hematology

Question 1

Blood cell maturation

Answer 1

1 - uncommitted pluripotent stem cell (in bone marrow)

EPO

2 - committed pro erythroblast
3 - normoblast (nucleus shrinks/reabsorbed)
4 - reticulocyte (leaves BM, enters blood stream) 1%
5 - RBC - Hb synthesis ceases

Question 2

Heme

Answer 2

HB has 4 & 2 globulins

made in mitochondria of RBC
carry 1 molecule O2
comprised of iron (deoxy or oxy)

broken into bilirubin and iron in spleen/liver by macrophage

apoferritin - liver, released as bile
ferritin - spleen

Question 3

reticulocyte count

Answer 3

normally 1%

high - more RBCs being produced (bleeding, anemia, increased EPO)

low - BM failure, low levels B12, low iron

Question 4

iron

Answer 4

67% bound to heme
30% storred/circulating
3% lost

Question 5

primary hemostasis

Answer 5

1 - vasoconstriction

2 - platelet plug (platelets activated by matrix, release vacuole contents/granules)

Question 6

secondary hemostasis

Answer 6

cytokines/chemokines released from epithelial cells

TPO changes prothrombin to thrombin, which changes fibrinogen to fibrin which stabilizes clot w fibrin mesh

Question 7

tertiary hemostasis

Answer 7

tpa from endothelial cells, plasminogen to plasmin

Question 8

platelet activation

Answer 8

by exposure to underlying matrix

1 - release granular content (facilitate further platelet activation)
2 - change confirmation (increase glycoproteins - “sticky”)

Question 9

bone marrow aspiration

Answer 9

liquid

gross exam of cellularity (anemia, infiltrate, platelet, imunoglobulin)

Question 10

biopsy

Answer 10

solid
used for diagnosis
more specific and reliable account of cellularity
more painful/expensive

Question 11

multilineage cytokines

Answer 11

SCF
GM - CSF
IL - 6

Question 12

lineage specific cytokynes

Answer 12

G-CSF
M-CSF
EPO
TPO

Question 13

cytokines that direct stem cell to myeloid lineage

Answer 13

GM-CSF
IL-3
IL-6

Question 14

cytokines that direct myeloid to granule stem cell

Answer 14

GM-CSF
G-CSF
M-CSF

after its a granule stem cell, GM-CSF or G-CSF change it to phis & mast cells

Question 15

cytokines that direct myeloid to megakaryocytes line

Answer 15

TPO

Question 16

cytokines that direct myeloid to monocyte/mactophage

Answer 16

GM-CSF

M-CSF

Question 17

cytokines that direct myeloid to erythropoetic to erythrocyte

Answer 17

EPO

Question 18

cytokines that direct lymphoid stem cell to lymphocyte

Answer 18

IL-3

IL-6

Question 19

Neutrophils

Answer 19

granulocytes

polymorphonuclear nuetrophil (PMN)
55% - majority of WBC
reach maturity in bone marrow 
lifespan 4 days 
phagocytes in early inflammation - first responder
clean up cellular debris

Question 20

Eosinophils

Answer 20

granulocyte

1-4%
ingest antigen-antibody complexes
recovery phase of inflammatory process

Question 21

Basophil

Answer 21

granulocyte

<1% WBC
vasoactive amines (histamine, serotonin) & anticoagulant (heparin)

Question 22

Mast Cells

Answer 22

granulocytes

histamine, chemotaxic factors & cytokines
rapid blood vessel perm
found in vascularized connective tissue
acute/chronic inflammation, fibrotic disorders, wound healing

Question 23

acceleration of hematopoesis

Answer 23

1 - yellow to red (EPO)
2 - increase rate of differentiation of daughters
3 - increase rate of proliferation of stem cells

Question 24

RBC count

Answer 24

M- 4.2-5.4x10 12/L

F- 3.6-5X10 12/L

Question 25

Hb

Answer 25

M: 14-18g/dl
F: 12-16g/dl

Question 26

HCT

Answer 26

M- 42-52%

F- 36-48%

Question 27

causes of slow erythrocyte replacement

Answer 27

1 - Fe depletion (Hb synthesis)
2 - decreased total serum iron
3 - decreased iron binding capacity
4 - decreased intestinal iron absorption

Question 28

a2 - antiplasmin

Answer 28

blocks action of plasmin (breaking clot)

Question 29

PAI

Answer 29

plasminogen activator inhibitor

blocks tPA (making plasmin from plasminogen)