Chapter 1: Hematopoiesis Flashcards

Question

What are stem cells?

Answer 1

Present in small #s in the BM (< 1% cells in the BM)

Answer 2

1. Totipotential stem cell 2. Pluripotential / Multipotential stem cell 3. Unipotential stem cell ## Footnote **PUT**

Answer 3

1. Present in the 1st few hrs after an ovum is fertilized 2. The most versatile type of stem cell ## Footnote **Most versatile because it can make all cells**

Answer 4

1. Can develop into any human cell type, including development from embryo into fetus 2. Can make all cells (eyes, brain, skin, hair, fibroblasts, and hepatologic cells) 3. Gives rise to CFU-S and CFU-L ## Footnote **TOTI (/ TOTO) = nagagawa pa lahat (ng cells) kasi bata pa**

Answer 5

Obtained from / present in the BM

Answer 6

These cells are capable of giving rise to multiple lineages of bld cells => can make limited, but many cells ## Footnote **MULTIpotential = many, but limited**

Answer 7

1. CFU-S 2. CFU-L

Answer 8

Obtained from / present in the BM

Answer 9

Gives rise to single lineage of bld cell ## Footnote **UNIpotential = single lineage**

Answer 10

Immunophenotypic analysis using flow cytometry

Answer 11

1. Capable of self-renewal 2. Give rise to differentiated progeny 2. Able to reconstitute the hematopoietic system of a lethally irradiated host

Answer 12

1. Self renewal 2. Differentiation 3. Apoptosis

Answer 13

1. Apoptosis 2. Necrosis

Answer 14

1. GlycoPRO 2. Encoded on chromosome 1q 3. Stem cell marker

Answer 15

1. Normal 2. Does not cause inflammation ## Footnote **Does not cause inflammation = because it is normal**

Answer 16

Because the scenario goes this way... Ex, the cell will rearranged into apoptotic bodies (w/c are small globules | w/c are contained -> hence, it is not scattered) -> hence, WBCs will not be triggered because there are no cell contents scattered ## Footnote **No cell contents scattered = no inflammation**

Answer 17

1. A newborn has webbed fingers -> but due to apoptosis, the webs are removed -> resulting to normal hands 2. An individual really has tail (reason why individuals have tailbone) -> due to apoptosis, the tail is cut

Answer 18

1. Abnormal 2. Causes inflammation ## Footnote **Causes inflammation = because it is abnormal**

Answer 19

Inflammation is present due to presence of abnormality / there is something wrong that is happening Ex: the cell is eaten by bacteria -> cell is destroyed -> the contents of the cell burst -> the organelles of the cell will be detected by the immune system (because the organelles are scattered) -> triggering the immune system to do inflammation ## Footnote **Cell contents are scattered = presence of inflammation**

Answer 20

1. General cell size (diameter): decreases w/ maturity 2. Nuclear-cytoplasmic ratio: decreases w/ maturity

Answer 21

1. Chromatin pattern: becomes more condensed 2. Presence of nucleoli: not visible in mature cells

Answer 22

1. Color: progresses from darker blue to lighter blue, blue-gray, / pink 2. Granulation: progresses from no granules to non-sp to sp granules 3. Vacuoles: increase w/ age

Answer 23

1. Continuous, regulated process of bld cell production that includes cell renewal, proliferation, differentiation, and maturation => since hematopoiesis is regulated (/ under control), all cells (specifically RBCs, WBCs, and PLTs) must have a normal value only (their value must not be too much / deficient) 2. Process of bld cell production, differentiation, and development 3. Is a collective term used to describe the process involved in the production of bld cells from HSCs w/ subsequent cellular differentiation and development (Turgeon) 3. These processes result in the formation, development, and specialization of all of the fxnal bld cells that are released from the BM to the circulation

Answer 24

1. Consists of BM, liver, spleen, lymph nodes, and thymus 2. Takes place in a unique microenvironment in the marrow consisting of stromal cells and extracellular matrix

Answer 25

1. Too much: bld will be viscous -> hence, heart will have a hard time Deficient: will result to anemia 2. Too much: may result to leukemia | bld may become viscous Deficient: will lead to infection 3. Too much: will lead to excessive clotting -> leading to stroke Deficient: will result to bleeding | will result to formation of petechiae

Answer 26

To regenerate all cells in the body

Answer 27

At various intervals in the liver, spleen, thymus, BM, and lymph nodes (at birth and continuing into adulthood)

Answer 28

BM ## Footnote **BM is only the normal site of hematopoiesis**

Answer 29

1. Spleen 2. Liver It is abnormal

Answer 30

Extramedullary hematopoiesis

Answer 31

The spleen, liver, and lymph nodes revert back to producing immature bld cells as extramedullary sites in certain abnormal substances => this situation suggests that undifferentiated primitive bld cells are present in these areas and are able to proliferate if an appropriate stimulus is present => enlargement of the spleen and liver is frequently noted on physical examination

Answer 32

False, because in certain dse states, the BM is unable to produce sufficient #s of hematopoietic cells

Answer 33

Hemolytics anemias Where there is increased demand placed on the BM

Answer 34

No, because of the fibrotic nature of the BM / infiltration w/ malignant cells

Answer 35

1. When BM becomes dysfxnal in cases such as: a. Aplastic anemia b. Infiltration by malignant cells c. Overfiltration of a cell line (leukemia) 2. When the BM is unable to meet the demands placed on it, as in the hemolytic anemias

Answer 36

1. Primitive hematopoiesis 2. Definitive hematopoiesis

Answer 37

Occurs during the mesoblastic phase

Answer 38

RBCs produced in this have different type of hgb (w/c is called as embryonic hgb)

Answer 39

Begins during the final hepatic phase and continuous through adult life

Answer 40

1. Yolk sac 2. Aorta-gonad-mesonephros (AGM) region 3. Fetal liver 4. BM 5. Thymus 6. Lymphocytes: spleen and lymph nodes of the 2ndary lymphoid tissues

Answer 41

1. Ribs 2. Sternum 3. Skull 4. Scapulae 5. Vertebrae 6. Pelvic bones 7. Proximal ends of the long bones ## Footnote **RSVP**

Answer 42

1. Have high O2 affinity => means that they are selfish w/ O2 because they only obtain limited amt of O2 2. They obtain O2 of the embryo from the mother (not from the environment) ## Footnote Notes: Only few O2 can pass through the inside because the embryo is present in the innermost part of the mother and because of the placenta-bld barrier -> hence, the embryo will spend the O2 wisely

Answer 43

True, hence, there are no Abs produced in the hepatic phase -> reason why reverse typing can't be done to newborns because they don't still have Abs ## Footnote Lymphocytes (B cells | plasma cell) -> makes Abs

Answer 44

1. Large 2. Nucleated

Answer 45

1. Gower-1 2. Gower-2 3. Portland

Answer 46

1. Erythropoiesis 2. Granulopoiesis 3. Megakaryopoiesis Others: 1. Monopoiesis => produces monocytes

Answer 47

In distinct anatomical sites called erythropoietic islands

Answer 48

Erythroid cells (specifically RBCs)

Answer 49

Myeloid cells (specifically granulocytes)

Answer 50

1. Proliferating pool 2. Maturation storage pool

Answer 51

3 - 6 days

Answer 52

If needed, cells from the storage pool can exit into the circulation rapidly

Answer 53

6 - 10 hrs

Answer 54

Lymphoid cells (specifically lymphocytes and plasma cells)

Answer 55

Lymphoid follicles

Answer 56

It takes place adjacent to the sinus endothelium

Answer 57

Megakaryocytes / PLTs

Answer 58

Megakaryocytes protrude through the vascular wall as small cytoplasmic processes to deliver PLTs into the sinusoidal bld

Answer 59

1. Mesoblastic phase 2. Hepatic phase 3. Medullary / Myeloid phase ## Footnote **MEHEME**

Answer 60

1. 19 / 20 day of gestation => / 3 wks => w/ bld already => O2 is needed to supplement the developing embryo 2. 8 - 12 wks of gestation 3. Mesodermal cells of the yolk sac and later to AGM 4. Gower-1, Gower-2, and Portland 5. RBCs (primitive erythroblasts) 6. Alpha globin production begins at this phase and continues throughout life

Answer 61

1. 5 - 7 gestational wk 1.1. 4 - 5th wk of gestation 1.2. 5 - 6th wk of gestation 1.3. Peak: 3rd month of fetal life 2.1 - 2 wks 3. Main: liver Minor: spleen, thymus, and lymph nodes 4. Hb F (major), Hb A1, and Hb A2 5. RBC, erythroblasts, granulocytes, monocytes, megakaryocytes / PLTs 6. N/A ## Footnote **HEPAtic phase = liver**

Answer 62

1. 5th month of gestation 2. Lifetime 3. BM 4. Hgb A1 (major | > 95%), Hgb A2, and Hgb F 5. All bld cells 6. N/A

Answer 63

1. Thrombopoietin (TPO) 2. Erythropoietin (EPO)

Answer 64

mpl kit ligand

Answer 65

Kidneys (85 - 90%) and liver (10 - 15%)

Answer 66

34,000 Daltons / 34 kD

Answer 67

Renal peritubular interstitial cells / renal tubular cells

Answer 68

1. Prevents the apoptosis of erythroid precursors 2. Induces hgb synthesis and serves as differentiation factor causing the CFU-E to differentiate to pronormoblasts

Answer 69

Chromosome 7

Answer 70

All stem cells starts w/ HSC -> HSC differentiates into colony forming unit-lymph (CFU-L) and colony forming unit-spleen (CFU-S: also known as CFU-GEMM) CFU-L differentiates into colony forming unit-thymus (CFU-T) and colony forming unit-bone marrow (CFU-B) -> cells produced by CFU-T will mature in the thymus | cells produced by CFU-B will mature in the BM -> thymus gives rise to T-cell | BM gives rise to B-cell CFU-S differentiates to colony forming unit-granulocyte monocyte (CFU-GM), burst forming unit-erythrocyte (BFU-E), and colony forming unit-megakaryocytic (CFU-MEG) -> CFU-GM differentiates to CFU-G and CFU-Mo BFU-E differentiates to CFU-E CFU-G + CFU-Mo + CFU-E + CFU-Meg = CFU-GEMM CFU-G matures / differentiates into basophil, eosinophil, and neutrophil CFU-Mo differentiates into monocyte CFU-E (under the influence of the hormone EPO differentiates into RBC [if EPO is absent -> CFU-E will undergo apoptosis]) CFU-Meg (under the influence of TPO) differentiates into PLT -> PLT shedding will occur

Answer 71

All egg cells (all dormant) that will be produced until lifetime are present in both ovaries (present from birth) -> only 1 egg cell will become mature after 1st menstruation (every menstrual cycle, only 1 egg cell matures | maturation occurs in both ovaries -> every time an egg cell mature, it goes out to the fimbriae -> the mature egg cell waits for the sperm cell in the fimbriae, w/c is called as ovulation: ovulation is the time when the female is in heat) -> when dormant egg cells are exhausted, it’s called as menopause -> once sperm passed through and goes to the ovaries, when sperm and egg cell met, it’s called as fertilization -> if the egg cell is fertilized, formation of embryo will occur -> the embryo will roll to the fallopian tube -> the embryo must implant / settle in the uterus (however, sometimes, the embryo does not implant in the uterus because sometimes they implant early in the fallopian tube, w/c is called as ectopic pregnancy [w/c is abnormal -> hence, baby will not be born] -> ectopic pregnancy must be terminated) When the fertilization occurred, it will divide into 2, 4, 8, 16, and so on cell stage -> w/c will look like berry / morula cell: morulla cell rolls towards the uterus w/c is also its location for it to implant (reason why uterus is called as ‘bahay bata’ because the uterus is the site where it will be supplemented w/ nutrients) -> in 19 – 20 days, bld (that already has RBC: this RBC is called as primitive erythroblast: because the RBCs present have hgb: the hgb contains Gower 1, Gower 2, and Portland) is already formed The site in the uterus where the embryo is implanted has 3 layers such as endoderm (w/c will soon be the internal organs such as the heart | w/c is the inner layer), mesoderm (w/c are the future organs | middle layer), and ectoderm (w/c are the future skin and brain | w/c is the outer layer) -> the developing embryo needs O2 w/c will come from the uterus w/c is specifically called as placenta-bld barrier: placenta-bld barrier is where all the nutrients (such as O2 and CO2 | GLU and other nutrients of the mother will only pass through inside the barrier, but the cells and Abs [only IgG can pass through inside this barrier] can’t pass through inside the barrier) can diffuse in this barrier (there are no cells that can pass through inside the embryo of baby due to the presence of this barrier) In 19 – 20 days, this is called as the mesoblastic phase: reason why if the female had undergone miscarriage, the Dr. can determine how many wks is the pt’s miscarriage: if the fetus obtained from the female pt already has bld, the pt’s pregnancy is already 3 – 4 wks because bld is already present

Answer 72

1. BM 2. Liver 3. Spleen 4. Lymph node 5. Thymus 6. Kidney

Answer 73

1. Major hematopoietic organ 2. A primary lymphoid tissue 3. 1 of the body's largest organs 4. Represents approx 3.5 - 6% of total body weight 5. Averages 1,500 g in adults 6. Consists of hematopoietic cells (erythroid, myeloid, lymphoid, and megakaryocyte), fat (adipose tissue), osteoblasts, osteoclasts, and stroma)

Answer 74

1. Red BM 2. Yellow BM

Answer 75

Metamyelocyte (juvenile)

Answer 76

Red marrow

Answer 77

Adipocytes become more abundant and begin to occupy the spaces in the long bones previously dominated by active marrow

Answer 78

Yes, in cases of increased demand on the BM (such as in excessive bld loss / hemolysis)

Answer 79

1. Main site of hematopoiesis during the hepatic phase 2. Main site of production of TPO

Answer 80

1. The liver is often involved in bld-related dses 2. In porphyrias, hereditary / acquired defects in the enzymes involved in heme biosynthesis result in the accumulation of the various intermediary porphyrins that damage hepatocytes, erythrocyte precursors, and other tissues 3. In severe hemolytic anemias, the liver increases the conjugation of bilirubin and the storage of Fe 4. The liver sequesters membrane-damaged RBCs and removes them from the circulation 5. The liver can maintain hematopoietic stem and progenitor cells to produce various bld cells (called extramedullary hematopoiesis) as a response to infectious agents / in pathologic myelofibrosis of the BM

Answer 81

1. Filters the circulating bld 2. Stores 1/3 of PLT

Answer 82

1. Play a role in the formation of new lymphocytes from the germinal centers 2. Involved in the processing of sp Igs 3. Filter particulate matter, debris, and bacteria entering the lymph node via the lymph

Answer 83

Secretes EPO to stimulate erythropoiesis

Answer 84

1. Color red => because it is hematopoietically active marrow -> hence, bld cell production happens here 2. Present at the end of BM => site where bld cells are produced | bld cells are not produced in the middle 3. Consists of developing bld cells and their progenitors 4. By age 18, found only in the vertebrae, ribs, sternum, skull bones, pelvis, proximal epiphyses of femur and humerus

Answer 85

Hematopoietically inactive marrow => only composed of fats (w/c are stored energy | w/c are used by the body as a source of energy if an individual does not eat | fats of the BM can’t be burned, instead, the 1st fats to be burned are those that are present in the liver: reason why if an individual [who is thin before] eats many foods and drinks many beers [w/c has molts: molts are sugar -> w/c becomes glycogen if stored -> and too much glycogen becomes fats], his/her liver will get fat 1st [specifically called as fatty liver])

Answer 86

1. Composed primarily of adipocytes (fat cells), w/ undifferentiated mesenchymal cells and macrophages 2. Also composed of stromal cells => stromal cells: supporting structures only 3. Under physiological stress, it will revert back to active red marrow => reversion will happen if pt has anemia: because the body will respond to anemia

Answer 87

Long term storage of CHOs ## Footnote Opposite of glycogen

Answer 88

Short term storage of CHOs ## Footnote Opposite of fats

Answer 89

In diet, the 1st that are burned are the available GLU (w/c are sugar present in the bld | w/c are 1st used by the body if diet is being done) -> hence, GLU lvls in the bld will decrease -> then, after consumption of GLU present in the bld, glycogen (w/c are GLU that are stored in the muscles) in the muscles will be the next to be consumed -> then, after consumption of glycogen, will be next to be consumed -> if diet is done excessively, muscles (/ PROs) will be the next ones to be consumed (reason of being malnourished

Answer 90

False, because yellow marrow is capable of reverting back to active marrow in cases of increased demand on the BM, such as in excessive bld loss / hemolysis

Answer 91

Red BM > yellow BM => red BM is > yellow BM in individuals that are < 18 yo because red BM contains RBCs: meaning, RBCs fxn is to deliver O2 (many RBCs = many O2 = resulting to addition of cells -> if many cells are present, there is a high demand of O2 [reason why babies grow big fast because of addition of cells] -> hence, red BM is needed)

Answer 92

Red BM = yellow BM => 50% each

Answer 93

Yellow BM > red BM => meaning, individuals that are > 18 yo are already in the declining phase where the cells are slowly declining: reason why individuals who are really old, they become smaller in height

Answer 94

1. Term called if red BM that becomes yellow BM (there is no terminology for yellow BM that becomes red BM) 2. Process of replacing the active marrow by adipocytes (yellow marrow) during development

Answer 95

Results in restriction of the active marrow in the adult to the sternum, vertebrae, scapulae, pelvis, ribs, skull, proximal portion of the long bones

Answer 96

Hematopoiesis

Answer 97

BM => pregnancy = 9 mos (w/c is divided into 3, reason why it is called as trimester: 1 trimester = 3 mos | / pregnancy is divided into 3) => 3 phases of hematopoiesis: mesoblastic phase, hepatic phase, and myeloid / medullary phase => mesoblastic phase: starts in 19 – 20 days => hepatic phase: 1 – 2 mos => medullary phase: approx 5 mos => half of 9 mos is 4.5 mos (midfetal life)  hence, best answer is BM

Answer 98

Lymphocyte => HSC differentiates into CFU-L and CFU-S (w/c is also called as CFU-GEMM)