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Hema Readings Chapter 5&9 > Chapter 9 Leukocyte Development, Kinetics, and Functions > Flashcards

Chapter 9 Leukocyte Development, Kinetics, and Functions Flashcards

1
Q

(also known as white blood cells, or WBCs) are so
named because they are relatively colorless compared to red blood cells

A

Leukocytes

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2
Q

The number of different types of leukocytes varies depending on whether they are being viewed with a light microscope after staining with a

A

Romanowsky stain

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3
Q

group of leukocytes whose cytoplasm is filled with granules with differing staining characteristics and whose nuclei are segmented or lobulated

A

Granulocytes

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4
Q

granules containing basic proteins that stain with acid stains such as eosin

A

eosinophils

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5
Q

granules that are acidic and stain with basic stains such as methylene blue

A

basophils

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6
Q

granules that react with both acid and basic stains, which gives them a pink to lavender color

A

neutrophils

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7
Q

nuclear segmentation is quite prominent in mature neutrophils, they have also been called

A

polymorphonuclear cells, or PMNs

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8
Q

categorized into monocytes and lymphocytes

A

Mononuclear cells

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9
Q

These cells have nuclei that are not segmented but are round, oval, indented, or folded

A

monocytes and lymphocytes

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10
Q

The number of circulating leukocytes varies with

A

sex, age, activity, time of day, and ethnicity;

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11
Q

leukocytes also differs according to whether or not the leukocytes are reacting to

A

stress, being consumed, or being destroyed

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12
Q

overall function of leukocytes is in mediating immunity, either

A

innate (nonspecific) or specific (adaptive)

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13
Q

phagocytosis by neutrophils

A

innate (nonspecific)

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14
Q

production of antibodies by lymphocytes and plasma cells

A

specific (adaptive)

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15
Q

movement of cells through developmental stages, into the circulation, and from the circulation to the tissues and includes the time spent in each phase of the cell’s life

A

kinetics

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16
Q

make up the vast majority of circulating leukocytes

A

Segmented neutrophils

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17
Q

Neutrophil development occurs in the bone marrow. Neutrophils share a common progenitor with monocytes and distinct from eosinophils and basophils, known as the

A

granulocytemonocyte progenitor (GMP)

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18
Q

major cytokine responsible for the stimulation of neutrophil production is

A

granulocyte colony-stimulating factor, or G-CSF

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19
Q

There are three pools of developing neutrophils in the bone marrow

A

stem cell pool, the proliferation pool, and the maturation pool

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20
Q

consists of HSCs that are capable of self-renewal and differentiation

A

stem cell pool

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21
Q

consists of cells that are dividing and includes (listed in the order of maturation) common myeloid progenitors (CMPs), also known as colony-forming units granulocyte, erythrocyte, monocyte, and megakaryocyte (CFUGEMMs)

A

proliferation (mitotic) pool

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22
Q

consisting of cells undergoing nuclear maturation that form the marrow reserve and are available for release: metamyelocytes, band neutrophils, and segmented neutrophils

A

maturation (storage) pool

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23
Q

not distinguishable with the light microscope and Romanowsky staining and may resemble early type I myeloblasts or lymphoid cells

A

HSCs, CMPs, and GMPs

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24
Q

make up 0% to 3% of the nucleated cells in the bone marrow and measure 14 to 20 “m in diameter

A

Myeloblasts

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25
Q

high nucleus-to-cytoplasm (N:C) ratio of 8:1 to 4:1

A

type I myeloblast

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26
Q

slightly basophilic cytoplasm, fine nuclear chromatin, and two to four visible nucleoli
no visible granules when observed under light microscopy with Romanowsky stains

A

Type I blasts

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27
Q

presence of dispersed primary (azurophilic) granules in the cytoplasm; the number of granules does not exceed 20 per cell

A

type II myeloblast

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28
Q

have a darker chromatin and a more purple cytoplasm, and they contain more than 20 granules that do not obscure the nucleus.

A

Type III myeloblasts

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29
Q

Type III myeloblasts are rare in normal bone marrows, but they can be seen in certain types of

A

acute myeloid leukemias

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30
Q

Mufti and colleagues10 proposed combining type II and type III blasts into a single category of

A

“granular blasts”

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31
Q

comprise 1% to 5% of the nucleated cells in the bone marrow

A

Promyelocytes

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32
Q

Promyelocytes are relatively larger than the myeloblast cells and measure

A

16 to 25 “m in diameter

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33
Q

Promyelocytes nucleus is round to oval and is often eccentric. A paranuclear halo or “hof ” is usually seen in normal promyelocytes but not in the

A

malignant promyelocytes of acute promyelocytic leukemia

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34
Q

make up 6% to 17% of the nucleated cells in the bone marrow and are the final stage in which cell division (mitosis) occurs

A

Myelocytes

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35
Q

Myelocytes production of primary granules ceases and the cell begins to manufacture secondary
(specific)

A

neutrophil granules

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36
Q

may look very similar to the promyelocytes
(described earlier) in size and nuclear characteristics except that patches of grainy pale pink cytoplasm representing secondary granules begin to be evident in the area of the Golgi apparatus

A

Early myelocytes

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37
Q

patches of grainy pale pink cytoplasm representing
secondary granules begin to be evident in the area of the Golgi apparatus. This has been referred to as the

A

dawn of neutrophilia

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38
Q

somewhat smaller than promyelocytes (15 to 18 “m), and the nucleus has considerably more heterochromatin

A

Late myelocytes

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39
Q

constitute 3% to 20% of nucleated marrow cells. From this stage forward, the cells are no longer capable of division and the major morphologic change is in the shape of the nucleus.

A

Metamyelocytes

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40
Q

Nucleoli are absent. Synthesis of tertiary granules (also known as

A

gelatinase granules

41
Q

The size of the metamyelocyte is slightly smaller than that of the myelocyte

A

14 to 16 “m

42
Q

The cytoplasm of metamyelocyte contains very little residual ribonucleic acid (RNA) and therefore little or no

A

basophilia

43
Q

make up 9% to 32% of nucleated marrow cells and
0% to 5% of the nucleated peripheral blood cells

A

Bands

44
Q

(also known as secretory vesicles) may begin to be formed during this stage

A

Secretory granules

45
Q

nucleus is highly clumped, and the nuclear indentation that began in the metamyelocyte stage
he cell should be called a

A

segmented neutrophil

46
Q

recommends that bands should be included within the neutrophil count and not reported as a separate category because of the difficulty in reliably distinguishing bands from segmented neutrophils

A

Clinical and Laboratory Standards Institute (CLSI)

47
Q

make up 7% to 30% of nucleated cells in the bone marrow. Secretory granules continue to be formed
during this stage.

A

Segmented neutrophils

48
Q

The only morphologic difference between segmented neutrophils and bands is the

A

presence of between two and five nuclear lobes connected by thread-like filaments

49
Q

present in the highest numbers in the peripheral blood of adults

A

Segmented neutrophils

50
Q

pediatric values are quite different; relative percentages can be as low as 18% of leukocytes in the first few months of life and do not begin to climb to adult values until after

A

4 to 7 years of age

51
Q

Neutrophil production has been calculated to be on the order of between

A

0.9 and 1.0 X 10 to the power 9 cells/kg per day

52
Q

proliferative pool contains approximately

A

2.1 X 10 to the power of 9 cells/kg

53
Q

maturation pool contains roughly

A

5.6 X 10 to the power of 9 cells/kg, or a 5-day supply

54
Q

transit time from myeloblast through myelocyte has been estimated to be roughly

A

6 days

55
Q

transit time through the maturation pool is approximately

A

4 to 6 days

56
Q

Granulocyte release from the bone marrow is stimulated by

A

G-CSF

57
Q

loosely localized to the walls of capillaries in tissues such as the liver, spleen, and lung

A

neutrophils in the MNP

58
Q

ratio of neutrophils of either the CNP or the MNP, two pools is roughly equal overall; however, marginated neutrophils in the capillaries of the lungs
make up a considerably larger portion of

A

peripheral neutrophils

59
Q

The half-life of neutrophils in the blood is relatively short at approximately

A

7 hours.

60
Q

significant importance in allowing neutrophils to marginate as well as exit the blood and enter the tissues by a process

A

Integrins and selectins

61
Q

Integrins and selectins are of significant importance in allowing neutrophils to marginate as well as exit the blood and enter the tissues by a process known as

A

diapedesis

62
Q

Those neutrophils that do not migrate into the tissues eventually undergo programmed cell death or apoptosis and are removed by macrophages in the

A

spleen, bone marrow, and liver

63
Q

the neutrophil’s life span is measured in hours

A

absence of infectious or inflammatory agents

64
Q

regulated by pro- and antiapoptotic members of the Bcl-2 family

A

Spontaneous neutrophil apoptosis

65
Q

inflammation and infection such as Mcl-1 and myeloperoxidase (MPO) tend to prolong the neutrophil’s life span through antiapoptotic signals, whereas others such as

A

MAC-1 trigger the death and phagocytosis of neutrophils

66
Q

Neutrophils are part of the

A

innate immune system

67
Q

Characteristics of innate immunity include

A

destruction of foreign organisms that is not antigen specific;
no protection against re-exposure to the same pathogen;
reliance on the barriers provided by skin and mucous membranes
phagocytes such as neutrophils and monocytes
inclusion of a humoral component known as the complement system

68
Q

major function of neutrophils is

A

phagocytosis and destruction of foreign material and microorganisms

69
Q

The process involves seeking and destruction

A

seeking (chemotaxis, motility, and diapedesis) and
destruction (phagocytosis and digestion)

70
Q

The first neutrophil response is to roll along endothelial cells of the blood vessels using stronger adhesive molecules than those used by

A

nonstimulated marginated neutrophils

71
Q

Rolling consists of transient adhesive contacts between neutrophil selectins and adhesive molecules on the surface of endothelial cells

A

(P selectins and E selectins)

72
Q

Activation is facilitated by the rolling of neutrophils on endothelium surfaces by

A

chemokines

73
Q

neutrophil scans the region while tightly attached and does not always transmigrate at the location of adhesion

A

adhesion occurs

74
Q

Surface cell receptors are primed when neutrophils are exposed to

A

lipopolysaccharide, tumor necrosis factor-alpha or granulocyte-macrophage colony-stimulating factor (GM-CSF)

75
Q

Surface cell receptors are primed when neutrophils are exposed to lipopolysaccharide, tumor necrosis factor-alpha or granulocyte-macrophage colony stimulating factor (GM-CSF), which are recognized by

A

Toll-like receptors

76
Q

Pseudopodia are extended around the foreign particle and enclose it within a

A

“phagosome” (engulfment)

77
Q

Respiratory burst through the activation of NADPH oxidase.

A

H2O2 and hypochlorite are produced.

78
Q

Formation of the phagosome allows the reduced

A

nicotinamide adenine dinucleotide (NADH) oxidase complex, NOX2, within the phagosome membrane to assemble

79
Q

second function of neutrophils is the generation of

A

neutrophil extracellular traps, or NETs

80
Q

extracellular thread-like structures believed to represent chains of nucleosomes from unfolded nuclear chromatin material (DNA)

A

NETs

81
Q

NETs are generated at the time that neutrophils die as a result of

A

antibacterial activity

82
Q

has been used to describe this unique form of neutrophil cell death that results in the release of NETs

A

NETosis

83
Q

third and final function of neutrophils is their

A

secretory function

84
Q

Neutrophils are a source of

A

transcobalamin I or R binder protein

85
Q

Neutrophils are a source of transcobalamin I or R
binder protein, which is necessary for the proper
absorption of

A

vitamin B12

86
Q

make up 1% to 3% of nucleated cells in the bone marrow

A

Eosinophils

87
Q

Eosinophil development is similar to that described earlier for neutrophils, and evidence indicates that eosinophils arise from the

A

CMP

88
Q

Eosinophil lineage is established through the interaction between the cytokines

A

interleukin-3 (IL-3), IL-5 (induced by IL-33), and GM-CSF and three transcription factors (GATA-1 (hematopoietic transcription factor), PU.1, and c/EBP)

89
Q

critical for eosinophil growth and survival

A

IL-5 and IL-33

90
Q

can be identified cytochemically because of the presence of Charcot-Leyden crystal protein in their primary granules

A

Eosinophilic promyelocytes

91
Q

presence of large (resolvable at the light microscope level), pale, reddishorange secondary granules, along with azure granules in blue cytoplasm

A

Eosinophil myelocytes

92
Q

Transmission electron micrographs of eosinophils reveal that many secondary eosinophil granules contain an

A

electron-dense crystalline core

93
Q

resemble their neutrophil counterparts with respect to their nuclear shape.

A

Eosinophil metamyelocytes and bands

94
Q

Secondary granules increase in number, and a third type of granule is generated called the

A

secretory granule or secretory vesicle

95
Q

The secondary granules become more distinct and refractory. Electron microscopy indicates the presence of two other organelles:

A

lipid bodies and small granules

96
Q

display a bilobed nucleus. Their cytoplasm contains characteristic refractile, orange-red secondary granules

A

Mature eosinophils

97
Q

last myelocyte mitotic division to the emergence of mature eosinophils from the marrow is about

A

3.5 days

98
Q

large storage pool of eosinophils in the marrow consisting of between

A

9 and 14 X 10 to the power 8 cells/kg

Hema Readings Chapter 5&9 (9 decks)

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