Hematology 2 Exam 1 Part 1 Flashcards
Define Leukopoiesis.
Production/proliferation of leukocytes in BLT
Define lymphopoiesis.
Production of lymphocytes in the bone marrow or lymph tissues
Define myelopoiesis (granulocytopoiesis)
Production of neutrophils, eosinophils, and basophils in the bone marrow ONLY
WBC classification in order from greatest to least
Neutrophils (segs): 5-70%
Lymphocytes: 18-42%
Monocytes: 2-11%
Eosinophils: 1-3%
Basophils: 0-2%
How do WBCs defend against foreign invaders?
-Immunocytes (lymphs) produce antibodies
-Lymphocytes produce cytokines
-Segs and monos produce inflammatory mediators
-Phagocytosis by granulocytes and mononuclear cells
As cells mature, what happens?
-Cell size decreases
-Nuclear chromatin becomes condensed
-Nucleoli disappear
-N:C ratio gets smaller
-Cytoplasm amount and color changes
As cell cytoplasm matures, what happens
-Deep blue color gets pale
-Granules may appear
-Amount increases
As cell nuclear maturation occurs, what happens?
-Nucleus decrease in size
-Chromatic becomes condensed or clumped
-Color changes from red to blue/purple
-Nucleoli may decrease or become absent
Define Erythron.
All stages or erythrocytes in the whole body
Define RBC mass.
Cells in circulation
What does erythropoietin do to increase RBCs in circulation?
-Allows early release of reticulocytes
-Increases number of mature erythrocytes
-Reduces marrow
What is the first stage of RBC maturation? Describe it.
Pronomoblast (or “blast”)
-Biggest stage
-Very basophilic w/ high RNA content
What is the first recognizable erythroid precursor cell?
Pronormoblast
BFU-E stays for _____ –> CFU-E stays for ___ –> Pronormoblast stays for ____
1 week, 1 week, 24 hours
What is the second stage of RBC maturation? Describe it.
Basophilic normoblast
-Round nucleus
-No visible nucleoli
-Temporarily more basophilic (RNA synthesis)
What is the third stage of RBC maturation? Describe it.
Polychromatic normoblast
-Round/sometimes eccentric nucleus
-opaque cytoplasm
-violet-blue or grayish color due to hgb synthesis
-polychromasia
What is the last stage of RBC maturation that is capable of mitosis?
Polychromatic normoblast
What stage in RBC maturation do we see hemoglobin synthesis (visually) and pyknotic clumping of the nucleus?
Polychromatic normoblast
What is the fourth stage of RBC maturation? What else can we call this stage? Describe it.
Orthochromic normoblast, or nRBC
-Nucleus is very pyknotic
-Cytoplasm is polychromatic
What is the 5th stage of RBC maturation? What else can we call this stage? Describe it.
Reticulocyte, Retic, or “shift” cell
-NO nucleus present
-May still have basophilic stipping
How long do retics stay in the marrow, pb, and spleen
marrow: 1 day
p.b.: 1 days
spleen: few days
What stain is used to view retics?
Methylene blue stain
What is the final stage of RBC maturation? Describe it.
Erythrocyte
-No nucleus
-Distinct central pallow
-No protein, or hgb made, or no mitochondria present
Life span of RBCs and how far do they travel in that time?
120 days; 300 miles
CFU-S or HSC consist of which antigen? What does it mature into?
CD 34 antigen; matures into CFU-GEMM
CFU-GEMM consists of which antigens? What does it mature into?
CD33 and CD34; matures into CFU-GM
CFU-GM is controlled by what? What does this mature into?
Controlled by ILs and CSFs; matures into myeloblasts
What are the four colony stimulating factors?
Multi-CSF (IL-3)
GM-CSF
G-CSF
M-CSF
Describe multi-CSF (IL-3), its source and its function.
-Stimulated by endotoxin released from infection
-Source: Fibroblasts, T-lymphs, macrophages, and monocytes
-Function: Stimulates regeneration, maturation, and differentiation of multi-potential and uni-potential stem cells
Describe GM-CSF, its source and its function.
Important for myeloid maturation in the marrow
-Source: T-lymphs, marrow fibroblasts, marrow endothelial cells, and monocytes
-Function: stimulates neutrophils, eosinophils, and monocyte growth
Describe M-CSF (CSF-1), its source and its function.
-Primary monocytic growth factor
-Source: mature monocytes, marrow fibroblasts, and endothelial cells
-Function: stimulates macrophages and release of G-CSF from monocytes, stimulates release of tumor necrosis factor (TNF), interferon, and IL-1 from macrophages
Describe G-CSF, its source and its function.
-Specific granulocyte GF
-Source: monocytes, marrow fibroblasts, and endothelial cells
-Function: stimulates neutrophils, and enhances functional response of neutrophils
What are the 6 stages of neutrophil maturation?
- Myeloblast
- Promyelocyte
- Myelocyte
- metamyelocyte (indentation)
- Band
- Segmented (polymorphonuclear)
What is the first stage of neutrophil maturation? Describe it.
Myeloblast or “blast”
-Primary granules begin to appear
-Large cell
-Lacy/smooth chromatin
-1-2% normal in b.m, but NOT IN P.B.
-Expressed antigens CD13 and CD33
What is the second stage of neutrophil maturation? Describe.
Pro-myelocyte
-Prominent primary granules (Azurophilic)
2-5% normal in b.m, BUT NOT IN P.B.
*The red-purple is helpful in distinguishing promyelocytes from myeloblasts
What is the third stage of neutrophil maturation? Describe.
Myelocyte
-Pinkish secondary/specific granules are now visible
-Primary granules are less visible
-Dawn of neutrophilia occurs
-Decreased RNA synthesis so less blue
What is dawn of neutrophilia?
Specific granules form in golgi area, causing a pink arc
What type of granules are visible in the promylocyte stage? What color(s) are these granules?
Primary/Nonspecific/Azurophilic; Red-purple color
What do primary/nonspecific or azurophilic granules contain? What do they stain positive for?
Lysosomes that contain lysozyme, acid hydrolases, myloperoxidase (MPO)
**, proteases and superoxide
YES, stains (+) for peroxide
What type of granules can be seen in the myelocyte stage? What do they cause and what color are they?
Secondary/specific granules; Pale lavender-pink color; Cause dawn of neutrophilia
What do secondary/specific granules contain? Do they stain positive for peroxidase?
Lysosomes; contain lysozyme, lactoferrin**, collagenases, and complement activators.
No they do not stain positive for peroxidase
Tertiary granules are invisible, but show what color with a special LAP stain? What do they contain? Do they stain positive for peroxidase?
Show blue-purple with lap stain;
Lysosomes; contain lysozyme, DAF, gelatinase, and LAP
No they do not stain positive for peroxidase
What is the fourth stage of neutrophil maturation? Describe
Metamyelocyte (indentation)
-Kidney bean or peanut shaped nucleaus
-Pink cytiplasm with pink-purple secondary granules
-12-25% normal in bone marrow, BUT NOT NORMAL IN P.B.
-NUCLEUS BECOMES INDENTED
What is the 5th stage of neutrophil maturation? Describe.
Band
-Curved, band-like nucleus (C or S shaped)
-some phagocytic ability
-Normal in small %’s in p.b.
An increase of bands in the p.b. is known as
Shift to the left
What is the last stage of neutrophil maturation?
Segmented or polymorphonucleus
-50-70% of total WBC population in normal adult p.b.
-Completely functional cell
-2-5 lobes
-Hypersegmentation is >5 lobes
Toxic granulation causes pronunciation of which granules
Secondary granules
Granulocytes reside in 2 main areas of the body, moving from:
Bone marrow –> p.b. –> tissues (Endothelium to tissues is non-reversible)
What are the three functions of granulocytes in bone marrow?
Proliferation:
Maturation:
Storage:
How much WBCs does the bone marrow hold?
About 25x the amount in circulation (4-10 day supply)
In the bloodstream, granulocytes enter and then divide up equally between two pools. What are they?
Circulating pool (CP): Counted in a WBC count
Marginating pool (MP): liest against endothelial lining of blood vessels
Marginating cells can be mobilized into p.b. circulating pool and cause an increase in WBC count due to:
Stress, exercise, crying children, and stressed out adults due to epinephrine
How long do granulocytes stay in p.b. before they move into tissues via diapedesis? How long do they ‘do their job’ before they die?
6-10 hours in p.b.
1-5 days to do their job
Which WBCs are capable of phagocytosis?
Primarily phagocytes (monocytes and neutrophils), but eos and basos are capable of LIMITED phagocytosis
What are the 5 steps of phagocytosis?
MRID(E)
M: Directed motility (migration)
R: Recognition and attachment
I: ingestion and phagocytosis
D: Degranulation/digestion and killing
E: exocytosis
