Components of blood Flashcards

1
Q

Blood cells are produced in the ____________ by a process known as haematopoiesis (or hematopoiesis or hemopoiesis)

A

Blood cells are produced in the bone marrow by a process known as haematopoiesis (or hematopoiesis or hemopoiesis)

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2
Q

All the different blood cell types are derived from a relatively small pool of precursor cells called…

A

Haematopoietic stem cells

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3
Q

What is the site of haematopoiesis in the embryo?

A

In the yolk sac
From 2 – 5 months gestation, in liver and spleen before finally establishing in the bone marrow from 5 months

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4
Q

What is the site of haematopoiesis at birth?

A

Mostly marrow, but liver and spleen when needed

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5
Q

As we grow, active marrow sites decrease but retain the ability. Active marrow is confined to ___________ eventually

A

Axial skeleton (skull, ribs, vertebrae, pelvis and proximal long bones)

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6
Q

Most stem cells sit in a ____________ state

A

Quiescent

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7
Q

In granulopoiesis, a myeloid lineage committed blast cells divide and mature through a number of intermediate stages (promyelocyte, myelocyte, metamyelocyte) to become a…

A

Mature neutrophil

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8
Q

An erythroid committed blast cell (____________) which goes through divisions with proliferation and maturation
to eventually form a mature erythrocyte

A

An erythroid committed blast cell (pronormoblast) which
goes through divisions with proliferation and maturation
to eventually form a mature erythrocyte

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9
Q

How is thrombopoiesis (platelet formation) different from other cells?

A

When the blast cells divide the cytoplasm does not, so an
increasing number of nuclei accumulate in a single cell
with a very large cytoplasm. The edges of which buds off to
form platelets that are released into the bloodstream.

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10
Q

In Eosinophils the granules take up ______ which is red and acidic

A

In Eosinophils the granules take up eosin which is red and acidic

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11
Q

In Basophils the granules take up ___________ dyes which are densely blue

A

In Basophils the granules take up basic (alkali) dyes which are densely blue

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12
Q

In Neutrophils the granules are ______ and ____________

A

In Neutrophils the granules are fine and ‘neutral’ mix of the two colours

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13
Q

What are the functions of neutrophils?

A

Phagocytosis
Granule release for elastases and attract other cells via small molecules released
‘Body stress’ eg bacterial infection, trauma, infarction

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14
Q

What are the functions of eosinophils?

A

Parasitic infections
Hypersensitivity (allergic) reactions

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15
Q

Segmented nucleus

A

Neutrophils

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16
Q

Bilobed nucleus

A

Eosinophil

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17
Q

Large deep purple cytoplasmic granules often obscuring the nucleus

A

Basophil

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18
Q

In basophils, granules contain ___________ and ___________ like molecules

A

In basophils, granules contain histamine and heparin like molecules

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19
Q

Function of basophils

A

Mediates hypersensitivity reactions IgE mediated histamine release (?)

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20
Q

Large single nucleus

A

Monocytes

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21
Q

Monocytes circulate for about a week then enter tissues to become specialised tissue ____________, so much longer lived than ____________

A

Monocytes circulate for about a week then enter tissues to become specialised tissue macrophages, so much longer lived than neutrophils

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22
Q

Function of monocytes

A

Clearing debris, engulfing and destroying infective organisms, and presenting antigen to immune cells and releasing signals to attract other cells

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23
Q

How do mature lymphocytes look like?

A

Small with condensed nucleus and limited cytoplasm

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24
Q

How do acticated/atypical lymphocytes look like?

A

Large with plentiful blue cytoplasm often extending up to neighbouring red cells on a blood film and with a larger less condensed looking nucleus

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25
Function of lymphocytes
The ‘cognate’ response to infection - the brains of the immune system (different types have different functions)
26
What does the image show?
Small mature lymphocyte
27
What does the image show?
Activated lymphocyte
28
Which cells are frequent/ morphologically remarkable?
The progeny (red cells, neutrophils, eosinophils etc)
29
Which cells are infrequent/ morphologically unremarkable?
Stem cell, and early committed precursors
30
How are primitive precursors identified?
Bio-assays - culture marrow in vitro/in vivo and show a colony of a particular cell type when incubated different growth conditions Immunophenotyping
31
In clinical practice what tools do we have to look at the
Automated full blood count analyser Reviewing a blood film Bone marrow biopsy from the posterior iliac crest trephine
32
Blood is made of _______
Plasma
33
What does plasma contain?
Red blood cells, white blood cells, platelets and clotting factors, such as fibrinogen
34
Once the clotting factors are removed from the blood, what is left is called the serum. Serum contains..
Glucose Electrolytes (sodium and potassium) Proteins (immunoglobulins (antibodies) and hormones)
35
Where do blood cells develop?
Bone marrow
36
Bone marrow is mostly found in...
Pelvis, vertebrae, ribs and sternum
37
What are the pluripotent haematopoietic stem cells?
Undifferentiated cells that can transform into various blood cells
38
Pluripotent haematopoietic stem cells can become..
Myeloid stem cells Lymphoid stem cells Dendritic cells (via different intermediate stages)
39
Red blood cells (RBC) develop from ___________, which originate from ___________ stem cells
Red blood cells (RBC) develop from reticulocytes, which originate from myeloid stem cells
40
Platelets are made by _____________, which develop from the myeloid stem cells
Platelets are made by megakaryocytes, which develop from the myeloid stem cells
41
What is the lifespan of RBCs?
Four months (120 days)
42
What is the lifespan of platelets?
Ten days
43
What is the role of platelets
Clump together (platelet aggregation) and plug gaps where blood clots need to form
44
Myeloid stem cells become myeloblasts, which can become..
Monocytes then macrophages Neutrophils Eosinophils Mast cells Basophils
45
Lymphocytes come from the __________ stem cells and become __ cells or __ cells
Lymphocytes come from the lymphoid stem cells and become B cells or T cells
46
B lymphocytes (B cells) mature in the bone marrow and differentiate into..
Plasma cells Memory B cells
47
B lymphocytes (B cells) mature in the..
Bone marrow
48
T lymphocytes (T cells) mature in the..
Thymus gland
49
T lymphocytes (T cells) differentiate into..
CD4 cells (T helper cells) CD8 cells (cytotoxic T cells)
50
Define Anisocytosis
Variation in the size of the red blood cells - seen in myelodysplastic syndrome and anaemia (e.g., iron deficiency, pernicious and autoimmune haemolytic anaemia)
51
Define Target cells
Red blood cells with a central pigmented area surrounded by a pale area, surrounded by a ring of thicker cytoplasm on the outside Seen in iron deficiency anaemia and post-splenectomy
52
What are heinz bodies?
Individual blobs seen inside RBCs. These are denatured haemoglobin seen in G6PD deficiency and alpha-thalassaemia.
53
What are Howell-Jolly bodies?
Individual blobs of DNA material seen inside red blood cells (normally removed by spleen so seen after a splenectomy or with a non-functioning spleen (e.g., sickle cell anaemia)
54
What are Reticulocytes?
Immature red blood cells - larger than RBCs and still have RNA material. Seen in haemolytic anaemia
55
What are Schistocytes?
Fragments of red blood cells. Seen in microangiopathic haemolytic anaemia and metallic heart valve replacement
56
What are Sideroblasts?
Immature red blood cells with a nucleus surrounded by iron blobs. Due to a genetic defect or myelodysplastic syndrome
57
What are smudge cells?
Ruptured white blood cells - chronic lymphocytic leukaemia
58
What are Spherocytes?
Sphere-shaped red blood cells without the bi-concave disk shape. Seen in autoimmune haemolytic anaemia or hereditary spherocytosis
59
What are the most common type of granulocyte?
Neutrophils
60
Give examples of granulocytes
Neutrophils Eosinophils Basophils
61
Give examples of lymphocytes
B-cells T-cells Natural killer cells
62
What are the types of leukocytes
Granulocytes (neutrophils, eosinophils, and basophils), monocytes, and lymphocytes (T cells and B cells)
63
What are the components of blood?
64
What cells undergo Erythropoiesis?
Red cells
65
What cells undergo Thrombopoiesis?
Platelets
66
Which cells undergo myelopoiesis/ granulopoiesis?
Neutrophils Eosinophils Basophils Monocytes → macrophages
67
Which cells undergo lymphopoiesis?
Lymphocytes
68
Which type of cells undergo self-renewal?
Stem cells (lost in descendents)
69
Define Differentiation
Descendents commit to one or more lineages
70
_____________ blood contains a higher proportion of haemopoietic stem cells
Umbilical cord
71
More primitive progenitors (eg stem cells) are ____________ during steady-state haemopoiesis
Quiescent/dormant
72
What does myeloid mean?
Marrow Lineage Granulocytes and precursors
73
Where is a bone marrow biopsy taken?
Iliac crest/sternum
74
75
What are the compartments of the bone marrow?
Haemopoietic cells Non-haemopoietic cells Connective tissue matrix Vascular elements
76
Give examples of non-haemopoietic cells
Adipocytes (fat cells) ‘Fibroblasts’ osteoclasts Osteoblasts
77
Describe bone marrow vasculature
Arterioles drain into ‘sinuses’ – wide venous vessels, which open into larger central sinuses These sinuses are larger than the capillary ones and have a discontinuous basement membrane
78
79
Explain how mature red cells are released from the marrow
80
After birth, active red marrow is gradually replaced by __________ marrow so that from age 20, haematopoiesis is concentrated in the __________ skeleton and articular ends of the __________ and __________ bones
After birth, active red marrow is gradually replaced by yellow fat marrow so that from age 20, haematopoiesis is concentrated in the axial skeleton and articular ends of the femoral and humerus bones
81
What is a normal M:E ratio
Myeloid portion is greater than erythroid portion
82
When does reversal of M:E ratio occur?
Haemolysis as a compensatory response
83
What regulates haemopoiesis?
Intrinsic properties of cells (e.g stem cells vs progenitor cells vs mature cells) Signals from immediate surroundings and the periphery (microenvironmental factors) Specific anatomical area (‘niche’) for optimal developmental signals
84
Neutrophil precursor maturation is regulated by...
G-CSF (granulocyte-colony stimulating factor)
85
____________ regulates growth and development of megakaryocytyes from their precursors
Thrombopoietin
86
How do we assess haemopoiesis? (non-lymphoid mature cells)
FBC, cell indices, morphology Bone marrow examination
87
How do we assess haemopoiesis? (lymphoid mature cells)
FBC/morphology Expression of antigens indicating lineage or stage of development required - immunophenotyping