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HAEM - RBC Flashcards

1
Q

Haemopoiesis

A

Blood cell type production which originate in the bone marrow

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2
Q

Lineage of cells

A

Derived from pluripotent haemopoietic stem cells
They give rise to lymphoid stem cells (forming lymphocytes)
OR
Myeloid stem cells (forming erythrocytes, platelets, monocytes, mast cells, eosinophils and basophils)

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3
Q

Erythrocyte

A

Intravascular life span - 120 days
Function - oxygen transport

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4
Q

Platelet

A

10 days
Haemostasis

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5
Q

Monocyte

A

Several days
Phagocytosis + killing of micro-organisms

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6
Q

Neutrophil

A

7-10 hours
Phagocytosis + killing of micro-organisms

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7
Q

Eosinophil

A

Lifespan shorter than 7-10 hours
Defence against parasitic infection

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8
Q

Lymphocyte

A

Very variable lifespan
Humoral/cellular immunity

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9
Q

Haemopoietic stem cells characteristics

A

1) They can self-renew - continuously provide more progenitors to differentiate further (pool of HSCs not depleted) - some daughter cells remain as HSC
2) Differentiate to mature progeny

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10
Q

After HSC comes

A

Common myeloid/lymphoid progenitors

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11
Q

Platelets are

A

Broken down from megakaryocytes

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12
Q

Sites of haemopoiesis 3 weeks

A

Yolk sac ; generation of HSC (mesoderm)

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13
Q

Mesoderm

A

Middle developmental layer giving rise to skeleton, muscle, heart and bones

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14
Q

Haemopoiesis 6-8 weeks

A

Liver takes over and principle source of blood in foetus until shortly after birth

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15
Q

Haemopoiesis 10 weeks gestation

A

Children - occurs in all bones’ marrow
Adults - mainly in bone marrow of the pelvis, vertebrae and sternum

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16
Q

HSC and progenitor

A

Distributed in orderly fashion within bone marrow of mesenchymal/endothelial/vascularate

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17
Q

What is haemopoiesis regulated by

A

Genes/transcription factors/microenvironment

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18
Q

Disruption of regulation of haemopoiesis

A

Proliferation and differentiation is disrupted - lead to leuakemia/bone marrow failure

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19
Q

Haemopoietic growth factors

A

Hormones which bind to surface receptors and regulate proliferation/differentiation of HSCs

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20
Q

Red cell production

A

Erythropoiesis is regulated by erythropoietin (made in kidney)

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21
Q

Granulocyte and monocyte production?

A

Regulated by cytokines like interleukins

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22
Q

Megakaryocytopiesis and platelet production

A

Thrombopoietin

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23
Q

Lymphoid differentiation

A

Lymphoid progenitor splits into 3 :
B cell progenitor - humoral (antibody)
T cell progenitor - cellular (cytokine)
NK cell progenitor - cellular (cytokine/natural killer)

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24
Q

Myeloid differentiation

A

Common myeloid progenitor splits into two
Granulocyte-monocyte
MEP (splits into erythroid and megakaryocytic)

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25
As differentiation progresses?
Self renewal and lineage plasticity decrease
26
Polychromatic RBCs
RBCs are immature - appear bluish grey
27
Reticulocytes
Higher RNA content (different methylene blue stain is used for this)
28
Erythropoiesis
Myeloid progenitor - porerythroblast - erythroblast - erythrocytes
29
4 components needed for erythropoiesis
Iron Vitamin B12 Folic Acid Erythropoietin (regulates everything)
30
Low iron deficiency
Anaemia - microcytic (small RBC size) ; due to loss of blood (gastro/menstrual)/reduced intake/increased requirement (pregnancy) or inflammation/chronic disease
31
Hookworm
Helminths - blood loss leading to anaemia
32
What do microcytic RBCs look like
Hypochromic (smaler/paler)
33
b12/folic acid deficiency
Anaemia - macrocytic (RBCs have a large size) - leads to megaloblastic anaemia - they grow but cannot divide due to lack of B12/Folic Acid
34
Hypoxia
Oxygen is not present in sufficient amounts at tissue level to maintain adequate homeostasis
35
Erythropoietin is glycoprotein synthesised in response to
Hypoxia so there is demand feedback loop - it stimulates bone marrow to produce more RBCs
36
Iron 2 major functions
Oxygen transport haemoglobin Mitochondrial proteins (cytochromes a b c for apt production)
37
Iron deficiency shows
Koilonychia Glossitis and Angular Stomatitis Hypochromic and microcytic
38
Where is iron absorbed
Duodenum
39
Animal derived iron
Best form - ferrous - FE2+
40
Iron in food (dariy/eggs etc too)
Ferric - Fe3+ - has to be reduced first by vitamin c for example before absorption
41
Iron homeostasis
Excess iron is toxic to heart/liver and no way to excrete iron so tightly controlled ; 1-2mg per day is absorbed
42
How is iron harmful?
Free radicals that can damage body tissues
43
Fe3+ foods also contain
Phytates which bind to iron and reduce its absorption
44
Iron forms/transport
Reduced to Fe2+ by duodenal cytochrome b ; either taken up as ferritin or in ferric form (fe3+) and transported to plasma via ferroportin
45
When iron is needed for erythropoiesis
Bound to transferrin which delivers it to bone marrow
46
Enterocytes
Columnar epithelial cells in gut lining
47
Action of hepcidin
Binds to ferroportin and induces its internalisation preveting efflux of iron from enterocyte
48
iron stores in cell is called
Ferritin
49
What does hepcidin do to ferritin
When iron stpres are full then upregulation of hepcidin and iron absorption is limited and vice versa for when increased erythropoeisis
50
Action of hepcidin
ACTS ON FERROPORTIN MEANING FE3+ CANNOT BE SECRETED INTO THE PLASMA FROM ENTEROCYTE WHEN ERYTHROPOEISIS IS NEEDED THEN DOWNREGULATION OF HEPCIDIN = ALLOWING EFFLUX OF FE3+ INTO PLASMA WHICH CAN GO TO BONE MARROW (TRANSFERIN) AND CREATE RBC STEM CELLS
51
Iron deficiency
Microcytic Hypochromia
52
How many days do rbcs circulate for
120 - then phagocytosed by macrophages in the spleen and haem is recycled - this is what produces bile
53
Folic acid
Enzyme reaction : dUMP to dTTP (synthesis of thymidine)
54
Vitamin B12
Cofactor in krebs and cofactor in regenerating tetrahydrofolate WHICH IS ESSENTIAL FOR dUMP to dTTP - so THEY ARE LINKED
55
Failure of RBCs due to B12/folate deficiency
Megaloblastic anaemia - which is a cause of macrocytic anemia
56
Folate absorbed mainly in
Duodenum/jejunum ; mainly from leafy greens and demand increases during pregnancy/sickle-cell anaemia where there is increased RBC production
57
B12
Only found in foods of animal origin - cleaved from food proteins by hcl first and then binds to haptocorrins - then cleaved from this and binds to IF which is essential for absorption in the ileum
58
In circulation B12 is bound to enzyme
Transcobalamin
59
Situations of B12 deficiency
Vegan diet Lack of stomach acid Autoantibodies - production of IF disrupted - PERNICIOUS ANAEMIA Diseases in ileum that reduces absorption
60
Shortened red cell survival
Haemolysis
61
Disruption of vertical linkages in membrane proteins
Hereditary spherocytosis - round with no central pallour - loss of membrane without loss of cytoplasm so membrane rounds up - removed by spleen
62
Disruption of horizontal linkages
Hereditary elliptocytosis
63
Haemolysis due to
Integrity of membrane Haemoglobin structure/function Cellular metabolism
64
G6PD deficiency
Glucose 6 phosphate produces NADPH in PPP ; NADPH provides reducing power for maintaining reduced glutathionine which is a vital antioxidant in RBCs G6PD maintains reducing power of NADPH that enavles glutathioine protection
65
Deficiency of G6PD means
Red cells vulnerable to oxidant damage
66
What does G6PD deficiency look like?
A lot of irregularly contracted cells (bite cells) - smaller and lost central pallour
67
Polycythaemia
Too many red blood cells in circulation ; Hb/RBC/Hct all increased
68
Cause 1 of Polycythaemia
Elevated erythropoietin levels
69
Cause 2 (independent)
Intrinsic bone marrow disorder - myeloproliferative disorder
70
Polycythaemia leads to
Thick blood - high viscosity which could result in thrombosis - removed via venesection

POM (12 decks)

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