Hematology Flashcards
Site of hematopoiesis
yolk sac, liver, spleen, bone marrow
Heme precusosrs
Succinyl CoA (TCA intermediate); Glycine
Source of energy of RBC
Anaerobic glycolysis
Vitamin B12 and folic acid deffeciency lead to
Megaloblastic anemia
Last stage of RBC with nucleus
Orthochromatic erythroblast
Immature RBCs, increases in hemolysis
Reticulocytes
2 alpha, 2 beta chains
HbA
2 alpha, 2 gamma chains
HbF
Transfers iron in the blood
Transferrin
Stores iron in the liver
Ferritin
For additional iron storgae
Hemosiderin
Granulocytes
Basophils, eosinophils, neutrophils
Releases histamin and heparin, involved in allergies
Basophils
Increases in allergies and parasitic invasions
eosinophils
Involved in bacterial infections, lasts 8 hours
neutrophils
Tissue macrophages
Bone: Osteoclasts Liver: Kupffer cells Skin: Langerhans cells CNS: Microglia Lungs: alveolar macrophages
Derived from beak-up of megakaryocytes; lasts 7-10 days
platelets
Requires glycoprotein 1b and VWF
platelet adhesion
Requires glycoprotein IIB-IIIa and fibrinogen
platelet aggregation
Secretes Ig
Plasma cells (derived from B cells)
Primary response Ig; also, largest
IgM
Ig in secondary response; also, smallest and can penetrate placenta
IgG
Ig in secretions
IgA
Ig in parasitic infections and allergies
IgE
MHC I, CD 8 is also known as
T-killer cell
MHC II, CD4 is also known as
T-helper cell
Abnormal azurophilic granules
Severe infection (toxic granules)
Patches of dilated endoplasmic reticulum that appear as sky blue cytoplasmic puddles
Severe infection (dohle bodies)
Distinctive needle-like azurophilic granules found in myeloblasts
AML (Auer rods)
Scattered macrophage with abundant wrinkled green blue cytoplasm
CML (sea blue histiocytes)
Small lymphocytes disrupted in the process of making smears
CLL (smidge cells)
Large cells with multiple nuclei or a single nucleus with multiple nuclear lobes
Hodgkin’s lmphoma (reed sternberg cells)
Nuclear remnants are phagocytosed by interspersed macrophages with abundant clear cytoplasm
burkitt’s lymphoma ( starry sky pattern)
Multi-lobulated nuclei
adult t-cell lymphoma (clover leaf cells)
Destructive plasma cell tumors involving axial skeleton
Multiple myeoloma (plasmacytoma)
Multiple nuclei, prominent nucleoli and cytoplasmic droplets containing Ig
Multiple myeloma (bizzare multinucleated cells)
Fiery red cytoplasm
Multiple myeloma (flame cells)
Pink globular cytoplasmic inclusions
Multiple myeloma (russel bodies)
blue globular nuclear inclusions
multiple myeloma (dutcher bodies)
M proteins causes RBCs in peripheral blood smear to sticl in linear arrays
Multiple myeloma (rouleaux formation)
erythroblasts with iron laden mitochondria visible as perinuclear granules
Sideroblastic anemia (ringed sideroblasts)
neutrophils with only 2 nuclear lobes
myelodysplastic syndrome (pseudo-pelger-huet cells)
megakaryocytes with single nuclear lobes or multiple separate nuclei
myelodysplastic syndrome (pawn-ball megakaryocytes)
Premature release of nucleated erythroid and early granulocyte progenitors
primary myelofibrosis (leukoerythroblastosis)
cells that were damaged during the burthing process in the fibrotic marrow
primary myelofibrosis (teardrop cells/dakrocytes)
pentalaminar tubules often with dilated terminal end
langerhans cell histocytosis (birbeck granules)
small yellow bronw or rust colored foci in the spleen
congestion of spleen (gandy gamna nodules)
Reed sternberg cells
hodgkin
associated with HIV and immunosuppresion
non hodgkin
extranodal involvment; noncontiguous spread
non hodgkin
low grade fever, night sweats, weight loss
hodgkin
EBV; bimodal distribution
hodgkin
most common type; lacunar variant RS cells
nodular sclerosis
Predominantly lymphocytic infiltrates; mononuclear variant RS cells
lymphocyte-rich
worst prognosis
lymphocyte-depleted
best prognosis
lymphocyte-rich
relatively good prognosis; popcorn cells
lymphocyte-predominant
triad of hemolytic anemia
pallor, jaunduce, splenomegaly
difference between intra and extravascular hemolysis
extravascular has splenomegaly
expected morphology on PBS for hemolytic anemia
normocytic normochromic
AD disorder caused by intrinsic defects in the red cell membrane causes MCHC
hereditary spherocytosis
x linked recessive; reduced ability of RBCs to protect against oxidative stress
G6PD
Intravascular hemolysis due to increased complement mediated RBC lysis
PNH
hemolytic anemia sin in DIC, TTP-HUS,b SLE, malignant HPN
microangiopathic hemolytic anemia
Caused by trauma to RBCs in those with cardiac valve prosthesis
Macrioangiopathic hemolytic anemia
Intrinsic, extravascular hemolysis
spherocytosis, sickle cell, thalassemia
Intrinsic, intravascular hemolysis
G6PD, PNH
Extrinsic, intravascular
autoimmune hemolytic, micro and macrovascular hemolytic
Normal PC, BT, PT, PTT
Ehlers-Danlos
Decreased PC, Prolonged BT, Normal PT PTT
ITP; TTP; Bernard-Soulier
Normal PC, Proloned BT, Normal PT PTT
Glanzmann’s thrombasthenia
Normal PC, Prolonged BT, Normal PT, Prolonged PTT
Von Willibrand’s disease
Normal PC, BT, PT, Proloned PTT
Hemophilia
Normal PC, BT, Prolonged PT, PTT
Vitamin K deffeciency
Decreased PC BT, Prolonged PT PTT
DIC
Impairment of DNA synthesis that leads to distinctive morphologic changes
Megaloblastic anemia
Microcytic hypochromic anemia; presents with koilonychia or pica
IDA
Most common cause of anemia in hospitalized patients
Anemia of chronic disease
Syndrome of chronic primary hematopioeitic failure and attendant pancytopenia
Aplastic anemia
Quarternary structure
Hemoglobin
Tertiary structure
Myoglobin
Binds to 4 O2 molecules
Hemoglobin
Binds to 1 O2 molecule
Myoglobin
binding of oxygen affected by chainge in PH and CO2
Hemoglobin
Binding not affected by PH and CO2 changes
Myoglobin
Sigmoidal curve
Hemoglobin
hyperbolic curve
Myoglobin
Most abundant in adults
Hgb A
Use to measure long term glucose levelsUsed to determine glucose by non-enzymatic addition of glucose to hemoglobin
Hba1C
Oxidation of the heme component of hemoglobin to iron which cannot bind to oxygen
Methemoglobin
Form of hemoglonin where CO binds tightly but reversibly
Carboxyhemoglobin
Tetramer consisting of 2 alpha and gamma chains
Fetal hemoglobin
Gamma tetramers in the neworns
HgB Barts
Small hyperchromic RBC lacking central pallor
Spehrocytes; Hereditiary spherocytosis
Small dark nuclear remnants present in RBCs of asplenic patients
Howell-jolly bodies; asplenia
Membrane bound percipitates on denatured globin chains
Heinz bodies; G6PD
RBCs with damaged membranes due to removal of heinz bodies by splenic macrophages
Bite cells; G6PD
RBCs shaped like curved blades
Sickle cell
Dehydated RBCs with bull’s eye appearance
Target cells; Sickle cell and thalassemia
Fragmented RBCs aka helmet cells
Shistocytes; RBC trauma, DIC, HUS
RBC with spiles
Burr cells or echinocytes; RBC trauma