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HEMATOLOGY > Erythrocyte Production and Destruction > Flashcards

Erythrocyte Production and Destruction Flashcards

1
Q

RBCs are formally called erythrocytes, but may also be called

A

normoblasts

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2
Q

erythrocyte precursors develop from two progenitors known as

A

burst-forming unit-erythroid (BFU-E) and colony-forming unit-erythroid (CFU-E)

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3
Q

BFU-E, gives rise to what colonies?

A

large colonies

because they are capable of multisubunit colonies (called bursts)

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4
Q

CFU-E gives rise to what colonies?

A

smaller

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5
Q

how many weeks does it take for the BFU-E to mature to the CFU-E

A

1 week

and another week for the CFU-E to become a pronormoblast

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6
Q

while at the CFU-E stage, the cell completes approximately how many divisions before maturing further

A

3-5 divisions

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7
Q

how many days are required to produce a mature RBC from the BFU-E.

A

18 - 21 days

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8
Q

what is the earliest morphologically recognizable erythrocyte precursor

A

pronormoblast

derived via the BFU-E and CFU-E from pluripotent hematopoietic stem cell

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9
Q

in hematology, what stain is commonly used

A

modified Romanowsky stain

such as Wright or Wright-Giemsa

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10
Q

The stage of maturation of any blood cell is determined by careful examination of the?

A

nucleus and cytoplasm

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11
Q

as erythroid precursors mature, several general trends affect their appearance such as:

A
  1. Overall diameter of the cell decrease
  2. Nucleus diameter decreases more rapidly than diameter of the cell ; N:C ratio decreases
  3. Nuclear chromatin pattern becomes coarser, clumped, and condensed
  4. Nucleoli disappear.
  5. Cytoplasm changes from blue to gray-blue to salmon pink
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12
Q

what will be the appearance of nuclear chromatin develop when it becomes even coarser and more clumped as the cell matures

A

raspberry-like appearance

dark staining (chromatin) distinct from white appearance (parachromatin)

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13
Q

morphologic feature used to identify and stage red blood cell and white blood cell precursors.

A

nucleus-to-cytoplasm (N:C) ratio

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14
Q

fill in the blanks

if the nucleus takes up less than 50% of the area of the cell, the proportion of nucleus is ____ and the ratio is ______

A

lower ; lower

e.g., 1:5 or less than 1

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15
Q

fill in the blanks

if the nucleus takes up more than 50% of the area of the cell, the ratio is _____

A

higher

e.g., 3:1 or 3

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16
Q

what is the diameter

Pronormoblast

A

12–20 um

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17
Q

what is the diameter

Basophilic normoblast

A

10–15 um

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18
Q

what is the diameter

Polychromatic normoblast

A

10–12 um

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19
Q

what is the diameter

Orthochromic normoblast

A

8–10 um

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20
Q

Nucleus to Cytoplasm Ratio

Pronormoblast

A

8:1

1-2 nucleoli

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20
Q

what is the diameter

Bone marrow polychromatic

A

8–10 um

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21
Q

Nucleus to Cytoplasm Ratio

Basophilic normoblast

A

6:1

0-1 nucleoli

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22
Q

Nucleus to Cytoplasm Ratio

Polychromatic normoblast

A

4:1

0 nucleoli

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23
Q

Nucleus to Cytoplasm Ratio

Bone marrow polychromatic

A

no nucleus

0 nucleoli

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24
Q

Nucleus to Cytoplasm Ratio

Polychromatic normoblast

A

1:2

0 nucleoli

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25
Q

bone marrow transit time

Pronormoblast

A

24 hr

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26
Q

bone marrow transit time

Pronormoblast

A

24 hr

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27
Q

bone marrow transit time

Polychromatic normoblast

A

30 hr

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28
Q

bone marrow transit time

Orthochromic normoblast

A

48 hr

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29
Q

bone marrow transit time

Orthochromic normoblast

A

24 - 48 hr

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30
Q

normoblastic to rubriblastic

pronormoblast

A

rubriblast

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31
Q

normoblastic to rubriblastic

normoblastic to rubriblastic

A

Prorubricyte

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32
Q

normoblastic to rubriblastic

Polychromatic (polychromatophilic) normoblast

A

Rubricyte

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33
Q

normoblastic to rubriblastic

Orthochromic normoblast

A

Metarubricyte

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34
Q

normoblastic to rubriblastic

Polychromatic (polychromatophilic) erythrocyte

A

Polychromatic (polychromatophilic) erythrocyte

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35
Q

nucleus is round to oval, containing one or two nucleoli and the purple red chromatin is open and contains few, if any, fine clumps

A

Pronormoblast (Rubriblast)

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36
Q

the cytoplasm is dark blue because of the concentration of ribosomes and RNA

A

Pronormoblast (Rubriblast)

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37
Q

this is where globin production begins

A

Pronormoblast (Rubriblast)

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38
Q

the chromatin stains deep purple-red. Nucleoli may be present early in the stage but disappear later

A

Basophilic Normoblast (Prorubricyte)

39
Q

the cytoplasm may be a **deeper, richer blue ** than in the pronormoblast

A

Basophilic Normoblast (Prorubricyte)

40
Q

Detectable hemoglobin synthesis occurs

A

Basophilic Normoblast (Prorubricyte)

41
Q

no nucleoli are present

A

Polychromatic (Polychromatophilic) Normoblast (Rubricyte)

42
Q

cytoplasm

the color produced is a mixture of pink and blue, resulting in a

A

murky gray-blue

42
Q

cytoplasm

first stage in which the pink color associated with stained hemoglobin can be seen

A

Polychromatic (Polychromatophilic) Normoblast (Rubricyte)

43
Q

polychromatophilic means

A

“many color loving”

44
Q

hemoglobin synthesis increases, and the accumulation begins to be visible as a pinkish color in the cytoplasm.

A

Polychromatic (Polychromatophilic) Normoblast (Rubricyte)

45
Q

nucleus is completely condensed (i.e., pyknotic)

A

Orthochromic Normoblast (Metarubricyte)

46
Q

increase in the salmon pink color of the cytoplasm reflects nearly complete hemoglobin production

A

Orthochromic Normoblast (Metarubricyte)

47
Q

True or False

orthochromic normoblast is capable of division

A

FALSE

it not capable because of the condensation of the chromatin

48
Q

hemoglobin production continues on the
remaining ribosomes using messenger RNA produced earlier. Late in this stage, the nucleus is ejected from the cell

A

Orthochromic Normoblast (Metarubricyte)

49
Q

RBC precursor that ejects its nucleus

A

pyrenocyte

50
Q

small fragments of nucleus are left behind if the projection is pinched off before the entire nucleus is enveloped. These fragments are called

A

Howell-Jolly bodies

51
Q

True or False

Polychromatic (Polychromatophilic) Erythrocyte or Reticulocyte has no nucleus

A

TRUE

52
Q

has the same cytoplasmic color as mature RBC (salmon pink) with remnant of residual RNA (bluish tinge) that can be visualized using vital stain

A

Polychromatic (Polychromatophilic) Erythrocyte or Reticulocyte

53
Q

the penultimate stage cell

A

Polychromatic (Polychromatophilic) Erythrocyte or Reticulocyte

54
Q

True or False

No nucleus is present in mature RBCs

A

TRUE

55
Q

it is a biconcave disc with central pallor

A

Mature Erythrocyte

56
Q

term describing the dynamics of RBC production and destruction

A

Erythrokinetics

57
Q

name given to the collection of all stages of erythrocytes throughout the body

A

Erythron

erythron is distinguished from the RBC mass

58
Q
  • A hormone produced by the kidney.
  • A circulating Glycoprotein
  • Acts mainly on CFU – E
  • Stimulates RBC production
A

Erythropoietin

59
Q

how EPO stimulates RBC production

A
  • Rescue cells from apoptosis
  • Release retics from the BM early
  • Reduce marrow transit time of cells
60
Q

essential for the synthesis of Hemoglobin

A

iron

61
Q

iron deficiency causes

A
  • microcytic
  • hypochromic anemia
62
Q

what is a Cyanocobalamine

A

vitamin B12

63
Q

vitamin B12: Cyanocobalamine deficiency causes

A

megaloblastic anemia or pernicious anemia

64
Q

needs the Intrinsic Factor (IF) from the gastric juice for absorption in the small Intestine

A

vitamin B12: Cyanocobalamine

65
Q
  • Important in the making of DNA
  • is also called Extrinsic Factor of Castle
A

vitamin B12: Cyanocobalamine

66
Q

is found in meat & dairy products.

A

vitamin B12: Cyanocobalamine

67
Q

what is senescence

A

RBCS are continually aging

68
Q

2 major pathways for RBC removal

A
  • Extravascular Hemolysis
  • Intravascular Hemolysis
69
Q

destruction of RBCs

as old RBCs removed, are replaced by ____ from the bone marrow.

A

younger RBCs

70
Q

destruction of cells

Old RBCs removed by macrophages located in the

A

reticuloendothelial system (RES)

spleen most important organ

71
Q

90% of destruction of RBCs occurs

A

extravasculary

72
Q

old or damaged RBCs phagocytized by RES cells and digested by lysosomes

A

extravascular hemolysis

73
Q

hemoglobin molecules disassembled and broken down into component parts

A

extravascular hemolysis

74
Q

Iron returned by transferrin to bone marrow.

A

Extravascular hemolysis

75
Q

True or False

in extravascular hemolysis, globin is broken down into amino acids and is returned to amino acid pool

A

True

76
Q

Extravascular hemolysis

what is disassembled into carbon monoxide, which is expelled

A

protoporphyrin ring

77
Q

Extravascular hemolysis

the remaining component, ________, is converted to ________ and carried by albumin to liver.

A

biliverdin ; bilirubin

78
Q

Extravascular hemolysis

in liver, bilirubin is conjugated to ______ and excreted with bile into intestine.

A

bilirubin glucuronide

79
Q

Extravascular hemolysis

Bilirubin glucuronide is converted by bacteria and excreted in the stool as

A

stercobilinogen.

80
Q

Extravascular hemolysis

small amount of __________ is reabsorbed into the blood circulation and then excreted through kidneys in the urine.

A

urobilinogen

81
Q

in extravasculary hemolyisis both _______ and ______ can be measured in plasma and used as indicators of the amount of extravascular hemolysis occurring.

A

** unconjugated (prehepatic) **and **conjugated bilirubin (posthepatic)

82
Q

only 5-10% hemolysis occurs in this pathway

A

intravascular hemolysis

83
Q

mechanical or fragmentation hemolysis

A

intravascular hemolysis

84
Q

RBCs break down within lumen of blood vessel, releasing hemoglobin directly into bloodstream.

A

intravascular hemolysis

85
Q

in intravascular hemolysis hemoglobin disassociates into globin dimers and picked up by

A

protein carrier - haptoglobin.

86
Q

intravascular hemolysis

________ complex is too big to be excreted through kidneys. Complex is carried to liver where it is further catabolized.

A

hemoglobin-haptoglobin

87
Q

at this point, pathway in liver identical to extravascular pathway.

A

intravascular hemolysis

88
Q

True or False

haptoglobin levels increase in intravascular hemolysis.

A

FALSE

should be DECREASE

89
Q

intravascular hemolysis

as haptoglobin levels diminish, unbound hemoglobin _____ and _____ are rapidly filtered by the glomeruli in the kidneys, reabsorbed by the renal tubular cells, and converted to hemosiderin.

A

alpha and beta dimers

90
Q

intravascular hemolysis

The renal tubular uptake can process as much as ______ of filtered hemoglobin.

A

5 g/day

91
Q

True or False

in intravascular hemolysis, hemoglobin may also appear in urine (hemoglobinuria).

A

TRUE

92
Q

Modified True or False

Hemoglobin that is neither bound by haptoglobin nor directly excreted in the urine is oxidized to methemoglobin. The heme groups in methemoglobin are released and taken up by another transport protein, albumin

A

First statement is true, Second statement is false

transport protein should be hemopexin

93
Q

The combined depletion of ____ and ______ and the presence of methemalbuminemia and hemosiderinuria can be seen in cases of intravascular hemolytic anemia

A

haptoglobin and hemopexin

HEMATOLOGY (2 decks)

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