Hematology Flashcards by Nancy Proszek

What is plasma made up of?

90% Water
Plasma proteins synthesized in the liver: albumin (oncotic pressure), globulins (alpha and beta transport lipids, gamma is immunoglobulin), clotting factors (fibrinogen)
Electrolytes, gases, nutrients, wastes, hormones

How well did you know this?

Not at all

Perfectly

What is the function of blood?

Transport nutrients/waste, defense against microorganisms/injury, acid-base regulation

How well did you know this?

Not at all

Perfectly

What is unique about the anatomy of a RBC?

No nucleus, disc-shaped, biconcavity (for diffusion), reversible deformity (for squeezing through tight spots)

How well did you know this?

Not at all

Perfectly

What are granulocytes vs. agranulocytes?

They are leukocytes
Granulocytes (many nuclei): neutrophils, eosinophils, basophils, mast cells
Agranulocytes (mononuclear): lymphocytes (NK cells), monocytes, macrophages

How well did you know this?

Not at all

Perfectly

What is unique about neutrophils?

They make up the majority of WBCs (55%), they are the first responders, they only live for 4 days

How well did you know this?

Not at all

Perfectly

Who has more digestive vacuoles? Granulocytes vs. macrophages/monocytes vs. lymphocytes

Granulocytes have the most
Macrophages/monocytes have fewer, larger digestive vacuoles
Lymphocytes have NO digestive vacuoles

How well did you know this?

Not at all

Perfectly

What is a thrombocyte? What is its function?

Platelet, it controls bleeding (it is in the coagulation cascade, when it is activated, it works with fibrin to form a clot)

How well did you know this?

Not at all

Perfectly

How many platelets do we have? What is the lineage?

140,000-300,000 (reserves are in the spleen)

They break off from megakaryocytes

How well did you know this?

Not at all

Perfectly

How long do WBC vs. RBC take to make?

WBC takes one week, RBC takes 4 months (lives for 120 days)

How well did you know this?

Not at all

Perfectly

Lymphopoesis vs. hematopoesis?

Synthesis of WBC vs. RBC, making them more differentiated, then they have less potential
They both start as pleuripotent stem cells

How well did you know this?

Not at all

Perfectly

What are the primary and secondary lymphoid organs?

Primary: thymus and bone marrow
Secondary: spleen, lymph nodes, tonsils, and Peyer’s patches

How well did you know this?

Not at all

Perfectly

The spleen is made up of red pulp and white pulp: What is the difference between white and red splenic pulp?

White: contains lymphocytes and macrophages
Red: principal filtration site, mainly phagocytize dead RBCs

How well did you know this?

Not at all

Perfectly

Where does hematopoiesis take place?

Bone Marrow! (Medullary/myeloid are other terms for bone marrow)
Liver/spleen during embryonic development
Extramedullary sites with diseases

How well did you know this?

Not at all

Perfectly

Red vs. Yellow bone marrow?

Red- active, hematopoietic tissue

Yellow- inactive, adipose tissue

How well did you know this?

Not at all

Perfectly

RBCs are destroyed in about 120 days, so hematopoiesis occurs at a rate to make up for this. What are 3 ways to upregulate (example: if hemorrhaging occurs)?

Yellow to red bone marrow using erythropoietin
increase rate of differentiation of daughter cells
increase rate of proliferation of stem cells

How well did you know this?

Not at all

Perfectly

Name a few multi-lineage growth factors, what does this mean?

SCF (stem cell factor)
GM-CSF (granulocyte-macrophage colony stim factor)
IL-6 (interleukin-6)
These growth factors are involved in more than one pathway

How well did you know this?

Not at all

Perfectly

What are some lineage-specific cytokines, what does this mean?

M-CSF (macrophage colony stimulating factor)
EPO (erythropoietin)
TPO (thrombopoietin)
Growth factors that are only involved in one pathway

What is EPO a growth factor for?

Makes erythropoetic stem cells into erythrocytes

What is TPO a growth factor for?

Makes megakaryocytic stem cells into megakaryocytes which can break off (endocytosis) into platelets

What is M-CSF a growth factor for?

From monocytic stem cells to monocytes and macrophages

GM-CSF also does this

What is G-CSF a growth factor for?

It helps differentiate G-M stem cells to granulocytes, then granulocytes into neutrophils, basophils, and eosinophils

What happens during erythropoiesis with the nucleus and with hemoglobin?

From pleuripotential stem cell to erythrocyte, it loses its nucleus, during the process it starts making hemoglobin, by the time it becomes an erythrocyte, it stops making hemoglobin

How is hemoglobin synthesized?

Hemoglobin is synthesized by vitamin B12 and folic acid, if someone is deficient they will have anemia

What does Iron have to do with hemoglobin?

67% of iron is bound to hemoglobin

Note: 30% is stored (ferritin in liver), 3% lost, it is recycled when RBC dies in 120 days

How is iron cycled?

1. Fe is released into erythroblast mitochondria, 2. it is used to make hemoglobin, 3. RBC circulates 120 days, 4. dead RBC removed from blood by macrophages, 5. Fe released back into blood or stored as ferritin/hemosiderin

What is endomitosis?

When the megakaryocyte is pinched off to form platelets, during mitosis it does not undergo cytokinesis (doesn't split to 2 daughter cells)

What does aspirating bone marrow NOT tell you clinically? How is aspirating different from biopsy?

Aspirating can't let you know the efficiency of activity (making RBCs), it is not diagnostic, aspirating tells you if there are certain cells present to give you an idea of what is going on but a biopsy is more specific and accurate

If you biopsy bone marrow and find fibrotic marrow, what does this mean?

There is injury/cell death happening, scar tissue is forming, multiple cell types will be reduced

What are some changes with aging regarding erythrocytes and lymphocytes?

Erythrocytes are replaced more slowly (Note: RBCs still live 120 days), less iron Lymphocyte function is decreased, less T cell function, less humoral response, platelets become "sticky" (more likely to clot)

What happens in primary hemostasis?

1. exposure to collagen, 2. platelets adhere (using glycoproteins) 3. platelets are activated (release granule contents and go through conformation change), 4. aggregation, 5. form platelet plug

What happens in the intrinsic vs. extrinsic pathway and what do they yeild?

Intrinsic: in skeletal muscle and joints, factor 7, subendothelial substances exposed Extrinsic: in brain, lung, and heart, tissue factor released by damaged endothelial cells Together, they yield prothrombin

What happens in secondary hemostasis?

Coagulation cascade

How are thrombin, prothrombin, platelets, and fibrin involved in the coagulation cascade?

Prothrombin becomes activated to yield thrombin Thrombin yields platelets and fibrin (fibrinogen -> fibrin), which together forms a clot Fibrin is a sticky substance that traps RBCs

What is tertiary hemostasis?

Fibrinolysis, clot dissolution

What primarily activates the lysis of a clot?

Plasmin, activated by pasminogen

How are tPA, PAI, plasminogen, and plasmin all related in the lysis of blood clots?

tPA activates plasminogen into plasmin | PAI inhibits tPA, inhibiting the conversion of plasminogen into plasmin

What happens if PAI is overactive?

It inhibits the tPA (the activation of fibrinogen to fibrin), so in the end, clots aren't getting broken down

When plasmin breaks up fibrinogen and fibrin, what are the products?

FDP (fibrin degradation products) and D-dimer

How are erythrocytes broken down?

1. aged RBCs destroyed by macrophages, 2. broken down into heme and porphyrin, 3. porphyrin makes bilirubin, 4. bilirubin is excreted into urine/feces

How does the blood cell count differ between adults and newborns?

Newborns have MORE, they have 88 mL/kg, adults have 75 mL/kg Newborns have more lymphocytes, but about the same number of platelets

What cells can be formed from GM-CSF?

Granulocytes and Agranulocytes (monocytes, macrophages)

Eosinophils vs. Basophils vs. Mast cells

Eosinophils ingest antigen-antibody complexes and are involved in the recovery phase of the inflammatory process Basophils are vasoactive amines (histamine) and anticoagulants Mast cells are involved in wound healing, also histamine, inflammation, and have rapid vessel permeability