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Blood > Erythropoiesis > Flashcards

Erythropoiesis Flashcards

1
Q

General stages of erythropoiesis

A

Myeloid stem cell ->proerythroblast-> erythroblast -> reticulocytes ->mature RBC

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2
Q

Duration of erythropoiesis

A

14-21 days

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3
Q

Where does erythropoiesis take place?

A

Bone marrow

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4
Q

What is erythropoietin?

A

Growth factor that stimulates MSC proliferation and differentiation

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5
Q

DNA synthesis requires..?

A

Folate and vit B12

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6
Q

Maturation of erythroblast

A
  • Filled with Hb which requires Fe
  • nucleus in erythroblast is reabsorbed/extruded so that more Hb can be added
  • remnants of organelles
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7
Q

What is diapedesis?

A

migration of reticulocytes through capillaries for further maturation into mature RBC

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8
Q

Indicator of bone marrow activity/erythropoiesis and how it is interpreted

A

amt of reticulocyte in circulation (normal is ~1%)
- too little -> erythropoiesis not functioning well
- too much -> abnormally high activity

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9
Q

How long for reticulocytes to mature after entering circulation?

A

1-2 days

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10
Q

Regulation of erythropoiesis and how the feedback loop works

A

Changes in arterial partial pressure of oxygen (PaO2); negative feedback loop

  • decrease -> HIF-1a synthesised and released into circulation -> stimulate production of erythropoietin (EPO) by kidney -> increased erythropoiesis -> increased mature RBC and O2 carrying capacity
  • increased O2 carrying capacity reliefs initial stimulus on EPO production
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11
Q

What are some factors that can affect arterial partial pressure of O2?

A
  • anaemia
  • cardiopulmonary issues
  • atmospheric PO2
  • O2 consumption (affected by strenuous activities -> increased consumption, less O2 avail in blood)
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12
Q

Homeostasis of blood system and some diseases as a result of imbalance

A

Balance btw production (erythropoiesis) and clearance (RBC loss/destruction)
- destruction > production -> anaemia
- production > destruction -> polycythaemia (rare; happens when neoplasia/ blood doping)

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13
Q

Factors affecting RBC loss

A
  • usual clearance (remove aged RBC)
  • blood loss
  • immune destruction
  • genetic defects affecting fn of Hb
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14
Q

Factors affecting erythropoiesis

A
  • hypoxia (lack of O2 -> increase erythropoiesis)
  • nutrients availability
  • neoplasia
  • erythropoietin/ blood doping
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15
Q

Ways to assess derangements of erythropoietic system

A
  • full blood count
  • reticulocyte count
  • peripheral blood film

not as impt: BM aspirates (evaluate integrity of bone marrow), bilirubin, ferritin level

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16
Q

What to look out for in FBC?

A
  • Hb -> most impt parameter when assessing if one has anaemia or not
  • RBC
  • MCV
  • MCH
  • MCHC
  • Haematocrit (give overall view of total volume of RBC)
17
Q

What is MCV?

A

mean corpuscular vol (vol per RBC)

18
Q

Interpretation of MCV

A
  • normocytic = normal
  • microcytic = smaller than normal
  • macrocytic = larger than normal (implication is that RBC cannot pass through capillaries to get into circulation and burst)
19
Q

What is MCH?

A

mean corpuscular Hb (amt of Hb per RBC)

20
Q

What is MCHC?

A

mean concentration (MCH/MCV = conc of Hb per RBC)

21
Q

Interpretation of MCHC

A
  • normochromic -> normal
  • hypochromic -> [Hb] less than normal -> lighter in colour
  • hyperchromic -> [Hb] more than normal -> darker in colour
22
Q

How is anaemia assessed?

A

RBC quantity and quality (size and shape)

23
Q

Definition of anaemia

A

Reduced Hb and/or reduced RBC

24
Q

(Classification of anaemia) cause of anaemia if RBC is normocytic

A

Increased RBC loss - eg: acute blood loss

Reduced RBC production - eg: renal disease

25
Q

(Classification of anaemia) cause of anaemia if RBC is microcytic

A

Insufficient/abnormal Hb synthesis - eg: Fe deficiency, hemoglobinopathies

26
Q

(Classification of anaemia) cause of anaemia if RBC is macrocytic

A

Impaired DNA synthesis and cellular division - eg: Vit B12/folate deficiencies/meds

27
Q

(Classification of anaemia) cause of anaemia if RBC is normochromic

A

Less likely to be Hb production issues and more likely to be due to increased RBC loss/reduced RBC production

28
Q

(Classification of anaemia) cause of anaemia if RBC is hypochromic

A

Insufficient/abnormal Hb synthesis - Fe deficiency

29
Q

(Classification of anaemia) cause of anaemia if RBC is hyperchromic

A

Only seen in spherocytes - RBC loss it concave shape so cant squeeze through capillaries (burst easily); inappropriate surface:vol ratio - delivery of O2 compromised

30
Q

Diagnostic tests to assess the blood system

A

Full blood count (FBC)
Reticulocyte count
Peripheral blood film (PBF)

31
Q

What is reticulocyte count and how is it interpreted?

A

Reticulocyte count - no. of reticulocytes in circulation; indication of rate of erythropoiesis

Interpretation:

Higher than normal - erythropoiesis happening at high rate

Lower than normal - erythropoiesis is hampered

32
Q

(PBF) What is anisocytosis?

A

Mixture of large and small RBCs

33
Q

(PBF) What do target cells look like?

A

Look like bullseye - dark red mark in center with white band surrounding it

34
Q

(PBF) What are inclusion bodies?

A

Protein aggregates

35
Q

(PBF) What do target cells and inclusion bodies indicate?

A

Hemoglobinopathy/dysfunction or dysregulation of Hb

36
Q

(PBF) What are cell fragments?

A

Lysed RBCs

37
Q

(PBF) What is poikilocytosis?

A

RBCs with different shapes and sizes

38
Q

(PBF) What is a megaloblast?

A

Huge erythroblast

39
Q

Implication of presence to erythroblast and megaloblast in PBF

A

Erythroblasts and megaloblasts are very immature RBCs and should not be present in a normal PBF, presence can indicate that pt is suffering from sever/chronic anaemia

Blood (9 decks)

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