contained in red marrow? (4)

A

hemopoietic cells, macrophages, mast cells and adipose cells

49
Q

where are megakaryocytes located in the bone marrow?

A

next to the sinusoid wall, discharge platelets directly into sinusoids

50
Q

describe the structure and function of sinusoids

A

sinusoids are specialized blood vessels that separate the marrow cavity from the peripheral circulation, located between artery and vein

51
Q

what do sinusoids contain?

A

endothelia, basal lamina, and adventitial cells

52
Q

described adventitial cells

A

send sheet-like extensions into the hemopoietic cords to provide support for developing cells

53
Q

what is another term for adventitial cells?

A

reticular cells

54
Q

how do newly formed cells exit the marrow?

A

penetrate the endothelia

55
Q

is the bone marrow considered open or closed?

A

closed

56
Q

what is the primary composition of yellow marrow?

A

adipose tissue

57
Q

in what members of the population is yellow marrow more prevalent?

A

adults

58
Q

can yellow marrow conduct hemopoiesis?

A

it is not active, but retains the potential for activity

59
Q

what disease occurs when too much marrow is replaced with fat?

A

aplastic anemia

60
Q

what equation can be used to calculate the expected decrease in bone marrow cellularity with age?

A

(100-Age) +/- 10%

61
Q

practice question- what is the expected bone marrow cellularity for a 30 year old?

A

(100-30) +/- 10% = 60-80%

62
Q

in what condition is the marrow hypercellular?

A

acute myeloid leukemia

63
Q

through which bone are bone marrow biopsies typically extracted?

A

iliac crest (avoiding sinusoids)