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3MB Haematology > Components of blood > Flashcards

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
Q

Function of lymphocytes

A

The ‘cognate’ response to infection - the brains of the immune system (different types have different functions)

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26
Q

What does the image show?

A

Small mature lymphocyte

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27
Q

What does the image show?

A

Activated lymphocyte

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28
Q

Which cells are frequent/ morphologically remarkable?

A

The progeny (red cells, neutrophils, eosinophils etc)

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29
Q

Which cells are infrequent/ morphologically unremarkable?

A

Stem cell, and early committed precursors

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30
Q

How are primitive precursors identified?

A

Bio-assays - culture marrow in vitro/in vivo and show a colony of a particular cell type when incubated different growth
conditions

Immunophenotyping

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31
Q

In clinical practice what tools do we have to look at the

A

Automated full blood count analyser
Reviewing a blood film
Bone marrow biopsy from the posterior iliac crest
trephine

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32
Q

Blood is made of _______

A

Plasma

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33
Q

What does plasma contain?

A

Red blood cells, white blood cells, platelets and clotting factors, such as fibrinogen

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34
Q

Once the clotting factors are removed from the blood, what is left is called the serum. Serum contains..

A

Glucose
Electrolytes (sodium and potassium)
Proteins (immunoglobulins (antibodies) and hormones)

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35
Q

Where do blood cells develop?

A

Bone marrow

36
Q

Bone marrow is mostly found in…

A

Pelvis, vertebrae, ribs and sternum

37
Q

What are the pluripotent haematopoietic stem cells?

A

Undifferentiated cells that can transform into various blood cells

38
Q

Pluripotent haematopoietic stem cells can become..

A

Myeloid stem cells
Lymphoid stem cells
Dendritic cells (via different intermediate stages)

39
Q

Red blood cells (RBC) develop from ___________, which originate from ___________ stem cells

A

Red blood cells (RBC) develop from reticulocytes, which originate from myeloid stem cells

40
Q

Platelets are made by _____________, which develop from the myeloid stem cells

A

Platelets are made by megakaryocytes, which develop from the myeloid stem cells

41
Q

What is the lifespan of RBCs?

A

Four months (120 days)

42
Q

What is the lifespan of platelets?

A

Ten days

43
Q

What is the role of platelets

A

Clump together (platelet aggregation) and plug gaps where blood clots need to form

44
Q

Myeloid stem cells become myeloblasts, which can become..

A

Monocytes then macrophages
Neutrophils
Eosinophils
Mast cells
Basophils

45
Q

Lymphocytes come from the __________ stem cells and become __ cells or __ cells

A

Lymphocytes come from the lymphoid stem cells and become B cells or T cells

46
Q

B lymphocytes (B cells) mature in the bone marrow and differentiate into..

A

Plasma cells
Memory B cells

47
Q

B lymphocytes (B cells) mature in the..

A

Bone marrow

48
Q

T lymphocytes (T cells) mature in the..

A

Thymus gland

49
Q

T lymphocytes (T cells) differentiate into..

A

CD4 cells (T helper cells)
CD8 cells (cytotoxic T cells)

50
Q

Define Anisocytosis

A

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
Q

Define Target cells

A

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
Q

What are heinz bodies?

A

Individual blobs seen inside RBCs. These are denatured haemoglobin seen in G6PD deficiency and alpha-thalassaemia.

53
Q

What are Howell-Jolly bodies?

A

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
Q

What are Reticulocytes?

A

Immature red blood cells - larger than RBCs and still have RNA material. Seen in haemolytic anaemia

55
Q

What are Schistocytes?

A

Fragments of red blood cells. Seen in microangiopathic haemolytic anaemia and metallic heart valve replacement

56
Q

What are Sideroblasts?

A

Immature red blood cells with a nucleus surrounded by iron blobs. Due to a genetic defect or myelodysplastic syndrome

57
Q

What are smudge cells?

A

Ruptured white blood cells - chronic lymphocytic leukaemia

58
Q

What are Spherocytes?

A

Sphere-shaped red blood cells without the bi-concave disk shape. Seen in autoimmune haemolytic anaemia or hereditary spherocytosis

59
Q

What are the most common type of granulocyte?

A

Neutrophils

60
Q

Give examples of granulocytes

A

Neutrophils
Eosinophils
Basophils

61
Q

Give examples of lymphocytes

A

B-cells
T-cells
Natural killer cells

62
Q

What are the types of leukocytes

A

Granulocytes (neutrophils, eosinophils, and basophils), monocytes, and lymphocytes (T cells and B cells)

63
Q

What are the components of blood?

A
64
Q

What cells undergo Erythropoiesis?

A

Red cells

65
Q

What cells undergo Thrombopoiesis?

A

Platelets

66
Q

Which cells undergo myelopoiesis/ granulopoiesis?

A

Neutrophils
Eosinophils
Basophils
Monocytes → macrophages

67
Q

Which cells undergo lymphopoiesis?

A

Lymphocytes

68
Q

Which type of cells undergo self-renewal?

A

Stem cells (lost in descendents)

69
Q

Define Differentiation

A

Descendents commit to one or more lineages

70
Q

_____________ blood contains a higher proportion of haemopoietic stem cells

A

Umbilical cord

71
Q

More primitive progenitors (eg stem cells) are ____________ during steady-state haemopoiesis

A

Quiescent/dormant

72
Q

What does myeloid mean?

A

Marrow
Lineage
Granulocytes and precursors

73
Q

Where is a bone marrow biopsy taken?

A

Iliac crest/sternum

74
Q
A
75
Q

What are the compartments of the bone marrow?

A

Haemopoietic cells
Non-haemopoietic cells
Connective tissue matrix
Vascular elements

76
Q

Give examples of non-haemopoietic cells

A

Adipocytes (fat cells)
‘Fibroblasts’ osteoclasts
Osteoblasts

77
Q

Describe bone marrow vasculature

A

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
Q
A
79
Q

Explain how mature red cells are released from the marrow

A
80
Q

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

A

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
Q

What is a normal M:E ratio

A

Myeloid portion is greater than erythroid portion

82
Q

When does reversal of M:E ratio occur?

A

Haemolysis as a compensatory response

83
Q

What regulates haemopoiesis?

A

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
Q

Neutrophil precursor maturation is regulated by…

A

G-CSF (granulocyte-colony stimulating factor)

85
Q

____________ regulates growth and development of
megakaryocytyes from their precursors

A

Thrombopoietin

86
Q

How do we assess haemopoiesis? (non-lymphoid mature cells)

A

FBC, cell indices, morphology
Bone marrow examination

87
Q

How do we assess haemopoiesis? (lymphoid mature cells)

A

FBC/morphology
Expression of antigens
indicating lineage or stage of development required - immunophenotyping

3MB Haematology (23 decks)

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