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Step 1 > Hematology > Flashcards

Hematology Flashcards

1
Q

Erythrocyte life span?

A

120 days

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2
Q

Define erythrocytosis.

A

Polycythemia (increased hematocrit)

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3
Q

Define anisocytosis.

A

Varying erythrocyte sizes.

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4
Q

Define poikilocytosis.

A

Varying erythrocyte shapes

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5
Q

What is a reticulocyte?

A

Immature RBC; reflects erythroid proliferation

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6
Q

Thrombocyte life span?

A

8-10 days

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7
Q

What is contained in thrombocytes?

A 
Dense granules (ADP and calcium)
Alpha granules (vWF, fibrinogen, fibronectin)
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8
Q

What causes petechiae?

A

Thrombocytopenia or decreased platelet functino

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9
Q

What does vWF bind to?

A

Gp1b

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10
Q

What does the fibrinogen receptor bind to?

A

Gp2b3a

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11
Q

What are the two broad categories of leukocytes?

A

Granulocytes (neutrophils, eosinophils, basophils, mast cells) and mononuclear cells (monocytes, lymphocytes)

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12
Q

What is the normal WBC differential?

A 
Neutrophils ~60%
Lymphocytes ~30%
Monocytes ~6%
Eosinophils ~3%
Basophils ~1%
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13
Q

What is contained within azurophilic granules (lysosomes) of neutrophils?

A

Proteinases, acid phosphatase, myeloperoxidase, beta-glucuronidase

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14
Q

When are hypersegmented neutrophils (6+ lobes) seen?

A

Vitamin B12/folate deficiency

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15
Q

What are band cells?

A

Immature neutrophils; when increased, they reflect states of increased myeloid proliferation (bacterial infections, CML)

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16
Q

List the 5 major neutrophil chemotactic agents.

A

C5a, IL-8, LTB4, kallikrein, platelet-activating factor

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17
Q

How do monocytes appear on blood smear?

A

Large, kidney-shaped nucleus

Extensive “frosted glass” cytoplasm

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18
Q

What activates macrophages?

A

IFN-gamma

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19
Q

What role do macrophages play in initiating septic shock?

A

Lipid A from bacterial LPS binds CD14 on macrophages to initiate septic shock

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20
Q

What is the role of eosinophils?

A

Defend against helminthic infection
Produces histaminase, major basic protein (MBP, a helminthotoxin), eosinophil peroxidase, eosinophil cationic protein, and eosinophil-derived neurotoxin

21
Q

How do eosinophils appear on blood smear?

A

Bilobate nucleus

Packed with large eosinophilic granules of uniform size

22
Q

What is the role of basophils?

A

Mediate allergic reaction

Granules contain heparin (anticoagulant) and histamine (vasodilator); leukotrienes synthesized and released on demand

23
Q

How do basophils appear on blood smear?

A

Densely basophilic granules

24
Q

What is the role of mast cells?

A

Mediate allergic reactions in local tissues
Bind the Fc portion of IgE to membrane; IgE cross-links upon Ag binding -> degranulation -> release of histamine, heparin, trypstase, and eosinophil chemotactic factors

25
Q

What is the major link between innate and adaptive immune systems?

A

Dendritic cells (highly phagocytic APCs)

26
Q

How do lymphocytes appear on blood smear?

A

Round, densely staining nuclei with a small amount of pale cytoplasm

27
Q

B cells are part of the ___ immune response. They originate from stem cells and mature in the ___. They migrate to peripheral lymphoid tissue, including what three places? When antigen is encountered, B cells differentiate into ___ and ___. They can also function as an ___.

A

Humoral; bone marrow; follicles of lymph nodes, white pulp of spleen, unencapsulated lymphoid tissue; plasma cells (Ab producers); memory cells; APC via MHC II

28
Q

What are the CD markers of B cells?

A

CD 19, 20, 21

29
Q

T cells mediate the ___ immune response. They originate from stem cells in the ___ and mature in the ___.

A

Cellular; bone marrow; thymus

30
Q

The majority of circulating lymphocytes are ___ (80%).

A

T cells

31
Q

How do plasma cells appear on blood smear?

A

“Clock-face” chromatin distribution and eccentric nucleus, abundant RER, well-developed Golgi apparatus; found in bone marrow and normally do not circulate in peripheral blood

32
Q

Where and when does fetal erythropoiesis occur?

A 
Yolk sac (3-8 weeks)
Liver (6 weeks-birth)
Spleen (10-28 weeks)
Bone marrow (18 weeks to adult)
"Young Liver Synthesizes Blood"
33
Q

What are the embryonic globins?

A

Zeta and epsilon

34
Q

When does the major shift from fetal HbF to adult HbA1 occur?

A

Around 6 months postnatal

35
Q

What will cause a hemolytic reaction in a person with type A blood?

A

Receiving B or AB blood

36
Q

What will cause a hemolytic reaction in a person with type B blood?

A

Receiving A or AB blood

37
Q

What will cause a hemolytic reaction in a person with type AB blood?

A

None - they are the universal recipient of RBCs and universal donor of plasma because they have no Ab

38
Q

What will cause a hemolytic reaction in a person with type O blood?

A

Receiving any non-O blood; they are the universal donor of RBCs and the universal recipient of plasma because they have no RBC Ag, but both anti-A and anti-B antibodies

39
Q

Describe what happens to the different types of Hgb on electrophoresis gel.

A

Hgb migrates from the negatively charged cathode to the positively charged anode.

HbA (adult, normal beta chain) migrates the farthest, followed by HbF (fetal, normal gamma chain), HbS (sickle cell beta chain), and HbC (hemoglobin C beta chain).

“A Fat Santa Clause”

The missense mutations in HbS and HbC replace glutamic acid (negative) with valine (neutral) and lysine (positive)

40
Q

What are the steps of primary hemostasis (platelet plug formation)?

A
  1. Injury (endothelial damage -> transient vasoconstriction)
  2. Exposure (vWF binds exposed collagen)
  3. Adhesion
  4. Activation (ADP binding to P2Y12 receptor induces GP2b3a expression at platelet surface)
  5. Aggregation (Fibrinogen binds Gp2b3a receptors and links platelets)
41
Q

What happens after vWF binds to exposed collagen?

A

Platelets bind vWF via GP1b receptor at the site of injury only. Platelets undergo a conformational change. They release ADP and calcium (necessary for coagulation cascade), TXA2. ADP helps platelets adhere to the endothelium.

42
Q

What are the pro-aggregation factors?

A
  1. TXA2 (released by platelets)
  2. Decreased blood flow
  3. Increased platelet aggregation
43
Q

What are the anti-aggregation factors?

A
  1. PGI2 and NO (released by endothelial cells)
  2. Increased blood flow
  3. Decreased platelet aggregation
44
Q

What are spur cells and how do they appear on blood smear?

A

Acanthocytes; spiny

45
Q

What is basophilic stippling?

A

Aggregation of residual ribosomes in red blood cells

46
Q

What are teardrop cells and how do they appear on blood smear?

A

Dacrocytes; tear drop shape

47
Q

What are bite cells and how do they appear on blood smear?

A

Degmacyte; bite taken out

48
Q

What are burr cells and how do they appear on blood smear?

A

Echinocyte - projections, more uniform and smaller than acanthocytes

49
Q

What are schistocytes and how do they appear on blood smear?

A

Fragmented RBCs; examples include helmet cells

Step 1 (19 decks)

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