Chapter 2: RBC Formation, Metabolism, and Destruction Flashcards
_______ is used to describe the process of RBC production
Eythropoiesis
This occurs in distinct anatomical sites called
Eythropoietic islands
_______ accounts for 5% to 38% of nucleated cells in normal bone
Erythroid cells
________ means decrease in oxygen content within the tissues
Tissue Hypoxia
True or False: Tissue Hypoxia is a primary stimulus for the production of RBC
True
_______ refers to all stages of erythrocyte development encompassing the earliest precursor cells in the bone marrow
Erythron
What are the basic substances needed for normal eythrocyte and hemoglobin production?
- Amino acids (protein)
- Iron
- Vitamin B12
- Vitamin B6
- Folic acid (B2 complex)
- Trace minerals (cobalt & nickel)
_______ is produced primarily by the KIDNEYS (80 to 90%) and LIVER (10 to 15%)
Eyrythropoietin (EPO)
Which organ is the primary source of EPO in the UNBORN
Liver
This is the site of EPO production in kidneys
Peritubular cells
EPO prevents ______
Eythroid cells apoptosis
Maturation through nucleated cell stages in _____ days
4 or 5
Bone marrow reticulocytes (days)
2.5 days
Reticulocytes in circulation (day/s)
1 day (0.5 to 1% of the circulating erythrocytes)
This is common in the US
Normoblastic
Common in Europe
Erythroblastic
Rubriblastic has what types of precursors?
- Rubriblast
- Prorubricyte
- Rubricyte
- Metarubricyte
_________ is the creator of Wright Stain
James Homer Wright
This is a stain for acid
Eosin (H+ = Hgb)
This is a stain for Alkaline/Basic
Methylene Blue (OH- = DNA, RNA)
_______ is also known as Rubriblast, Proerythroblast
Pronormoblast
N:C ratio of Pronormoblast
8:1
Pronormoblast has a ________ and ______ which STAINS INTENSELY
Fine and Uniform chromatin pattern
______ days for the pronormoblast to develop into the ________
3 days, orthochromic normoblast
This is the earliest recognizable RBC precursor in light microscopy
Pronormoblast
Basophilic normoblast is also known as
Prorubricyte, Basophilic erythroblast
Basophilic is slightly smaller than _____
Rubriblast
N:C ratio of Basophilic normoblast is
4:1
This is the last stage with nucleolus
Basophilic normoblast
What does Basophilic normoblast looks like when stained?
Cytoplasm is less; intensely basophilic
Why does the Basophilic normoblast is intensely basophilic? What is the stain?
Due to RNA, methylene blue (intensely blue)
Polychromatophilic normoblast is also known as
Rubricyte, Polychromatophilic erythroblast
This is where hemoglobin appears for the first time
Polychromatophilic normoblast
N:C ratio for Polychromatophilic normoblast is
1:1
What does Polychromatophilic normoblast looks like when stained?
Muddy, light gray appearance; pink coloration mixed with basophilia (red is hemoglobin; blue is RNA)
This is the last stage capable of mitosis
Polychromatophilic normoblast
Orthochromic normoblast is also known as
Metarubricyte, Orthochromic erythroblast
What does Orthrochromic normoblast looks like when stained?
Nucleus is tightly condensed; pyknotic (dense or compact)
True or False: In Orthochromic normoblast, in a much later stage, nucleus will be extruded from the cell
True
This is a last stage with nucleus
Orthochromic normoblast
____ occurs in the bone marrow and later takes place in the circulating blood
Polychromatophilic erythrocyte
When in supravital stain, Polychromatophilic erythrocyte is
Reticulocyte
Last stage capable of hemoglobin synthesis
Polychromatophilic erythrocyte
In Polychromatophilic erythrocyte, reticulocytes retained in the marrow for _____ days
2-3 days (1-2 days in circulation)
An increased in number when reticulocytes are prematurely released under the stimulus of EPO is known as
Acute bleeding
When stained with a supravital stain, stress reticulocytes exhibit a
Much denser, meshlike network
An elevated reticulocyte count accompanies a shortened RBC survival
Polychromatophilia, polychromasia, reticulocytosis
Earliest recognizable
Pronormoblast, Proerythroblast, Rubriblast
Last stage with MITOSIS
Polychromatophilic normoblast, Polychromatophilic erythroblast,
Rubricyte
Last stage with NUCLEOLUS
Basophilic normoblast, Basophilic eryhtroblast, Prorubricyte
Last stage with NUCLEUS
Orthochromic normoblast, Orthochromic erythrocyte, Metarubricyte
Last stage that can SYNTHESIZE HEMOGLOBIN
Reticulocyte
This pathway is where the ATP is controllung the flow of sodium and potassium in and out of the RBC
Embden-Meyerhof Pathway (EMP)
Embden-Meyerhof Pathway (EMP) important enzyme
Pyruvate Kinase (Pyruvate Kinase Deficiency)
This pathway is also known as the Pentose Phosphate Pathway
Hexose monophosphate pathway (HPP/PPP)
This pathway has a decreased activity of enzyme resulting in oxidizes hemoglobin which denatures and precipitates as Heinz bodies
Hexose monophosphate pathway
Hexose monophosphate pathway (HMP) important enzyme
G6PD, Glutathione
This pathway maintains the iron in the hemoglobin and reduces the ferrous state for oxygen transport
Methemoglobin reductase pathway
Methemoglobin reductase pathway’s important enzyme
Methemoglobin reductase or Cytochrome b5 reductase
This pathway allows the production of 2,3 DPG; combines reversibly with the deoxygenated hemoglobin, decreasjng the affinity
Rapoport-Luebering pathway
___ has a bioconcave shape disk
RBC
Cell membrane according to BROWN
50% protein
40% lipid
10% carbohydrate
Cell membrane according to RODAK
52% protein
40% lipid
8% carbohydrate
2 classes of proteins in the membrane
Integral/Transmembrane
Peripheral/Cytoskeleton/Skeletal
Serves as a transport and adhesion
Integral/Transmembrane
Integral/Transmembrane’s proteins
Protein 4.1, ankyrin, Glycophorin A
Responsible for the negative charge of the red blood cell
Glycophorin A (M & N antigen)
Does not penetrate bilayer
Peripheral/Cytoskeleton/Skeletal
Peripheral/Cytoskeleton/Skeletal’s proteins
alpha and beta spectrin, Actin
_____ consists of an alpha and beta chain; helix circular pattern like a spring
Spectrin
_____ is a contractile protein; deforms RBC
Actin
Variation in SHAPE
Poikilocytosis
Variation in SIZE
Anisocytosis
Variation in HEMOGLOBIN CONTENT
Anisochromia
This has a normal hemoglobin content, centrall pallor, and occupies 1/3 of the cell diameter
Normochromic
Decreased hemoglobin content with increased central pallor
Hypochromic
Does not have a central pallor but increased thickness; often seen in spherocytes, sickle cell, Hb CC and SC
Hyperchromic
RBC: shift to the left
Microcytosis
RBC: shift to the right
Macrocytosis
WBC: shift to the left
Hyposegmented neutrophil
WBC: shift to the right
Hypersegmented neutrophil
ODC: shift to the left
Increased oxygen affinity
ODC: shift to the right
Decreased oxygen affinity
Spherical in shape, does not have central pallor
Spherocyte/Bronze Cell
DECREASED surface membrane ratio to volume ratio
INCREASED MCHC
Spherocyte/Bronze Cell
MCHC g/dL of Spherocyte/Bronze Cell
36 and 38 g/dL
Centrally stained with thin outer rim of hemoglobin
Codocyte/Leptocyte/Traget Cell/ Thin Cell
Increases in cholesterol and phospholipid
Codocyte/Leptocyte/Traget Cell/ Thin Cell
Slit-like (rectangular) area of central pallor
Stomatocyte/Mouth Cell
Lost the indentation to one side
Stomatocyte/Mouth Cell
Red bloos cell fragments
Schistocyte
Single pointed extension resembling a teardop or pear
Dacrocyte/Teardrop cell
RBC fragment in shape of HELMET
Helmet Cell/Keratocyte
Shape of a sickle or crescent, formation of rod-like polymers of hemoglobin S
Sickle cell
Elliptical (cigar shaped) and Oval (egg shaped)
Elliptocyte/Ovalocyte/Cigar cell
Crenated RBC, blunt spicules evenly distributed
Echinocyte/Burr Cell
Echinocyte/Burr Cell is seen in which disease?
Pyruvate Kinase Deficiency
Irregularly spaced projections; spicule vary in width but with bulbous, rounded end
Acanthocyte/Spur Cell/Thorn Cell
RBC membrane folded over
Folded cell/Biscuit cell
Folded/Biscuit cell is associated in which disease?
Hemoglobin C and SC
RBC with one or more semi-circular portions
Bite Cell/Keratocyte/Degma Cell
Bite Cell/Keratocyte/Degma Cell is associated with which disease?
G6PD deficiency
RBC with thin rim of hemoglobin and a large clear central area
Analocyte/Ghost Cell
Analocyte/Ghost Cell is often associated with
Artifact
“Poker-chip” stacking of RBC
Roleaux formation
Roleaux formation is associated with
Cold agglutinins