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Hematopoiesis Flashcards

1
Q

Where does hematopoiesis occur in an embryo? What time frames?

A

Yolk sac: 0-2 months
Liver: 2-7 months
Bone Marrow: 7 months to birth

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2
Q

Where does hematopoiesis primarily occur after puberty?

A

“Axillary” location, Vertebrae and pelvis, sternum, ribs

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3
Q

Describe the hematopoietic cell compartment

A

highly vascular, contains hematopoietic stem cells, committed precursor cells, and maturing cells

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4
Q

Describe the marrow stromal compartment

A

contains a barrier of endothelial cells, adipocytes for energy, structural support by stromal cells and fibroblasts and macrophages

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5
Q

What are the main hematopoietic growth factors?

A

CSF, interleukins, EPO, TPO

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6
Q

Where are hematopoietic growth factors produced?

A

endothelial cells, stromal cells, fibroblasts, developing lymphocytes, macrophages

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7
Q

What is the function of SCF?

A

weak stimulator of hematopoiesis that makes stem cells responsive to other cytokines; produced by fetal tissues and bone marrow

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8
Q

What is the function of IL-3?

A

influences the replication and growth potential of hematopoietic progenitors

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9
Q

What is the function of IL-6?

A

Stimulates megakaryocytes and neutrophil production, key factor in leukemoid reactions

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10
Q

What is the function of IL-2?

A

Serves as a T-cell growth factor

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11
Q

What is the function of IL-2 combined with IL-6?

A

B-cell growth factor

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12
Q

What is the function of GM-CSF?

A

Stimulates the formation of all leukocytes and reticulocytes

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13
Q

What is the function of G-CSF?

A

Stimulates an increase in neutrophils

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14
Q

What is the function M-CSF?

A

Stimulates monocyte and macrophage production

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15
Q

What is the function of EPO?

A

Stimulates RBC production

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16
Q

What is the function of TPO?

A

stimulates an increase in megakaryocytes and platelets

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17
Q

What is a reticulocyte?

A

large, immature, nucleated RBC, with a residual reticular network of ribosomal material

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18
Q

What are some examples of differentiated macrophages throughout the body?

A

microglia, kupffer cells, alveolar macrophages, osteoclasts

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19
Q

What does plasma consist of?

A

dissolved proteins, glucose, ions, hormones, clotting factors

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20
Q

What does hematocrit measure?

A

volume percentage of red blood cells in blood

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21
Q

What is red cell distribution width (RDW)?

A

Measure of range in variation of RBC volume

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22
Q

What is MCV?

A

average volume of red blood cell

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23
Q

What is MCH?

A

average mass of hemoglobin in erythrocytes

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24
Q

What is MCHC?

A

concentration of hemoglobin in a given volume

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25
Q

What is RPI?

A

Corrected reticulocyte % based on RBC volume, reticulocyte production index

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26
Q

What is anisocytosis?

A

variation in RBC size, increase in RDW

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27
Q

What is poikilocytosis?

A

variation in RBC shape

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28
Q

Definition by anemia

A

decreased RBC volume

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29
Q

Definition of polycythemia

A

Increased RBC

30
Q

Definition of thrombopenia

A

Decreased platelets

31
Q

Definition of thrombocythemia

A

Increased platelets

32
Q

Definition of leukocytosis

A

Increased WBC

33
Q

Definition of leukopenia

A

Decreased WBC

34
Q

Definition of lymphocytosis

A

Increased lymphocytes

35
Q

Definition of lymphopenia

A

Decreased lymphocytes

36
Q

Definition of neutropenia

A

Decreased neutrophils

37
Q

Definition of eosinophilia

A

Increased eosinophils

38
Q

Definition of neutrophilia

A

Increased neutrophils

39
Q

Pancytopenia

A

Decrease of all cell lines

40
Q

Normal male Hb

41
Q

Normal Male Hct

42
Q

Normal male MCV

43
Q

Normal female Hb

44
Q

Normal female Hct

45
Q

Normal female MCV

46
Q

What are the signs and symptoms of iron deficiency anemia

A

fatigue, weakness, headaches, dizziness, lightheadedness, pale skin, irregular heartbeats, shortness of breath, chest pain, cold hands and feet

47
Q

What can cause iron deficiency anemia?

A

Dietary lack of iron or decreased absorption, impaired absorption, chronic blood or iron loss

48
Q

What are the steps in lab evaluation of anemia

A
  1. CBC and reticulocyte index
  2. Categorization as microcytic, macrocytic, normocytic based on MCV
  3. Exam of peripheral smear
  4. Serum iron level, Total iron binding cap, serum ferritin levels (separate out microcytic anemias)
49
Q

What are the types of anemia that occur due to MCV<80?

A

Iron deficiency, thalassemia, anemia of chronic disease, sideroblastic anemia

50
Q

What are the types of anemia that occur due to MCV>100?

A

Megaloblastic anemia due to B12 or folate deficiency, alcohol liver disease

51
Q

What are the types of normocytic anemia that have a high reticulocyte count?

A

Sickle cell anemia, G6PD Deficiency, hereditary spherocytosis, autoimmune hemolytic anemia, paroxysmal nocturnal hemoglobinuria, Thalassemia may also have a high reticulocyte count

52
Q

What are the types of normocytic anemia that have a low reticulocyte count?

A

Marrow failure, aplastic anemia, myelofibrosis, leukemia, renal failure, anemia of chronic disease

53
Q

When might nucleated RBCs be seen in blood?

A

compensatory erythropoiesis due to severe anemia or chronic hypoxia; hyposplenism or asplenia due to sickle cell anemia or traumatic splenectomy

54
Q

What are some morphologic changes seen in megaloblastic hyperplasia?

A

macrocytic ovalocytes (MCV>100), hypersegmented neutrophils, hypercellular bone marrow with giant metamyelocytes and bands

55
Q

What are some morphologic changes seen in aplastic anemia?

A

Hypocellular bone marrow, reduced hematopoiesis; pancytopenia of all cell lines

56
Q

What are some morphologic changes seen in metastatic carcinoma?

A

Replacement of bone marrow by metastatic tumor, may see a fibrotic response

57
Q

What is leukoerythroblastosis?

A

Nucleated and teardrop RBC, immature WBC, suggestive of displacement of hematopoietic elements

58
Q

Define extramedullary hematopoiesis

A

hematopoiesis occurring in organs outside bone marrow, like the spleen, liver, lymph nodes

59
Q

What conditions might EMH occur?

A

severe chronic anemia of thalassemia, stem cell failure, infection, severe chronic anemia, malignant transformation and replacement

60
Q

What are schistocytes?

A

Fragmented red blood cells typically seen in microangiopathic hemolytic anemia

61
Q

What are “bite” cells or Heinz bodies?

A

RBC with denatured hemoglobin typically seen in G6PD deficiency, oxidative stress, cross binding and protein deposition

62
Q

What is the normal WBC count?

A

4.8-10.8k/ul

63
Q

What are some potential causes of neutrophilia?

A

acute bacterial infection, medications, cigarette smoking, various types of physical stress, myeloproliferative neoplasms

64
Q

What is a “band”?

A

horseshoe nucleus, premature WBC

65
Q

What is toxic granulation?

A

dark coarse granules in neutrophils seen in inflammatory conditions

66
Q

What is a leukemoid reaction?

A

WBC>50,000 with increased neutrophils, without evidence of leukemia due to infection, drugs, carcinoma; leukocyte alkaline phosphatase is elevated

67
Q

What is chronic myelogenous leukemia? Morphological features?

A

WBC count 100,000; typically seen in adults; increased WBCs with spectrum of peripheral blood, immature blasts which eventually can be seen in bone marrow

68
Q

What is acute myeloid leukemia?

A

accumulation of immature myeloid blasts in bone marrow typically peaks at 60yo, can present with anemia, throbocytopenia, and neutropenia due to bone marrow crowding

69
Q

What are some morphological findings seen in acute lymphoblastic leukemia?

A

numerous blasts on peripheral smear or bone marrow

70
Q

What is the typical count for platelets?

A

140-450k /uL

71
Q

What is the clinical presentation of thrombocytopenia?

A

Mucocutaneous bleeding with low platelet counts

72
Q

What are some causes of thrombocytopenia?

A

Increased platelet destruction (autoimmune, drug induced, etc.), decreased production of platelets (bone marrow replacement), or sequestration

MOD (34 decks)

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