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Hematology 1 > Hematopoiesis > Flashcards

Hematopoiesis Flashcards

1
Q

____ is the controlled, continuous, regulated process of blood cell production.

A

Hematopoiesis

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2
Q

Hematopoiesis deals with the following: ____.

A
  • Cell renewal
  • Proliferation
  • Differentiation
  • Maturation
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3
Q

____ result in the formation, development, and specialization of all functional blood cells.

A

Hematopoiesis

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4
Q

Blood cells produced through Hematopoiesis are released from the ____.

A

bone marrow

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5
Q

A ____ is capable of self-renewal and directed differentiation into all required cell lineages.

A

Hematopoietic Stem Cell (HSC)

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6
Q

Hematopoiesis in the developing human can be characterized as a ____ in specific sites that rapidly changes during development.

A

select distribution of embryonic cells

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7
Q

Hematopoiesis in healthy adults is restricted primarily to the ____.

A

bone marrow

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8
Q

During fetal development, the restricted, sequential distribution of cells is initiated in the ____ and then progresses in the ____, then to the ____, and finally resides in the ____.

A
  • Yolk sac
  • Aorta Gonad Mesonephros (AGM) region (mesoblastic phase)
  • Liver (hepatic phase)
  • Bone marrow (medullary phase)
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9
Q

Stages of Hematopoiesis

A
  • Mesoblastic Phase
  • Hepatic Phase
  • Medullary Phase
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10
Q

Mesoblastic Phase

Hematopoiesis is considered to begin around ____.

A

19th day of gestation

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11
Q

Mesoblastic Phase

Chief site

A

Yolk sac

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12
Q

Mesoblastic Phase

Cells from the mesoderm migrate to the ___.

A

Yolk sac

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13
Q

Mesoblastic Phase

Cells from the ____ migrate to the yolk sac.

A

mesoderm

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14
Q

Mesoblastic Phase

Some of the cells form ____ in the central cavity of the yolk sac.

A

primitive erythroblasts

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15
Q

Mesoblastic Phase

Type of cell produced

A

Erythroblast

immature or primitive RBC

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16
Q

Mesoblastic Phase

____ surround the cavity of the yolk sac and eventually form blood vessels.

A

Angioblasts

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17
Q

Mesoblastic Phase

The transient yolk sac erythroblasts are important in early embryogenesis to produce ____.

A

Hemoglobin

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18
Q

Mesoblastic Phase

____ is needed for the delivery of oxygen to rapidly developing embryonic tissues.

A

Hemoglobin

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19
Q

____ is a protein made up of 4 units of heme that is paired with a globin.

A

Hemoglobin

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20
Q

Hemoglobin is made up of ____ units of heme and globin.

A

4

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21
Q

What differentiates the mesoblastic phase from all the different phases of hematopoiesis?

A

It occurs intravascularly (within the developing blood cells)

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22
Q

Mesoblastic Phase

The yolk sac can remain active up to ____ of gestation.

A

8 to 12 weeks

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23
Q

____ are only present during the mesoblastic stage or embryonic life.

A

Embryonic hemoglobins

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24
Q

Embryonic hemoglobins

A
  • Gower I
  • Gower II
  • Portland
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25
Q

Which Embryonic Hemoglobin?

2 epsilon + 2 zeta globin chains

A

Gower I

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26
Q

Gower I globin contents

A
  • 2 Epsilon globin chains
  • 2 Zeta globin chains
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27
Q

Which Embryonic Hemoglobin?

2 alpha + 2 epsilon globin chains

A

Gower II

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28
Q

Gower II globin contents

A
  • 2 Alpha globin chains
  • 2 Epsilon globin chains
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29
Q

Which Embryonic Hemoglobin?

2 zeta + 2 gamma globin chains

A

Portland

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30
Q

Portland globin contents

A
  • 2 Zeta globin chains
  • 2 Gamma globin chains
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31
Q

Cells of mesodermal origin migrate to the ____ and give rise to HSCs for definitive or permanent adult hematopoiesis during embryonic development.

A

Aorta-Gonad-Mesonephros (AGM) Region

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32
Q

The ____ was previously considered to be the only site of definitive hematopoiesis during embryonic development.

A

Aorta-Gonad-Mesonephros (AGM) Region

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33
Q

Hepatic Phase

The hepatic phase of hematopoiesis beings at ____.

A

5 to 7 weeks of gestation

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34
Q

Hepatic Phase

Types of cell produced

A
  • Erythroblasts
  • Granulocytes
  • Monocytes
  • Lymphoid cells
  • Megakaryocytes
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35
Q

The ____ phase is characterized by recognizable clusters of developing erythroblasts, granulocytes, and monocytes.

A

Hepatic

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36
Q

Hepatic Phase

Chief site

A

Liver

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37
Q

Hepatic Phase

The peak production of cells occur at the ____.

A

3rd month of pregnancy

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38
Q

Hepatic Phase

The decline phase occurs ____.

A

After the 6th month

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39
Q

Hepatic Phase

Other active sites

A

Spleen, kidneys, thymus, and lymph nodes

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40
Q

Hepatic Phase

The ____ is the predominant hemoglobin.

A

Hemoglobin F or Fetal Hemoglobin (HbF)

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41
Q

HbF globin content

A
  • 2 Alpha globin chains
  • 2 Gamma globin chains
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42
Q

Hepatic Phase

Hemoglobins present

A
  • Hemoglobin F or Fetal Hemoglobin (HbF)
  • Hemoglobin A or Adult Hemoglobin (HbA)
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43
Q

2 Types of Hemoglobin A

A
  • HbA1
  • HbA2
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44
Q

Which type of HbA?

95%

A

HbA1

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45
Q

Which type of HbA?

2 alpha + 2 beta globin chains

A

HbA1

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46
Q

Which type of HbA?

2-3%

A

HbA2

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47
Q

Which type of HbA?

2 alpha + 2 delta globin chains

A

HbA2

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48
Q

% content of HbF in adults

A

1-2%

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49
Q

Medullary phase is also known as the ____.

A

Myeloid phase

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50
Q

Medullary (Myeloid) Phase

Time

A

5 to 6 month of gestation

Rodak’s: Between fourth and fifth month

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51
Q

Medullary (Myeloid) Phase

Chief site

A

Bone marrow

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52
Q

Why is hematopoiesis in the bone marrow termed as medullary hematopoiesis?

A

Because it occurs in the inner part of the bone cavity, which is the medulla.

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53
Q

Medullary (Myeloid) Phase

Types of cell produced

A
  • Hematopoietic stem cells
  • Mesenchymal cells
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54
Q

During the myeloid phase, HSCs and mesenchymal cells migrate to the ____.

A

core of the bone

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55
Q

____, a type of embryonic tissue, differentiate into structural elements that support developing hematopoietic elements.

A

Mesenchymal cells

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56
Q

Measurable levels of growth factors are evident in ____ phase.

A

medullary

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57
Q

Medullary (Myeloid Phase)

The principal source of production are the ____.

A

Flat bones (e.g. sternum)

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58
Q

At the end of the 24th week of gestation, the ____ will be the main site of hematopoiesis.

A

Bone marrow

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59
Q

When will the bone marrow be the main site of hematopoiesis?

A

At the end of 24th week of gestation

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60
Q

The ____ is responsible for the synthesis or production of cells.

A

Adult Hematopoietic Tissue

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61
Q

____ is where Lymphoid Development occurs.

A

Adult Hematopoietic Tissue

Primary and Secondary Lymphoid Tissue

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62
Q

Primary Lymphoid Tissues

A
  • Bone marrow
  • Thymus
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63
Q

Secondary Lymphoid Tissues

A
  • Lymph nodes
  • Spleen
  • Liver
  • MALT
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64
Q

____ is where B cells and T cells are derived.

A

Primary Lymphoid Tissue

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65
Q

____ is where lymphoid cells respond to foreign substances.

A

Secondary Lymphoid Tissue

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66
Q

The ____ develops in the embryo by the hollowing out of the skeletal bone forming a central cavity.

A

bone marrow

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67
Q

The soft tissue inside the central cavity is called ____.

A

bone marrow

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68
Q

The bone marrow contains ____.

A
  • Hematopoietic cells
  • Stromal cells
  • Blood vessels
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69
Q

Main function of bone marrow

A

Production and proliferation of blood cells

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70
Q

All blood formed elements ultimately develop from the undifferentiated and primitive precursor called ____.

A

Hematopoietic Stem Cell (HSC)

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71
Q

Hematopoietic stem cell developed from ____.

A

Hematopoietic cell

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72
Q

The bone marrow is ____ at birth.

A

red

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73
Q

In young adults, the marrow is about ____ active.

A

60-70%

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74
Q

The cell production usually happens in the ____.

A

flat bones

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75
Q

____ is the replacement from red to yellow bone marrow.

A

Retrogression

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76
Q

____ regulate the microenvironment of hematopoietic tissue so that we can produce cells.

A

Stromal cells

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77
Q

Kinds of Bone Marrow

A
  • Red
  • Yellow
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78
Q

Which Kind of Bone Marrow?

Active

A

Red

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79
Q

Which Kind of Bone Marrow?

Composed of hematopoietic cells, and macrophages

A

Red

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80
Q

The red marrow is composed of ____.

A
  • Hematopoietic cells (developing blood cells and their progenitors)
  • Macrophages
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81
Q

Which Kind of Bone Marrow?

Components are arranged in extravascular cords

A

Red

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82
Q

The components of red bone marrow is arranged in ____.

A

extravascular cords

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83
Q

Hematopoietic cells will later on develop and mature in ____ within the cords.

A

niches

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84
Q

Usually at birth, the bone marrow is 100% ____.

A

red

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85
Q

Main functions of Red Bone Marrow

A
  • Production of blood cells
  • Iron storage
  • B-cell development
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86
Q

Which Kind of Bone Marrow?

Inactive (not capable of producing cells)

A

Yellow

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87
Q

Which Kind of Bone Marrow?

Composed of adipocytes and undifferentiated mesenchymal cells

A

Yellow

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88
Q

The yellow marrow is composed of ____.

A
  • Adipocytes
  • Undifferentiated mesenchymal cells
89
Q

Bone Marrow Cellularity

Normal bone marrow in a stained smear

A

Normocellular

90
Q

Bone Marrow Cellularity

30-70% hematopoietic cells

A

Normocellular

91
Q

Bone Marrow Cellularity

____ is the abnormal increase in the production of cells.

A

Hypercellular (Hyperplasia)

92
Q

Bone Marrow Cellularity

More than 70% hematopoietic cells

A

Hypercellular (Hyperplasia)

93
Q

Bone Marrow Cellularity

____ is the abnormal decrease in the production of cells.

A

Hypocellular (Hypoplasia)

94
Q

Bone Marrow Cellularity

Less than 30% hematopoietic cells

A

Hypocellular (Hypoplasia)

95
Q

Bone Marrow Cellularity

There is very few or a total absence of hematopoietic cells

A

Aplastic (Aplasia)

96
Q

The ____ supplies blood only for the bone marrow.

A

Nutrient Artery

97
Q

The ____ provides nutrients both for the bone and for the bone marrow.

A

Periosteal Artery

98
Q

Hematopoietic Microenvironment is also called ____.

A

Hematopoietic Inductive Microenvironment or Niche

99
Q

____ functions in nurturing and protecting HSCs.

A

Hematopoietic Microenvironment

100
Q

____ functions in the balance in quiescence, self-renewal, and differentiation of HSCs.

A

Hematopoietic Microenvironment

101
Q

____ is responsible for supplying semifluid matrix.

A

Stromal Cells

102
Q

The ____ is the semifluid matrix supplied by stromal cells.

A

Stroma

103
Q

____ secrete extracellular matrix that serves as an anchor for the developing HSCs.

A

Stromal cells

104
Q

The extracellular matrix secreted by stromal cells functions in ____.

A
  • Anchoring
  • Promote cell adhesion
  • Regulate HSCs
  • Maintenance of proteins
105
Q

____ play critical roles in the regulation of HSCs for them to surive and be differentiated.

A

Stromal Cells

106
Q

Stromal Cells

A
  • Endothelial cells
  • Adipocytes
  • Macrophages
  • Osteoblasts
  • Osteoclasts
  • Reticular cells
107
Q

____ regulate the flow of particles, entering and leaving the hematopoietic spaces.

A

Endothelial cells

108
Q

____ are essential for the secretion of various steroids that influence erythropoiesis, maintain bone integrity, and regulate the volume of bone marrow.

A

Adipocytes (fat cells)

109
Q

Adipocytes (fat cells) secrete ____.

A

steroids

110
Q

____ are important for phagocytosis and the removal of unwanted materials.

A

Macrophages

111
Q

____ secrete cytokines which later on regulate hematopoiesis.

A

Macrophages

112
Q

Macrophages secrete ____.

A

cytokines

113
Q

____ are referred to as the bone-forming cells.

A

Osteoblasts

114
Q

____ are mistaken as plasma cells.

A

Osteoblasts

115
Q

Osteoblasts are sometimes mistaken as ____.

A

plasma cells

116
Q

____ are referred to as the bone-resorbing cells or bone-destroying cells.

A

Osteoclasts

117
Q

____ support the vascular sinuses and hematopoietic cells.

A

Reticular cells

118
Q

Components of the Extracellular Matrix of the Marrow

A
  • Fibronectin
  • Collagen
  • Laminin
  • Thrombospondin
  • Tenascin
  • Proteoglycans
119
Q

Between ___ years of age, adipocytes become more abundant and begin to occupy the spaces in the long bones.

A

5 to 7

120
Q

Active red marrow sites in adult skeleton

A
  • Skull
  • Proximal ends of large bones
  • Sternum
  • Vertebrae
  • Axial skeleton
  • Iliac crest
121
Q

____ is a comparison or numerical expression of the distribution of myeloid precursor (granulocytes) and erythroid precursor (RBCs).

A

Myeloid to Erythroid Ratio (M:E)

122
Q

Normal M:E Ratio

A

2:1 - 4:1

123
Q

TRUE OR FALSE.

In M:E ratio, myeloid precursors should be less than erythroid precursors.

A

False

Myeloid > Erythroid

124
Q

RBCs can survive in the body for ____.

A

120 days

125
Q

WBCs stay in the blood for ____.

A

1 - 2 days

126
Q

M:E ratio of infection

A

6:1

127
Q

M:E ratio of leukemia

A

25:1

128
Q

M:E ratio of myeloid hyperplasia

A

20:1

129
Q

Marrow Differential

Cell Type: Erythroblasts
Range:

A

18-24%

130
Q

Marrow Differential

Cell Type: Myeloblasts Type I
Range:

A

0-1%

131
Q

Marrow Differential

Cell Type: Myeloblasts Type II
Range:

A

0-2%

132
Q

Marrow Differential

Cell Type: Promyelocytes
Range:

A

1-4%

133
Q

Marrow Differential

Cell Type: PMNs and precursors
Range:

A

53-63%

134
Q

Marrow Differential

Cell Type: Monocytes
Range:

A

0-2%

135
Q

Marrow Differential

Cell Type: Eosinophils and precursors
Range:

A

1-3%

136
Q

Marrow Differential

Cell Type: Basophils and precursors
Range:

A

0-1%

137
Q

Marrow Differential

Cell Type: Lymphocytes
Range:

A

8-12%

138
Q

Marrow Differential

Cell Type: Plasma cells
Range:

A

0-2%

139
Q

Medical practitioners usually count at least ____ in the bone marrow.

A

500 cells

140
Q

Other Normal Marrow Cells

A
  • Macrophages
  • Mast cells
  • Osteoblasts
  • Osteoclasts
141
Q

____ specimens are collected when there are hematologic disorders.

A

Marrow

142
Q

Preferred site for marrow specimens

A

Posterior iliac crest

143
Q

Occasionally preferred sites for marrow specimens

A
  • Anterior iliac crest
  • Spinal processes
  • Vertebral bodies
  • Sternum
144
Q

Preferred sites for bone marrow specimen in newborns

A

Upper end of tibia

145
Q

____ are used to check cellularity.

A
  • Trephine biopsy
  • Aspiration
146
Q

____ is the needle used for Trephine biopsy.

A

Jamshidi needle

147
Q

Jamshidi needle gauge

A

11

148
Q

____ is the needle used for aspiration in bone marrow specimens.

A

University of Illinois Sternal Needle

149
Q

____ is the blood cell production in hematopoietic tissue other than the bone marrow.

A

Extramedullary Hematopoiesis

150
Q

____ occurs whenever the bone marrow cannot meet the physiologic needs of the body.

A

Extramedullary Hematopoiesis

151
Q

When does extramedullary hematopoiesis occur?

A
  • Whenever the hyperplasia cannot meet the physiological needs of the body.
  • When there are infectious agents or pathologic myelofibrosis in the bone marrow.
152
Q

Sites of Extramedullary Hematopoiesis

A
  • Liver
  • Spleen
  • Lymph nodes
  • Thymus
153
Q

The ____ serves as the major site of cell production in the second trimester of fetal development.

A

Liver

154
Q

The liver serves as the major site of cell production in the ____.

A

second trimester of fetal development

155
Q

The ____ stores essential minerals and vitamins that are needed in the synthesis of DNA and RNA.

A

Liver

156
Q

The liver stores essential minerals and vitamins that are needed in the synthesis of ____.

A

DNA and RNA

157
Q

The ____ is often involved in blood-related diseases such as Porphyria.

A

Liver

158
Q

____ is the defect in the enzymes involved in the synthesis of heme.

A

Porphyria

159
Q

Extramedullary Hematopoiesis

Functions of the Liver

A
  • Protein synthesis & degradation
  • CHO and Lipid metabolism
  • Drug and toxin clearance
  • Iron recycling and storage
  • Hemoglobin degradation
160
Q

The ____ is the largest lymphoid organ in the body.

A

Spleen

161
Q

The ____ is essential for lymphopoiesis and phagocytosis.

A

Spleen

162
Q

The spleen is essential for ____.

A

lymphopoiesis and phagocytosis

163
Q

____ is known as the “graveyard of the body”.

A

Spleen

164
Q

The ____ removes old and damaged blood cells.

A

Spleen

165
Q

What can happen when the spleen is enlarged?

A

It can affect even the young and healthy cells

166
Q

When does the spleen become enlarged?

A

When there is an increased need for the removal of unwanted cells

Ex. Leukemia

167
Q

Two methods of RBC removal by spleen

A
  • Culling
  • Pitting
168
Q

During ____, the cells are phagocytized and all organelles are degraded.

A

Culling

169
Q

During ____, macrophages of the spleen will remove RBCs as well as its inclusions.

A

Pitting

170
Q

Functions of the Spleen

A
  • Sequesters platelets (stores in case of emergency)
  • Removal of unwanted/abnormal cells
171
Q

Rate of blood received by the spleen

A

350 mL/min

172
Q

Types of Splenic Tissue

A
  • White pulp
  • Red pulp
  • Marginal zone
173
Q

The ____ are follicles with germinal centers that contains lymphocytes and macrophages.

A

white pulp

174
Q

The ____ are primarily composed of vascular sinuses that contains specialized macrophages.

A

red pulp

175
Q

The ____ surrounds the white pulp and contains blood vessels, macrophages, and some hematopoietic cells.

A

marginal center

176
Q

The ____ are bean-shaped structures located along the lymphatic capillaries.

A

Lymph nodes

177
Q

Functions of Lymph Nodes

A
  • Lymphocyte proliferation
  • Initiation of specific immune response
  • Filter unwanted substances
178
Q

Regions of the lymph nodes

A
  • Cortex
  • Medulla
179
Q

In which region of the lymph nodes are T-cells found?

A

Medulla

180
Q

In which region of the lymph nodes are B-cells found?

A

Cortex

181
Q

____ originated from endodermal and mesenchymal tissue.

A

Thymus

182
Q

____ is responsible for the conditioning, maturation and development of T-cells.

A

Thymus

183
Q

Function of Thymus

A

Conditioning, maturation and development of T-cells

184
Q

Lobules of Thymus

A
  • Cortex (peripheral zone)
  • Medulla (central zone)
185
Q

Two Cell Theories

A
  • Monophyletic Theory
  • Polyphyletic Theory
186
Q

The ____ states that all blood cells are derived from a single progenitor cell called Pluripotential Hematopoietic Stem Cell.

A

Monophyletic theory

187
Q

The monophyletic theory states that all blood cells are derived from a single progenitor cell called ____.

A

Pluripotential Hematopoietic Stem Cell

188
Q

The ____ is the most widely accepted theory.

A

Monophyletic Theory

189
Q

The ____ states that each blood cell is derived from its unique stem cell.

A

Polyphyletic Theory

190
Q

The ____ states that all cells are derived from a pool of stem cells that are self-renewing.

A

Stem Cell Theory of Hematopoiesis

191
Q

____ give rise to committed stem cells for each cell line.

A

Pluripotential and Multipotential Stem Cells

192
Q

Characteristics of HSCs

A
  • Self-renewing
  • Pluripotent
  • Capable of apoptosis
193
Q

Which characteristic of HSC?

They differentiate into one or another type of committed cell.

A

Self-renewing

194
Q

Which characteristic of HSC?

Multiple cells can be produced in one stem cell

A

Pluripotent

195
Q

Which characteristic of HSC?

Can reconstitute the hematopoietic system of a lethally irradiated host

A

Apoptosis

196
Q

Pluripotent stem cell gives rise to two progenitor cells, the ____.

A
  • Lymphoid stem cell
  • Myeloid stem cell
197
Q

Progenitor cells need ____ in order for them to be committed in producing a specific cell.

A

Growth factors (stimulants)

198
Q

____ are formed after progenitor cell has been stimulated by a growth factor.

A

Colony-Forming Units (CFUs)

199
Q

____ promote proliferation and differentiation of cells.

A

Colony-Forming Units (CFUs)

200
Q

Identify the cell line based on the abbreviation

CFU-GEMM

A
  • Granulocyte
  • Erythrocyte
  • Megakaryocyte
  • Monocyte
201
Q

Identify the cell line based on the abbreviation

CFU-E

A

Erythrocyte

202
Q

Identify the cell line based on the abbreviation

CFU-Meg

A

Megakaryocyte

203
Q

Identify the cell line based on the abbreviation

CFU-M

A

Monocyte

204
Q

Identify the cell line based on the abbreviation

CFU-GM

A
  • Granulocyte
  • Monocyte
205
Q

Identify the cell line based on the abbreviation

CFU-BASO

A

Myeloid to basophil

206
Q

Identify the cell line based on the abbreviation

CFU-EO

A

Myeloid to eosinophil

207
Q

Identify the cell line based on the abbreviation

CFU-G

A

Myeloid to neutrophil

208
Q

Identify the cell line based on the abbreviation

CFU-pre-T

A

T-lymphocyte

209
Q

Identify the cell line based on the abbreviation

CFU-pre-B

A

B-lymphocyte

210
Q

Stem Cell Cycle Kinetics

A
  • 2.5 billion erythrocytes
  • 2.5 billion platelets
  • 1 billion granulocytes
  • 1:1000 nucleated blood cells
211
Q

Earliest identifiable stem cells

A
  • CD34+
  • CD38-
  • HLA-DR
  • Thy1
  • Lin-
212
Q

loss of “stemness”

A

CD38 and HLA-DR

213
Q

committed myeloid progenitors

A

CD33 and CD38

214
Q

T-lymphoid progenitor cells and natural killer cells

A

CD7

215
Q

B-lymphoid progenitors

A

CD19

216
Q

Cytokine with positive influence

A
  • Erythropoietin (EPO)
  • Thrombopoietin (TPO)
  • Granulocyte CSF (G-CSF)
  • Granulocyte-macrophage CSF (MG-CSF)
  • Interleukins (1,3,6,7,9,11)
  • KIT Ligands (KITLG)
  • Tyrosine kinase 3 (FLT3 TG)
217
Q

Cytokines with negative influence

A
  • Transforming Growth Factor-β
  • Tumor Necrosis Factor-α
  • Interferons
218
Q

Cytokine functions

A
  • Prevent precursor cell from dying by inhibiting apoptosis
  • Stimulate stem cells to divide
  • Stimulate cell production
  • Regulate differentiation

Hematology 1 (4 decks)

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