Hematopoiesis Flashcards

1
Q

Hematopoiesis

A

the process by which blood cells are formed from hematopoietic stem cells (HSCs)

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2
Q

HSC to myeloid stem cell stimuli

A

IL-1

IL-3

IL-6

SCF

G-CSF

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3
Q

HSC to lymphoid stem cell stimuli

A

IL-1

IL-6

SCF

FLT-3L

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4
Q

Myeloid lineage

A

RBC

Platelets

Monocytes

Neutrophils

Eosinophils

Basophils

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5
Q

RBC formation pathway

A

BFU-E –> Proerythroblast –> RBC

*IL-3 and EPO

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6
Q

Platelet formation pathway

A

CFU-Mega –> Megakaryocyte –> Platelet

*IL-3, IL-11, and TPO

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7
Q

Monocyte formation pathway

A

CFU-GM –> Monoblast –> Monocyte

*IL-3, GM-CSF, and M-CSF

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8
Q

Neutrophil formation pathway

A

CFU-GM –> Myeloblast –> Neutrophil

*IL-3, GM-CSF, and G-CSF

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9
Q

Eosinophil formation pathway

A

Eosinophilic myeloblast –> Eosinophil

*IL-3, IL-5, and GM-CSF

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10
Q

Basophil formation pathway

A

Basophilic myeloblast –> Basophil

*IL-3 and IL-4

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11
Q

Lymphoid lineage

A

B cells

T cells

NK cells

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12
Q

B cell formation pathway

A

Pre-B cell –> B Lymphoblast –> B cell

*IL-1, IL-2, IL-4, IL-5, and IL-6

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13
Q

T cell formation pathway

A

Prothymocyte –> T Lymphoblast –> T cell

*IL-2 and IL-4

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14
Q

Prenatal hematopoiesis

A

Yolk sac (early)

Liver**

Spleen*

Bone marrow (late)

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15
Q

Postnatal hematopoiesis (child)

A

*before puberty

Tibia

Femur

Ribs

Sternum

Vertebrae and pelvis

Skull

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16
Q

Postnatal hematopoiesis (adult)

A

*after puberty

Ribs

Sternum

Vertebrae and pelvis

Skull

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17
Q

Hematopoietic cell compartment of bone marrow

A

highly vascular

contains hematopoietic stem cells (duh)

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18
Q

Marrow stromal compartment of bone marrow

A

Endothelial cell barrier (fenestrated)

Adipocytes for energy

Stromal cells and fibroblasts for structure

Macrophages to remove dead cells

Hematopoietic growth factors produced here

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19
Q

G-CSF

A

Given as treatment for neutropenia after chemotherapy or bone marrow transplant

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20
Q

Erythropoietin (EPO)

A

Produced by the kidneys

RBC formation

Agonists used as anemia treatment

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21
Q

Thrombopoietin (TPO)

A

Produced by the liver

Megakaryocyte and platelet formation

Agonists used as clotting disorder treatment

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22
Q

Reticulocyte

A

enlarged immature erythrocytes with residual RER

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23
Q

Metamyelocyte

A

Juvenile granulocyte with an indented nucleus

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24
Q

Buffy coat

A

Leukocytes and platelets

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25
Plasma cell
Antibody producing cell
26
Types of macrophages
Microglia (CNS) Kupffer cells (Liver) Alveolar macrophages (Lungs) Osteoclasts (Bone)
27
Band Neutrophils
Immature neutrophils Present in "left shift" leukocytosis associated with bacterial infections
28
Hemoglobin (Hg) lab value
Concentration of Hg per unit volume of blood 13. 5-17.5 for males 12. 3-15.3 for females
29
Hematocrit (Hct)
Volume percent of RBC in blood 40-52 in males 36-48 in females
30
Red cell distribution width (RDW)
measure of range in variation of RBC volume
31
Mean corpuscular volume (MCV)
Average volume of RBC –\> Size of RBC MCV = Hct/RBC determines macrocytic vs normocytic vs microcytic normocytic = 80-100
32
Mean corpuscular hemoglobin (MCH)
Average mass of hgb in RBC MCH = Hb x 10/RBC
33
Mean corpuscular hemoglobin concentration (MCHC)
Concentration of hemoglobin in given volume –\> color of RBC determines hypochromic vs normochromic vs hyperchromic MCHC = Hb/Hct
34
Reticulocyte production index (RPI)
Corrected reticulocyte % based on RBC volume
35
Anisocytosis
Variation in RBC size with increased RDW
36
Poikilocytosis
Variation in RBC shape
37
Anemia
decreased RBC volume or Hgb
38
Polycythemia
Increased RBC or Hgb
39
Thrombocytopenia
Decreased platelets
40
Thrombocythemia
increased platelets
41
Leukocytosis
Increased WBC
42
Leukopenia
Decreased WBC
43
Lymphocytosis
Increased lymphocytes
44
Lymphopenia
Decreased lymphocytes
45
Neutropenia
Decreased neutrophils
46
Neutrophilia
Increased Neutrophils
47
Eosinophilia
Increased eosinophils due to allergic reaction or parasites
48
Pancytopenia
Decrease of all cell lines (RBC, platelets and WBCs)
49
Iron deficiency anemia
Anisocytosis, poikilocytosis, microcytic and hypochromic Increased RDW Decreased MCV Decreased MCH Decreased MCHC Decreased RBC count Decreased retic count Decreased Hct
50
Lab evaluation of anemia
1. CBC and RPI 2. categorize as microcytic, macrocytic or normocytic 3. exam peripheral blood smear 4. serum iron level, total iron-binding capacity, and serum ferritin level 5. RDW to determine iron deficiency vs thalassemia
51
Nucleated RBC
Created during compensatory erythropoiesis (anemia or chronic hypoxemia) Occur with sickle cell anemia or splenic injury
52
Microcytic conditions
MCV \< 80 Iron deficiency anemia Thalassemia Anemia of chronic disease Sideroblastic anemia
53
Normocytic conditions with low reticulocyte count
Marrow failure Aplastic anemia Myelofibrosis Leukemia/metastasis Renal failure Anemia of chronic disease
54
Normocytic conditions with high reticulocyte count
Sickle cell anemia G6PD deficiency Hereditary Spherocytosis Autoimmune hemolytic anemia Paroxysmal nocturnal hemoglobinuria
55
Macrocytic conditions
MCV \> 100 Megaloblastic anemia (B12 or folate deficiency) Alcoholic liver disease
56
Marrow replacement/invasion
Caused by malignancy, infection, myelofibrosis, or myeloproliferative disorder Leukoerythroblastosis: Nucleated and teardrop RBC with immature WBC
57
Extramedullary hematopoiesis
Hematopoiesis occurring outside the bone marrow Usually spleen, liver or lymph nodes Occurs in normal fetal development A compensatory mechanism for abnormal hematopoiesis
58
Schistocytes
RBC type found in microangiopathic hemolytic anemia (DIC and TTP) Thrombocytopenia with anemia
59
Bite cells and Heinz bodies
Indicate G6PD deficiency Caused by oxidative stress
60
Sickle cells
deformed erythrocytes due to polymerized abnormal hemoglobin S
61
Spherocytes
Associated with hereditary spherocytosis
62
WBC Count normal values
Total: 4.8-10.8 Neutrophils: 1.4-6.5 (40-60%) Lymphocytes: 1.2-3.4 (20-40%) \*CD4 T cells Monocytes: 0.1-0.6 (2-10%) Eosinophils: 0-0.5 (\<1-6%) Basophils: 0-0.2 (\<1-2%)
63
Causes of Neutrophilia
\*\*Bacterial infection Medications (steroids) Smoking Physical stress Leukemia
64
Left shift
Increased immature leukocyte production primarily band neutrophils and metamyelocytes Indicates neutrophilia and acute bacterial infection
65
Leukemoid reaction
WBC count \> 50,000 with neutropenia No evidence of leukemia Due to infection, drugs or cancer Elevated leukocyte alkaline phosphatase Bone marrow would show complete maturation without increased blasts
66
Chronic myelogenous leukemia (CML)
Low blast count at first but increases with disease progression Pancytopenia
67
Acute Myeloid Leukemia
All ages Accumulation of immature myeloid blasts in bone marrow anemia, thrombocytopenia and neutropenia due to bone marrow crowding
68
Chronic lymphocytic anemia
older adults lymphadenopathy hepatosplenomegaly
69
Acute lymphoblastic leukemia
children many blasts on peripheral smear or bone marrow
70
Basophilia
Rare but can be seen with leukemia
71
Monocytosis
Seen with atypical bacterial infections and autoimmune diseases
72
Platelet mechanism of action
Gp1b binds to von Willebrand factor on exposed collagen Platelets release ADP and TxA2 to recruit more platelets GpIIb-IIIa receptor binds to fibrinogen for platelet aggregation